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IPL stands for intense pulsed light. It’s a type of light therapy used to treat wrinkles, spots, and unwanted hair.
You can use IPL to minimize or remove:
IPL is similar to a laser treatment. However, a laser focuses just one wavelength of light at your skin, while IPL releases light of many different wavelengths, like a photo flash. The light from IPL is more scattered and less focused than a laser. IPL penetrates down to the second layer of your skin (dermis) without harming the top layer (epidermis), so it causes less damage to your skin.
Pigment cells in your skin absorb the light energy, which is converted into heat. The heat destroys the unwanted pigment to clear up freckles and other spots. Or, it destroys the hair follicle to prevent the hair from growing again.
You can use IPL anywhere on your body, but it may not work as well on uneven areas. It isn’t recommended for people who tend to get thick, raised keloid scars or who have darker skin tones.
The Carbon Dioxide (C02) Fractional Laser Resurfacing removes layers of skin tissue in a fractionated method (columns of skin are removed, leaving the skin surrounding each column intact to aid in healing) to help reduce “age-spots” (also called sun freckles, liver spots, and lentiginous), fine lines, wrinkles, scarring, uneven coloration, skin laxity, textural irregularities, dull tone, and a thinned collagen layer of the face, neck, and chest.
CO 2 is the best treatment if you wish to get the most results with one treatment. If you have the ability to take some time to heal (7-14 days), having this one treatment is like having multiple other non-invasive treatments at once. It is also the best single treatment for advanced skin damage and wrinkling.
CO 2 is an in-office procedure that requires pre and post-treatment medications to ensure proper healing and comfort during the procedure. Discomfort varies on the depth of the treatment. For your comfort during the treatment, we may apply a topical anesthetic or inject local anesthetic and/or tumescent anesthetic and prescribe sedative medications to reduce discomfort. After the treatment most patients describe the post-procedure feeling as a bad sunburn for about 12 hours to 2 days. Please also follow the instructions for all other prescribed pain medication is needed post treatment. We also recommend pain or relaxation medications prior to treatment therefore you will need to have somebody drive you home after treatment.
Typically, one laser treatment with C0 2 is recommended. Occasionally, in an area that cannot be treated aggressively, we may need to do more than one treatment to optimize results. Maintenance treatments may also be necessary to maintain results, especially if the sun is not avoided or proper skin care used.
Occasionally, even with the best care, another treatment may be necessary in a few years (in the area around the eyes, it may only be 1-2 years).
Facelift (traditional facelift, formal facelift, Z-lift, mini-facelift, endoscopic face lift)
Facelift is one of the most frequently preformed procedures. it often refers to the lift of the lower face. Depending on the condition of the patients’ facial aging, a traditional facelift or formal facelift could be done for a person with more advanced skin aging. Or, if the aging is minimal to medium, a mini-facelift or our famous Z-lift could be performed. While a formal facelift could entail a recovery time of one to two months, a mini-facelift may only require a recovery time of one to three weeks. This later benefit is one major factor for the mini-facelift to be our most sought after procdures by our Award-winning Board Certified Plastic Surgeon, Dr. Arthur Yu.
Both formal facelift and mini-facelift involves removal of excess loose skin and tightening of the SMAS fascia that covers the deeper facial muscle groups, resulting in a much more youthful look after the surgery. In our doctor’s hands, the mini-facelift may achieve an equal or better result than the traditional/formal facelift. On one hand, our doctor utilizes endoscopic approach to make the big formal facelift surgery much smaller, without skipping the most important SMAS tightening component of the surgery; on the other hand, because there is much less swelling and bruising involved, the mini-facelift patients will have much less wrinkling a few months after the patients recover. Therefore, more satisfactory results are expected.
Z-lift, our most in-demand procedure for an easy and minimally invasive facelift, is done with a hidden incision inside the hair. Being designed by Dr. Yu, this one hour surgery is a much more updated variant of mini-facelift. It is done under local anesthesia. The patients experience almost no pain during the whole process. Because the same amount of SMASectomy/SMAS lift is done, the effect of the face lift equals that of the traditional facelift. Yet, due to the fact that much less dissection is needed, there is absolutely no risk of skin compromise, or injury to the important facial nerves. More importantly, the patients recover in a matter of a few days. One patient, a high school teacher, was able to go back to her teaching post the next day! Even if this procedure is combined with other procedures, it is never a rate limiting factor in terms of recovery time.
Traditional/formal facelift is characterized by an incision made in front of the ears, going around the earlobes, passing behind the ears and ends at the back hairlines. This makes the scars quite visible and hard to hide, even with carefully designed hair styles. On the other hand, a min-facelift only requires an incision hidden inside the hair above the upper pole of the ears, making the scars almost impossible to detect.
A mid-face lift could greatly lift up the cheek structures. It could be done via a lower eyelid surgery incision, in combination with a brow surgery, being it open or endoscopic approach, or via a superior extension of a traditional facelift. An intra-oral approach could also be employed with the help of 8-prone Poly L-lactic acid ribbons.
Similar effect could be obtained by adding volume to the relevant structures in the mid-face, such as tear troughs, the apple cheek, the lateral portion of the cheek bone arch and the nasolabial folds. Both fillers and fat grafting could be used.
Whle most neck lift surgeries are done together with facelifts, neck lift can be performed independently, especially for younger people with prominent turkey necks. The essence of a neck lift is to tighten the loose and separated patisma muscke sheets back onto the area just in front of the windpipe, with rearrangement of the side portion of the platisma and neck skin behind the ears.
While most of the neck lift is done the traditional way, i.e., with incisions in front, around, and then behind the ears, some younger people can have the neck lift done with just a minor incision under the chin to obtain a great result. The patient will need to consult our doctor in person to find out whether he or she is a good candidate for this minimally invasive neck lift.
Furthermore, some people might just have a large lump of fat under the chin, presenting as a fat turkey neck. In these people, the is a possibility that a minor liposuction in the under chin (under-chin, under chin) area might suffice. In some cases, the fat may be very stubborn for removal, our doctor will employ a special device called SmartLipo laser, utilizing a 1 mm thick glass fiber to safely burn away the fibrous fat to reclaim the neck contour, with very minimal trauma.
For people with minimal to modest turkey neckbands, it is possible to utilize Botox injection to soften the platismal bands to regain the cervical-chin angle (neck-chin angle), because softened turkey neckbands will conform the original neckline again.
For people with enlarged and ptotic (low lying) submandibular glands, which can hardly be corrected by any surgical procedure, our doctor may use a botox injection approach to drastically diminish the glands, in order to restore the jawline.
Classic beauty concept dictates that the brows need to be in the correct positions. While the brows in males need to sit right on top of the brow ridges for a perfect Alpha male look, the brows in females need to be 1 to 2 cm (depending on the trend) above the brow ridges in order to make the eyes look attractive. with aging, the brows will descend, creating hooding above the eyes, giving the eyes droopy looks.
Brow lift surgeries were created to correct these aging problems.
Traditional brow lift (coronal approach) utilizes an incision one to two inches behind the hair line. after the skin flap is elevated, the brows are fixated in a higher position. typically, the brows can be elevated about 1/2 cm to 1.5 cm this way. The benefit of this procedure is that the result is sure and the fixation more permanent. As a result, it is very often provided to people with very significant droopy brows. The drawback is that it cannot be done on people with a receding hairline, because the hairline will drop back by 2 to 3 cm. To avoid this issue, Hairline Brow Lift was designed.
Hairline brow lift employs an incision alone the hairline in the middle portion. When the brows are elevated, the hairline is actually lowered by 2 to 3 cm, making this procedure a favorite to the people with receding hairlines. Because after the surgery, the person not only have corrected brow position, but also have a more normal hairline. Since the incisions are made in a zig-zag way, the scars are almost invisible to the naked eyes. Furthermore, because the very original hairline shape and hairs are preserved, the new hairline is much more natural than that created by hair transplantation!
Direct brow lift is usually done in more senior people i.e., for the people with deep wrinkles on the forehead. the incision could be made in the middle of the forehead, right in the furrows of the forehead; or just above the brow hairs. Because the incisions are closer to the brows, the lifting is more efficient. The drawback is, of course, the scars being more visible. Many people choose to have the scars tattooed over to create new brows. If done right, this combination works quite well. Due to the much lighter nature of the surgical trauma, this procedure is quite popular among certain groups of people.
Endoscopic Brow lift is done via 2 or 3 small incisions in the hair. In the right hands, this procedure works quite well, and it can typically provide 0.5 to 1 cm lift to the brows, although longevity of the result could be an issue. Additionally, it may also make the already hollowed-out upper eye socket even more hollow, and the deflated brow ridges flatter and more skeletonized. Consequently, these and the much smaller lifting effect make this a less favorable procedure than our fat grafting to the brow ridges or our most recent innovation: internal brow lift.
Brow ridge fat grafting has been our main staple to provide to our patients with minimal to moderate droopy brows. And this goes quite well with the new trend of brow position, shape and volume. If you step into a department store, especially the higher end stores, you would notice right away that all the cosmetic counters are sporting attractive models with lower lying, less peaking but very full eye brows. The new concept of aging found that all people show signs of aging typified by deflated forehead, brows and temples, making the forehead having more horizontal wrinkles and the brows more easily to drop down, and the eye socket more sunken in. By using autologous (self) fat to graft into the forehead, temple, and brow ridges (to replace the deflated and disappearing brow fat pads that only exists in young people), the brows becomes naturally inflated back into their original, younger shapes and forms, resulting in a lifted look much better and much more natural than that created by the endoscopic approach, without any of the potential complications. Our Award Winning Board Certified Plastic Surgeon has more than 19 years of experience in fat grafting. This makes our doctor a great choice when it comes to choosing the right doctor to rejuvenate your looks, especially around the eyes.
Internal brow lift by our doctor is accomplished by lifting the orbicularis (eyelid) muscles and fixing it onto the bone membrane of the brow ridges, creating a silhouette holding up the already dropped eyelid muscles, deflated brow fat pads and the upper eyelid skin, making the brows naturally fuller and lifted again, and therefore, restores the attractiveness of youthful eyes. The surgery is accomplished within a few minutes and the result extremely natural. Furthermore, none of the dreadful complications of the traditional or endoscopic brow lift is associated with this procedure, and the recovery is rapid. Consequently, this method of brow lift is our patients’ top pick!
Upper eyelid surgery (upper blepharoplasty) for aging looks (Dermatochalasis) is a very common procedure. when we age, there will be more excess skin and more wrinkles appearing in the eyelids. the excessive skin droops and weighs down on the eyes, causing an aged appearance, and in some people, causing blockage of the lymphatic drainage, resulting in swollen/edematous look. At the same time, the eyelid muscle may also become excessive, along with down-migration of the eye socket fat pads into the lower medial and lateral positions, causing a more senile effect. Additionally, some people may experience one or both eyes becoming much smaller, due to the eye opening muscle(s) (levator muscle) being dehisced (broken) at the fascia level. Hence, upper eyelid surgery is devised to fix these problems.
Dr. Yu, our Board Certified Plastic Surgeon, graduated from the world famous Maye Clinic and studied under quite a few world renowned master plastic surgeons. he is very strict on following the routines about eyelid surgery. In addition to performing the usual eye examination, he would carefully examine the amount of excess skin, the crease widths, the skin quality, the fat pad positions, muscle functions, among others, before forming a treatment plan. Detailed risks, benefits, and alternatives will be discussed. Right before the surgery, he would have the patient in a sit-up and spend as much time as necessary to draw the markings for the procedure and later to reconfirm the markings with the patient in a lying down position, so no error is made.
The surgery is typically done with skin removal, fat pad repositioning back into their original positions, capsule tightening, levator muscle repair (if necessary), and crease fixation. if the wyw socket is too hollowed out, fat grafting may need be done at this stage. Particularly need to be mentioned here is the crease fixation step: most older methods involve the incision of the levator fascia attachment at the Tarsal plate with reattachment of the skin edges back onto the repaired levator edges. Now this maneuver results in a stable crease fixation, at the same time, it also causes the creases to be “dead fixed”(creases remain even when eyes closed), with a resulting unnatural appearance. Our doctor utilizes his knowledgeable understanding of the human anatomy and without the need to incise the levator aponeurosis/fascia attachment, he fixes the eyelid creases directly onto the levator aponeurosis, creating very natural creases that is “dynamic live”(only shows creases when eyes are open). So the final result is natural appearing upper eyelids that are full in volume as they should appear when young. If needed, an internal brow lift could be done along with this upper blepharoplasty, to further augment the beautiful results.
The suture removal is around 7 days. If there is bruising, it usually lasts 2 weeks, and swelling, one to three weeks, for most people.
It is well knowing that 50% of the Asian population do not have crease formation on the upper eyelids (double creases), which makes the eyes appear much smaller and sometimes not so friendly. Hence, it is no wonder that double eyelid surgery ranks the highest among all the cosmetic surgery procedures in Asian countries.
Due to the complicated anatomical differences between Asians and Caucasian upper eyelids, it is imaginable that a plastic surgeon who is only trained in Caucasian upper eyelid surgery should be extra careful when deciding whether to perform a double eyelid surgery. Asian double eyelid is not a simple copying of the Caucasian eyelid creases. Rather, almost all the internal anatomical structures are different. without knowing own limitations, a Western plastic surgeon could easily Caucasianize an Asian person’s upper eyelids, which could prove to be a disaster–wide creased eyelids housed in shallow eye sockets will not glorify an Asian’s appearance, it would only be rather destructive. Unfortunately, even in Asian countries, including Japan, China, Korea, Vietnam, Thailand and Singapore, most plastic surgeons are trained with Western textbooks, not knowing how to deal with Asian eyelids. As a result, we see very often Westernization of Asian eyelids by Asian country doctors.
Contrary to Caucasian eyelids, Asian eyelid anatomy could vary widely from person to person. while some may have well developed creases, others may have absolutely no crease, very little creases, or unstable creases. For the people who has creases, they may want to have the creases somewhat wider (but not to the Caucasian extreme). These different people will have the levator aponeurosis fibers inserted at the skin at completely different levels from or at the tarsal plate. Often times, people with single eyelid appearance also have levator aponeurosis being so poorly developed that they appear to have levator muscle weakness, resulting in very small eyes.
Then there is also the “Mongolian folds”(medial epicanthal folds), which most Asians have, but does not exist in normal Caucasians. Some people may wish to keep their ethnicity, while others may wish to have the Mongolian folds removed in order to make the eyes look even bigger.
Our doctor’s approach to Asian double eyelid surgery is most up to date as compared to other plastic surgeons. Your concerns will be heard and thoroughly discussed. During the consultation, the anatomy will be carefully analyzed in order to form a final treatment plan. The surgical markings will be made while the patient is in a sit-up position, and then confirmed again on the OR table. The width of the creases will be discussed again and again with the patient, so the patient’s desire is met. For a typical Asian female, the crease width is usually 5 to 6.5 mm, whereas for Asian male, it is usually 3 to 5 mm. All measurements made on the person will be reconfirmed on the photos to avoid any discrepancy.
Double eyelid surgery can be done using thee different approaches: suture method, window methods (partial incision), and open incisional method (full incision).
The suture method involves burying a very fine permanent suture to form the creases. it is a method that fits people with thin skin and no excess eyelid skin. The benefit is the surgical trauma being smaller. But the drawback is also obvious: very high failure rate at one-year point. Additionally, some people may develop swelling that does not go away for years.
The partial incision method also fits people with thin skin. It is done one or two small incisions made on the desired crease position. The excess fat can be removed through the windows. At the same time, the capsule membrane is incised and pushed upward to expose the underlying levator aponeurosis, where the suture will be placed to form the creases. A very important point here is that the creases formed this way are “dynamic live” and natural creases, instead of “fixed” or “dead” creases.
The full incision method works well for people with excess skin, or when it appears that there is a levetor problem. The excess skin is removed, fat pads are either removed or repositioned, problem levator is repaired, and then the creases are created and fixed according to the design. Again, the crease formation done this way gives only natural creases. Both fat grafting to the brow ridges and/or the internal brow lift could be added to obtain even better results.
Because blepharoplasty (eyelid surgery) is so frequently done by unqualified surgeons, at least 30% of the people may need to have revisional surgery done to have their surgical defects corrected (failed Asian double eyelid surgery). And an essential part of the repair demands that the surgeon could restore the patients’ original anatomy and then go from there to perform the required repairing steps. Dr. Yu has a profound understanding of the Asian eyelid anatomy and knows the inside and out of every single minute details as to what could go wrong when it comes to restructuring the damaged anatomies, he could be your best choice when it comes to repairing or reconstructing a person’s botched eyelid surgery.
For 19 years, our Award Winning Board Certified Plastic Surgeon Dr. Yu has been deeply involved in perfecting the surgical procedures for Asian double eyelids. After finishing his plastic surgery training at Mayo Clinic, he followed Dr. Robert Flowers, the then world class master of Asian eyelid surgery. At the time, Dr. Flowers’ technique was without a doubt the state of the art in the field of Asian double eyelid surgery. However, Dr. Yu did notice some major limitations and many grounds for improvement. Afterwards, he spent the next ten years polishing his Asian double eyelid surgery techniques, which made him a true world master of Asian double eyelid surgery.
When people age, the eye bags protrudes out. With each passing year, the eye bags become bigger and bigger, causing the appearance of tiredness and lack of sleep. Very often, these are accompanied by dark circles and tear troughs. Simply put, there could be a huge difference for people of the same age with or without eye bags. Sometimes, a pair of eye bags could easily add up to ten years on a person’s face.
Eye bag surgery is such a common procedure that our doctor performs hundreds of these procedures a year. The types of procedures include transconjunctival and subciliary approaches, with some additions and variations.
Transconjunctival lower blepharoplasty (inner incision) is done when there is no significant amount of excess skin on the lower eyelids. An incision is made on the mucosa side of the lower eyelid with the lower eyelid being gently pulled away from the eye ball. There are three fat pads in a lower eyelid. because of the complexity of the anatomy, it is very often that some surgeons would unintentionally leave behind one or two fat pads behind, causing weird bumpy looks after the surgery. Additionally, it is almost completely empirical when it comes to deciding how much fat to remove from a person. The deciding factors depends on a person’s age, skin elasticity, the density of the fat, the positioning of the eye balls, and the severity of the tear troughs. Consequently, it becomes extremely important when it comes to choosing the right doctor for this seemingly easy procedure.
Subciliary incision lower blepharoplasty (outside incision) is done for people with excess skin. The design of the incision point is such that it sits right below the eyelashes and excess skin is conservatively removed, so when the wound heals, the wounds barely show as an artificially created line. In our doctor’s hands, these scars cannot be detected most of the time. The removal of the fat pads is done the same way as the inner incision procedure, except for the fact that the fat removal is done on the opposite side for most of the time. For people above the age of 40, the lower eyelid tissue become loose in all layers. In these people, a canthopexy (temporary outer corner tightening with an absorbable stitch fixed on the bone membrane on the upper outer eye socket frame) is done along with lateral muscle hitching to further strengthen the upward pulling of the lower eyelid skin, to prevent the possible dreadful lower eyelid eversion (ectropion).
Pinch blepharoplasty is a simplified low eyelid surgery when the lower eyelid skin excess is not accompanied by bulging fat pads. because it does not change the mid-lamella (layer) structure, the recovery is typically much faster. When carefully designed, this pinch blepharoplasty could often be combined with the transconjuctival approach for removal of skin from outside and fat from inside, the fact that the surgical trauma from this combination is much less than that the subciliary approach makes it a very popular choice amongst our patients.
Laser blepharoplasty is often done as an accessory procedure to the above mentioned approaches. it utilizes fractional CO2 laser to tighten the skin when the excess skin is not severe enough to warrant a skin excision. Depending on the skin texture and the healing capability, one to three sessions of laser may be required to secure a desirable result. The great benefit of this procedure is that the skin would become resurfaced and greatly rejuvenated, adding much more elasticity with much less fine wrinkles. The drawback is longer recovery time because of the temporary pink color lingering around.
Canthopexy (fixating the outer eye corner tendon) is done in conjunction with lower eyelid skin removal to prevent the lower eyelid from everting. To make the protection more secure, a muscle hitching (pulling up the lower lateral orbicularis muscle) is often done together. Because an absorbable stitch is used to fixate the outer eye corner tendon structure and the orbicularis muscle to the upper outer frame at the bone membrane, no suture removal is needed afterwards. While canthoplasty could be done via the lower eyelid surgery subciliary incision wound, it is better if an opening at the upper blepharoplasty could be used at the time of surgery. Please check with our doctor when it comes to the selection of surgical approaches.
Lower eyelid ectropion (eversion from scarring) repair is a huge topic in that it encompasses many different clinical presentations with different etiologies. The basic components of ectropion repair would include possible mid-lamella buttressing/enhancement, possible skin grafting, possible fat grafting, possible repair with hard palate vs. Alloderm, and most of the time, canthoplasty (forming a new, higher positioned and tighter lower eyelid). At times, a mid-face lift may be needed to further enhance the lateral support of the lower eyelid structures. Because every case is different, it is the best that the patient has detailed discussions with our doctor to form the final treatment plan.
Dark circles could be a very distractive and depressive feature on any person’s face. It could be cause by deep tear troughs, under eye pigmentation, dark colored veins lying too superficial, bad lymphatic drainage, or iatrogenic reasons such as injection of a wrong filler in the tear troughs.
Tear troughs could be treated with either fat grafting using nano fat (extra-fine, rich in stem cells), or non-water absorbing fillers such as Restylane Silk or Restylane L. Radiess could be used in this area, but it requires the surgeon to be a master injector.
Under eye pigmentation could be treated with a bleaching cream, coupled with ultrasound micro-exfoliation for better absorption of the medication.
The superficial lying veins could be a difficult issue. With our doctor’s judgement, nano fat grafting may be utilized in some cases to mask the appearance of the veins. Currently, there is no other ways of treating this condition.
Bad lymphatic drainage could be treated with outward massaging and limiting the intake of salt and MSG. Please do drink lots of water and sleep with head lifted!
Iatrogenic reasons could easily be avoided by choosing the right doctor and the right fillers. Many of the Juverderm products could cause excessive water absorption resulting in bluish discoloration (Tyndall effect) and swollen appearance in the under eye area. Do make sure that only safe filler products are chosen for the tear trough region.
Baby fat is characterized by fat accumulating in the lower face from the chin/jowl junction all the way to the jaw angle. it exists since childhood. Characteristically, the baby usually co-exists with excessive fat existence in the under chin area, causing a chubby look. The treatment is extra-fine precision liposuction with flat-headed cannulas.
Jowling typically shows after the age of 35, more in the females, with accompanying jaw bone absorption. There is more fat in the front portion of the lower face, stopping at the chin/jowl junction (sulcus). It is a sign of aging. Therefore, many people seek help from a plastic surgeon to have it removed. For people with tighter and more elastic skin, simple precision liposuction is the only treatment required. Although Ultherapy or Thermage could be good accessory treatments. On the other hand, when the skin is loose, a mini-facelift might be a necessity after liposuction is performed, to offset the resulting excess skin that cannot be retracted by itself.
Under chin fat could exist in any age, and the treatment is, most of the time, liposuction. The obtuse angle at the neck will be greatly improved when the fat is removed. Interestingly, after liposuction, the neck skin is almost always tighter, because the newly formed right-angle structure at the neck requires more skin to drape the newly formed surfaces (Pythagorean Theorem).
Buccal fat pads function as the ball bearing between the buccinators and the masseteric muscles. With aging, buccal fat may begin to migrate anteriorly in some people, causing a wider and fatter look in the frontal view. With time, the SMAS fascia overlying the fat pad become thinned and the fat pads become more and more prominent. If at any point of time, you think that your face is becoming wider at the mid-lower face, it is most likely that buccal fat is to blame.
While most surgeons remove the buccal fat by make a long incision on the oral mucosa along the lower teeth, our doctor does each and every one of his buccal removal with a tiny incision at the oral mucosa corresponding the second lower molar. The fat is about half a golf ball in size, but our doctor is able to gently tease the fat out through the small opening, drastically reduce the trauma from the surgery. That explains why almost every one of our patients requires almost no recovery time!
Caucasian noses most of the time require reduction rhinoplasty, with the nasal bones reduced in height and tip tripod structure supported with strong cartilage pieces harvested from self. On the other hand, Asian noses are more delicate and more complicated in anatomy, which require more specific knowledge and better maneuvers to obtain satisfactory results.
Asian nose job (Asian rhinoplasty) is typified by nose bridge augmentation. Nose bridge implant surgery (Asian nose augmentation with implants—-remains the number one choice for most Asian patients. With the understanding that an over-exaggerated nose bridge sends a person directly into the Avatar Kingdom, our doctor observes the principle of listening to the patients’ needs, in every single detail. The nose bridges done by our doctor are almost always conservative and sublime, showing very little signs of doneness. This is accomplished by careful selection of implant materials and masking the radix area where the top of the nose implant usually ends, with a little fat grafting. if a bump is present, a corresponding depression area would be carved out by our doctor to better accommodate the sitting of the implant on the bridge, making the nose bridge smooth and avoiding a potentially necessary bony reduction. While most surgeons insert implants via a nose incision, our doctor choose to insert the implants through an intra-oral approach, through the oral side of the nose root, just below the columela. By avoiding an incision on one side of the nasal cavity, it effectively minimizes the chance of a later deviation of the implant due to scar contracture (crooked nose). Furthermore, because the implant is inserted under the lower lateral cartilages, and under the periosteum (bone membrane) of the nasal bone, it prevents the direct contact of the implant with the tip skin, which has been a concern for possible future erosion of the implants. Over the years, our doctor has been able to keep the revision rate of his nose job well below 1%, which is a great achievement considering the fact that some doctors may need to revise up to 20% of their nose jobs.
Nose tip surgery is becoming more and more in high demand. The focus of the surgery is to utilize self-cartilage (ear cartilage, septal cartilage or rib cartilage) to sculpture the nose tip to make it more attractive. To achieve this, our doctor mostly chooses a closed approach (no cutting open the nose at the columela) via an intra-oral approach. Dr. Yu gained this ability after doing thousands of nose implant surgery using the intra-oral approach. He invented a special device to insert pre-shaped tip cartilage grafts through the intra-oral incision, passing in front of the medial crus of the lower lateral cartilages and positioning the grafts over the dome of the old cartilaginous tip. Subsequently, cartilage strut grafts are inserted in front of the medial crus of the lower lateral cartilages (right in the frontal part of the columa) to provide better support to the new tip. This is a major improvement for nose jobs, and we expect that most surgeons will follow suit once it is published by our doctor in the near future. When coupled with the above intra-oral approach for nose implant surgery, this method could be utilized to effectively elongate the nose, overcoming one of the most difficult hurdle in Asian nose jobs.
due to its abundance, rib cartilages could be utilized to correct both nose bridge insufficiency and the tip/columela complex. Although at this point of time, the revision rate remains high.
Columela veiling/columela show is a very easy to correct, provided that the surgeon knows how to correct it. Our doctor utilized extremely minimally invasive approaches of augment the columela, for either its thickness or its vertical supporting strength, mostly via an intra-oral approach. So no scar is visible from anywhere and, the recovery is super-fast!
Canine fossa depression (base of the nose deficiency/depression) can be treated with fat grafting if minor, or with self-cartilage grafting and or Alloderm if moderate to severe. Or a combination of all three approaches could be used for even better and much more coordinated aesthetic correction.
Nasal alar reduction works to shrink the size of the nostrils. Dr. Yu uses an internal approach, by making incisions at the lateral aspect of the nasal sill to remove a wedge of tissues, including the corresponding nasal floor. After the mucosa is trimmed, the floor tissue can actually be turned down to augment the canine fossa (base of nose) right then and there. At the same time, the alar is brought in to cinch down on the size of the nostril. The recovery is fast and the scars are barely detectable most of the time.
It is becoming a new trend for Asian people to go through a comprehensive combination surgery in order to correct the nose shape. Any or all of the above-mentioned steps/approaches could be chosen and carried out for the desired nose shape.
Corrective surgery for failed nose job—-Dr. Yu treats all kinds of failed nose jobs, especially after implant surgeries. An in-person consultation with Dr. Yu would greatly help in designing the salvaging plans.
While most of the breast augmentations in the US remain implant surgeries, fat grafting for breast augmentation is increasingly becoming more and more popular on a yearly basis, for its more natural appearance and feel and, for its maintenance-free nature.
Our doctor prefers to suggest to our patients to have their own fat grafting for breast augmentation. His philosophy is that there is no waste material in the human body. If there is excess fat in your body, that fat could be liposuctioned out to create a better-shaped body, and at the same time, the harvested fat should be used for augmentation of the breasts or the buttocks. Depending on the fat distribution in a particular person, fat could be harvested from the tummy, waist, the back, thighs, or the upper arms. There is essentially no difference in the survival rate for the fat from different sites. Generally, the fat survival rate in the breast could be as high as 60 to 70%, unless the fat is unhealthy. The only rate-limiting factor for fat grafting is that only 250 cc to 400 cc of fat could be grafted to each breast, due to the fact that breasts could only provide enough nutrition to sustain a certain amount of grafted fat. Please keep in mind that one cup size for the breast equals to about 150 to 250 cc, depending on the size of the body frame. Breast fat grafting results not only depend on the amount of fat survived but also depend on how the new breasts are shaped. For younger patients, our doctor emphasizes on the augmenting the cone part of the breasts; while for more mature people, he would try to clean up the breast tails in the axilla region to re-form the outer round contours of the breasts and then the upper pole along with the cones are strategically filled up show the perky beauty again for the somewhat more droopy breasts. By choosing the right ports for grafting, the breast fat grafting by our doctor shows very little trauma and minimal calcification post-surgery. Due to the very high survival rate for our breast fat grafting, this procedure has been one of the most requested among our offerings.
Breast implant surgery utilizes saline or silicone implants. The entry route could be from peri-areolar, infra-mammary, transaxillary, or through the belly button (transumbilical). Even fancier, if a tummy tuck is done concomitantly, the breast implants could even be placed through the tummy tuck opening, thus avoiding any visible sign of an incision wound for the augmentation. The most frequently performed incision point is the inframammary fold, where the entry avoids the mammary glands, which minimizes the exposure of the implants to the potentially contaminating mammary glands that could harbor annoying bacteria (less capsular contracture/breast hardening). The peri-areolar approach seems to provide more direct access to the pocket for housing the implants; it does have to pass the potentially contaminating breast glands. Transaxillary approach hides the scars in the armpits and at times, they are almost invisible, but it is the dirtiest entry point, which also generates the highest rate for capsular contracture. Statistically, with all the entry points combined, capsular contracture and accompanying asymmetry remain as high as 12 to 19 percent, or even higher, nationwide. So essentially, breast implant surgery is, at the present time, still an imperfect surgery. Although it could still be a great choice for people who desire larger breasts without any available fat, or for people who just want to have one surgery done to gain more than two cup sizes for their breasts. Indeed, with the teardrop shaped breasts, we do see a surge in the number of better-looking breast implant surgery results. The possible complications are mostly listed in the relevant manufacturers’ websites, and the potential risks of the requirement for redo surgery after four years could still be as high as more than 35%. We do make every potential patient aware of all the benefits, risks, and alternatives about the implant surgeries. Our doctor does his breast implant surgery very conservatively and utilizes all possible means to prevent the contact of implants with the skin or any other contamination sites in order to reduce the chance of capsular contracture. Consequently, the satisfactory rate from our breast surgery cases is quite high.
Breast augmentation with either fat grafting or implants could also be combined with breast lift procedures if the breasts are too droopy. In cases of significant breast size discrepancy, or breasts with weird shapes (such as constricted breasts or tuberous breasts), or breasts being mangled up by either cancer surgeries or improperly performed breast implant removal, fat grafting is without a doubt the procedure of choice for restoring the shape of the breasts.
We do many revisional breast surgeries, for those who had bad results from around the world. The failure could be malpositioned implants, size disparity, capsular contracture, gross asymmetry, significant scarring, or areolar depressions, so on and so forth. One major breakthrough is the use of Alloderm for capsular contracture, which is already showing signs of being the perfect solution for breast hardening. For issues such as breast implant rippling, implants being palpable, funnel chest, lack of upper pole fullness, we can certainly use fat grafting to correct them in a nice and easy way.
People could have droopy breasts for all kinds of reasons: weight loss, congenital factor, large sizes, pregnancy, breastfeeding, or aging could all play a role.
Liposuction, when strategically performed, could solve the problem of a young person’s large breasts when being too droopy. In some cases, the nipples could rise more than one inch, after “weight loss” from breast liposuction. The prerequisite is that the breast is large with thick fat and the skin, elastic.
Circumareolar lift (Donut lift or Benelli lift) works by having a donut-shaped piece of skin removed around the areola. While it could potentially remove a sign of excess skin, it does flatten the breasts to some extent. The success of it depends on the integrity of placed thick permanent sutures around the areola just under the skin.
Short scar breast lift (Keyhole pattern breast lift) can be performed if the amount of skin in excess is mild to moderate. The skin is cinched at the inframammary fold vicinity to facilitate the closure of the excisional wounds, whereas the breast tissue is divided into medial and lateral flaps to allow for self augmentation, by folding on each other, resulting in a very perky look when the everything heals. And the upper poles in the “V” area becomes naturally fuller. So, instead of making the breasts into the usual flat and small “pancakes” when the traditional method is employed, Dr. Yu is always able to turn his patients’ droopy breasts into something that they could only have when young: full, round, and perky! Dr. Yu invented his own technique and has been doing this for the last ten years, and the results are very satisfying.
Wise-pattern breast lift (Anchor shaped scar breast lift) is performed when the breasts are too droopy and the skin is too much excess. A much broader area of skin is removed and finally, when the skin is closed, the scars mimick that of an anchor shape. The internal rearrangement of tissue could be done in many different ways. However, Dr. Yu is almost always able to use his unique medial and lower flap, a simple and elegant approach to create self augmentation in the upper poles and the central mount regions, giving his patients very natural and beautiful results.
Breast augmentation, at the time of breast lift, with either implants or fat grafting could be done when there is not enough breast tissue to provide a desired size for the patients. All you need to do is to talk to our doctor about your needs.
Liposuction could solve the problem of a young person’s large breasts when they are too droopy. In some cases, the nipples could rise more than one inch. The prerequisite is that the breast is large with thick fat and the skin, elastic. One to two cup sizes could be removed by this technique.
Vertical scar or short scar breast reduction (Keyhole pattern breast reduction) refer to the same technique. A wedge of excess breast tissue, along with excess skin, is removed, then medial and lateral flaps of breast tissue are folded (one on top of the other) to provide self-support for the upper poles and the central mount. After careful closure, the new breasts will be significantly reduced in size and the shape much better than before. To make the shape even better, Dr. Yu adds a liposuction procedure to the outer breast tail region to get rid of this particular lump of tissue that makes the breasts unsightly, or at least unpleasant to look at. This makes the breasts look even younger.
Wise-pattern breast reduction, similar to the above Wise-pattern breast lift description, except for the fact that a wedge of breast tissue is removed according to preoperative planning, before the medial and lateral breast tissue flaps are developed.
Breast reduction for people with breast implants can be made for either implant removal or exchange for smaller implants. The same principles for achieving nice and full shapes apply. So there is no worry about the presence of implants hampering the final result.
Failed breast reduction can be repaired so long as a detailed history and OR record is provided to our doctor.
Our doctor is meticulous with his surgical planning, execution, and skin closure. Regardless of which technique he employs, the breast reduction results by our doctor are constantly praised by our patients and their family members.
Minor breast reconstruction for patients with lumpectomy (partial breast removal) is usually done with fat grafting. Because there is often significant scarring involved, special instruments are employed to relieve the tension of the scars to facilitate the fat grafting.
For complete breast excision (Mastectomy, radical mastectomy), the patient is encouraged to see our doctor prior to having the surgery, so coordinated reconstruction procedures could be arranged seamlessly. But for the ones who already had the mastectomy done, the choices for reconstruction are relatively limited. In any case, the reconstruction involves flap surgery, expander, or direct placement of implants. The good news is that, with the availability of Alloderm, reconstruction even in patients, post-radiation therapy could yield great results.
Gynecomastia surgery is gaining popularity due to the simple fact that American people are getting bigger and fatter. First, certain endocrinological etiologies or cancers need to be ruled out. Then the surgery can usually be done by utilizing a combination of liposuction and direct excision of the breast glands sitting just under the nipples.
Our doctor designs his surgery by making small incisions just under the nipples, and each incision can be used for the liposuction port for the other breast. The effectiveness of the liposuction is warranted by using a power-assisted device. And after the fat is all cleaned out, the remaining gland tissue is easily teased out for removal. Typically, the skin will shrink to a significant extent, so there is no need for excess skin removal for most people.
Liposuction is one of the top performed procedures in aesthetic surgery. A successful liposuction is dependent on 1) a good surgeon; 2) good instruments; 3) good understanding of human body aesthetics.
Quite a few doctors claim to be able to do liposuctions, however, not too many know how to do it properly. With the insurance companies paying less and less for regular medical treatments, doctors of many different specialties jump in to make a living on liposuction, a specialty they were never trained on, or only trained for a few hours. These doctors may be a family doctor, an internal medicine doctor, a gynecologist, an anesthesiologist, or even an emergency room doctor. Naturally, it would be prudent to find out who your doctor is first before you make a commitment to a body beautifying procedure. Or else, regret is almost always guaranteed. A board certified plastic surgeon requires a minimum of 6 to 7 years of formal plastic surgery training, and then certified after a series of rigorous examinations. To find out whether your doctor is a board certified plastic surgeon, it is extremely useful to find it from the medical board of your local state.
As far as instrumentation, liposuction can be done with manual liposuction, water jet assisted liposuction, ultrasound assisted liposuction or power assisted liposuction. While manual liposuction is the many stay of technique for performing liposuction, it is by no means a technique of precision, due to the fact that the surgeon cannot control the tip of the liposuction cannula precisely. Water assisted liposuction was becoming a hot item for a few years, but more and more doctors are recognizing the drawbacks of this technique: low yield and more trauma (due to the fact that only thicker cannulas can be used, in order to harbor an internal numbing fluid tubing). Furthermore, the promise that water jet stream could flush fat clumps out of the intact human tissue is a dream that could never be realized. Not to mention that in the end, this technique remains a variant of manual liposuction, hence lack of precision. Ultrasound assisted liposuction offers a different way to pretreat the fat tissue by emulsifying the fat first for easier removal, however, it does generate possibilities of tissue burn injuries and possible additional injuries resulting in unwanted scarring. A comprehensive study shows that power assisted liposuction circumvents most of the problems listed above. The power assisted device we use is MicroAire power assisted device, when be in use, the tip of the cannula oscillates more than 300 times a minute, mimicking the surgeon’s manual movement, freeing the surgeon from doing fast thrusting movements. Consequently, the tip of the cannula could be placed within millimeters of the target area, instead of centimeters, raising the precision by at least ten folds. Because a much smaller cannula is used during the liposuction, the entry ports are much smaller (much smaller scars), and, much less trauma is caused to the nerves and the blood vessels. More importantly, the liposuction is much more efficient in terms of the amount of fat removal and being able to chew through tough and fibrous fat tissues, making a dramatic body makeover a routine possibility, and precision body sculpturing a reality!
For safety reasons, our doctor never needs to put a patient under general anesthesia for liposuction, thus avoiding the high incidence of venous thrombosis. As a matter of fact, most of the liposuctions done by our doctor is done under local anesthesia. And if you are nervous, a little oral sedative with a low dose diazepam is all that is required. This greatly enhances our safety records for the procedures. Additionally, because our facility has its own Joint Commission Certified Operating Room, safety is even better guaranteed.
SmartLipo laser utilizes a flexible 1mm DM glass fiber to transmit hot laser energy into the fatty tissue under the skin, melting the fat away, while shrinking the loose skin above. This technique was scientifically proven to be able to shrink an additional 14% of the overlying skin after liposuction as compared to regular liposuction procedures.
Our doctor has done thousands of SmartLipo Laser liposuctions, generating numerous extremely pleasing results, tightening the loose skin and cutting through tough fibrous/hard to liposuction regions. He found that this technique works the best in the upper arms, the under chin, the tummy, the “Buffalo Hump” area of the upper back/lower neck junction, the inner knee and the area just above the knees.
Abdominal liposuction is probably the most challenging of all the liposuctions, considering the fact that there are so many naturally existing aesthetic marks such as “six packs”, “corset lines”, “the midline groove in the upper abdomen”, the belly button, and the “groin lines”. A great plastic surgeon could almost always liposuction a fat tummy into something very aesthetically pleasing, showing the natural aesthetic/anatomical marks that reflects the natural tension points of the underlying abdominal muscles. And our great tool MicroAire Power-assisted liposuction device certain weighs heavily on the success rate for achieving great results.
For people with loose skin from overweight, pregnancy, or weight loss, SmartLipo could prove to be a great accessory for further improvement.
UVÉDERM VOLUMA® XC injectable gel is for deep injection in the cheek area to correct age-related volume loss in adults over 21. JUVÉDERM VOLLURE™ XC injectable gel is for injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds (such as nasolabial folds) in adults over 21. JUVÉDERM® XC injectable gel is for injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). JUVÉDERM® Ultra XC is for injection into the lips and perioral area for lip augmentation in adults over the age of 21. JUVÉDERM VOLBELLA® XC injectable gel is for injection into the lips for lip augmentation and for correction of perioral lines in adults over the age of 21.
The products include Juvederm XC, Juvederm XC Plus, Juvederm Vobella, Juvederm Voluma, Juvederm Vollure
* We are an Allergan top 50 injector clinic and, our doctor is the only one who does the injections in this clinic. This makes our doctor one of the most experienced doctors in the USA. In total, we have 12 different fillers (listed below). As a result, we have a very broad choice of fillers to treat various problems. For instance, in the cheek, lips and temple area, our doctor likes to use the Juvederm family products, but in the eyelids, nose and chin areas, he would pick the Restylane family products as the preferred fillers. For the fine wrinkles and the thick wrinkles, the choices will be completely different, so is it different when it comes to choosing fillers for the hands.
We do not carry permanent or semi-permanent filler, because our doctor believes that “permanent filler means permanent troubles”. As an extremely experienced master injector, Dr. Yu invented many novel techniques for facial enhancements, especially in the nose, eyelid, and temple areas. If you want to have a well-revered and respected injector/doctor to work on your beauty, Dr. Yu is, by all means, the best choice!
RESTYLANE is a popular, healthy, and natural cosmetic filler product. Hyaluronic acid, also known as hyaluronic acid and glucuronic acid, is one of the critical components of human dermal tissue. There is no risk of the immune response, transplant rejection, etc.
Includes Restylane L, Restylane Lyft, Restylane Silk, Restylane Defyne, Restylane Refyne
We do not carry permanent or semi-permanent filler, because our doctor believes that “permanent filler means permanent troubles”. As an extremely experienced master injector, Dr. Yu invented many noval techniques for facial enhancements, especially in the nose, eyelid, and temple areas. If you want to have a well-revered and respected injector/doctor to work on your beauty, Dr. Yu is, by all means, the best choice!
There are only a few FDA approved uses for butolinum toxins made by various manufacturors. Consequently, most of the uses are off-label applications:
Wrinkles around the eyes, i.e., crow’s feet, “11” sign, nasolabial folds, Forehead wrinkles, eyelift brow lift by botulinum toxin, nasal alar reduction with botulinum toxin, gummy smile treatment with botulinum toxin, mouth corner lifting, chin dimple treatment, masseteric muscle (biting muscle) reduction with botulinum toxin, neck lift and face lift with botulinum toxin, shoulder muscle (trapezious muscle) reduction for lower neck slimming and elongation, arm muscle reduction, leg muscle reduction by botulinum toxin, etc.
The DISCOVERY PICO Series generates a pure photoacoustic effect to shatter inks and pigmentations leaving the surrounding tissues unharmed. This picosecond laser, thanks to its shorter pulse durations and high peak power can effectively pulverize even the deepest skin pigment.
The Discovery Pico Laser delivers both picosecond and nanosecond pulses with industry-leading 1.8 Gw of peak power. Pico-Boost technology offers four separate emission modes: Picosecond, Q-Switched, OptiPuse, and PhotoThermal for even more treatment options. With a wide range of top hat square, round and fractional spots, the Quanta OptiBeam II handpieces make Discovery Pico a powerful and flexible laser in its class.
Pearl Fractional, or Fraxel lasers, are a new, volumizing, fractional laser perfected for treating photodamaged skin in just one treatment. Pearl Fractional offers the best combination of patient experience and recovery time. Patients see improvements in brown spots, sun damage, tone and texture and have a noticeably smoother, brighter complexion.
What does “fractional” mean? How does the Pearl Fractional Laser Treatment work?
Fraxel laser therapy describes a treatment that exposes only a fraction of the skin to the laser beam in a pattern of tiny dots. With the Pearl Fractional laser pulse, tiny holes are made in the skin. Columns of damaged tissue are selectively removed, leaving surrounding skin intact.
The treatment shortens healing time and stimulates the body’s own natural process for creating new collagen, plumping the skin from below and reversing photoaging and other imperfections.
Tiny holes enable safe treatment and a rapid recovery
Deep treatment provides results in a single session
Controlled energy means maximum results with a more comfortable patient experience
The board-certified dermatologists and skin specialists at Premier Cosmetic Surgery & Med Spa know that birthmarks can adversely impact your appearance and life. Our team offers a wide variety of state- of-the-art birthmark and mole removal treatments that can be customized to eliminate or reduce these marks and help boost your self-confidence.
If you have a mole or birthmark that is affecting your appearance, or you have one that has grown over time, then call Pima Dermatology and schedule a consultation for an expert evaluation and treatment.
TYPES OF MOLES AND BIRTHMARKS
Also Known as: Birthmark, Congenital Nevus, Brown Mole, Brown Birthmarks Flat or elevated brown spots on the skin.
Also Known as: Birthmark, Strawberry Birthmarks, Red/vascular Birthmark, Hemangioma Hemangiomas are present in up to 10% of newborns. They may become apparent in the first days and weeks of life.
Also Known As: Moles, Nevi, Brown Birthmarks Sun exposure may darken or increase the number of moles.
Port Wine Stain Birthmark
Also Known As: Birthmark, Port Wine Stain, Vascular Malformation Port wine stains commonly appear as red or burgundy patches on the skin which slowly darken and thicken in the first several decades of life.
Red Vascular Birthmark
Also Known As: Port Wine Stain, Strawberry Birthmarks, Hemangioma
The two primary types of red birthmarks treated are the hemangioma and the port wine stain.
Red Birthmark Removal
The two primary types of red birthmarks treated are the hemangioma and the port wine stain.
Anti-oxidant – IV therapy has been used for decades in hospitals to treat a range of conditions, from dehydration to nutrient-absorption disorders, but it’s increasingly offered at independent clinics and through house call-type services that pledge to help people feel better without clogging already-burdened emergency departments. And, while it may be most buzzed about as a hangover cure in party cities like Las Vegas, New Orleans and Los Angeles, IV therapy is also given to people with migraines, fibromyalgia and chronic fatigue syndrome, as well as those who want a nutritional, athletic, energy, beauty or immunity boost.
Our IV anti-oxidant therapy is a custom blend of multi-vitamins, electrolytes and Glutathione. It is a powerful way to boost your body’s resources and minimize the damage of free radicals and oxidative stress that can damage and even kill cells all over your body. In fact, our anti-oxidant blend includes a mega dose of Glutathione as well as a mega dose of Vitamin C.
If you’re interested in boosting your antioxidants, strengthening your immune system and minimizing the chances of damaging oxidative stress.
Heavy metal poisoning is the accumulation of various heavy metals in your body. Environmental and industrial factors expose you to high levels of heavy metals every day, including the foods you eat and air you breathe.
Some of these metals — such as zinc, copper, and iron — are good for you in small amounts. But overexposure can lead to heavy metal poisoning, such as what occurs in Wilson’s disease. This can be fatal.
Depending on your level of exposure, medications given intravenously under medical supervision can remove these toxins. These medications bind to the metals, a process called chelation. You doctor will test your blood, urine, and hair to measure metals toxicity.