Plastic Surgery Taxation Discussed By Terry L. Hand, MD
September 1st, 2009 Dr.Terry Hand
Help me understand this. I choose to have a Botox injection. You choose to have your hair cut and colored. I save Read the rest of this entry »
Help me understand this. I choose to have a Botox injection. You choose to have your hair cut and colored. I save Read the rest of this entry »
Let me give you an example, the patient below needed a facelift and eyelid lift. Her neck had lost definition, her jowl lines were softened and her midface was sagging. To have merely injected dermal fillers and Botox into her face would have created relaxed muscles in the areas that were already relaxed and a puffiness to her face that did not match her distinctive look. She was better served by performing a facelift and an eyelid lift, followed by strategically utilizing injectable dermal fillers, Radiesse and Restylane, to correct the nasolabial lines. Her facial muscles were tightened, her midface was lifted with her eyelid lift, her neckline redefined and the extra skin from her face and eyelids were removed. No Botox was used on this patient.

The next patient was an excellent candidate for Botox and injectable dermal fillers, but again, they were used as an adjunct to cosmetic surgery. Before surgery, this patient had lower lid puffiness and upper lid drooping that was correctable only by an eye lift. She had midface laxity and her nasolabial lines were prominent, as were the lines between her brows. Botox was utilized to weaken her brow lines and the the lines in her crow’s feet areas, and to slightly lift her brows. Restylane was used to correct her nasolabial lines. However, the greatest correction was seen following her upper and lower eyelid lift. At that time, extra skin and muscle were removed, the malar fat pads (over the cheekbones) were repositioned and the midface was lifted.

There are certainly times when the physical anatomy of the face or financial choices make the usage of Botox and injectable dermal fillers, without cosmetic surgery, a wonderful choice. My concern is that patients need to be informed of all methods, tried and true, that may be of benefit for the cosmetic concerns that they are trying to solve. Dermal fillers and Botox are great temporary solutions, but when used in great quantities to avoid a surgical solution, their costs can be equally as daunting.
My recommendation: By all means utilize these valuable nonsurgical solutions, however, an informed plastic surgeon can assist you in providing a reality based plan for your short-term and long-term goals. At my Marin County plastic surgery practice, I evaluate every patient’s individual needs so that you understand all of your options prior to treatment.
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