Ear, Nose and Throat Surgeons of Western New England is pleased to welcome Dr. Kimberley Rutherford to our staff. A board certified otolaryngologist specializing in facial plastic and reconstructive surgery, Dr. Rutherford offers facial rejuvenation including surgery of the aging face and neck, blepharoplasty (eyelid surgery), rhinoplasty, hair restoration, Botox® and Xeomin®, and dermal fillers; skin cancer reconstruction; and adult and pediatric head and neck surgery. Please call our office at 413-732-7426 if you have any questions on her article below, or to schedule a consultation with Dr. Rutherford in either our Springfield or Northampton office.
By Kimberley D. Rutherford, MD
As we age, many facial changes occur that lead to a "tired appearance." The skin begins to loosen on the face and neck, and forehead lines and crow’s feet gradually become deeper folds. The jaw line softens into jowls and, beneath the chin, vertical folds appear at the front of the neck. It is difficult to not feel a loss of self-esteem with these changes that affect us all. As a result, we are constantly trying to find ways to look and feel our best.
If you can look better with a cosmetic intervention, then the next question is, “What are the risks?” The answer is “primum non nocere”— first do no harm. This is the mantra by which every physician should practice his or her trade. There is risk with any cosmetic intervention. The more aggressive the intervention, the more risk involved. In addition, most people want the least amount of downtime, and they do not want any identifiable sign left behind that a cosmetic procedure was performed. A consultation with a facial plastic surgeon can help provide clarification of the individualized options with an explanation of the associated risks, benefits and alternatives for a particular patient.
Facial aesthetic and reconstructive surgery is a main subspecialty of otolaryngology and head and neck surgery. A facial plastic surgeon specializes in aesthetic and reconstructive surgery of the face and will provide a careful assessment of the anatomy of the face and neck to develop a plan that is personalized to the patient. The aesthetic goal is to provide patients with a more harmonious and balanced appearance to their face. Achieving a refreshed look is always sought with the foremost goal of providing a natural appearance. Though each patient has unique, individualized needs, there are some common aspects to the aging process that shed light on some of the non-surgical options available to patients.
With aging, the supporting structures of the face (including bone and fat) weaken and diminish in volume. This gives the face a deflated appearance. Volume restoration refers to the goal of “reinflating” the underlying tissues of the face with a dermal filler agent. This restores a more youthful and natural contour to the areas of the face that are more vulnerable to volume loss. This applies to bags under the eyes with infraorbital hollowing, to cheeks and lips that have lost their prominence, and to the deep nasolabial folds and marionette lines.
There are many options available to address this loss of volume. For a volume-filling agent, Restylane® is a popular option. Restylane® is a clear gel composed of hyaluronic acid that is specifically formulated to act like the body's own naturally produced hyaluronic acid. It helps to instantly, visibly reduce moderate to severe facial wrinkles and folds or add fullness to the lips. It received U.S. FDA approval for clinical use in 2003, and has been in use in Europe since 1996. Benefits for the use of this filler include an excellent ongoing safety record for many years. The effects generally last at least six months and gradually disappear from the body. If you are treated again at 4 ½ or 9 months after your first treatment, Restylane® can last up to 18 months in the nasolabial folds. In the lips Restylane® generally lasts six months.
Radiesse® is another popular volume-filling agent. It is made of calcium-based microspheres that are suspended in a water-based gel. The microspheres act like a scaffold under the skin to provide structure and stimulate your body's own natural collagen production. It is used for nasolabial folds, marionette lines, lines at the corners of the mouth, the pre-jowl area, and chin wrinkles. About 80 percent of your results are instantaneous, and the full effects are evident within one week. Radiesse results can last over a year, but touchups may be necessary.
Many wrinkles are actually creases formed by the repetitive contraction of a muscle under the skin in that area. Botox® and Xeomin®, commonly referred to as neuromodulators, help achieve a smoother, fresher appearance for the upper one-third of the face, addressing wrinkles of the brow, forehead, and crow’s feet. These products contain purified protein (botulinum toxin) that acts to relax the muscle responsible for creating the wrinkle. Although neuromodulators contain a toxin, they are an extremely safe product with over 20 years of clinical use. In addition, injections of neuromodulators are the most common cosmetic procedure currently undertaken in the United States for facial enhancement. The effects may last three to six months.
Complications with the use of neuromodulators and dermal fillers are rare and relatively short-lasting. For neuromodulators, side effects include bruising and swelling at the injection site. Upper eyelid drooping can occur when a neuromodulator is injected too close to the upper eyelid. With dermal fillers, bruising, swelling, nodules under the skin, and irritation of the skin can occur. Treatment of this kind is performed in an office setting, making it convenient, private and safe. Prior to injection of dermal fillers, numbing medicine is used to increase the comfort. In comparison to typical cosmetic procedures, injections take less than 45 minutes to perform, and patients may resume normal activities immediately.
To determine what options would be most appropriate, a consultation with a facial plastic surgeon is recommended. During this consultation, the patient’s individual anatomic areas of concern are analyzed, photographs are taken, and an individualized treatment plan is developed.
If you would like to schedule a cosmetic consultation, please call our office at 413-732-7426.