Facial Aesthetics

Treatment Modalities:

Neuromuscular Modulators – Most commonly known as Botox, Xeomin or Dysport, these medications help relax the muscles which minimizes the lines and wrinkles. This is best utilized in the upper third of the face – forehead, brow and around the eyes.

Dermal Fillers – These materials provide a safe way to improve the lost volume due to aging and trauma. The most common filler is hyaluronic acid which comes in various forms by various companies. Some examples include Restylane, Juvederm, Belotero. Another dermal filler is composed of calcium hydroxylapatite – which is found in bone and teeth. This is a more durable product and often used over the bony structures of the face.

Lifting Threads – There are two types of threads but both are dissolvable and about the size of a suture thread. The first is the Lifting Thread, which have very small tines which engage the skin and reposition the sagging skin upwards. This is commonly known as Non-surgical face lift. The results are dramatic. The other thread is a Smooth Thread, this is used much like dermal filler to enhance the volume of skin, lips and brows. The results are not immediate, however, yet they smooth the skin and is ideal for the lips, neck around the eyes and even the forehead.

Lasers – We utilize several types of lasers to address the skin issue. IPL – Intense Pulse Light, is used to reduce brown and red pigmentation commonly called age spots. Although it sounds intense, the laser is quite gentle and there is minimal sensation during the procedure and minimal recovery. CO2 lasers are used to resurface the skin, remove age spots, tighten the skin and provide smoother skin surface. This is a more aggressive laser and will require some downtime, generally 3-5 days being out of the sun.

Common areas of treatment:

Brow/Forehead
Low, heavy brows and wrinkles on the forehead can make the face look older. Both of these problems can be treated with BOTOX or Dysport, giving a relaxed and youthful appearance.

“One of the most common concerns patients bring up is that they look angry or as if they are frowning all the time. This is due to the vertical lines between the eyes – commonly called the “elevens”. Botox and Dysport literally erase these lines making my patients very happy!”

Temples
Like other areas of the face such as the tear troughs, cheeks, and mid-face, the temple area can benefit from dermal filler treatment. The temples can lose volume with age, creating a hollowed and gaunt appearance. Dr. Smith carefully restores the youthful contours of the temple area using RADIESSE or Juvederm Voluma, softening the appearance of age.

Eyes
One of the most important areas of the face is the transition zone between the eyes and the cheeks. This is one of the earliest places to show signs of fatigue or aging. When there is a lack of support beneath the skin in this area, the surface becomes uneven, creating shadows, dark circles or even bags under the eyes. Dr. Smith uses a cannula to deliver the filler rather than a needle. “A cannula will not puncture veins or arteries which needles often will do. Our patients benefit greatly with minimal discomfort and virtually no swelling or bruising.”

Cheeks
The cheeks are critical to the attractive face. Having adequate cheekbone structure supports the cheek skin (reducing nasolabial folds), helps reduce circles under the eyes, and gives the face an overall attractive appearance. This is another area where fillers are able to do what cannot be done surgically. “I believe the most impressive results which provide a more youthful appearance is the subtle re-definition of the cheekbones which provide the tapered look of youth”

Nasolabial Folds
Patients frequently ask Dr. Smith for treatment to reduce the deepening “smile lines” around the mouth what we call nasolabial folds. They have noticed that their face is looking older and assume the heavy folds are the main reason. “In many instances after patients have had their teeth fully restored they still have concerns about the areas around their mouth, I show them that often the heavy folds are due to the skin losing it’s anchoring and elasticity especially from the cheek and under the eyes”. As the cheek skin loses support it begins to sag, while the skin around the mouth doesn’t move. As the sagging cheek skin meets the immobile mouth skin, the nasolabial folds form. Non-surgically placing fillers directly into the nasolabial folds or augmenting the cheeks to lift the skin is a much better option than surgical mid-face lifts, cheek implants, or full-face lifts.

Lips
The lips are an important part of the youthful, attractive face. As we get older, we lose volume both in the lips and in the area around the lips. Fillers may be used to smooth wrinkles around the mouth, remove shadows on the side of the mouth and restore the healthy appearance of volume to the lips. The lines around the mouth, often called “smokers” lines detract from the overall smile and facial esthetics. With the use of botox, smoothing threads, fillers and lasers, Dr. Smith can reverse these lines and rejuvenate the lips giving you those kissable lips!

Chin
A strong chin is key for an attractive face. The chin helps define both the face and the neck line. Dr. Smith states, “A beautiful smile is not confined to pretty teeth and healthy gums”. A proportionate beautiful smile encompasses the proportion of the face as seen horizontally and vertically. Essentially the chin and lower portion of the face should be one third of the entire face (upper mid and lower should all be equal in proportion), if it is too narrow or short this throws off the proportion. Adding a more durable dermal filler called Radiesse Dr. Smith can achieve a fuller more proportionate chin

Lifting & Contouring With PDO Threads and Fillers
Dr. Smith is one of the few professionals in the Philadelphia area that has been formally trained to place PDO lifting threads. Dr. Smith teaches for the American Academy of Facial Esthetics and was one of the first to train and then teach the rationale and clinical usage of the PDO threads.

“The use of PDO threads is a game changer in non-surgical facial esthetics”. According to Dr. Smith, “With the lifting threads we can obtain similar results to surgical face lifting without the cost or down-time”.

PDO threads are resorbable sutures embedded with tiny barbs. “I make an insertion site with a needle and use a cannula to position the threads under the skin. After I am satisfied with the position I remove the metal cannula leaving behind the suture with the barbs. It is then a simple matter of lifting the overlying skin over the threads which then support the skin upward.”

In most cases three to four threads per side can accomplish amazing results. Of course Dr. Smith will review with you the best option for you.

Contouring the Face with Fillers, BOTOX, Threads & Lasers
Injectables, threads and lasers offer many advantages over traditional surgical procedures. Nonsurgical treatments yield almost immediate results, do not require incisions or sutures, and in many cases the results may be reversed if needed. Non-surgical procedures are performed inoffice by Dr. Smith following a thorough esthetic analysis. Although a disproportionate number of our patients are female, non-surgical treatments are increasingly popular among men at our practice.

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