3252 Holiday Court, SUITE 206, La Jolla, CA 92037 | Phone: 858.658.0595

Procedures

SAN DIEGO Endoscopic Brow lift


 

Example of Endoscopic Browlift

 

Patient was concerned about tired look of upper face and eyes. Note how elevation of brows imparts a more youthful, alert appearance.

Before
After

 

For an endoscopic browlift in San Diego or La Jolla California contact Dr. David today at 858.658.0595.

 

 

 

Example of neck liposuction:

 

sample photo
Before After
(Liposculpture, rhinoplasty)

 

Fat Transfer involves harvesting fat from areas of the body such as the abdomen, "love handles," or thighs, refining the harvested fat, and transfering it to areas of the face and neck.

 

Common areas for fat transfer in the face include the lower eyelid boney margin, the nasolabial folds or "smile lines," the submalar region (hollow area below the cheek bones), or the cheek prominences.  Fat transfer has grown in popularity as we have come to recognize that fat loss or "volume loss" is an integral part of the aging process, along with skin laxity or wrinkling. Fat transfer can complement a facelifting procedure to give an overall more enhanced, natural and youthful appearance.

 

A majority of transplanted fat is expected to survive and become permanent, effectively increasing the volume of the cheeks, lips, temples and remainder of areas affected by aging and fat loss. The key to successful fat transfer is the use of specially designed micro cannulas, which transfer small parcels of fat that are more likely to survive. The harvested fat is also carefully cleansed prior to injection. Fat transfer is always accompanied by some degree of swelling, however within one week appearance is generally quite pleasing. Complete resolution of swelling may take several months or more, however this process is gradual and generally not noticable. At six months, retained facial volume is considered permanent. 

 

Excess fat may be stored frozen for up to one year following fat transfer in our La Jolla, San Diego office. This fat may be used for touch up injections when necessary.

 

Example of Fat Transfer:

 

Patient had fat transfer to cheeks, submalar hollows, lips, smile lines. Note increased fullness of face.

Before
               After  

 

For a necklift or fat transfer in San Diego or La Jolla California contact Dr. David today at 858.658.0595.

 

Lip Enhancement

 

Full, well-shaped lips represent a desirable sign of youth and good health. There are several permanent, as well as temporary, methods of lip enhancement or lip augmentation which are used in our San Diego practice. Permanent methods of lip enhancement include lip advancement surgery, as well as implants such as alloderm or gortex and newly-developing permanent injectables. Lips may be enhanced using one's own harvested fat, as well as "extra" fatty tissue removed during a facelift. Various forms of collagen can be injected into the upper and lower lips to produce dramatic changes that generally last three to four months. Usually, lip augmentation can be performed under local anesthesia in our San Diego practice.

 

Permanent Lip Enhancement

The Lip Lift

 

Surgical lip enhancement, also known as a lip lift, is performed in one of two ways. For younger patients who have a slightly ptotic or droopy nasal tip (which hides the region of the nasal sill) an incision is made along the bottom edge of the nose, and tissue excised thus "lifting" the upper lip. The scar generally hides well in this region. This technique is commonly called a subnasal lip lift. In older patients who may have vertical wrinkles along the upper lip, the incision is instead made along the upper border of the red lip. The result of both methods is that the red portion of the upper lip is increased in size, and the distance from the nose to the lip is decreased.  This can be especially useful in patients who have an overly long upper lip, completely hiding the upper incisors.

 

Lip Implants

 

Lip implants are used to permanently enhance lip volume and projection. The procedure involves small incisions at the corner of the mouth which are hidden in the red lip. A tunnel is created under the lip mucosa and the implant material is introduced into position and trimmed, and the incision is then closed with fine suture. Common materials used for lip augmentation using implants include alloderm and gortex.

Click here for a case study on permanent lip enhancement

 

Fat Injection or Fat Transfer

 

Lip enhancement using one's own fat is a procedure commonly performed in our San Diego office . Fat is typically harvested from the abdomen or hips and placed in submucosal fashion as well as into the muscle of the upper and lower lips. While some fat may resorb or disappear over time, patients typically obtain good long term results with this technique. Fat that is present after six months is considered permanent.

 

Temporary Lip Enhancement

 

Synthetic Fillers

 

Lip augmentation using fillers is perhaps the most popular choice for patients because of the reduced cost, no downtime, and safety of commonly used fillers. Hyaluronic Acid fillers are perhaps most popular due to the above reasons: the material is naturally occuring, and resorbs or dissolves over six to twelve months. Examples of hyaluronic acid lip fillers include Restylane and Juvederme.  Permanent fillers such as artefill may be used in the lips, but with caution to due the greater risk of lumpiness or complications over time.

 

[Click photo to enlarge]
sample photo
Before After
(Restylane® lips)

 

 

For lip enhancement or lip augmentation in San Diego or La Jolla, contact our office today at 858.658.0595.

 

 

 


 

CASE STUDY: Permanent Lip Augmentation

 

Small, or "hypoplastic" lips are a common complaint among patients of varying ages. Some people are born with thin lips, while others experience progressive thinning as they get older. This is due to the effects of gravity and loss of tissue elasticity.

 

The patient below is typical in that she complained of always having somewhat small lips, but this had become more noticeable to her in recent years. She had tried restylane injection to her lips and was very happy with the result, which lasted about six months for her. She was ready for a more permanent solution so she could enjoy full, youthful lips without the need for repeat office visits and expenses.

 

Case Study

 

Permanent lip augmentation with gortex has been performed for quite some time, however the initial results were not always pleasing due to the firmness and bulk of the implants. More recently, a porous design has been created resulting in a more natural look and feel and a much softer implant.

 

Example of AdvantaTM lip implant:

 

Advanta

 

The implants are introduced through small incisions in the upper and lower lips and the procedure is generally done in the office using local anesthetic. Healing time is one to two weeks, during which the patient is asked to refrain from excessive chewing and smiling.

 

At two weeks post-op, this patient is completely healed and very happy with her new, permanent enhanced lips.

[Click photo to enlarge]
sample photo
Before After
(Restylane® lips)

 

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