Eyelid Surgery (Blepharoplasty)

This was a particularly rewarding week.  It started on Monday with a difficult revision rhinoplasty in a man with both nasal obstruction and a very scarred tip.  The surgery required ear cartilage and extensive tip surgery, but in the end the result looked incredible.  Following that case, I performed an augmentation rhinoplasty on a Philipino man with excellent overall improvement using a Gore-tex dorsal implant.  

On Tuesday, the day started with another very difficult revision rhinoplasty on a woman.  This case required both ear cartilage and septal cartilage, as well as lining from the temporalis muscle.  I created a beautiful new tip out of very distorted cartilages, and built her dorsal profile up to where it should have been all along.  The profile was improved with diced ear cartilage wrapped in temporalis fascia. This produced a beautiful dorsal line to complement her tip.  That case was followed by taking care of a rare complication…removing an infected dorsal nasal graft made out of Gore-tex.  This case went smoothly, and after her infection clears the height of the nose can be restored with a new graft, likely from diced cartilage and temporalis fascia this time.

On Wed, I performed a scar revision pro bono on a victim of domestic violence.  This was through the Face to Face program of the American Academy of Facial Plastic Surgery (of which I am chair).  I spent the afternoon supervising laser hair removal at a local spa, Le Petit Spa.  The laser I use, the latest diode laser, has provided excellent results over the last few months that I have been using it.

The week ended with several days of patient office hours and office procedures, including Botox and Restylane.  I am eagerly awaiting the arrival of Perlane in the next few days.

I just received an email:

Dr. Constantinides: You gave a lengthy interview for The Body.com discussing Sculptra, however, you did not mention the possibility of “lumps” forming. Unfortunately, I have had these lumps under my eyes for over a year. Will they go away?

My answer:  

Thanks for your question.  Nodules, or lumps, are the most common complication of Sculptra.  They occur either when too much Sculptra is placed into one location, or when muscle motion pushes the Sculptra together in a location.  The lumps are actually your body’s formation of collagen around the Sculptra particles, and not the Sculptra itself. Fortunately, they can be improved with steroid injections.  The lumps will last for as long as the Sculptra particles are there, if they are not treated with steroid injections.  This is typically for 2 to 3 years after the injections.

Lumps can be prevented by not injecting the Sculptra into very mobile areas, any by massaging the area for the first 3 weeks after injecting.  I advise my patients to vigorously massage the injected areas for 10 minutes a day for the first 3 weeks.  I have had some small lumps develop in a few of my patients, but have not had a lump develop that is visible.  I attribute my success to experienced injection technique and careful instructions about post-injection massage.

I have just been nominated for a national elected position in the American Academy of Facial Plastic Surgery (AAFPRS): Eastern Region Credentials Representative.  I hope to be able to increase my contribution to the national scene of facial plastic surgery if elected.   I am looking forward to continuing my international pro bono work with my ongoing chairmanship of the Face to Face Committee of the AAFPRS.  This is the committee that directs all domestic and internatioal pro bono efforts of the AAFPRS, and I have had the good fortune of chairing the committee for the past 3 years.  Under my leadership, we have doubled the number of int’l trips and have re-invigorated the domestic program that provides pro bono surgery for victims of domestic violence.

I just saw the patient who had her facelift yesterday.  She looks absolutely fantastic.  Swollen, of course, but minimal bruising and already she can see the amazing contour her face and neck will have.  She is very happy so far.

My office will be hosting “A Summer Night of Beauty” on Thursday, June 14, 2007 from 6:30 to 8:00 PM.  I will have some guest speakers, and we will speak about the latest in esthetic procedures, injectables, and treatments…just in time for summer!  Call 866.557.9042 and reserve your place today.  Seating is limited, so call now.

I just tried Artefill on two of my established patients.  It really looks great…very easy to inject, excellent flow characteristics, and very easy for the patient to tolerate.