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1250 South Tamiami Trail, Suite #302
Sarasota, Florida 34239
941.951.2220
Tuesday, 09 September 2014 15:41

The Two Main Goals of a Facelift

The eternal facelift conundrum for almost everyone goes somewhat like this:

facelift333“I want to look better, even way better. I want to look in the mirror and see that I look awake and happy instead of tired and sad. I really want that change to happen, but I don’t want people to notice that I’ve had a facelift.”

If this is what you’ve thought, you have a lot of company. If you feel a little embarrassed about saying that, you have a lot of company. The good news is that you can have it both ways – and the reasons are twofold.

First, and most importantly, the facelift must look natural, but the road to natural has to be through the vision and skill of your surgeon, not just doing less. We could do nothing and get natural, but that’s not what you’re signing up for. You’re signing up for skilled surgery, artistic vision and the ethics of someone who will treat your face as if it were their own. Let’s say you’ve found that with your doctor and you get a result that makes you look more as you did in your youth. The vitality, radiance, lift and definition of your face are back, but what will people think????

Here’s the reality. Just to bring it into perspective, let’s look at a situation most of us have experienced. You go to a gathering. You wear a lovely outfit. A couple months later, a similar event is to take place with some of the same people. You agonize because while the outfit you wore to the first event is perfect and you feel fabulous in it, you’re a little embarrassed to wear the same thing again. But think of the people who were at that event. 
Can you remember what they wore? Chances are that unless something particularly stood out, you can’t.

For better or worse, human nature is engineered to make us a bit more self-
absorbed than we’d like to admit.

Now back to the facelift. If it looks natural, most people will just subconsciously register that you look great, or they will consciously register that you look great and will ascribe it to just about anything but surgery on your face. They will think you changed your hair. (If you actually changed your hair around the time of the surgery, all the better.) They will think you lost weight, fell in love, went on a long vacation, retired, began working out, whatever. Of course there are exceptions to this, but mostly these will be people who either have had facial work done themselves and are now primed to notice these things or people who have been thinking about it and want to have some of what you got. And in the latter case they may pull you aside and ask where you had it done. In any event, the bottom line is 
that if it looks good, if it looks natural and if it looks like the best version of you, your face will cause endorphins to be released in those that look at you – and that’s all good.

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What is it exactly that is happening when our skin sags and wrinkles? The answer may be complex, but most of it boils down to loss of collagen and elastin fibers in the skin. We have known for years that if we cause a “micro-injury” to the skin – just enough to stimulate an exuberant healing reaction – we can end up with that healing reaction creating better skin than we had before it was “injured”.

Microneedling is based on that principle and is producing significant results for mild to moderate wrinkling, laxity, coarseness and acne scars. It is a potent collagen stimulator, can be used anywhere on the body and requires no downtime.

In the office, the face is thoroughly cleansed and a numbing cream is applied for 20 to 30 minutes. The procedure uses a “Micropen” that has tiny needles at its tip. The depth to which the needles go is tailored to each individual and to different parts of the area being treated. The procedure is enhanced by use of a gel containing growth factors that are driven into the skin by the needles. For an even more intense treatment, some people prefer to use platelet-rich plasma (PRP), which is rich in your own growth factors. Most treatments take about 30 minutes and you will look a little rosy for a day.

Over the next three days your skin will be a little flakey, but it’s not bad. Amazingly, the tightening, the improvement in texture and the smoothing of wrinkles and scars will be visible quite rapidly. Some of that is due to imperceptible swelling, but over the next few weeks the improvement becomes obvious. While three to four treatments about four weeks apart are recommended, the result is cumulative and you will see improvement after the first time.

Published in Blog
Tuesday, 08 July 2014 16:25

Happy Mother's Day to All!

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Bring us a photo of anything you’ve mothered – a child, a pet, a plant, your own parents – and we’ll honor you with a FREE ($150 value) IPL treatment for your busy hands when you purchase a full face IPL treatment.

IPL (Intense Pulsed Light) is the ideal way to eliminate age spots and small red blood vessels from anywhere on the body and get smoother, silkier skin as a side effect!

Call us today at 941.951.2220 and get your very own Mother’s Day treat, from now until the end of May!

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Q. Sally asks: I read your article about why eyes may get smaller as we age. Can you explain how I should insert and remove my contact lenses? contact lenses small eyes dr. holly barbour

A. The best way to insert soft contact lenses is to place them without stretching the eyelids. The best way to do this is as follows: Place the contact near the tip of your index finger. Make sure it's not too wet - this will allow it to grab onto your eye and not stick on your fingertip when you're trying to insert it. Get in front of a mirror and brace your third or fourth finger on your cheek without pulling down on your eyelid.

Tuck your chin down while looking up into the mirror so you've exposed as much white at the lower part of your eye as possible. Let the contact touch the lower part of the eye and as soon as it "grabs" look up as high as you can (you won't be able to see yourself at this point) and roll your fingertip up slightly to allow the top of the contact to seal onto your eye. It's really easy once you get the hang of it, and it's not that much different than the way people normally insert CL's.

To remove the contact, place the sides of the pads of your fourth fingers together, place them over your contact, and then pinch the pads together a bit to break the seal of the contact with your eye. This way, you can put them in and take them out day after day and year after year without ending up with a saggy lower lid margin down the road.

Q. Sally also noted that her eyes seemed smaller since she began wearing contact lenses about a year ago. Here was my reply:

A. If your eyes seem smaller since you began wearing contact lenses, it may be that the eyes are a little dry. When the eyes are dry we sometimes squint a bit in an unconscious effort to reduce their exposure to the air. If that's the case, you may want to try a contact lens solution that is moisturizing. Opti-Free Replenish is a great solution (no pun intended) for the drying effects of contact lenses. Other than that, contacts should have no effect on the size of your eyes.

Published in Blog
Tuesday, 22 April 2014 14:59

Product Description: JUVEDERM VOLUMA XC

                Juvederm VolumaXC-logo-4c

The newest Juvederm product, Voluma has been FDA-approved for use in restoring volume in the cheek area. Voluma has been shown to last up to 2 years.

If you loved Juvederm, you will love Juvederm Voluma even more! Voluma is made of hyaluronic acid (HA), a naturally occurring sugar in the body. In large part, the longevity of HA fillers has been determined by the amount of "cross-linking" of the molecules, meaning essentially how densely they're packed together. Voluma is highly cross-linked, to the point where the density of the filler allows it to last up to two years. This added density has not detracted from the smooth, silky way it goes into the face, but (aside from the fact that there is 20% more product in each syringe than there was with Juvederm's former incarnations) Voluma is definitely creating more fullness just from the density alone.

Published in Blog
Monday, 14 April 2014 20:24

Product Description: Artefill

A long lasting filler with immediate results. It works with your body's own collagen to give volume that will last years instead of months. artefill

For people who tend to "burn up" filler, Artefill offers a solution for both needle- and credit card-fatigue. This revolutionary volumizer has been around in its present form since 2006, but I have been watching it all these years to make sure of its safety profile.

Twenty per cent of each syringe-full of Artefill is made up of microspheres -- each one being 40 thousandths of a millimeter in diameter -- of polymethylmethacrylate (known by its acronym, PMMA). PMMA is an inert substance that has been used for decades in medicine, for instance in bone glue and the intraocular lenses that are put in the eyes at the time of cataract extractions.

The other 80% is bovine (cow) collagen, which is what most collagen injections were made of back in the 90's. The reason we don't use bovine collagen anymore as a filler is because it doesn’t last more than a few months.

However it has an ionic charge that suspends the PMMA microspheres the perfect distance from each other while they stimulate the body to form its own collagen around them. PS: For those of us who try to live cruelty-free, I've been assured by the company that the collagen is procured from trimming the hooves of this closed herd of cows - a pedicure, if you will.

For those of you who seem to metabolize away anything, take comfort in knowing that 20% of each Artefill treatment just can't be metabolized, so you get to keep it. Some people ask for multiple sessions over time so that the percentage of filler they retain becomes more and more of the entirety of the volume they want.

Published in Blog
Thursday, 03 April 2014 14:33

Amazing April Specials

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Microneedling is a sensational way to smooth and firm your skin. It really makes a difference, and no, it doesn’t hurt.

This procedure has been getting a lot of press lately. We tried it, we love it and we want you to have its benefits too!

We’ll give you 20% off during April and you’ll get the compliments.

And take care of your lashes with Nouriche. This is a $125 value for $89 during April.

Call us today to find out more! 941.951.2220

Published in Blog
HOW TO MAKE YOUR FACE LOOK INSTANTLY YOUNGER WITH CONTRAST

PART 2: EYES AND LIDS 

pink-Lip-LinerAs children, most of us have lips with a rosy cherubic color. As the decades pass, the lips tend to fade in color and the contrast between the border of the lips and the skin around the lips becomes less defined. With the loss of definition the border can become irregular and any asymmetries in the contour of the lip borders can appear exaggerated.

This is where lip liner comes in. A "lip-colored" lip liner allows you to restore that border, smoothing its contour and restoring the contrast between the rosiness of natural young lips and the skin outside of the lip line. Keep the lip liner close to your natural lip color or the lip color you're applying that day. Lip liner that is more than a shade darker than your lip color will look artificial and harsh. While you can "push" the border a little bit if you want the look of more volume, it's important to keep the lip liner from going onto the flat part of the lip outside the border.

If you feel that you've lost so much volume in the lips that enhancing them with lipstick or liner is an exercise in futility, I can restore the volume of the lips with a very long-lasting technique that will look beautifully natural. With all the overdone and "trout-mouth" lips that frighten people out of restoring lost volume, the fact remains that those results absolutely never need to happen. The difference between a disaster or even mediocrity and a beautifully restored lip requires:

1. An in-depth understanding of the anatomy and embryonic development of the lips and the area around them,
2. Impeccable technique,
3. Commitment,
4. Experience,
5. The correct product to restore the lips and
6. Artistic skill to sculpt a beautiful and natural-looking lip while correcting asymmetries.

"I was out to dinner with a few friends and they were talking about how awful those filled-up lips looked. They were saying they'd never have it done. Then one of my friends turned to me and said how lucky I was that I didn't need it. I just smiled."
--As related to Dr. Barbour by an actual patient whose lips she had restored.

Published in Blog

sparse-eyebrowBy now, with those little taxicab yellow smiley faces having become iconic, we’ve all had a chance to see how changing the position of the eyebrows on an otherwise bland round face with dots and dashes for features can have a powerful effect on the emotion that face conveys.  (If you use an Emoticon app on your cell phone or tablet, you know how you communicate more effectively with these faces attached to the text.)

The eyebrows are important.  They’re important for you and the look and mood you present to our vision-oriented world.  Standards of beauty change over the decades and right now a lower brow is considered more of the moment, but part of that may be a reaction to the over-arched, over-lifted, “surprised” brows that we’ve come to associate with a “surgical” look.  Also, while low brows on a tired appearing face can make one look more tired, low brows on a fresh appearing face just tend to look sultry -- and we have so many ways to keep a face looking fresh nowadays!  Injectables like BoTox, Dysport and Xeomin -- and fillers too -- can tailor the position of the brows a bit – and “a bit” can make a big difference in your appearance.  All that aside, a healthy, natural looking brow that sits in a position that is most harmonious with your individual facial shape will be the ideal for you. 

This is where I’ve seen the problem come in.  Many of us get so used to looking at ourselves, and the changes that take place over time can be so insidious, that we may lose sight of those changes and how much they affect the mood we project.

Let me share with you a few easily correctable problems that I see again and again in my practice. 

  1. It is not uncommon for the brows to take a little dip at the upper border just a few millimeters before the end that is near your nose.  This can create an artificially angry look and is corrected by filling in that dip with a bit of brow color.  Irrespective of the general shape of your brows, you want the upper border of your brows to have a smooth, gentle curve without dips or points.  Smoothing that contour out has an immediate softening effect on the face and can be easily done with short soft strokes of your brow pencil (or cream or powder),
  2. As we age, the brows can become thinner and horizontally shorter.  A full, healthy brow is both softer and younger looking.  However, our eyes may adjust over the years to the thinner, shorter brow.  If your brows are thin, try creating a fuller brow with your brow color – and give yourself some time to adjust to the new look before deciding that it’s too heavy.  Remember, they don’t need to be darker, just fuller.  Always use short, feathery strokes rather than a hard line.  We don’t want them to look pasted on.
  3. Hold a pencil at the side of your nose and tilt it so it grazes the outer corner of your eye.  Although there are minor variations depending on facial shape, generally the ideal ending point for the tail of the brow will fall where that pencil hits your brow bone.  A lot of women stop their brows short of this point and that can indeed be aging.  Also, keep the tail of the brow lifted if you can, not so that it wings out, but so that it falls more on the top of the brow bone rather than on the lower side where the brow can look “sad”.  If the brow hairs at the tail are rotating downward so that your pencil can’t correct it without looking as though you have two brow tails, you may want a little more help and we can talk.

I hope this was helpful.  As always, if you would like some assistance, give us a call and make an appointment with our wonderful aesthetician, Jill or with me.                

by 

Published in Blog
Monday, 18 February 2013 15:12

LOOKING “WORKED-ON”

Almost every week, a new patient will say something to the effect of, “I want to look better, but I’m so afraid of looking ‘worked-on’”. While there are unfortunate examples of what I call “The Look” all around us, it’s important to know that the sort of overdone, vaguely alien appearance that most of us want to avoid never ever needs to happen. Nor do we need to sacrifice a significant improvement for a natural appearance. We can have the best of both worlds -- really.

It goes without saying that extensive training in the head, eyes/eyelids and neck is imperative for a physician who is going to perform any eyelid, facelift or filler procedures. Additionally, aside from performing the procedures well, the physician needs to make an even more basic assessment of just which procedures need to be performed! As basic as that sounds, there are, for instance, facelifts done when the skin is wrinkled and volume has been lost from the face. In these cases, the lift may be OK technically, but the patient still looks tired, weathered or even a bit flattened out. In other cases, fillers may be given as a “lift” when the problem is gravity and a real lift needs to be done.

Fortunately in many cases revision procedures can be done to correct suboptimal results, although they may need to be “staged”, that is, done over time. In some cases involving fillers, I’ve just seen the patient periodically until a poorly placed or overdone filler starts to wear off. Then we start “tweaking” until eventually the effect is what we want.

The most beautiful and natural looking results require the physician to have a distinct talent, an “eye” for beauty. This, like any artistic talent, is inborn and includes, but goes beyond, technical expertise and training. But when your “work” is done well, it won’t look done; you’ll just look great and people will say things like, “You look wonderful! Did you change your hair?”

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dr barbour

Oculofacial Plastic Surgeon,
Sarasota, Florida

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