Holly L. Barbour, MD
Oculoplastic and Facial Surgeon
“I was a fashion designer for 12 years before I went to medical school. My orientation has always been giving women a sense of self conﬁdence.”
With a ﬁne artist’s touch, Dr. Holly Barbour creates beauty in her artwork, intricate jewelry and on her patients’ faces. As one of only 500 fellowship trained oculoplastic surgeons in the country, Dr. Barbour dedicates herself to facial rejuvenation grounded in the precise movements honed through her training in ophthalmology and guided by her understanding of aesthetics from her ﬁne arts education. “I really do understand what a pretty face looks like and how to get there,” she says. “Any woman who ever has used lipstick knows that half a millimeter can make or break the way a face looks, and sometimes that’s not appreciated enough by patients or doctors.”
In order to create beauty, Dr. Barbour says a comprehensive evaluation of the face is important. “I must do a face lift in three dimensions, and not in two dimensions where the contours of the face are ﬂattened out,” she said. She cites correction of deep nasolabial folds on either side of the mouth as an example. “Sometimes people will get the folds injected with ﬁllers and walk out happy because they are now ﬂatter,” she said, “but they are a secondary phenomenon. If you restore the natural pretty curve of the cheek where you actually have lost fat, the folds will automatically be lifted. That requires artistic sculpting skills.”
As a woman of a certain age herself, Dr. Barbour believes she can relate to her patients and encourages them to live a healthy lifestyle. She also strives to ensure her personal values come through in her work. “Truth and non-violence are two cardinal rules I live by. I approach my patients on a very genuine level and will tell them when I think they don’t need something,” she says. “I allow a lot of time with my patients. We do a lot of hugging here.”
We women have a special talent for chopping ourselves apart. We’re more adept at totally mowing ourselves down than just about any male I’ve ever met. So you probably are a lot better looking than you think you are, but if your face or neck is making you unhappy, know that just about anything can be restored.
Basically, there are four things that contribute to our feeling that we look “used up”:
• Changes in the skin that we never expected when we were twenty and working on our tans – coarseness, loss of elasticity and loss of luminosity or radiance of the skin• Contraction and bulking up of certain facial muscles, giving us, most notably, “frown lines” and “crows’ feet”. The skin changes noted above are accomplices to this• Loss of volume in the face, giving it a more hardened appearance as opposed to soft curves• Gravity
All of these can be successfully treated in most people. But no matter what else is going on, healthy, glowing skin is your best asset. That’s because it’s a reflection of general health and health is always beautiful. We all know that the best cure is prevention with sunscreens, a nutritious diet and regular exercise, but what can we do about the damage from past neglect?
Fortunately, we have a gamut of products from newer incarnations of Retin-A, to antioxidants and growth factors that can be applied topically and actually make a difference over time. Peels range from something to make you look especially glowing that night to deeper peels that will have you molting for a few days, but can gradually make a significant difference in the texture and uniformity of color of the skin, even taking away brown spots. If the skin is severely wrinkled a dramatic restoration can be had with laser skin resurfacing and about 12 days of downtime.
In the past, I’ve been fond of admonishing that “lunchtime procedures” give you lunchtime results. But then came Pellevé, a fairly new device based on a not so new technology called “radio waves”. Some predecessors of Pellevé overpromised and under delivered, but this procedure has proved, with good technique, to effect a subtle but significant tightening and smoothing of the skin and the supporting tissues beneath it. It also stimulates collagen production. (Collagen is much of what gives young skin its luminosity and bounce.)
For my patients, it feels like a hot stone massage, and it is not uncommon for patients to drift off while they’re having it done. No anesthetic is required, and there is absolutely no downtime. The radio waves work by heating up the collagen in the skin and beneath it. The collagen then contracts and firms up, and new collagen is formed. The studies that were performed for FDA clearance of Pellevé demonstrated continued improvement of the skin up to 6 months, but clinically, operators have seen improvement for up to two years. In the one year-plus that I have been using Pellevé, I have seen sustained improvement in my patients’ skin and in a few instances, a marked improvement in wrinkling (after two treatments) that I never would have expected from something so benign.
What exactly do we see with Pellevé? There is an immediate firming and smoothing of the skin especially visible at the jaw line and around the eyes. The contours of the face seem to actually lift in most people who are candidates for this procedure. Over time, the skin appears firmer and more radiant.
Any medical procedure must be prescribed on an individual basis, and sometimes we may require more than one type of procedure to bring the patient to her best result. But Pellevé has shown itself to be of real benefit to many of my patients and it’s gratifying to see that we can have great results with something that actually feels good!
Oculofacial Plastic Surgeon, Sarasota, Florida
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