Non-Surgical Full Face Lift and Rejuvenation

Patient Goals: Our patient is a young woman in her late-thirties, wanting to look refreshed. Her chief concern was her smile lines (laugh lines/nasolabial folds). 

Treatment Plan: When assessing the smile lines, it’s important to consider the surrounding structures like the cheeks, which provide integral support and structure to the mid- and lower-face. We first treated the anterior and lateral cheeks with 3 syringes of Juvederm Voluma. We then treated the nasolabial folds (smile lines) and marionette lines using 1 syringe of Juvederm Vollure. To support the marionette lines and jowls, we also placed 2 syringes of Juvederm Voluma in the chin, pre-jowls, and angle of the mandible. Lastly, we used both cannula and injection techniques with 1.0cc Juvederm Volbella  to enhance and support the infra-orbital hollows (under eyes). 

Results: By strategically placing filler for structure and volume restoration, we were able to significantly improve the appearance of the under eyes, smile lines, marionette lines, and jowls. This created a more youthful, lifted appearance for our stunning patient. 

Who is a good candidate? Patients who have noticed volume loss, or the development or deepening of facial static (resting) lines, folds, and creases. 

Am I a better candidate for surgery? Filler provides support, structure, and volume restoration. You may be a better surgical candidate if you have noticed significant volume loss and skin sagging, most often appreciable in the 6th and 7th decades of life (50-60+). We may need to reposition and support deeper structures such as the superficial muscular aponeurotic system (SMAS), which allows us to reposition ligaments and soft tissue, providing long-term results. Additionally, we may recommend fat transfer to the under eyes, cheeks, smile lines, marionette lines, lips and chin to provide volume restoration for a more youthful look. 

Maintenance: We recommend returning annually for facial harmonization/volume restoration treatments with filler.

Learn more about facial balancing: e-mail consultations can be held with Nurse Sage. Please send straight on, 45 degree angle, and profile view photos to our office e-mail: hello@sfcosmeticsurgery.com 

Top 10 Tips You’ll Need to Know Before Breast Augmentation Surgery (And a Few Useful Secrets!)

The decision to get a breast augmentation, depending on who you are, can either be a long road of deliberation and thought, or one of the easiest decisions you’ve ever made. Regardless of what boat you’re in, everyone who decides to undergo breast augmentation surgery can find common ground in having some amount of fear and uncertainty about the procedure. And for good reason – it’s a life-changing event that will surgically alter your appearance! However, preparation and knowledge are great antidotes to fear for those who are feeling skittish. If you’re like me, you’ll spend hours pouring over the internet and writing down everything you’ll need to know before the big day. Let yourself rest. We’ve done the work for you, and put together the top 10 most mentioned tips on the web that you’ll need to know before the big day – plus a few little-known (and very useful) secrets!

1. Buy a Sports Bra: It’s a wonder that so many people forget this, but this is one of the most important steps you’ll need to take before surgery. Buy a comfortable sports bra that zips in the front and has NO underwire. It's important to have it zip in the front because it's much easier to get in and out of. No need to get fancy/sexy here! One of our favorite bras is from Target (link: https://www.target.com/p/women-s-high-support-zip-front-bra-all-in-motion/-/A-77641037?preselect=77347060#lnk=sametab). Comfort is key.

2. Get a Button Down Shirt. You’ll want to have a loose-fitting button-down shirt to wear on the day of your surgery. A zip-up hoodie/jacket also works! They’re easy to open, easy to close, and easy to get in and out of. While you’re at it, get a few more to wear during the recovery process.

3. Do Your Laundry and Clean Your House. Let’s face it, you’re not going to be able to do your laundry for at least a couple of weeks post-op. You’ll be spending the majority of your time in bed, so make sure this area is clean. Wash your pillowcases, sheets, and comforters – and have a few extra just in case. Clean your house so you’ll be able to recover with a clear mind in a clean space.

4. Stop Taking Aspirin/NSAIDS. Prior to surgery, you’ll need to stop taking aspirin and all aspirin-containing medications and products. Aspirin thins the blood and can lead to surgical complications. We recommend avoiding aspirin for at least 3 weeks before surgery. This includes ibuprofen, Advil, and Aleve!

5. Drink Lots (Water, Not Alcohol!) Drink lots of water on the days leading up to your surgery. Hydration is very important and can reduce nausea after the surgery. The catch? Stop drinking water by midnight the night before your surgery. In addition, avoid alcohol for at least 24 hours prior to the operation. Tempting as it may be to indulge in a de-stressing drink in the days prior to surgery, this must be avoided at all costs.

6. Stop Smoking. Do your best to quit smoking 4-6 weeks before surgery. Smoking reduces oxygen levels in the blood, which can slow down the healing process. However, if you are having a breast lift, you will need to have quit smoking for at least 3 months. Smoking increases the risks of necrosis (tissue death) in those having breast lifts. As hard as it may be to stop smoking, the results are always worth it!

7. Buy Cold Compresses. Yes, for your boobs! Buy a cold compress or stock on some frozen peas. You’ll need cold compresses to apply to your breasts after surgery in order to reduce swelling and pain.

8. Friend/ Family Support. You might feel like you can handle it on your own, but you’ll need someone to drive you and to help you with a few things after your surgery. Find a friend or get your spouse to transport you to and from your surgery, and to stay with you for at least 24-48 hours afterward. You never know if you’ll need someone to help fetch you the remote, reach for a can of soup in the cabinet, or go on a drugstore run.

9. No Make-Up and Acrylic/Gel Nails/Fake Eyelashes. Remove all makeup, jewelry, and nail polish. You’ll want to be clean for the surgery, so take a shower the morning of surgery. Wash your hair, since you won’t be able to shower until about 48 hours after surgery. If you wash your hair, make sure your hair is dry before surgery. Don't refill your eyelashes prior to surgery as these may be inadvertently pulled when anesthesia tapes your eyes. Remove acrylic/gel nails and trim your nails short. You will need to clean your breasts and incisions after surgery. Having long nails can harvest lots of bacteria that can transfer onto your breasts! Nail polish also makes it difficult to get an accurate read on your oxygen levels during surgery. Once everything is healed, schedule an appointment to get your nails done again ;)

10. Have Food Ready. It’s time to hunker down and accept the fact that you probably won’t be leaving your house much for the next week. Have some light, ready-made food easily available, as well as a few pre-made meals. Place them on lower shelves and cabinetry, since you won’t be able to reach over your head after surgery. Purchase some Ensure or Boost protein drinks for those days when you’ll have little to no appetite.

There you have it! The top ten most mentioned tips you’ll need to know before the big day. For those who are ultra-prepared, here are a few extra useful secrets to help get you by.

Who is an ideal candidate for nose filler (non-surgical rhinoplasty)?

Who is the ideal candidate for non-surgical rhinoplasty? 👃🏼💉

An ideal candidate is a patient who:

- wants to improve the appearance of their nasal bump
- has a tip that plunges and drops down when they smile
- has a shorter, smaller nose and wants more volume and a taller bridge

⚠️ Disclaimer: Dr Usha Rajagopal has over 20 years of experience with treating the nose inside and out. This type of procedure should only be performed by an expert injector with a great amount of experience and understanding of nasal anatomy.

Top 3 Non-Surgical Butt Lift Treatments in San Francisco

Non-surgical butt lifts are becoming increasingly popular, as they can enhance projection, accentuate your natural curves, and fill in hip-dips without the downtime of surgical procedures. These non-surgical options are quick, relatively painless, and create long-lasting results. There are two different options for non-surgical butt lift: biostimulatory injectables (Sculptra and Radiesse), and Emsculpt. 

Emsculpt Butt Lift

Emsculpt is one of our most popular treatments. It is the first non-invasive FDA-approved treatment for lifting and strengthening the gluteus muscles. This uses High-Intensity Focused Electromagnetic (HIFEM) technology to stimulate supramaximal contractions, creating muscle volume (increased tone). Clinical trials showed an average of 16% increase in muscle growth after four 30-minute treatments spaced 2-7 days apart. Immediately after the procedure, you may notice enhanced strength and tone, but it takes about 4-8 weeks for the final results to develop. The only downside? If you are pregnant, breastfeeding, or have a copper IUD/metal in your body, unfortunately, you would not be a candidate. 

There are other options to consider, though! 

In our office, we are happy to announce that we now offer two biostimulatory injectables for the non-surgical butt lift: Sculptra, and Radiesse. Both are dermal fillers that contribute to volume restoration and skin rejuvenation. Unlike hyaluronic acid dermal fillers, Sculptra and Radiesse work to increase our body’s natural collagen production. Therefore, it will take some time to see your results! 

Sculptra Butt Lift

Sculptra is made of poly-L-lactic acid. This dermal filler triggers an inflammatory response, stimulating the production of Type 3 (reticulate) collagen and scar tissue to lift and tighten the buttocks. Most individuals will require three treatments spaced 2-3 months apart for optimal results. 

Radiesse Butt Lift

Radiesse is made of calcium hydroxyapatite. This dermal filler initially stimulates the production of Type 3 collagen as well as elastin, and later stimulates the production of Type 1 collagen, which is most commonly found in our skin and tendons. Most individuals will require three treatments spaced 2-3 months apart for optimal results. 

What does a treatment look like?

When you come to the office for this treatment, you will topically numb for 30-45 minutes. The procedure will then be performed using a cannula for optimal comfort, to produce minimal bruising, and allow for precise product placement. The product will be massaged to stimulate the body’s response and lymphatic drainage, and then you get to go home! 

What is the downtime?

We typically advise our patients to avoid exercising for 24 hours post-procedure. These products do require a home massage; Sculptra requires a five-minute massage five times daily for five days, whereas Radiesse requires a five-minute massage twice daily for five days. 

You may have some swelling and bruising around the injection sites, which is normal. The product may initially feel lumpy and uneven, which is normal.

How long will it take to see results?

It typically takes 2-3 months to see the results of neo-collagenesis (new collagen production). Most individuals will require 2-3 treatments spaced about 2-3 months apart to see their optimal results. 

Can you quantify my expected results?

Unfortunately, no. These are biostimulatory agents, meaning they depend on your body’s ability to respond to the dermal filler and stimulate your own collagen production. It is always recommended to continue living a healthy, active lifestyle. 

How long will my results last?

Sculptra’s butt lift lasts 2-3 years on average, however it may last up to 5 years in some individuals. The Radiesse butt lift can last 2-5 years. The product longevity varies based on patient metabolism.

Which product is right for me?

It comes down to the patient’s goals and injector preference. The product used on each patient is a shared decision between the patient and provider. 

What are the contraindications?

Pregnancy, breastfeeding, allergy to poly-L-lactic acid or calcium hydroxyapatite or other inactive ingredients, or history of keloid or hypertrophic scar formation.