THE HEAD…Hair Replacement
• Flap surgery: A bald area of scalp is removed, and a thin flap of hair-bearing scalp is sutured to the site while remaining tethered to the original blood supply. The flap gradually attaches and grows where the bald area had been.
• Hair grafts: Small sections of hair are implanted in bald or thinning areas to increase density. Micro-grafts involve one or two hairs; mini-grafts involve two to four hairs; round punch grafts involve 10 to 15 hairs; slit grafts insert four to 10 hairs into slits created in the scalp; strip grafts are long and thin and contain 30 to 40 hairs.
• Follicular unit transplantation (hair transplants): Small pieces of hair-bearing scalp grafts are taken from the sides or back of the head and relocated to bald or thinning areas.
• Scalp reduction: Hair-bearing scalp flaps are brought forward to reduce the appearance of a bald crown.
• Tissue expansion: A balloon-like device is inserted under hair-bearing scalp near a bald area and gradually expanded to provide grafts for the bald area.
• Laser hair restoration: Often used in combination with hair stimulants to prevent further hair loss and increase fullness by improving blood flow to existing hair follicles.
• Hair stimulants: Medications like Rogaine that help regenerate hair if used consistently and at first signs of hair thinning.
• Hair systems: High-tech variations on hairpieces that are invisibly secured to the head. Monthly service visits keep them firmly attached.
• Rhytidectomy (face-lift): A surgical procedure that improves sagging facial skin and loose neck skin by removing excess fat, tightening muscles and re-draping soft tissues.
• Deep-plane rhytidectomy: A surgery that also corrects deep nasolabial folds by dissecting the fat layer more completely off the muscle and re-draping the skin.
• Mini-lift: This targets areas of the face that may be aging before others and can also refer to a brow lift and lower face-lift.
• Lifestyle Lift™: A mini-lift in which the muscle is pleated and the skin re-draped, done through incisions at the ear.
• Thread lift: A non-surgical procedure that involves ‘threading’ six to 18 barbed sutures into deep soft tissue to lift and compress, creating a smoother appearance.
The Forehead and Brow
• Forehead lift (brow lift): Cosmetically corrects drooping brows and upper eyelids as well as sagging skin on the forehead. Usually an outpatient procedure, it typically involves an incision at the top of the head just behind the hairline.
• Endoscopic brow lift: A less invasive forehead lift, done with an endoscope inserted through three to five very short incisions.
• Botox: A purified form of the Clostridium botulinum toxin injected into the muscles to temporarily reduce contraction. It is a temporary treatment for frown lines between the brows and lasts for several months.
• Dysport (Reloxin): Using the same active ingredient as Botox, it treats forehead wrinkles and frown lines.
Eyes and eyelids
• Blepharoplasty (eyelid surgery): A surgical procedure that improves upper and lower eyelids by repositioning fat deposits, removing excess skin and tightening muscle. Incision scars are hidden in natural eyelid creases, lash-lines or inside the lower lid.
• Rhinoplasty (nose job): Reforming nose size, shape or nostrils.
• Fillers (see ‘cheeks’): The use of facial fillers, such as Radiesse, to raise the bridge of the nose, reshape the tip and camouflage bumps.
• Otoplasty: Re-positioning prominent ears closer to the head or reducing their size. Most often performed on children, it may require two procedures on adults.
• Fillers (dermal fillers/injectables): Inert substances in a variety of consistencies that are injected under the skin to plump up troughs and wrinkles and give the skin a smoother appearance. These include:
• ArteFill: Approved by the FDA in 2006 to diminish nasolabial folds, it is composed of 75 percent collagen and 25 percent polymethylmethacrylate microspheres (PMMA). Effects may last a decade or more.
• Juvederm: A hypoallergenic, hyaluronic acid filler used to fill wrinkles and restore facial volume. Typically lasts six months.
• Restylane/Captique/Hylaform/Perlane: Used to smooth facial folds and wrinkles around the mouth and eyes with results lasting about six to nine months.
• Prevelle Silk: This includes lidocaine, an anesthetic that provides pain relief at the injection site, making it ideal for sensitive areas such as the lips.
• Collagen (CosmoDerm/CosmoPlast): A naturally occurring protein, collagen can help restore a smoother, more youthful-looking appearance by filling in lines and creases.
• Sculptra: A suspension of poly-L-lactic acid particles, the same material as some dissolvable sutures, that causes the body to form a collagen scar capsule around it, extending its effect for up to two years.
• Radiesse: A firm filler made from calcium hydroxyapatite most used for filling in hollowness and bony defects. Results last for a year or more.
• Evolence: Made from porcine collagen, this formulation minimizes post-injection swelling and bruising and lasts up to a year.
• Filler Cocktails: A combination of different substances.
• Autologous fat injections (fat transfer): See lips. Good, long-lasting results.
• Cheek implant: A surgical procedure in which small implants are inserted beneath the skin to create a fuller appearance.
• Collagen: A naturally occurring substance in the body that requires no allergy testing.
• Autologous fat injection (fat transfer): Fat from another part of the body – usually the abdomen, thighs or buttocks –purified and injected into the lips. It lasts up to two years, and part of it will be permanent.
• Botox: Used at the corners of the mouth to prevent depressor muscles from pulling down.
• Laser whitening: A bleaching gel is applied to the teeth and activated by laser heat.
• Composite bonding: Fillings that have the same color as natural tooth surfaces.
• Dental veneers: Made of composite or porcelain and bonded to the front and/or biting surface of the tooth to fill in gaps or lost heights or to give teeth a more even appearance.
• Crowns: Coverings over teeth that have been reduced in size or over a dental implant.
• Dental implants: Posts inserted and integrated into the jawbone used as a foundation for a permanent bridge.
• Invisalign®: Clear trays that fit over the teeth to straighten them by gradually changing the spacing.
• I-Braces®: Fit on the backsides of the teeth, they are invisible from the front.
• Inlays/Onlays: Made from porcelain or composite materials and used to restore teeth that have decay or structural damage. These are created in a dental laboratory before being fitted and adhesively bonded into place.
• Mentoplasty (chin surgery): A surgical procedure to reshape the chin either by enhancement with an implant or reduction of the bone.
• Chin implants: A soft silicone material used to add subtle projection to the chin.
Skin and Wrinkles
• Cosmeceuticals: A term that combines ‘cosmetics’ and ‘pharmaceuticals’ for products not regulated by the FDA. Applied like cosmetics, they contain ingredients that may influence the biological function of the skin.
• Chemoprevention: The use of topical or oral agents to help decrease skin cancer risk.
• Tattoo removal: The use of lasers, dermabrasion or excision to remove tattoo ink. In laser removal, the ink absorbs the laser energy, breaks down and is removed by the body’s lymphatic system. Dermabrasion ‘sands away’ layers of skin; surgical excision removes the tattooed skin with a scalpel.
• Skin resurfacing or rejuvenation: Catch-all phrases for chemical peels, microdermabrasion and laser skin resurfacing. The outer (dead) layer of skin cells and varying portions of the underlying dermal layer are removed to eliminate age spots, fine wrinkles and other sun damage.
• Chemical peels: Chemical compounds applied to the skin to remove the outer layers. These can destroy pre-cancerous skin growths, soften acne facial scars, reduce uneven pigmentation and control acne. Common chemical solutions include:
• Alpha hydroxy acids (AHAs): Known as ‘light peels’ and derived from fruit and milk acids.
• Trichloroacetic acid (TCA): ‘Medium peels’ remove deeper wrinkles and precancerous lesions but can leave skin red for up to a week.
• Phenol: ‘Deep peels’ are used to treat coarse facial wrinkles, skin damaged by sun exposure or precancerous growths and are not recommended for dark-skinned individuals. Can require several months of skin recovery.
• Laser resurfacing: Used to reduce wrinkles, acne scars and pigmentation by concentrating heat on the skin cells. Usually done under local anesthetic, it may require IV sedation. Redness may last for several months, but the effects last for years.
• Intense pulsed light (IPL): Treats photo aging of the face, chest and hands, wrinkles, rosacea, and vascular lesions like spider veins and unwanted hair.
• Fotofacial RF Pro: A treatment that uses Intense Pulsed Light (IPL), Infrared (IR), laser and/or radiofrequency (RF) energy, combined in the same pulse. Invisible micro-injuries repair themselves by producing new collagen, which over time smoothes and softens wrinkles and decreases pore size and textural irregularities.
• Microdermabrasion: A highly controlled spray of fine crystals on the skin that removes dead cells and leaves the skin looking more radiant.
• Fractionated laser treatment: A series of microscopic, closely spaced laser spots applied to about 20 percent of the skin resulting in fast recovery and good results in wrinkle and acne scar removal and texture improvement. Brand names include Fraxel and Pixel.
• Non-ablative (cold) laser: Cold or low-level lasers that use light energy to stimulate collagen remodeling and/or remove irregular pigmentation and enlarged blood vessels without downtime.
• SkinTyte™ Sciton ST: Infrared light energy that delivers heat below the skin’s surface for increased tissue tightening.
• Thermage: Heating deep layers of skin with radio waves while the skin’s surface is cooled simultaneously. The heat encourages collagen formation, resulting in a gradually tighter appearance. Results can be dramatic.
• Physician-directed skin care: A term used to describe a complete skin care program involving individually selected procedures and products based on a patient’s skin type and goals.
• Laser hair removal: A laser generates a single wavelength of light absorbed by the color, or melanin, in the hair follicle causing the hair to fall out in one to seven days. Effective only on hair in the active growth phase, it requires four to six treatments.
• Electrolysis: A tiny electrode grasps the single hair and sends an electrical current into the follicle to kill it.
• Chemical depilatories: Dissolves hair via a highly alkaline chemical, usually calcium thioglycolate, that dissolves the protein structure. May cause a rash or irritation.
• Vaniqa: A prescription cream that retards new hair growth by prohibiting production of a key enzyme.
• Mammoplasty: Any reconstructive or cosmetic surgical procedure that alters the size or shape of the breast.
• Breast augmentation: Surgery that increases breast size.
• Augmentation mammoplasty: Enhances breasts using saline or FDA-approved, silicone-filled implants.
• Mastopexy: Also called a breast lift, this removes excess skin in order to lift sagging breasts.
• Liposuction: Also known as lipoplasty or suction-assisted lipectomy, uses a cannula to break up and suction fat. Tumescent liposuction targets fat cells by infusing them with saline solution adding a local anesthetic to reduce bruising and swelling.
• Ultrasound-assisted liposuction (UAL): Uses sound waves to loosen fat, making it easier to remove.
• Pulsed ultrasonic liposuction (pUAL): Cycles power on and off very quickly, reducing treatment risk. Micro-pulsed ultrasonic liposuction uses very small (2mm) diameter probes to allow treatment in the cheeks, jowls or neck and to collect fat for fat injection.
• Power-assisted liposuction (PAL): A new technology in which the tip of the suction tube vibrates at a rapid speed to loosen fat cells so they can be suctioned with less trauma to surrounding tissues.
• Lipodissolve: Involves injecting small amounts of chemicals to break down fat cells so the body’s lymphatic system and bloodstream can cart them away. Studies are underway to determine where the fat goes; some practitioners suspect the bloodstream carries it to another area of the body.
• LipoLite: Radiofrequency energy heats up fat tissues, collapsing them so they can be metabolized. If the person gains weight, fat will return because the cells don’t die, but the treatment can make a difference of 1 to 2 inches or more.
• Fat transfer: Harvests fat from the hips, thighs, buttocks or abdomen via liposuction, followed by purification of the fat and injection into lips, cheeks or other areas that require fullness.
• Body implants: Once only available for breasts, implants are now also used to contour the buttocks, chest, calves and biceps.
• Panniculectomy: A surgical procedure used to remove excess skin and fat from the lower portion of the abdomen, generally beneath the belly button often performed after significant weight loss.
• Acoustic wave therapy: Sound waves sent through the skin and fat to induce vibration in the connective tissue, leading to increased vascularization and the creation of a new, thickened band of collagen in the upper and mid portions of the skin. The result is a smoother appearance.
• Abdominoplasty (tummy tuck): Flattens the abdomen by removing excess fat and skin and tightening the muscles of the abdominal wall, usually through an incision below the bikini line from hip to hip.
• Brachioplasty (arm lift): Removes flabby skin and fat deposits from the back of the upper arm.
• Thigh lift: Reduces excess skin and fat from the thighs and knees in order to create a smooth, taut leg.
• Body lift: Also called a circumferential body lift, this may involve a tummy tuck, thigh lift and buttock lift through an incision around the body starting at the bikini line in the front. Often performed after significant weight loss.
• Cellulite: A condition affecting more than 90 percent of adult women, even slim ones, in the thighs, buttocks, hips, breasts and abdomen, it refers to lumpy fat deposits that result in an uneven, dimpled appearance.
• VelaSmooth: Approved by the FDA, this non-invasive medical device delivers bi-polar radio frequency (RF) and optical energy (either laser or light) along with negative pressure (vacuum) and tissue manipulation to temporarily decrease the appearance of cellulite. Some patients also report that the procedure provides relief from muscle aches.
• Bra-line back lift: Removes rolls of fat and excess skin from the back. The incision is hidden under the bra-line.
• Spider veins: There are several ways to treat vein problems, including IPL and laser treatments for small veins, especially on the face.
• Varicose veins: These are enlarged, twisted veins with valves that don’t work effectively, causing blood to pool in lower extremities resulting in ‘rope-like knots.’
• Sclerotherapy: Used on small varicose and spider veins, a solution (generally saline) is injected into the vein to make it collapse.
• Stab phlebectomy: Multiple small stab punctures performed on an outpatient basis under local anesthesia. With special hooks, the varicosities are extracted through the punctures. When fully healed, no scars are visible.
• Endovenous laser ablation: A thin catheter is placed into the saphenous vein through a pinprick incision. The radiologist applies heat, causing the vein to collapse.
• Radiofrequency occlusion: Treats varicose veins by heating them, causing the vein to contract and then close, a newer alternative to phlebectomy (vein stripping).