Fine lines, wrinkles and other unwelcome signs of aging can now be treated using non-invasive and minimally invasive techniques. Botox, Fraxel laser, and other treatments can provide natural, refreshing results, right in the doctor's office!
Get an overview of these techniques and more with Reza Momeni, MD, board-certified plastic surgeon with Summit Medical Group.
Selected Podcast
Non-invasive Procedures in Plastic Surgery
Featured Speaker:
Reza Momeni, MD
Board-certified plastic surgeon, Reza Momeni, MD, has expertise in cosmetic surgery of the face and body, as well as extensive experience in hand surgery and cancer reconstruction. To achieve natural and functional results that enhance his patients’ lives, Dr. Momeni consults with patients to understand their needs and provides honest and personalized recommendations to each patient, keeping treatment safety and effectiveness in mind. Dr. Momeni is particularly interested in minimally invasive aesthetic techniques and nonsurgical facial rejuvenation using Botox®Cosmetic, Juvederm®, SculptraTM, Fraxel®, and Thermage®. Transcription:
Non-invasive Procedures in Plastic Surgery
Melanie Cole (Host): Have you noticed the little lines around your eyes or some sagging skin but you’re just a little bit too nervous to go in for surgery and you’d like some non-invasive procedures, things that can be done in the office and you’ve wanted to look into Botox and fillers? Well, my guest is Dr. Reza Momeni. He is a board certified plastic surgeon with the Summit Medical Group. Welcome to the show, Dr. Momeni. Let’s talk first about non-invasive procedures for cosmetics that can change the way that you feel about yourself, change the way that you look, and that are not quite as scary as people might imagine.
Dr. Reza Momeni (Guest): Hello, Melanie. It’s a great pleasure to be here. It’s also really exciting to be able to talk about some of these new things that have become not only more popular but also safer and safer as time has gone on over the past 10 years or so. Let’s talk about maybe a typical patient that comes in to see us. Our patients are about 85 to 90 percent women, but we also have a lot of men patients. Increasingly, we have patients who are not just the privileged, not your usual typical suspects you might think about who might ask for plastic surgery but regular working people who want to look as rested as they actually feel. A common thing we sometimes we hear from a patient is they say to us, “You know, I feel great, but my face doesn’t reflect it. People ask me why I’m frowning all the time, or people ask me if I’m sad or if anything is wrong.” It’s nice for us to be able to have some of these tools so that without surgery we can get a patient’s outside to reflect their happy inside. To be a little bit more specific about your question, we have a lot of things available now, and it’s nice if we’re going to talk about this to break it into several categories, and then perhaps we can talk about each one of those categories for a minute or two. The one item that everybody has heard about is Botox. Botox has been around for 30 or 40 years now in some fashion, but it was only year 2000 when the FDA approved Botox for cosmetic use. The indication that it was approved for was the glabellar lines. Glabella is that vertical frown line. Some people call it their eleven, right in between the eyebrows, those vertical lines you get when you frown. Off-label use of Botox is also very common, and it’s important for patients to understand what off-label and on-label use means. Using Botox for other lines around the face is considered off-label use, but it’s perfectly legal. And as long as it’s done under the care of a practitioner, a plastic surgeon, or a dermatologist who is board certified and knows what they’re doing and is prescribing the medication in the way that is appropriate for that patient, it is perfectly safe to do.
Melanie: Okay. Botox, people are hearing about it where stars are coming right out and talking about it. First question, does it hurt? And other injectables, things that you’re doing that we see results almost immediately and that can last for a little while, do they hurt? Doesn’t everybody want to know this?
Dr. Momeni: Of course, we do. And would I not be lying if I said they don’t hurt? They hurt a little bit. But people have had shots before. The pain of the shot really depends on how the doctor’s delivering it and what level of finesse is involved and whether or not we do little extra bits to try to minimize the discomfort. So, one of the nice things about Botox is that it’s a fairly small molecule, and you don’t need very large needles to inject it. In our office, for example, we order the smallest needle that people make, an insulin needle, and we inject Botox with an insulin needle. We also use a couple of little tricks like putting cold space on the area and putting numbing medications over the area that we’re going to inject to try to make sure that there’s not a lot of discomfort when we inject it. Most patients may have a little transient discomfort maybe for a second or two with each injection, but the entire injection episode takes no more than 10 or 15 minutes. Usually, in two to seven days, patients have a really nice, visible, refreshing result, and we try to do it as naturally as we can so that hopefully, it doesn’t look like some of the celebrities you might have seen where they cannot really move their face. If it’s done right, it should look very, very refreshing and, in fact, very natural.
Melanie: What about some laser services that are available at Summit Medical Group? Laser is also so new and so exciting. Speak about what people can do to make themselves feel a little fresher with some laser services.
Dr. Momeni: Laser services are another really exciting area in plastic surgery and dermatology. At the medical group, we have two fantastic departments to collaborate together. Our dermatology department and our plastic surgery department both work with lasers. The lasers that we have to offer come in several categories. I’ll mention three of them because I think those are the ones that will matter the most for your listeners. One of the lasers that we use is the Fraxel treatment. The Fraxel treatment is a device that is used to try to delivery energy to the surface of the skin, and its target is those unwanted brown spots and sun damage and the fine little wrinkles that a lot of patients will see over time if they have a lot of sun exposure. Obviously, the more light complexioned the patient is, the more likely it is that they will have these. But we even have patients who are of Latina origin or they might be of Asian origin who may have a lot of these spots. Fraxel laser’s a godsend with these treatments. The typical downtime is two to four days, and the typical treatment is two to four cycles, but most patients can expect to have 50 or 60 or even 70 percent improvement in those areas that are essentially permanent improvements. Really exciting. Second area of laser that I’ll mention to you is something called the Vbeam pulsed dye laser. I know that’s a mouthful. Think of this as the laser that we use for the little blood vessels around the face. A lot of patients will come and tell us about these tiny little red blood vessels that they have around the nose or around the mouth. Some of them are induced by the sun. Some of them are familial. Sometimes patients see them more if they drink a glass of wine. And the pulsed dye laser is a fantastic tool to use, and the good news about it is that usually one or two treatments take care of the job. The third laser that I’ll mention is not really for the face but can be used for the face. This is a hair-removal laser. A lot of patients have a thousand tricks up their sleeves about removing hair where they don’t want the hair to be growing, but certainly, for facial hair in areas where ladies may not want the hair or even for body hair where men and women don’t want the body hair to grow, the hair-removal lasers are a fantastic tool.
Melanie: Now what about chemical peels? People are afraid they’re going to look like a melting candle. Back in the day, I remember elderly aunts not coming out of the house for weeks when they did something like that. But it’s different now, isn’t it?
Dr. Momeni: I think you just described two of my aunts. Just to be serious about it, yes. Chemical peels are used in very much the same way as we use lasers. Now, chemical peels are much older if you go back in the history of the literature of cosmetic surgery and plastic surgery. In some form or another, people have known about chemical peels probably for hundreds of years if you go back into the literature. But chemical peels are very, very helpful. In the right hands, they can be very safe. One thing that I would caution your listeners about is that, both with lasers and with chemical peels, you will probably find a lot of people, even in the corner store or the strip mall around the corner, that will deliver some of these treatments, but you should always check people’s credentials and be sure that they have the right experience and they know how to treat problems that may come up with these. Thankfully, problems are not very common, but certainly, you wouldn’t want to be at a place where they don’t know how to treat their own complications. But to answer your question about chemical peels, chemical peels are particularly good at removing fine wrinkles. One of my favorite places to use chemical peels is around the eyes, where a lot of times patients will get little crow’s feet and little wrinkles around the lower eyelids. There’s actually not a lot of surgery for those, so all the surgery in the world will not treat those fine wrinkles but a chemical peel done right will do wonders for it.
Melanie: That’s amazing. I know every woman listening is right now writing all of this down. Now, if we’re afraid of full-on surgery, there are other little procedures, things that can be done in the office. Speak about a few of those in the last minute and a half or so.
Dr. Momeni: Sure. I won’t belabor this too much, but let’s just say that we have a lot of patients who do wish to have more improvement than the non-invasive treatments can offer. But at the same time, what they’re really worried about is anesthesia and going under and going into a hospital. Thankfully, because we’ve set up our office safely enough and we’ve done a lot of planning, there are a lot of smaller surgical procedures that we can do in our office under local anesthesia so that the patients don’t have to have anesthesia. They don’t have to go to sleep, and we can just numb up the area we’re taking care of. The most common area that we take care of in this fashion are the facial areas. For upper eyelids, we can do eyelid tucks, eyelid lifts. In our parlance, it’s called the blepharoplasty, and that can be done very nicely, very easily and safely with local anesthesia. Another favorite for a lot of our patients is fat grafting, where we take fat with small needles from the abdominal area or the love handle areas, and we’ll use that fat as your own natural filler for the face so that we can volumize and we can perk up those areas of the face that may have lost their fat over time and they’d be looking sagging or aged.
Melanie: These procedures, do they last for just a little while? We only have a minute left, Dr. Momeni, but do they last for a while? Are they something that people have to have redone at some point?
Dr. Momeni: Well, I’ll go briefly over the ones we’ve talked about. Things like Botox and fillers will last anywhere between three months and 12 months depending on the product. A laser procedure or a peel will be forever effective. Now, if somebody gets more sun damage or more aging, certainly, all will add on, but it’s always better than if you’ve never done it. And then the mini surgical procedures, like an upper eyelid lift or fat grafting, are, again, good forever. Now, that’s not to say that you don’t continue aging—the clock is always ticking—but certainly, it’s one major dent that you take in the time.
Melanie: That’s fantastic news. Thank you so much, Dr. Reza Momeni, board certified plastic surgeon with Summit Medical Group. For more information, you can go to summitmedicalgroup.com. You can find out all about their various surgeries and cosmetic procedures and non-invasive procedures, Ultherapy, and injectables and lasers. It’s really quite amazing if you want to give yourself a real freshening up. This is Melanie Cole for SMG Radio. Thanks for listening.
Non-invasive Procedures in Plastic Surgery
Melanie Cole (Host): Have you noticed the little lines around your eyes or some sagging skin but you’re just a little bit too nervous to go in for surgery and you’d like some non-invasive procedures, things that can be done in the office and you’ve wanted to look into Botox and fillers? Well, my guest is Dr. Reza Momeni. He is a board certified plastic surgeon with the Summit Medical Group. Welcome to the show, Dr. Momeni. Let’s talk first about non-invasive procedures for cosmetics that can change the way that you feel about yourself, change the way that you look, and that are not quite as scary as people might imagine.
Dr. Reza Momeni (Guest): Hello, Melanie. It’s a great pleasure to be here. It’s also really exciting to be able to talk about some of these new things that have become not only more popular but also safer and safer as time has gone on over the past 10 years or so. Let’s talk about maybe a typical patient that comes in to see us. Our patients are about 85 to 90 percent women, but we also have a lot of men patients. Increasingly, we have patients who are not just the privileged, not your usual typical suspects you might think about who might ask for plastic surgery but regular working people who want to look as rested as they actually feel. A common thing we sometimes we hear from a patient is they say to us, “You know, I feel great, but my face doesn’t reflect it. People ask me why I’m frowning all the time, or people ask me if I’m sad or if anything is wrong.” It’s nice for us to be able to have some of these tools so that without surgery we can get a patient’s outside to reflect their happy inside. To be a little bit more specific about your question, we have a lot of things available now, and it’s nice if we’re going to talk about this to break it into several categories, and then perhaps we can talk about each one of those categories for a minute or two. The one item that everybody has heard about is Botox. Botox has been around for 30 or 40 years now in some fashion, but it was only year 2000 when the FDA approved Botox for cosmetic use. The indication that it was approved for was the glabellar lines. Glabella is that vertical frown line. Some people call it their eleven, right in between the eyebrows, those vertical lines you get when you frown. Off-label use of Botox is also very common, and it’s important for patients to understand what off-label and on-label use means. Using Botox for other lines around the face is considered off-label use, but it’s perfectly legal. And as long as it’s done under the care of a practitioner, a plastic surgeon, or a dermatologist who is board certified and knows what they’re doing and is prescribing the medication in the way that is appropriate for that patient, it is perfectly safe to do.
Melanie: Okay. Botox, people are hearing about it where stars are coming right out and talking about it. First question, does it hurt? And other injectables, things that you’re doing that we see results almost immediately and that can last for a little while, do they hurt? Doesn’t everybody want to know this?
Dr. Momeni: Of course, we do. And would I not be lying if I said they don’t hurt? They hurt a little bit. But people have had shots before. The pain of the shot really depends on how the doctor’s delivering it and what level of finesse is involved and whether or not we do little extra bits to try to minimize the discomfort. So, one of the nice things about Botox is that it’s a fairly small molecule, and you don’t need very large needles to inject it. In our office, for example, we order the smallest needle that people make, an insulin needle, and we inject Botox with an insulin needle. We also use a couple of little tricks like putting cold space on the area and putting numbing medications over the area that we’re going to inject to try to make sure that there’s not a lot of discomfort when we inject it. Most patients may have a little transient discomfort maybe for a second or two with each injection, but the entire injection episode takes no more than 10 or 15 minutes. Usually, in two to seven days, patients have a really nice, visible, refreshing result, and we try to do it as naturally as we can so that hopefully, it doesn’t look like some of the celebrities you might have seen where they cannot really move their face. If it’s done right, it should look very, very refreshing and, in fact, very natural.
Melanie: What about some laser services that are available at Summit Medical Group? Laser is also so new and so exciting. Speak about what people can do to make themselves feel a little fresher with some laser services.
Dr. Momeni: Laser services are another really exciting area in plastic surgery and dermatology. At the medical group, we have two fantastic departments to collaborate together. Our dermatology department and our plastic surgery department both work with lasers. The lasers that we have to offer come in several categories. I’ll mention three of them because I think those are the ones that will matter the most for your listeners. One of the lasers that we use is the Fraxel treatment. The Fraxel treatment is a device that is used to try to delivery energy to the surface of the skin, and its target is those unwanted brown spots and sun damage and the fine little wrinkles that a lot of patients will see over time if they have a lot of sun exposure. Obviously, the more light complexioned the patient is, the more likely it is that they will have these. But we even have patients who are of Latina origin or they might be of Asian origin who may have a lot of these spots. Fraxel laser’s a godsend with these treatments. The typical downtime is two to four days, and the typical treatment is two to four cycles, but most patients can expect to have 50 or 60 or even 70 percent improvement in those areas that are essentially permanent improvements. Really exciting. Second area of laser that I’ll mention to you is something called the Vbeam pulsed dye laser. I know that’s a mouthful. Think of this as the laser that we use for the little blood vessels around the face. A lot of patients will come and tell us about these tiny little red blood vessels that they have around the nose or around the mouth. Some of them are induced by the sun. Some of them are familial. Sometimes patients see them more if they drink a glass of wine. And the pulsed dye laser is a fantastic tool to use, and the good news about it is that usually one or two treatments take care of the job. The third laser that I’ll mention is not really for the face but can be used for the face. This is a hair-removal laser. A lot of patients have a thousand tricks up their sleeves about removing hair where they don’t want the hair to be growing, but certainly, for facial hair in areas where ladies may not want the hair or even for body hair where men and women don’t want the body hair to grow, the hair-removal lasers are a fantastic tool.
Melanie: Now what about chemical peels? People are afraid they’re going to look like a melting candle. Back in the day, I remember elderly aunts not coming out of the house for weeks when they did something like that. But it’s different now, isn’t it?
Dr. Momeni: I think you just described two of my aunts. Just to be serious about it, yes. Chemical peels are used in very much the same way as we use lasers. Now, chemical peels are much older if you go back in the history of the literature of cosmetic surgery and plastic surgery. In some form or another, people have known about chemical peels probably for hundreds of years if you go back into the literature. But chemical peels are very, very helpful. In the right hands, they can be very safe. One thing that I would caution your listeners about is that, both with lasers and with chemical peels, you will probably find a lot of people, even in the corner store or the strip mall around the corner, that will deliver some of these treatments, but you should always check people’s credentials and be sure that they have the right experience and they know how to treat problems that may come up with these. Thankfully, problems are not very common, but certainly, you wouldn’t want to be at a place where they don’t know how to treat their own complications. But to answer your question about chemical peels, chemical peels are particularly good at removing fine wrinkles. One of my favorite places to use chemical peels is around the eyes, where a lot of times patients will get little crow’s feet and little wrinkles around the lower eyelids. There’s actually not a lot of surgery for those, so all the surgery in the world will not treat those fine wrinkles but a chemical peel done right will do wonders for it.
Melanie: That’s amazing. I know every woman listening is right now writing all of this down. Now, if we’re afraid of full-on surgery, there are other little procedures, things that can be done in the office. Speak about a few of those in the last minute and a half or so.
Dr. Momeni: Sure. I won’t belabor this too much, but let’s just say that we have a lot of patients who do wish to have more improvement than the non-invasive treatments can offer. But at the same time, what they’re really worried about is anesthesia and going under and going into a hospital. Thankfully, because we’ve set up our office safely enough and we’ve done a lot of planning, there are a lot of smaller surgical procedures that we can do in our office under local anesthesia so that the patients don’t have to have anesthesia. They don’t have to go to sleep, and we can just numb up the area we’re taking care of. The most common area that we take care of in this fashion are the facial areas. For upper eyelids, we can do eyelid tucks, eyelid lifts. In our parlance, it’s called the blepharoplasty, and that can be done very nicely, very easily and safely with local anesthesia. Another favorite for a lot of our patients is fat grafting, where we take fat with small needles from the abdominal area or the love handle areas, and we’ll use that fat as your own natural filler for the face so that we can volumize and we can perk up those areas of the face that may have lost their fat over time and they’d be looking sagging or aged.
Melanie: These procedures, do they last for just a little while? We only have a minute left, Dr. Momeni, but do they last for a while? Are they something that people have to have redone at some point?
Dr. Momeni: Well, I’ll go briefly over the ones we’ve talked about. Things like Botox and fillers will last anywhere between three months and 12 months depending on the product. A laser procedure or a peel will be forever effective. Now, if somebody gets more sun damage or more aging, certainly, all will add on, but it’s always better than if you’ve never done it. And then the mini surgical procedures, like an upper eyelid lift or fat grafting, are, again, good forever. Now, that’s not to say that you don’t continue aging—the clock is always ticking—but certainly, it’s one major dent that you take in the time.
Melanie: That’s fantastic news. Thank you so much, Dr. Reza Momeni, board certified plastic surgeon with Summit Medical Group. For more information, you can go to summitmedicalgroup.com. You can find out all about their various surgeries and cosmetic procedures and non-invasive procedures, Ultherapy, and injectables and lasers. It’s really quite amazing if you want to give yourself a real freshening up. This is Melanie Cole for SMG Radio. Thanks for listening.