Cosmetic Procedures:
Dr. Ting's philosophy regarding rejuvenation is based on achieving natural results by softening facial lines with minimal downtime. There are 4 fundamental issues that should be addressed to achieve complete rejuvenation:
Consistent with his emphasis in preventive medicine, Dr. Ting believes that strict daily sun protection in addition to a right mix of physician-strength cosmeceuticals form the foundation of aesthetic dermatology. He recommends a combination of minimally invasive cosmetic procedures to help you look your best.
#1 Over-activity of facial muscles is due to constant need for human beings to express themselves, stress of life, as well as familial traits. Involuntary contraction of facial muscles lead to dynamic wrinkles, particularly along upper half of the face as manifested by frown lines on the glabella (the 11's), forehead, and crows feet around the eyes. These dynamic wrinkles can be minimized by relaxing the affected facial muscles by an expert clinician injector such as Dr. Ting by precisely injecting right amount of Botox Cosmetic to the targeted areas. The Botox effect lasts typically 4-6 months. Make sure you ask your physician whether or not the Botox is freshly mixed on the day of the treatment.
#2 Loss of volume is due to prior sun damage, smoking, acne scarring and genetic predispositions. The resultant static wrinkles are seen as valleys and divots, prominently displayed along lower half of the face such as our smile lines along nasolabial folds, tear trough areas beneath the lower eyelids (causing dark circles due to optical shadowing), and marionette lines around the corners of the mouth. These static wrinkles can be softened by replenishing the lost volume with fillers.
- Non-animal stabilized hyaluronic acid (NASHA) such as Restylane or Juvederm is a versatile filler for nasolabial folds, marionette lines around corners of the mouth, lip augmentation, vertical ridges along lips and tear troughs under the eyelids. These NASHAs typically last 4-9 months. Restylane has been shown to stimulate collagen production over time.
- Perlane and Juvederm Ultra Plus are also NASHAs of slightly thicker caliber and are useful for facial contouring and reverse aging and discolored appearance of photodamaged hands. These NASHAs may last 6-12 months.
- Radiesse is a good option for individuals in need of cheek augmentation and/or more volume along nasolabial folds. Radiesse is made of calcium-based microspheres that are suspended in a natural gel and serves as a scaffold for further collagen production. Radiesse provides more volume than NASHAs and may last 9-18 months but has slightly greater potential for transient swelling and/or bruising.
- Dr. Ting does not endorse permanent fillers due to long term nature of adverse events, though rare, and that people's preference of certain facial contour may change over time.
- Filler injection is absolutely operator and technique-dependent and one should not shop by price alone. Filler injections should be performed by a board-certified dermatologist or plastic surgeon.
#3 Textural and pigmentary disparities can be minimized by enhancing sun protection efforts and right combination of cosmeceuticals. However, more often than not, minimally-invasive procedures are needed to gently slough off the aging and discolored skin cells. Fractional CO2 laser is the latest and most efficacious modality to achieve thorough resurfacing of the skin and to stimulate collagen formation. According to WebMD, Fractional CO2 laser is the Number 1 antiaging breakthrough in year 2007. Fraxel and Pearl lasers have the right idea but the wrong wavelengths and the clinical results are typically suboptimal even after several treatments compared to one treatment of the Fractional CO2 resurfacing laser. Other procedures to consider include TCA chemical peels and/or microdermabrasion. Intense pulse light (IPL) fotofacial laser remains very useful to treat facial redness and excessive pigment.
#4 Sagging of the face and neck is something that all of us will have at some point of our lives. However, early intervention involving consistent sun protection and tightening achieved by Fractional CO2 resurfacing laser may help to postpone the need for invasive plastic surgery face/neck lift procedures for years. Though increasingly popular, radiofrequency-based devices are quite painful, lack consistent measurable, meaningful results and any clinical benefits may be short-lived.
Liposuction remains the gold standard that offers immediate and gratifying reduction of adiposity so one can fit into clothing much more comfortably. Tumescent liposuction refers to a technique that uses large volumes of very dilute local anesthesia that is injected into the fat causing the targeted areas to be come tumescent, or swollen and firm. Local anesthesia is widely regarded as the safest form of anesthesia. Because local anesthesia persists for many hours there is no need for narcotic pain medications after surgery.
- No general anesthesia
- Less painful, more pleasant due to long lasting local tumescent anesthesia
- Smoother liposuction results due to use of Microcannula
- Minimal blood loss due to vasoconstriction from large volumes of very dilute local anesthesia
- Quick recovery, back to work in 3-4 days
Dr. Ting is expertly trained by Dr. Jeffrey Klein (who invented tumescent liposuction) in the art and sciences of lipo-sculpturing of the neck, arms, chest (breast reduction for men), abdomen, flanks (love handles), back rolls, hips, thighs and knees.