These days we have a much greater assortment of of safe and effective dermal fillers to choose from. Fillers can be injected into the lines that travel from your nose to each side of your mouth or fill-in areas that have lost volume, such as thinning lips and those deep furrows that develop between the eyebrows. Having any of these areas injected can take years off the face. It may even allow you to postpone cosmetic surgery for a while.

All these new fillers can be used quickly, in an outpatient setting, and you’ll look great almost immediately. Of course the downside is, fillers are temporary (lasting anywhere from a few months to a year), and some patients experience minor bruising and swelling.

The question many people want answered is: “Which one should I choose?”

The majority of the new fillers (not all) are made from Hyaluronic Acid, a natural substance found in the body. Below is a list and brief description of 5 dermal fillers that are available only from qualified practitioners:

1. Restylane – a hyaluronic acid based filler touted as “the world’s best-selling dermal filler.” It is used for correcting moderate facial wrinkles and folds.
2. Perlane – very similar to Restylane, it is designed primarily for treating deeper and more severe wrinkles and folds.
3. Radiesse – this thick compound is made with (natural, biocompatible) calcium based microspheres in water based gel.
4. Juvederm – Like Perlane, this popular filler is designed for treating deeper wrinkles and restoring volume to the face. It’s been called the “liquid facelift” treatment.
5. Evolence – one of the newest and best fillers on the market, Evolence is made with purified porcine collagen. It helps create plumper cheeks and lips, and has a reputation for quick results and minimal bruising.

If you’re pursuing a treatment of this type, you should choose a surgeon you trust and one who operates a practice that makes you feel comfortable. Remember, the use of injectables is an art, not just a science. If you want more information about fillers, or need help choosing the proper brand, contact us at the Las Vegas office of Dr Pancholi.

Those interested in cosmetic and facial plastic surgery first go through a sort of ‘lifestyle makeover,’ modifying their habits until they have reached a set goal. At Cosmetic Surgery of Las Vegas, we want our patients to have the best surgical experience and outcome possible, so we ask them to focus on being healthy first. The ideal patient refrains from smoking or using illegal drugs, has a stable weight, and realistic expectations about cosmetic surgery.

Contact us for a consultation and we can provide more specific information on health and surgery outcomes.

The value of social media for our surgical practice (this blog for example) is found in education, and in opening the channels for further correspondence. We want to let the community know what we’re doing and how we might be of service.

Dr. Christian Sinclair, who maintains a blog about palliative care, tells the NYTimes, “I can help to inform the public, I can put the knowledge I have out there. And if there are patients or families who need this knowledge, I can help them because of this network.”

How else can surgeons and other physicians connect with prospective patients? When you’re seeking a physician with the right amount of expertise, getting out the yellow pages just won’t cut it anymore; it’s more convenient, and probably wiser, to get to know the doctor’s areas of expertise and surgical portfolio before scheduling, and traveling to, a consultation.

When it comes to the medical profession, the point is to provide a service, and for surgeons that service is actualized in the operating room. But that doesn’t mean surgeons shouldn’t augment the service they provide by using all the latest networking and communication tools this generation is so fortunate to have.

On the day of surgery, patients should expect a mild headache and some nasal congestion.

Although we don’t use any packing inside your nose, which allows easier breathing, some congestion is normal during the first week due to swelling inside the nose.  During this time we ask patients to keep the inside of their nose moist with a saline nose spray.  This also helps to gently wash the inside of the nose.  It’s also important during this time to refrain from doing anything that will increase your blood pressure or heart rate.  

A small splint is worn on your nose to help protect it for one week.  If the bones were moved, than some bruising around your eyes can occur, which typically goes away in 7-10 days.  

A significant amount of swelling gets resolved during the first 2 weeks.  The majority of it will be gone in the first 2 months.  After that you will see subtle changes in your nose as the healing continues.  The tip of your nose may feel slightly numb and tingly at first, but these sensations will improve and disappear over the next 6 months to a year.

As long as you follow our post-operation instructions, you can usually return to normal social activities at about 10-14 days.

Pronounced dis-port, the drug has been launched in the United States by Medicis Pharmaceutical and the French company Ipsen.  Dysport has been used by medical practitioners in the UK since 1991.

We’re excited to offer Dysport to the people of Las Vegas.  Given the immense popularity of Botox - a drug used in 2.4 million cosmetic procedures in the U.S. last year - we’re expecting great things.  

Cosmetic indications for Dysport include glabellar lines, i.e. forehead wrinkles.  For more information on this exciting new offering, contact us today.

Yes.  It can be difficult for your body to ease swelling around the nose.  After about 2 weeks, people you don’t know won’t even notice the swelling.  Those who see you daily may notice it 3 weeks after surgery (depending on how well they know your nose). Most people won’t examine your nose that closely and therefore, won’t understand why you look different.  They might think you’re just well rested, or perhaps that you’ve changed your hairstyle.  

You will likely notice it and feel it for about 3-6 months from surgery.  Rhinoplasty changes your nose quickly at first as most of the swelling goes away, and then it changes little by little throughout the healing process.

The Patient:

The big question is “Have you ever had rhinoplasty before?” Rhinoplasty is a meticulous and exacting surgery that challenges many surgeons.  Performing revision surgery raises the bar even higher.  If you’ve had rhinoplasty surgery in the past, and you aren’t happy with the results and want changes, the cost will likely be more.  

If this is your first rhinoplasty, what would you like changed? Changes such as softening a bump on the nose will likely cost less than narrowing the entire nose and changing the appearance of the tip.

The Surgeon:

Remember, plastic surgeons may all have the same title, but they don’t all have the same skills. The skill and expertise of the surgeon plays a role.  A known skilled surgeon may charge more while a lesser skilled plastic surgeon may charge very little.  This is by no means a hard and fast rule.  So how do you judge what you’re paying for?  Consult with the surgeon, assess his comfort level with the topic and surgery, compare this with other surgeons you meet with, and view their before and after pictures.  But don’t just base it on price. 

The Location:

It’s likely that rhinoplasty surgery in Beverly Hills will be more expensive than the same surgery in El Paso.  That doesn’t necessarily mean you will have a better plastic surgeon in Beverly Hills.  The most important thing for you to do is check out the doctor and the ‘before and after’ photos; this will provide you with a decent foundation to compare prices.

In Las Vegas, the cost at my practice is $6990 for an initial rhinoplasty.  This includes the costs of anesthesia, the surgery center, and all of your post surgery visits. This summer (June-August) we’ve chosen to reduce the price of rhinoplasty to $5990!

A documented ‘complication’ or side effect of using topical prostaglandins was “hypertrichosis,” a condition characterized by darkening, thickening, and lengthening of the eyelashes.   

 Allergan offered the topical prostaglandin Lumigan in 2001, a drug that contained the active ingredient bimatoprost. Two important precursors to Latisse occurred after the FDA clearance was granted for Lumigan.

Jan Marini Skin Research Inc had over $2 million worth of product seized by the Food and Drug Administration.  The product, Age Intervention Eyelash, evidently contained bimatoprost, which was unapproved for cosmetic use at the time. Allergan later filed a patent infringement suit against Jan Marini and several other companies that had tried to market bimatoprost in their eyelash enhancing drugs.

Some doctors started prescribing Lumigan off-label to enhance eyelashes.  Knowing the desirable side effects it could produce. But Lumigan wasn’t formulated for cosmetic use and many believed more research was needed to confirm the safety of topical prostaglandins for cosmetic use.  

Clinical trials and further research is exactly what Alllergan Inc did.  In one early study, 278 healthy adults with minimal to moderate eyelash prominence applied bimatoprost or a placebo to their lash line.  The results were favorable; researchers observed that the average patient’s eyelashes were 25 percent longer, 106 percent fuller, and 18 percent darker, while only 3.6 percent experienced itchy eyes and redness, and only 2.9 percent experienced skin hyperpigmentation.  

Latisse received FDA approval late last year for the treatment of ‘inadequate’ eyelashes.  Allergan now owns the patent on use of bimatoprost for eyelash enhancement.

For more information on Latisse in Las Vegas, contact us.

According to news sources in the UK, Ms. Halep complained that her large (34 DD) breasts have slowed her reaction time on the court and caused discomfort. “It’s the weight that troubles me – my ability to react quickly”, she told The Sun.

Ms. Halep is now ranked 317th in the world.

Women pursue breast reduction surgery for a several reasons, increased mobility being just one of them. One breast reduction patient stated, “Before I didn’t want to run anywhere, [not] even across the street. If something happened, I would not run.  It was painful and embarrassing” (Klassen 2009).

Beside issues with physical activity, many women hope to alleviate irritation around their bra strap and underneath the breast, pain in the back and neck, and discomfort during sleeping.

The procedure can be described as a ‘normalizing’ experience for women. Once the surgery is complete, patients often say they are less self-conscious, they fit into more ‘regular’ sized clothes, and their shape is more characteristic of ‘the norm’ for the female body.

The following statistics illustrate the opinions of the ‘typical’ patient. Who is the ‘typical’ patient?  According to the survey results, “a married, working mother between 41-55 years of age with a household income of under $100,000.”

Roughly 70 percent of the respondents claimed that Botox and dermal fillers play an important role in their cosmetic routine.

When asked what their motivation was for pursuing Botox treatment, 34 percent said their appearance looked “stressed” or “angry”. Others said that a friend, family member, or their physician had recommended it, or they were preparing for a social event. 66 percent said they received Botox treatment 2-3 times per year. 72 percent of the respondents chose Botox to treat glabellar lines – the vertical lines that appear between your eyebrows.  

When asked about their motivation to use hyaluronic acid fillers, the majority (63 percent) of patients reported a desire to remove facial wrinkles and folds - mostly the nasolabial folds that travel from the nose to each side of the mouth.

Nearly 70 percent of the respondents who had been treated with Botox also opted for dermal filler treatment.

A full summary of the results is available (in MS Word) here.  For more information on the latest wrinkle treatments in Las Vegas, see our homepage.