Your Villa Magazine - Foothill Cities - October-December - 2022

Gregory J. Vipond, M.D., F.R.C.S.C. VIP Facial Artistry (909) 608-7770 drvipond@drvipond.org www.drvipondplasticsurgery.com 1601 Monte Vista Avenue Suite 200, Claremont, CA 91711 Facial Artistry Gregory J. Vipond MD, Inc. New patients mention ‘ YOURVILLA ’ and receive $50OFF your first treatment! *Cannot be combined with others offers. Expires 12/15/2022 For this month’s editorial/cosmetic corner, I would like to address some of the more popular questions and recent trends and developments in the field of cosmetic surgery and rejuvenation . Q: I’ve heard that there is a new kind of Botox that may last longer than the old one. What is it and why is it different? A: The FDA recently approved DAXXIFY (daxibotulinum toxin A) which is manufactured by Revance. In FDA trials, the median duration of effect was 6 months (compared to 4 months with the other brands). While each brand boasts superior results compared to each other, Daxxify is actually unique. There is a proprietary peptide that is attached to the active chemical which increases the amount of product that binds to the neuromuscular junction of the muscle being injected. Simply, it causes more product to get to its target and this higher concentration results in a longer duration of effect. One other proposed benefit of Daxxify is that it does not contain the protein albumin. What we don’t know yet is the pricing of Daxxify, but it should be available before the end of the year. I am quite interested in this product in the hope that it will add more value to my patients. Q: I recently saw some photos of Demi Moore that scared me. What happened and why does she look like that? A: Not being her physician, I cannot say for sure what procedures she has done. However, it appears that she has undergone extensive volumization of her cheeks, either too much filler, cheek implants, or both. This is exacerbated by her gaunt lower cheeks along the jawline that could have been the result of a buccal fat pad excision in the past. There is also a pulled look to her face that could have been the result of an over-aggressive facelift or threadlifts. Hopefully, it is threadlifts as they will dissolve, and the pulled look will eventually soften. She unfortunately is one of the many examples of cosmetic procedures that have crossed the line from improvement to distortion of the appearance. It is extremely important to find a medical provider that understands facial anatomy, what is normal, and errs on the side of being conservative rather than overly aggressive. You can always do a little more, but you can’t always go back and do less. Q: I recently read that Jaw Filler has become quite popular. Why would someone want to put filler in their jaw? A: Although it has recently received more publicity, filler along the jaw has been performed for over a decade. Fillers are used just about everywhere in the face to add volume where it is needed. In the jaw, fillers can be used to add volume to the chin region, help restore volume to areas of bone loss, and to add definition along the jawline. I have used both hyaluronic acid and calcium-based fillers for these areas, but the choice of which filler to use depends on the area and the individual patient. One caveat to jaw filler is that when trying to increase bone volume, I typically place the injection on top of the existing bone. While this ensures a very naturally appearing result, sometimes more filler is required. This is especially true of the jawline: this is a larger area where more volume may be necessary to create improved definition. Q: I’m only 47. Am I too young for a facelift? A: When it comes to facial plastic surgery, there is no age requirement or restriction. As a surgeon, I want to feel for muscle and skin looseness so that I can determine if I am able to make a noticeable difference for the patient. I see a large age range of patients, and everyone approaches the aging process differently. Some patients want to be more aggressive and address aging earlier on while other patients wait until further along in the aging process. Facial plastic surgery is generally extremely safe, so if I can see something to work on and it would be safe for the patient to proceed, then I feel comfortable recommending and performing it. There is some thought in the field that doing something earlier when skin quality and muscle elasticity is stronger, can result in better long-term results. While the differences may be more dramatic with older patients, younger patients may have a longer-lasting result. However, there are no right or wrong answers when it comes to rejuvenation, and so the right time for you is the right time to do it. Q: I have heaviness in my upper eyelids that makes me look tired. I want to do something but am very worried about looking different, especially after seeing so many celebrities with poor results. Why does that happen and what should I do? A: Like with most things in cosmetic medicine, there is no standard approach or technique. Consequently, there are differences in opinion between providers as to what looks good and what doesn’t. I compare our field to getting a haircut/hairstyling. There isn’t an absolute right or wrong hairstyle, but there are some that better fit a person than others. It is important to understand the individual and how everyone is a little different. With respect to the upper eyelids, it is essential to analyze each patient’s individual anatomy and customize what it done. Eyelids are definitely not “cookie-cutter” surgeries. In my training, my Facial Plastic Surgery Director was very strict on proper facial analysis and only addressing the areas that needed to be corrected. In the upper eyelids, there are three components that we look at: extra skin, thickened muscle, and extra fat. I tell my patients that it is far more important what you leave behind than what you take out. While it may sound more thorough to take out skin, muscle, and fat, taking out too much will leave the eyes looking hollowed out and will change one’s appearance. Kenny Rogers is an excellent example of someone that had too much taken out. The goal with upper eyelid surgery is to leave the patient looking refreshed or rested, but not to look like they had surgery. Cosmetic medicine and rejuvenation is a field that continues to change and evolve and there is a lot of advertising with regard to different treatments. This can be confusing for both patients and providers. It is important to find someone that will talk about your concerns and various options to address them, not try to sell you on anything. It should always be your choice if you do anything and, if so, what you do for you. If you have any questions that you would like me to answer in future Cosmetic Corners, please feel free to email me at drvipond@drvipond.org COSMETIC CORNER