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Fat Transfer vs. Injectable Fillers: Which One Should I Get?

We’re lucky to live in an era that gives us so many options for minimally-invasive cosmetic treatments. These days, you can improve your facial aesthetics without surgery or the extensive downtime and discomfort involved with it. However, not all problems can be fixed with non-invasive treatments alone. The key to a successful procedure is choosing the right procedure and the right plastic surgeon to help you reach your goals. But how do you choose? If you’ve been interested in injectable treatments, then you’ve probably heard of both injectable fillers and fat transfer. But which is right for you? Let’s take a look at the differences between the two treatments. Facial Fillers vs. Fat Transfer The first difference between the two treatments is that fat transfer is a surgical procedure, while fillers are not. Fat transfer involves removing unwanted fat from a “donor” area of the patient’s body, preparing it in a centrifuge, then injecting it into various areas of the face in order to rejuvenate and revitalize the face. Not all of the fat will survive long-term, but the cells that remain after about six months are considered to be permanent. Injectable fillers are synthetic formulas created to help fill in wrinkles and contour the face. Many are comprised of hyaluronic acid, a substance found naturally in the skin. Injectable fillers are injected directly into the areas with signs of aging. There is no surgery required and there is little to no downtime involved. However, the results are not permanent. Patients… Read more »

What Cheek Procedure is Right for Me? LuxeCheeks

Are your cheeks starting to sag? Are they flat or hollow? If so, then you’ve probably wished at some point that you could achieve a sophisticated, youthful even model-esque appearance in your cheeks. You know how you want to look, but how do you get there? Cosmetic surgery can be the perfect solution to aging or undefined cheeks, but there are several different options for cheek enhancement for patients to choose from. If you’re wondering about which cheek procedure is right for you, rest assured that you’re not alone. Many people are unsure as to which procedure will help them reach their goals. Let’s take a look at some of the options to help you make a decision about your procedure. Cheek Implants Cheek augmentation with implants is a surgical procedure that adds permanent volume to the cheek area using implants. For those who have always wanted beautiful, high cheekbones, the cheek augmentation procedure can be a great option. It can add lift, volume, and contour to the cheek area. The implants create a more prominent cheekbone, which improves overall facial harmony and contour. This is not an anti-aging procedure, but is a great option for people who are dissatisfied with the natural shape and prominence of the cheekbones. Cheek augmentation is a surgical procedure that takes about 30 minutes to an hour to complete. It may be performed with local anesthesia and sedation, or with general anesthesia. Hidden incisions will be used to place the implants, so there should be no… Read more »


Taking Facial Plastic Surgery to the Extreme Following a successful facial cosmetic surgery, the people in the patient’s life should not feel compelled to ask him or her: “Have you had work done?” A plastic surgeon’s intent is not to construct perfection, but rather to create aesthetic improvements that each patient is pleased with. Satisfactory results are those which produce or enhance facial harmony, and appear so natural that a patient looks as though he or she was born with the attractive feature. In facial plastics, certain procedures have been performed inappropriately to create extreme results, which appear neither attractive nor natural. Liposuction of the neck and submental area, facelift surgery, and rhinoplasty can dramatically improve the treatment site, but in the wrong hands can also produce obviously synthetic results. An artificial appearance following a facial plastic surgery is commonly due to patient requests and surgeons who practice facial plastics without the necessary education or training. There are many times that patients may seek over-correction from a procedure because they want to minimize the look of certain parts of their face. What they may not realize is that by manipulating the tissues to such extremes, results can draw unwanted attention to that area of the face due to the artificial look. A knowledgeable plastic surgeon will explain the medical and artistic aspects of aesthetics to patients and may provide them with preliminary photo-enhanced results. Excessive Fat Removal The Issue: Liposuction is an effective fat removal procedure that eliminates unwanted fat from… Read more »

4 Signs You Should Invest In Blepharoplasty 

signs you should invest in blepharoplasty

The eyes are often one of the first areas of the face to start showing signs of serious aging, and the results of this aging can be aesthetically devastating for many people who experience them. If you look in the mirror and you’re not happy with what you see, it may be time to consider plastic surgery to help restore your youthful appearance and self-esteem. Blepharoplasty is an anti-aging surgery that focuses on rejuvenating the eye and eyelid area by tightening the skin and repositioning tissues for better contour. This procedure can be a great choice for people struggling with the effects of aging eyes. If you’re wondering if eyelid surgery is right for you, read on for some signs that you should consider investing in upper or lower lid blepharoplasty. You Look Tired or Angry All the Time One of the surprising effects of eye aging is that the resting facial expressions can change as well. Many people start noticing that they look tired all the time—or worse, friends, family and even new acquaintances notice a change. Depending on the individual facial structure and the problems with the eyelids, the resting expression could become angry, sad, or tired, but regardless, this permanent change in expression can be a good reason to seek blepharoplasty. You Have Permanent Bags Under Your Eyes Temporary eye bags are a common occurrence for many people, but when they become an everyday problem, it’s time to consider more lasting solutions. Blepharoplasty is a good option for eye bags caused by sagging skin and… Read more »

 AAFPRS Nashville Meeting October 2016

Just returning from a great meeting in Nashville from an American Academy of Facial Plastic Surgery in Nashville.  It is always a great meeting to catch up on what friends and peers in the other parts of the country and in the world are doing to discuss best practices for our patients.  During the meeting in addition to my presentation on optimum rejuvenation of the periorbital area (the area around the eyes) with synthetic fillers and fat transfer (VolumeLift), there were presentations on use of PRP (platelet-rich plasma), for hair restoration as well as skin rejuvenation, new fillers coming to the market in the US soon, and new Botox alternatives which are being studied.  These are balanced with more traditional presentations on comparison of facelift techniques and nose reshaping (rhinoplasty) techniques.  Prior to the formal part of the meeting, we had our committee meetings, which included the emerging trends technologies committee on which I am honored to sit.  During one meeting, we discussed the latest trends and techniques which will be beneficial for our members to hear presentations on.  Last year’s committee meeting presented a formal part of this fall meeting and included new treatments for under eye bags, PRP (platelet-rich plasma), applications, and new fillers which are being approved by the FDA including those from Allergan and Galderma.  The meeting was fantastic all around and very well organized by my friends and colleague doctors, Langdon, Lam, and Batniji, who helped to ensure that the content was current and well categorized… Read more »

Astounding Results from Platelet Rich Plasma

I am thrilled to report that we have seen wonderful success with PRP injections for hair restoration. As an example, this is a patient who had only one round of PRP injections for his thinning hair with impressive results. We typically recommend a series of three to four such procedures over the course of several months for best effects, followed by a maintenance treatment only once a year. As can be seen in the pictures, the lighting is almost identical and yet it is clear that he has improved thickness and coverage of his hair, both near the part and hairline. There is practically no downtime with such a procedure. What is the PRP procedure? PRP is short form of platelet rich plasma, which we get by drying a little bit of blood and processing it in a centrifuge in order to get the portion of your blood that is rich in platelets.

6 Things to Keep in Mind When Looking for a Hair Restoration Surgeon

hair restoration

If you’re losing your hair, you no longer have to sit there and just watch it fall out. Hair restoration can give you back your hair. A surgical procedure, the goal of hair restoration or hair transplantation is to reduce areas of baldness, usually on the top of the head. People dealing with male pattern baldness and certain other types of hair loss might be great candidates for the surgery. Learning about the hair restoration procedure is just part of the process of deciding if it’s the right call for you. You also want to find the best surgeon to perform your transplant. When looking for a hair restoration surgeon, keep the following things in mind. Training While where your surgeon went to school might not be of that much importance, what he went to school for is. Ideally, you’ll want to work with a doctor who has training as a facial plastic surgeon. A surgeon who’s been board certified and who has completed years of residency training in facial plastic surgery is ideal. Medical school teaches doctors the basics they need to know to become doctors. Residency training allows them to zero in and  focus on one particular area. A doctor who’s trained to be a facial plastic surgeon will be well versed in and experienced with the anatomy of the face, head, and neck. Experience Training is important, but it’s not the only qualification to look for in a hair restoration surgeon. You also want to get a… Read more »

6 Months After Hair Transplantation Results

Hair Transplant, Dr. Donath, CincinnatiThis is an example of how natural the results look from hair restoration procedures.  This patient is a relatively young patient who underwent FUT, hair transplantation (micro follicular unit grafting) to the crown area, using 1,037 grafts.  He has shown before (left) and six months after (right) this procedure.  Note how natural the results appear – no one would suspect that he had had a procedure done to achieve this result.  He has improvements in the coverage of the scalp as well as the contour of the hair from the top to the back of the head.  Note also that the donor area is completely invisible, even in this patient with relatively short hair; this is typically what we see because we take the time to do a careful two-layered closure and use trichophytic technique. This causes the hair to grow through the scar to further camouflage it.  This patient is very pleased with the results and he can’t wait to see the results at his one year follow up.

Bye, Bye, Double Chin!

KybellaWe are pleased to now offer Kybella for the non-surgical treatment of the “double chin” for excess fullness/fat beneath the chin.  This new treatment offers a high rate of success in treating the chin with no downtime, although there is some swelling which can occur.  No incisions are needed.  No sedation is necessary.  While liposuction continues to be a great procedure, many patients wish to have reduction of the neck fullness by itself and do not wish to have downtime, even if it means the possibility of several repeat treatments in the office. Kybella is a treatment with “deoxycholic acid” which is a normally occurring substance in the body where it functions as a bile salt to break up fats in the intestines.  As an injection, it breaks up fat cells in the area treated and the fat cells are then metabolized and excreted through normal metabolic processes of the body. From one to four treatments may be desired for the optimum effect but there is minimal discomfort and aside from swelling, there is minimal chance of unwanted effects.

Minimizing Bruising in Rhinoplasty

Minimizing Bruising in RhinoplastyWhen it comes to surgery, there are some inevitable side effects that are caused by the trauma of the operation. Bruising is an extremely common phenomenon following surgery, particularly rhinoplasty. This bruising is concentrated on the nose and the eye area, and can take quite a while to fade, making many patients uneasy about leaving the house during recovery. While bruising cannot be entirely avoided following rhinoplasty, many patients are understandably interested in minimizing the bruising as much as possible. But is there a way to help prevent bruising as a patient? And can you help accelerate the rate of recovery for bruising that does occur?

Causes of Bruising

Bruising is caused by blood vessels breaking or tearing and leaking blood into the tissue. Bruising is visible under the skin and fade slowly over time. The trauma from nasal surgery often causes bruising in rhinoplasty that takes time to resolve. In the past, techniques used in preparing the nose for recovery, such as nasal packing, could actually make bruising worse, but modern techniques are much less traumatic to the patient and to the nose. While it is difficult to predict how much bruising each patient will have prior to the surgery, there are some ways to help prevent and treat postoperative bruising.