I have been happy with wrinkle control Botox, but more recently my brow position is getting slumped. What should I do?

You may be experiencing brow ptosis. This is defined as the lowered position of the brow and forehead laxity that comes with genetics, sun damage, age, and sometimes the dosing of your Botox or neurotoxin of your choice. I first need to examine you to determine what is going on. We will review your injection experience and perhaps recommend a lower dose of the neurotoxin you may be receiving in your frontalis muscle, the muscle that elevates your brow and contributes to forehead wrinkles. If the lower dose lets you compensate, then the problem is solved for a time. But if your examination shows slumping of your brow in the outer rim of your orbit, you may be a candidate for a one-hour procedure that repositions your brow through three 1 inch incisions, called an endoscopic brow lift. This long-lasting procedure restores your upper facial eye brow position, it relaxes the crows feet around your eyes, and it takes away the hooding between your eyes (over your nose) in a way that Botox, Juveau, Dysport, and Xeomin cannot. The appearance change is very natural, and involves very small incisions in your hair, that allow me to restore your youthful appearance with a 5 mm endoscope! You don’t need your hair shaved. You can shampoo and style your hair the next day. The incisions usually heal in about 10-14 days. Your softened upper face looks well rested, not surprised. You can resume most business activities in a few days after surgery. While bruising is possible, there are no incisions around the eyes for endoscopic brow lifting, unless you wish to remove the under-eye “bags” the same day, or you have a lot of excess upper eyelid skin. If you look in the mirror and like the appearance you see when you softly raise your eyebrow with your fingers, and see that your nose bridge looks less tired and grumpy and your face looks more rested. If this is your desire, you can contact my office and arrange for a complimentary consultation to evaluate what’s going on. We will discuss the options, and perhaps use some digital imaging to show you how you will look with your new look. I will show you gallery photos of patients who have undergone this revolutionary procedure! Merry Christmas to my readers!

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What is the state of the art for body contouring?

After we get up from our Thanksgiving celebration, there is a tendency to reflect upon our good fortune, our family, and our waistline! If you are experiencing hard to lose areas of your body, you may wish to address them with some lifestyle modifications to see if they improve with that effort. But some body areas are stubborn reflections of our genetics and life events like childbirth, that nagging knee injury that precludes the same amount of cardio, or just not enough hours in the day.

If you are inclined to seek improvement in your body shape, then you may wish to call for a consultation for body contouring. The gold standard mommy make over (or dad bod make-over) is a lipo-abdominoplasty, which combines the technology of Vaser ultrasound and helium plasma Renuvion. These technologies are selective to reduce fat in areas of the thighs, knees, abdomen, flanks, back, buttocks, and love handles. A 4 mm incision is created to instill a little IV fluid mixed with local anesthesia, so that when your treatment is over you are comfortable. The Vaser probe is passed under the skin, selectively reducing the fat in a permanent way.

The results are smoother body areas, tighter skin, and a thinner you! Because the elasticity of skin is one of our problems as we age, Renuvion energy has been shown to tighten areas that have had fat removal by liposuction technique to improve overall contour and stimulate a more youthful appearance.

The Renuvion technology is also passed under the skin at the time of Vaser use to further optimize the surgical outcome. These technologies are combined in my practice with other more advanced techniques like tummy tuck, face lift, buttock lift, arm lifts and Brazilian Buttock lifts. If you are interested in improving your body contour, and have been frustrated with your current situation, it is time to give my office a call to start your journey! My staff and I welcome your inquiry and will teach you about your options for body contouring in the coming year! We at Mentor Plastic Surgery & MedSpa are thankful for your support of our practice!

Ultrasound energy is a wavelength that can be used externally to “see-through” the tissues and let us determine anatomic detail. Its most prevalent use is to see babies in utero and measure growth progress, including a heartbeat, facial features, and hand formation from as early as 6 weeks of gestation! This same energy is now available to guide a needle into the body to place anatomic blocks of local anesthetics to help you recover from tummy tucks and breast augmentation surgery. The TAP block and PEC blocks are incorporated into my practice at the time of surgery so that when you wake up from the procedure you are moving more freely and comfortably. This lessens your narcotic use as well as makes you generally feel better in the most critical 1-2 days after your procedures.

Another state-of-the-art use of ultrasound waves is with Vaser liposelection. This liposuction technique uses sound waves created by a crystal handpiece that is sterilized and used in the operating room. The crystal handpiece is connected to a sterile titanium 3.9 mm probe, which is passed under the skin allowing the sound waves to break the fat cells selectively. In the areas of unwanted fat, as well as unwanted male breast tissue [called gynecomastia] this selectively and gently pops the fat cells like a water balloon. Because it is selective, it preserves the nerves, blood vessels, lymphatics, and collagen, which allows you to recover more quickly with less blood loss, numbness and swelling, and bruising. Older techniques are hollow cannulas that indiscriminately rasp away everything under the skin. We only need to treat the fat- which is why Vaser is the state of the art for liposuction. The Vaser Ultrasound also stimulates more “shrinkwrap” of the areas treated. I participated in clinical studies as a scientific investigator studying Vaser compared to other techniques. Our multi-center study demonstrated that VASER energy had 53% more shrinking of skin than hollow cannula lipo, and also showed 23% less blood loss. Our study scientifically concluded that Vaser has better tightening, less blood loss, and less bruising and pain than older methods of liposuction.

Another area of research in my past at Cal Berkely, Lawrence Berkely laboratories was in the biological effects of radio waves and microwaves on human cells and wound healing. Since then, the use of radio waves to activate helium gas came into the market to treat and tighten human skin and subcutaneous tissues. This energy is called Tesla energy and is delivered at the time of liposuction with Vaser to further improve body contour and tighten skin in all areas. I utilize Vaser ultrasound and Renuvion radio wave energies at the same time in the operating room and in the office to selectively improve body contours. These state-of-the-art body contour modalities are available at Mentor Plastic Surgery & MedSpa. They can be done with tummy tucks, arm lifts, thigh lifts, or breast reshaping surgeries to enhance your shape and improve your outcome. Single areas can be performed in the office with a little ProNox gas to keep you happy during the awake procedure.

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Click here to learn more about sound waves.

The most effective methods of treatment for fat and muscle definition involve radiofrequency waves and multi-directional muscle stimulation and their effects on the different tissues of your trunk, abdomen, flanks, thighs, arms or buttocks, even chins. TruSculpt Flex and TruSculpt iD can combine to rock your abs and make you look more toned and firm as well as strengthen your muscles and reduce your fat. Trusculpt Flex tones and tightens your muscles. Trusculpt id permanently shrinks your fat and shrinks your skin if your weight stays the same. Each treatment takes about 45 minutes in the office. Depending upon your fitness level and B

BMI we do the fat treatment areas using up to six treatment zones in a single session. We usually wait about 6 weeks between fat treatments in your target areas. While you’re waiting for the fat to shrink, your skin will also tighten. During this waiting period, you can start the 4 to 6 sessions of the Flex treatments. Trusculpt Flex can be done twice a week and this will produce muscle toning and definition. Most patients are a candidate for treatment for this treatment, although there are some contra-indications. During the consultation, you will be evaluated to see if you are a good candidate for non-surgical improvement. If your goals are more extensive or you have too much laxity, then you may need to consider surgery. You don’t need to be a bodybuilder to benefit from hard-to-lose areas toning, or hard-to-shape areas slimming. People who don’t work out a lot can see some nice results. For those that are already in good shape, there are great sculpting effects that can occur because of the effects of radiofrequency waves on your tissues. Unlike freezing methods, the radio waves tighten the skin while it shrinks your fat.

You won’t get bigger fat in the areas treated with radiofrequency energy like seen in up to 20% of fat freezing treatments. It really works! The treatment has no recovery time and enables you to return to immediate normal activities after treatment. With the Trusculpt Flex, some people experience muscle soreness after the multi-directional stimulation of the muscle groups that replicate intensified twisting, squat, and crunch actions. In addition, the muscles are contracting and stimulated to the point of exhaustion, then relaxing occurs to increase strength and enhance endurance. The fast, deep, sequential contractions of the muscles simulate interval training to increase basal metabolic rate and define the muscle mass.

Give us a call and schedule a consultation. Whether it’s a bathing suit or a board room, you’ll look better!

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Beauty trends are always changing, but a good set of brows never goes out of style. Throw in the fact that, when wearing a mask, our eyebrows are one of the main features, and you’ll see why stellar eyebrows are one of your biggest beauty must-haves of 2021. Rather than spend hours of precious time plucking, penciling, and obsessing over your brows, perhaps it’s time to consider something else. If you want to make sure your eyebrows are always on point, a surgical brow lift might be in order — this endoscopic minimal incision procedure is long acting- lasting for over a decade, it takes one hour to perform, and is affordable compared to a decade of Botox that doesn’t raise your brow position or solve the concerns of droopiness around the eyes the way brow repositioning does. The patient who decides brow surgery is for them usually sees eyebrow hooding, unhappy face, tired face, or angry appearance. They may or may not have social feedback that reinforces that internal narrative that they “don’t look happy.” A brow lift can often be performed at the same time as upper or lower eyelid surgery. Often, elevating the brow to its rested, relaxed position improves the appearance of the excess skin of the upper eyelid enough to not have to do anything else!

The one-hour surgery called endoscopic brow lift is an innovation over older methods, in which the incision is placed from ear to ear in the mid-scalp. Instead, a 5 mm endoscope is placed under the scalp line through 3 tiny incisions covered by your hair. We won’t shave your head! The incisions heal in about 3 weeks, so those who color their hair should do it before surgery. For men looking to take some years off their face, the incisions are readily covered by a baseball cap or letting your hair grow out a little bit to comb over until you are healed. The brow elevation is natural-looking, the 11’s lines between the eyes are gone, and the brow muscles and sensation are normal after you recover. You can resume heavy exercise and contact sports in about 3 weeks. Because it is a minimally invasive, endoscopic procedure you may return to work in a few days. My staff and I will show you photographs of real patients who allow review of their recovery to let you know about how it will go for you. Our photo gallery of before and after pics will let you carefully decide what works best for you. I can morph your image to show you how you will look post-op.

Regardless of what specific goals or resolutions you’ve set for yourself this coming year, we hope that your 2021 is rejuvenating and filled with hope! If you’re hoping to grow your confidence by trying a new plastic surgery or aesthetic treatment this year, we are here to guide you along the way.

Just five blistering sunburns between the ages of 15 and 20 increases melanoma risk by 80%. We know that the use of sunscreen has been shown to reduce melanoma and skin cancer risks. Valisure, an online pharmacy known for testing every batch of medication they sell, announced this week that they petitioned the FDA to recall 40 batches of sunscreens and after-sun products they say tested for high levels of the chemical benzene. The company tested 294 batches from 69 companies and found benzene in 27% ― many in major national brands like Neutrogena and Banana Boat. Some batches contained as much as three times the emergency FDA limit of 2 parts per million (ppm).

Long-term exposure to benzene is known to cause cancer in humans.

“This is especially concerning with sunscreen because multiple FDA studies have shown that sunscreen ingredients absorb through the skin and end up in the blood at high levels,” says David Light, CEO of Valisure. The FDA is seeking more information about the potential risks from common sunscreen ingredients.

“There is not a safe level of benzene that can exist in sunscreen products,” Christopher Bunick, MD, PhD, associate professor of dermatology at Yale University, said in Valisure’s FDA petition. “The total mass of sunscreen required to cover and protect the human body, in single daily application or repeated applications daily, means that even benzene at 0.1 ppm in a sunscreen could expose people to excessively high nanogram amounts of benzene.”

Chemicals in sunscreen may be harmful to other forms of life, too. For years, scientists have been examining whether certain chemicals in sunscreen could be causing damage to marine life, in particular the world’s coral reefs. Specific ingredients, including oxybenzone, benzophenone-1, benzophenone-8, OD-PABA, 4-methylbenzylidene camphor, 3-benzylidene camphor, nano-titanium dioxide, nano-zinc oxide, octinoxate, and octocrylene, have been identified as potential risks. Earlier this year, the National Academies of Sciences, Engineering, and Medicine created a committee to review the existing science about the potential environmental hazards.

Although I have advocated for the use of sunscreen for the reduction of wrinkles and the reduction in skin cancer, at this point it is difficult to recommend to you a specific brand of sunscreen. The reason is that some manufacturing processes introduce specific toxic residuals in the product that perversely, increase your skin cancer risk! After a lifetime of use and recommendation of sunscreen for me, and my children, and my patients, I am at a loss as to finding a resource to verify which sunscreens are still safe. Their claims and descriptions on websites do not validate that they have been tested.

If you’re nervous about using sunscreen, it isn’t the only way to stay safe. It may be as simple as seeking shade, which reduces the risk. Barrier technology clothing like Solumbra really works. We know it is not true that a base tan reduces your risk of skin cancer. The more sun, UVA, and UVB you get, the higher risk of skin cancer.
We need FDA safety testing of current products. Get our government working for us!

Men are frequently troubled by exercise-resistant pockets of fat in certain areas as they age. In many cases, this problem is genetic; their bodies are programmed to store fat in those areas, and no amount of exercise will eliminate it.

For men with good skin elasticity and only a moderate amount of fat, VASER Lipo® or liposuction alone can provide a solution for neck or body contouring. Vaser Liposuction has recently been shown by Dr. Vanek and many other clinical investigators to result in up to 53% more skin contraction than traditional liposuction technique. The VASER Lipo® procedure is a minimally-invasive form of liposuction that uses ultrasound waves to destroy unwanted fat deposits.

“This is a great procedure for treating the neck, axilla, arms, back, abdomen, flanks, inner and outer thighs, knees, and calves,” says Dr. Vanek. “Men have just an inch-deep layer of subcutaneous fat; the rest is intra-abdominal or visceral fat that will only shrink when he loses weight. But I want to be upfront: this is not an effective treatment for a man’s beer belly. The beer belly is impenetrable. The only solution for that is to lose weight through proper dieting and exercise.”

Dr. Vanek will meet with you one-on-one to speak about target areas, incisions, cost, risks and benefits, and any other questions you may have. He will attend to you himself in all of your follow-up care and will offer advice and support for further weight loss efforts.

“I pride myself on catering to the individual needs of my patients, and I think patients who are interested in body contouring deserve to have someone who sees them from start to finish, and who performs the surgery themselves,” explains Dr. Vanek, a fellow of the American College of Surgeons. “I can talk with you about your goals and our respective perfectionism and say, ‘What’s going to give us the longest-lasting result and what will make you very happy?’ If there is more than one choice, I have the ability to explain the difference in outcomes in a forthright way. That’s where having a doctor who has more than one arrow in his quiver becomes indispensable.”

In addition, we now offer one area VASER Lipo® in our office procedure room. A patient that meets certain criteria can come into our office in Concord and have a local anesthetic as well as the option of using our Pronox, nitrous oxide unit, to make them very comfortable during the procedure.

If you are interested, men or women, in a complimentary consultation to get more information on VASER Lipo® and see if you are a candidate, please reach out to our staff to schedule an appointment.

I hear that an Oxygeneo facial treatment will brighten my skin. How does it work?

An innovation in rejuvenation of the skin is available at Mentor Plastic Surgery & MedSpa. Oxygeneo is a spa that treatment uses the energy of ultrasound applied topically to activate a pathway in your skin to help restore a healthy glow and luster. Oxygeneo uses a chemical phenomenon, where the change of the skin pH during the treatment activates local oxygen, supercharging your skin appearance. It actually works on your own carbon dioxide in your blood serum. An ultrasound wavelength in the Oxygeneo treatment wand activates an applied gel that results in the chemical stimulation of your tissues.

What you feel is a cool and gentle exfoliation of your skin, removing dead cells and debris from your skin and deeper dermis. The results of the chemical reaction create an immediate healthy glow, and radiant skin improvements in luster and texture. The serial application of this technology improves blood flow to distressed skin, and creates your own immune response and cellular action to improve your brightness and appearance. It can be done on the face, neck and decolletage. You will notice an improvement after the first treatment.

How Oxygeneo Works

It can be done even the day of an important event to bring a glowing you to the spotlight. Some of our patients use this technique weekly on their countdown to an important time in
their life, like a presentation, a wedding or any other social event. You need a little moisturizer after the treatment, but make-up can be applied immediately after the treatment, if you like.

Your face is first cleaned by the aesthetician, and you are in a beautiful spa room. The thick cool gel is applied and the Oxygeneo Capsugen treatment head is activated. The treatment head creates the ultrasound and gel interaction, and feels coarse as it glides over your skin, even though there is no mechanical effect. This feeling is the blood flow stimulating effect on your skin after the exfoliation.

The gel is cleansed, followed by an antioxidant infusion step. Depending upon your skin quality, either Illuminate or NeoBright gel is activated and the ingredients that includes hyaluronic acid, retinol, and kojic acid get to work immediately to make you look and feel dewy and hydrated. We also have a Carbon Acne infusion mode to help treat and calm any active acne breakouts using Oxygeneo technology. You have warm towels to remove the excess and you are good to go. Men and women benefit from this complexion enhancing treatment.

Those who try it, say they didn’t know that their skin could look this good this quickly. If you would like a beautiful gift to yourself or someone you regard, who appreciates a beautiful
complexion then Oxygeneo is a great start. You can get your friend a gift certificate for this treatment, as it treats even the most sensitive skin types with great results!

What is new in the world of wrinkle filler?

A Swiss company has recently launched a new Hylaluronic acid (HA) wrinkle filler that has shown great promise for patients who don’t like their deep lines in their face. It is called RHA. Like other HA molecules, the drug is comfortably injected in the office. I do all the injections! The innovation is a newer method of chemical preparation that makes it act, feel and look like your own tissue. Hyaluronic acid is naturally found throughout your body, in your joints and ubiquitously in your tissue spaces. As we age, the content of both collagen and “ground substance” becomes less prevalent, giving us a depleted look.

There are techniques to stimulate cellular collagen that I spoke of last week. But a direct method of supplementing the face with a material that acts natural is through the use of an injectable formulation called RHA. You may have seen these advertised in past, as they are workhorse agents that have been successfully on the market for some years. Restylane, Juviderm and their newer iterations have been franchising the HA molecule effect with various cross-linking modifications that enable each formulation to work better in separate places in your face. They all derive their base molecular activity from the attributes of the original material found in high concentration from chicken cock’s comb!

Newer techniques of manufacture of HA have eliminated the animal sourcing, as well as refined the behavior and longevity of the HA agent. What this means for you is a supple, long lasting material that you won’t feel, but will love right after it is injected. It should last about a year, depending upon your physiology. My practice offers a host of injectable fillers and agents that restore your tired or sagging appearance. The day of the injection your face will be prepped and the injectable agents are placed in the area(s) we decide upon.

Multiple areas of the face can be addressed in a single injection appointment. The rationale is that doing more than one area is that you have only one potential bruising, swelling and social down time event. There is some risk of bruising which I address with having you off anti-platelet and anticoagulation drugs for a few days prior to injection. I also recommend you take some Arnica montana, which I have available in the office for your use. With coronavirus mask use, that social pressure of bruising is lessened, however.

Aftercare involves some icing and light massage after the injection to reduces the post injection swelling. Should you get bruised, you may return for some complimentary laser, which dramatically reduces the bruising duration. All the tools of analysis, decision making and photo-documentation are available in my practice at Mentor Plastic Surgery and MedSpa, for your facial rejuvenation using fillers.

I look forward to meeting you and assisting you in decision making to make you look natural, younger, and more rested appearing!

Can I buy a treatment for my friend from Mentor Plastic Surgery and MedSpa without knowing what she needs?

Who wants “Bohr-ing” skin?

An innovation in the rejuvenation of the skin in a spa-like treatment uses the energy of ultrasound applied topically to activate a pathway in your skin to make it recover a healthy glow and luster. The treatment technique is called Oxygeneo. It uses a chemical phenomenon called the Bohr effect, where the change of pH the treatment activates local oxygen, supercharging your skin appearance. The effects of your own carbon dioxide in your serum activated by the ultrasound interaction with the applied gel creates the Bohr effect. What you feel is a cool and gentle exfoliation of your skin, removing dead cells and debris from your skin and deeper dermis. The results of the chemical reaction create an immediate healthy glow and radiant skin improvements in luster and texture. ]

The serial application of this technology improves blood flow to distressed skin and creates your own immune response and cellular action to improve your brightness and appearance. It can be done on the face, neck, and decolletage. You will notice an improvement after the first treatment. It can be done even the day of an important event to bring a glowing you to the spotlight. Some of our patients use this technique weekly on their countdown to an important time in their life, like a presentation, a wedding or any other social event. You need a little moisturizer after the treatment, but make-up can be applied immediately after the treatment if you like.

Your face is first cleaned by the aesthetician, and you are in a beautiful spa room. The thick cool gel is applied and the Oxygeneo Capsugen treatment head is activated. The treatment head creates the ultrasound and gel interaction, and feels coarse, even though there is no mechanical effect. This is the blood flow stimulating effect on your skin after the exfoliation. The gel is cleansed, followed by an antioxidant infusion step. Depending upon your skin quality, either Illuminate or NeoBright gel is activated and the ingredients that include hyaluronic acid, retinol, and kojic acid get to work immediately to make you look and feel dewy and hydrated.

We also have a Carbon Acne infusion mode to help treat and calm any active acne breakouts. You have warm towels to remove the excess and you are good to go. If you would like a beautiful gift to yourself or someone you regard, who appreciates a beautiful complexion then Oxygeneo is a great start.

You can get your friend a gift certificate for this treatment, as it treats even the most sensitive skin types with great results!