Webinar 10: Aristocrat’s Best Minimally Invasive Treatments

   

During this webinar, Dr. Tehrani, Dr. Kashan, and Tara Cutrone are sharing their knowledge on the best minimally invasive procedures done at Aristocrat Plastic Surgery. They are discussing some of our most popular non-surgical treatments.
  This conference will now be recorded. Hi everyone. Thank you for joining us today. My name is Tatiana. So today we’re going to be having dr. Terrani, dr. Keshaun and our amazing nurse practitioner Tara. And so let’s begin.

So I’d like to welcome everyone that joined us on this nice COVID friendly day to do this. In our past, we always had our flings nicely done in our offices, and this is actually the first fling that we’re having virtually. And it’s a really a nice thing to have. All of you join us. I’ll be not in person, but at the very least we can talk about some things that are new. If you were joining us during the the shutdown, you guys saw that we did a lot of these webinars and we were able to kind of educate and be able to talk to you guys about the different ways to do things at home. And now that our offices are open, can actually come in to do these, even though initially we’d like to have some consultations virtually.  

So what I wanted to talk about today is some non or minimally invasive procedures in different ways of improving facial aesthetics and body treatments that are non-surgical. So that’s what we’re going to talk about. That’s what the focus of our feelings are bad or non-surgical treatments. Tatiana is going to talk about at the very end, some of the specials that we have for the day and in terms of injections and non-surgical treatments. So I’m going to talk about different varying degrees of improvements that could be given using different procedures. So a lot of people have heard about PDO threads, Nova threads basically thread lifts. It’s something that’s, that’s been around now for probably close to three to four years within which within the grand scheme of how aesthetic improvements are done, aesthetic procedures are actually is quite a, quite a bit of a time.

  So they’re, they’re FDA approved threads that are out there, and there is not sort of the approved that red therapy Nova threads is an FDA approved device. It comes in different smooth or or threaded devices is not necessarily for lifting purposes, at least not all of them are for lifting purposes. Occasionally we use them to fill out lines support structure, and they give you a bit of a lift, occasionally the tip of the nose, lift a little bit of a brow lift. So in the grand scheme of things, the more fillers kind of think of them as, as, as fillers that we put either in the folds, put it in the lips put it in, in, in the frown lines to improve those areas. So that’s, NovaThreads they come no with smooth or no twist. So think of them as brow, think some of that around the lips and overall rejuvenation and college and building, and that’s what they they do really well. These threads are placed under the skin, so that’s how they are able to lift up and bill college and under your skin and your skin continues to build and similarly college and about these threads that are not nothing very ingenious, that actually typical suture material that we use in the operating room very regularly and they’re absorbable. So they stick around for about six to eight months. And the college and building will last maybe a little bit longer than that.  

So these are some patients that have had these threads done. Again, they’re not night and day differences. There, there are people that needed just a little re rejuvenation in the cheek area, low rejuvenation in the pre-judge area, and very subtle results. Very nice results with that fillers. One of the areas that we’d like to put this is around the eyelids, especially in somebody like her, who’s got the early signs of aging. The problem with that is if you put a lot of filler in that area, you can actually make an aging more and make it look like it actually is puffy more than it is. And some of these fillers are able to do that without causing edema or swelling in that area. And it becomes a really nice option for patients like her. The next step after that is the silhouette insulin. So Silva insulin was the first FDA approved, true lifting device, and that’s called a bi-directional device. It’s a device that actually is made to lift up the, the cheeks the gel wine and, and the neck. But and the reason it’s my favorite thread in terms of true lifting is because it actually has a lot of barbs  

The instead of actually the design itself has cones, so has not in cones and not exactly barbs the wave NovaThreads was and its ability to actually catch tissue and lift is phenomenal. There is, that’s the best part about it. The worst part about it is unfortunately, because we have to lift it up. I had a bit of a downtime. So that downtime is, is something along the lines of about three to five days where your face is gonna look overly pooled as it’s settled in. Cause we exaggerated to make your face look lifted and settles into a little bit of a lower position. And that takes a bad three to five days. So it’s done similar to a, an injection will be done for fillers and it lifts up the face really nicely. And that’s my go-to for nasal labial folds for cheeks.  

And occasionally for the neck, these are some patients that have had the Insta lift done as a Kasita cheetah elevated really nicely, supernatural, still some elevation in the pre Zhao. These are results that last good year and a half up to two years after having this minimally invasive procedure. But some of these patients actually end up having a bit of an injection fatigue where they’ve had a lot of fillers on it. And it’s not at some point in time, it’s not about filling anymore and you have to lift things. And before somebody actually needs a form of facelift, this becomes a really viable option. I am a firm believer in our practice that if you’re going to have a facelift, it’s best to have it done when you’re in your early sixties, or maybe even later, depending on how the facial aging is.

  So the end up doing it, maybe once at most, twice in your lifetime, as opposed to if you did it in your fifties. And then in five to seven years later, you’re starting having repeated facelifts. And that’s when it starts looking not so natural. So these are the procedures that will really help get you along during that critical period of time, late forties, fifties, and get some really natural improvements until the time they actually need a facelift. There’s another 57 year old who who needed a ideally a facelift, but in her case, she just wanted an, a, a bit of a national improvement. We did this silhouette Insta lift, the fad, the jowls are better. They cheek line is improved as a cutesy. Her cheeks are fuller. All we did is lifted it, but she looks fuller and that’s because the the Insta lift, not only it lifts, it actually builds collagen in that area.  

And the nice thing about it is it gives you volume and lift the next solution is in next solution. So everything we’ve talked about so far is really good at fold is really good at the forehead. And in terms of the silhouette lift is really great at the at the cheeks. It’s okay for the neck is not great for the next. So for a very long time, we actually we’re missing a really good device. And non-surgical thing for the neck. And here comes elevate. Elevate is a really ingenious procedure, combines neck lift non-starter with liposuction, skin tightening, and a special thread. That plate is placed under the neck. So it’s something that’s done on the local anesthesia. You haven’t done, you go home the same day. It does have a better five day downtime because you will be swollen and bruised.  

It’s non-surgical meaning that you are not going to have any scars short of the tiny little holes where we going to put the the liposuction canny line or the threads. So this is kind of an idea of where are we going to place these lines? The numbers are for our purposes, but the idea is it has the special, smart light that lets us a suture that’s permanent underneath your skin after elevated the neck and tighten the skin and be able to actually give you a neck line lift. And it’s a pretty dramatic neck line lift. As you can see in this patient, it’s almost a surgical result with a neck line lift in the past, we’ve done liposuction with laser, and if you’re young, you actually get some good skin tightening with laser or body type or FaceTime, or even renew me on.  

But if physical suture to hold your jawline back is what the brilliant part of elevators. And that combination again take took ages years of her age, and has a really great result for the neck, especially for the neck, as somebody who doesn’t have a lot of college and bullying and is, is a bit older. So they’re not going to tie it up as much. So that’s another non-invasive treatment for the neck. Next I want to talk about is a little bit of a a diet thing, something that’s not some strange for me personally. We went through a big porn scene and a lot of people had the quarantine 15, or maybe even more than that after the quarantine stop myself included actually had the quarantine 20, and we’re getting a bit of a weight during the shutdown being around kids home and whatever, are there a good excuses everybody had, but in any event, one of the things that we have at our office is the nouveau diet, normal diet is something that is a medical grade weight loss that we’ve actually offered patients for preoperative weight loss.

  So the idea of this new diet is say, somebody is going to have an abdominoplasty tummy tuck or liposuction, and they’re a bit off of the ideal way. The idea is that we want to get them as close as we can to their ideal body weight before we operate on them. The best things about this procedure is you could lose this diet is that you can lose 30 to 40 pounds in 40 days, pretty dramatically, and pretty consistently like any other diet. Its biggest problem is the fact that you can then afterwards, if you’re not good, you can gain it back and you have to redo the diet or in the surgical realm. We want to do the surgery to lock your weight at that lower late that, that you are achieving immediately before surgery. So we’ve used it as a tool for preoperative weight loss and for patients that are struggling with weight in general, when it comes to a post COVID weight gain, these are some examples of patients that have lost quite a bit of weight in her case 30 pounds in a, in 40 days.  

And in my case, 40 pounds in over two years. So I actually started this journey myself quite a few years ago and admit only, so I’ve gained a bit, I’ve lost a bit, I’ve gained a bit, but overall I’ve been able to keep the weight off and probably actually closer to 45 pounds between those two pictures and have been able to keep keep it off using this diet. One of the nicest things about it is the fact that it actually allows you to eat properly and teaches you how to correct things if you had a bad weekend and are able to kind of reset to a lower weight and not continue on the bag wrath of losing weight. So other non-surgical things are of course, CoolSculpting CoolSculpting is the number one, FDA approved, non-Surgical Fat reduction and the leading one in the country. It is good for specific area of reduction, but there are not, as you tell me, your waistline, this areas are those areas, the neck arms, inner thighs, and there’s about a 20 to 25% reduction with one treatment permanently. A lot of times we do multiple sessions, like in her case, she had her abdominal area done her waistline done. It’s good for somebody. Who’s got a little pooch that’s exercise intolerance, weight loss, and tolerance. So again you used to be pretty close to your weight loss, weight loss goal. Before you try this, even patients that are a little bit heavier, you don’t, you don’t have a liposuction results. You don’t have a perfect tiny Tami or, or smashed waistline, but for some patients having a nonsurgical answer for something that they have done within a few hours in the office and then go about their business and have this kind of a result is a really appealing option. So this is for somebody who says, I never want to have surgery. This is something that I want to do. And they want with it  

  Introduced dr. Keshaun the, a new associate to our practice. Dr. Kashani I’ve known for the past 10 years now. He was one of my, his team, their residents during training in general surgery training. Then he then completed his plastic surgery fellowship at the infamous Cleveland clinic where he basically with top artists. I like to think of them as artists in plastic surgery because they’re they’re my idols as well. And I’m proud to have him back in our practice now. And he’s going to talk to you guys about some good non-surgical facial rejuvenation as well. All right, dr. Sean, take it away.  

  Awesome. Thank you so much for the kind words, and I’m really happy to be here right now. So let’s hop right into it, liquid rhinoplasties. This is hands down. One of my favorite types of injectables to do this is for hold on. Sorry, let me just get this little bit more organized so you guys can see it. Can you see me? Okay.  

  So this is, this is really the way to get the result or as close to a result of a surgical rhinoplasty, but without any of the downtime. And I really think that’s, that’s the most important part of the liquid rhinoplasty that it can be done in 10, 15 minutes. It’s an outpatient procedure. You really it really requires a very minimal amount of filler and you can tailor it to whatever the patient is looking for. This is really one of those scenarios that when someone comes to see us for this, they tell us I really don’t like this bomb on the D on the back of my nose. I’d like a little bit more tip projection and really can get an absolutely amazing result. And you get to go home the same day and everyone thinks, you know, people won’t even realize what you had done, but they’ll know that it looks different. And they’ll get an idea that you had some type of change to your face. Let me tell you a few examples over here.

    This is the perfect example of someone that I would say, God, the perfect result from a liquid rhinoplasty, you can see that there’s a little bit of a dorsal hump. And even the tip, if you look at the tip on the before, picture is almost beaming down a little bit. And when you take a look at the after picture, there’s that beautiful line that you want to see coming down the doors, the nose goes on both sides. There’s no more hump going on over there and it’s a straight line. And you can see that by doing that, it actually rotated the tip up, which is really aesthetically pleasing. You really want to see that when you do the same thing, when you do a surgical rhinoplasty, so it’s really phenomenal results you can get with it, then you can also have this. And this is what I would say.  

I see the most when it comes to liquid rhinoplasties, it’s someone that’s either had multiple surgeries before on their nose or not traumatic surgery. Someone, I had this, not this patient specifically, but someone that’s had their nose bitten off by a dog and really didn’t want to have any more surgeries done. And this patient specifically had two previous rhinoplasties and said, you know what? I don’t want to do it anymore. I really want something that I can get done quick and easy and with very minimal risk of causing any more damage to her nose. So if you really take a look at the dorsum of her nose, she has almost a double bump deformity there where the dorsum of her nose. I actually collapsed a little bit because her cartilage from the previous surgeries just didn’t hold up as much. So what we ended up doing is just literally with 0.1 CCS of Voluma, we ended up giving her that perfectly straight nose that you wanted.  

And if you really take a look at the after, outside of just it being straight, it again, it makes it look like the tip actually pulled up and rotated up a little bit specifically with her. I didn’t inject anything into the tip. It actually just does that just by putting it in the dorsum. The other thing is, and we didn’t have to do this with her, but a lot of people come in and they’ve had their septum worked on previously and they still have a lot of issues with breathing. If you place the filler in the perfect position between the septum and the cartilage in the nose, you can actually improve the breathing. That’s something that we do surgically too, by actually putting cartilage there. We’re just replacing that process with with the filler. In this particular case, I use something like Voluma.  

  It’s going to last anywhere from a year to a year and a half. You have the option of using something that’s not as long lasting, or you could even go something that’s a little bit more semi-permanent. My recommendation always is when you start off, always try to start off with the less, and then if you love the results, then go and move on to something more permanent. That way, you know, would kind of get an idea of what you’re going to be getting out of it. The other benefit, which, sorry, let me click here. It’s not working again. One second. The other benefit before I go to the next slide is you, there’s a lot of people that just aren’t ready for a formal rhinoplasty. And really, again, want to get an idea of what kind of result they can get out of it. They’re not, let’s say they’re either working. They can’t get time off from work. And that’s really the ideal person for this. That’s someone that wants to go back to work the same day, doesn’t have about a week or two of bruising on their eyes. And they don’t want to wear a splint for that timeframe. And really you can get them at a position where they look great and they really can just go back to work the same day, even now, Signs of facial aging. Unfortunately we all go through this myself included and you can see the left side of the picture. That’s really the young aesthetically pleasing type of face. You can see that Jen, this is what dr [inaudible] was talking about. Most of her fat is located in her upper part of her face. You can see she has great volume in her cheeks. She’s got no wrinkles around their mouth, on her forehead or around her eyes. And then if you direct your attention to the picture on the right, you can see that she does have some forehead wrinkles. You can see that she has teardrop that form and use of those lines that develop over time underneath your eyes, the lines that develop here, which we call nasal labial folds, and that all has to do with fat kind of descending on the face. And you can see where those lines are right above them. That I actually used to be where her cheek used to be higher up. And then you can see wrinkles around her mouth. And also the angle of her lips are actually a little bit downturn. So it almost looks like she’s frowning a little bit. And then finally, around the jaw line, you can see what we call pre Giles or jowling, which is again, the descent of the fat kind of coming down on the face  

  In terms of what we can do for this, you know, dermal fillers are a great option. We have stuff like Juvederm products wrestle in radius. And really, I think this is where it makes a difference that the person you’re going to really understand what the fillers should be used for, why they’re used in those specific places and how to tailor them to yourself, not one filler is going to is going to solve every problem there. And I really that’s the important thing you have to, you have to really tailor it to the patient. So I’m going to go actually back one second. And if we’re looking at, at our patient here on the right, and we go from top-down approach, let’s say, we’re talking about her for it. So everyone always asks, where do you put filler, as opposed to where would you put Botox?  

  And the way to really think of that simply is Botox goes where you have muscle that’s hyperdynamic filler goes where you have fat that has kind of moved or deflated over time. So if we’re looking at her forehead, wrinkles, that would be an excellent place to place filler. In her particular case, you can actually see that she has a little bit of her brow medially that’s coming down. And what we would do is inject Botox here as well, which actually gives you a brow lift here. And we would also do a laterally to give a brow lift there as well. We can’t see it as much here because she’s not smiling, but she would also probably have smile line or prose feet, what you can inject Botox around there, which does twofold. It gets rid of those smile lines. And it could also act to elevate the brow laterally too, which is something that everyone always wants.  

  Now, if we’re talking about under eye, this is, this is in the last, I would say five to 10 years has become extremely, extremely popular specifically with social media and the way that people take selfies. So a lot of people are actually focusing more on their under eyes in the shadowing. Whereas before the answer was put some makeup, put some contour to try and hide it. Now we have a few things in our armamentarium to kind of fix that problem. One of the main things being you can place filler in two different levels. I think that if you’re going to do under eye fillers, you could put it very superficially under the eye to really kind of tapered that eye to cheek junction, make it a little bit smoother, but they also are missing some of the fat in that area. So this is where a nice heavier volume type of filler would be injected onto the bone.    

And it really pushes it out and really kind of gets rid of that fold. The other thing I would say to do is if you’re going to address the under eye filler, you really have to look at it as a full unit. I think that if you’re going to do that, it always makes sense to think about doing your cheeks as well. So what the cheeks and putting fillers in the cheeks does, while it also distracts the eye to looking at a more appealing kind of cheek structure, it also actually does a little bit of a facelift. And this is kind of where everyone talks about doing liquid facelifts. This is the, this is what they’re talking about. This is one of the first stages of doing that liquid facelift is really getting that cheek filler in filling in the volume that goes underneath the eyes.  

  And this is the same thing that we would do if we were doing an actual surgical facelift, instead of fillers, we would end up using your own fat. So it’s the same idea now for going down to the nasal labial folds here, you can see that they’re pretty deep there. Same concept. If you add enough volume into those folds and right around that area, you can actually, again, lift the cheek a little bit. You do blend that. So it doesn’t look as age. Then it doesn’t look as sunken and appearance. And it actually gives the appearance of more volume overall on the face. You have to be conservative here. Some people, if you put too much in them, it does make them look puffy. So this is where that finesse comes in in terms of how you’re going to inject and where you’re going to inject.  

  One of the things that I’d say people come a lot about too. If you’re looking around her mouth, she does have these wrinkles around their mouth. You can go a lot of different ways of how to treat this, but if we’re talking about fillers specifically, I love talking about lip fillers for this. I think if you accentuate the lips, it actually gets rid to the, for the most part of those wrinkles around the mouth. And you get the bonus of having fuller lips. And it looks like almost like you’re wearing lipstick. You don’t have to necessarily put so much in the lips that they’re very drastic, but you could put enough where it just enhances them a little bit. And while you’re doing that, as you, as I was mentioning before, she has almost the downturning in the corner of her mouth, that’s something that if you’re going to put filler in the lips, I inject out here and out here as well, which actually gives a little bit of a lip lift at the same time.  

  You also can have the option of kind of doubling up a little bit, doing the filler, and also doing Botox injections to the chin area here. And between the two of them, you actually get a pretty significant increase of the corners of the mouth. And now finally, the pre-judge area, this is something that you have to be extremely careful. This is, you know, you don’t want to necessarily do this on someone that needs a facelift, but you want someone that’s in between that can use a fit, maybe need a face lift in five to 10 years, but not really ready for it, and still has good skin quality. And while you’re doing that, you can inject filler right down on the bone. It gives volume, you know, people don’t like that notching appearance where they see the jowling. So what you do is you just blend that in.  

  And this is where I would say, if you’re going to go down that path and you’ve always wanted to have chin filler, this is the best time to visit that idea because you’re going to be injecting the same thing that you would be injecting into your chin, that you would be injecting into the jawline anyway. So you’re building up the jaw line, you’re building up the chin structure. So it matches what you’ve already built up with the lips and the rest of the face. And that’s really how you kind of complete at least for the most part, a liquid facelift and what you can’t really see on her. But, you know, if you were looking at the side view, if you didn’t have as well-defined the job, because that’s really what happens again, the fat is sending what you can do is do the same type of filler and really get a very nice face and even neck lift out of it. If you put the the fillers along the jaw line, and it really looks nice if you do it right, and you get a really well-defined jawline. So moving forward. All right. So we kind of talked about this already. Second. So I’m going to bring Tatiana over and she’s going to introduce Tara. Thank you guys.  

Hi everyone. So next we’re going to have her nurse practitioner, Tara. She is specialist in cosmetic injections. She has been working with dr. Turani for over 12 years. She is definitely amazing. And today you guys are going to be watching her do some fillers and one of her patients. So I’m going to introduce you guys to Tara now.  

Okay. Hi everybody. I’m Tara. I’m a nurse practitioner with the rest of crop classics. [inaudible] Hi I’m a nurse practitioner with plastic surgery. I’ve been working alongside dr. Trani for over 12 years and specializing in cosmetic noninvasive injectables. So today we’re going to be showing you my lovely patients. You have to turn it down here. So I’ll be showing you my lovely patient who has been with the practice for, for many years. And I’m going to show you today doing some noninvasive treatments. And Joan, can I tell you your age? So she is 84. And we’re going to show you that surgery may not be an option for you. And if not, then there are some noninvasive treatments that we can do is to just help make you a little more useful or feel a little more refreshed. So we’re going to be doing some Jupiter we’ll, we’ll not, and I’m going to just wipe off the skin so you can see The different areas Age we lose. We lose there’s loss. There’s pause. And that’s those now. So what the whole movement in a class of fillers is called hydronic acid. And what they do is a health is the area [inaudible], they last about two years and and the results are immediate. So I’m going to show you and we’ll do some markings. So you can see on Joan when we’re younger, the shape of our faces inverted triangle, and long, we start to age if the cross swear. So you can see where John has lost some of her chronicity buying Walgreens, and it kind of comes down creating some of these lines and poles down the lower base. So we’re going to add a little bit of a Loma to the new face because the cheek area, and it’s going to help to lift this area and creating a little more useful, both for her progress. So the area,  

Yeah.  

Can these markings tell me where I need to treat her.  

Cool.  

Hi Tara. Thank you for sharing. Rami was good to see you.  

Yeah,  

He’s saying the thank you for sharing. Great. John’s excited to be here as always. So we’re going to work a little on her lateral part of her face over here. It is. It’s not an equal, just like a little pinch. Okay.  

Sorry.  

Can you please share with everyone why you as a particular kind of filler in that area, as opposed to like the folds somewhere else? Because we’re really trying to keep that inverted triangle and when you feel cold or happening, it’s   The latter part.  

The mid part of her face is, is losing the volume and starting to kind of come down. So actually with this inverted triangle, you’re hoping lifts as well as these needs legal falls, rather than just filling these areas. And making her continue to look more square. It makes her look more useful, but then if they still have some volume, so we should expose to the Luma it, because it is soft and malleable and it’s an, you know, an injection that can last up to two years, which is really nice.  

Okay.  

I usually recommend not taking any Advil or aspirin for a few days also. You know, homeopathic, arnica can calve with any bruising or slime. It’s showing that Xeikon prior to the treatments,  

Wow,  

Just one syringe and you can already see how it’s lifted and given her that little bit of an arch here, which helps indirectly, you know, lift up this lower part of her face. So I’ll go ahead and go on the other side and we’ll add some as well.  

Okay.  

This is a deeper injection. It’s injected down to the awesome. So it lifts from underneath the thing, the surrounding tissue. So how often do you recommend That again? How often do you recommend,  

Then about up to two years, but because you know, Joan’s 84, she’s going to have more volume loss. And she has not, she does not want to do any surgery. There are a lot of  

That Joan is not, Joan is not 84, no, not 80, right? So there’ll be some swelling which usually lasts about 48 hours. And then that can come down, but you can already see there’s a little swelling here. Maybe want a little more on one side versus the other, and that’s normal, but it already helps to kind of lift this area and restore some of the bombing she had.  

Awesome  

And helps with that. Another payment we’re going to do for Joan is some Xeomin. And then at the omen is a, is a neurotoxin. It is, it helps we have static and dynamic wrinkles. As we’re younger, we have dynamic meaning when we move, when we frown, we instruct ourselves, we have wrinkles, but when, whenever we don’t have wrinkles, but as we start to age you know, breaking down the college and in those areas and use this with some static wrinkles. So you can see on Joan and by her eyes, she has some fine lines and it’s really not too bad, but can you raise your bra up for us, Joan? And can you squeeze in over here? So what the neurotoxin does is it relaxes the muscle. It releases a chemical that will relax the muscle, and it’s just a temporary relaxation of the muscle. It’ll help relax these muscles. So this is a downward facing muscle. So when we inject it, it’ll help to open this area up. And sometimes when we look at somebody it’s not necessarily the most important thing isn’t necessarily getting rid of every single line, it is we look at the level of her proud and how we can lift her brow. Those are things that all can make somebody look more useful with neurotoxin injections with the omen. So I’m going to do some of those now  

And was this, then you won’t see the results right away at 18, a few days to start some Kadian up three to five days, but can see up to two weeks. And then the results lasts about three to four months.  

Tara, can you also share when you would use a yeoman versus this board or Botox, or as you vote in different patients, maybe can you share when you would use Xeomin versus Botox or did you vote or Dysport in different patients?  

Sure. So, so they all, all the neurotoxins work very similarly on it for the most part after a while, do you like to switch the different types of neurotoxins because your body can build an antibody to them? Have you been using that for a long time? Xeomin with them and they take out some of the unnecessary proteins. So that minimizes the chance of antibodies forming. So for somebody that’s been on Botox for a long time, sometimes I’ll switch it up and do Xeomin and cord does kick in a little quicker. So within 48 hours that kicks in and sodas jump out, but they are all really fairly similar. Sometimes one may last a little longer for some one patient versus another, but for the most part, they’re very similar. Let me see, I’m asking Jones to kind of raise up because with her movement, her motto, I want to see really where she’s pulling and that’s going to help that she’s the best improvement and then out smile for me. Okay. And then can you make this side see, like she’s pulling around here and then all throughout this muscle around her eye.  

Okay.  

Let me ask you to move your muscles around, make the neurotoxin work in quicker and the muscle a little quicker. And then after the carer, more for the filler are some using some ice for about 48 hours and then like a song as well.  

Yeah.  

So you can see with the boat, that is the old man that you don’t see the results. Right. But over time, what will happen is this muscle will lift up the browser. Those create a little bit of an elevation in the lateral parts and round in this. So that’s some of these spots.  

Yeah.  

And that we’ll see over the next few days has Maluma is pretty in as well. But yeah. They can take them in or they can see if there’s some,  

Nope.  

They can always call me and email us and we’d be happy to answer any questions you have regarding any treatments.  

Kids are great for sharing, and we’re going to go to our a Q and a bit, and we’ll answer your questions in the meantime, ice and enjoy  

Hi guys. So now I would like to talk about our giving things together. So we’re, now we have 30% off of non-surgical treatments, including Botox, fillers, please  

Share your screen.

  Okay. Can you guys see it now? Yes. Okay. So as I was saying we do have 30% off for this week of non-surgical treatments, including Botox, fillers, lasers, peels, and more. And if you guys have any questions at the end, you will see our phone number, email, so you guys could reach out to us. So now dr. Turani and dr. Keshaun would like to answer your questions.  

So one of the questions says that does CoolSculpting kill fat cells. So CoolSculpting, the way it works is by killing fat cells and you want it to, so CoolSculpting permanently removes fat cells, and that’s the bat, the 20% reduction that you get with CoolSculpting 20 to 25% reduction. So that permanently reduces fat cells. It does it by process called apoptosis, which basically tricks the fat cells into killing themselves. So they actually freeze away the inside part of the cells and they go away and that result is permanent. Now, next question is, are our fillers? It says three Oh five off, but I think they mean 30% off. So all surgical or non-surgical treatments, including fillers, metastatic treatments all of our lasers are 30% off. Now. We obviously cannot do everybody this week, even though when they, in the years past, we actually used to do that during or Flynn, gab a Bonanza, but now we actually extend it. So you can, as long as the purchase happens within the first week, which is this week coming up, you can actually bank it and I’ve actually treatment done within the next three months. Next question is how to treat eyelid sagging. I’m going to let dr. Roxanne handle that question. Awesome.

  So yeah, I mean, it’s, it’s kind of a I guess a little bit of vague, but there’s a couple options. It depends what you mean by sagging. If you’re referring to the lines underneath the eye that’s something that we could definitely put filler under. Like I said, and give some volume over there to kind of blend it in a little bit. I will say it’s not an option for everyone. So it’s a, not an all-comers type thing. If some people that even if we put fillers in there that kind of bulging appearance to it, you may end up needing surgery anyway, to correct that, but fillers is definitely an option there. I’m assuming that’s what we’re talking about with eyelid sagging is sometimes that you can actually get the eyelid itself that droops a little bit, that’s something that would need to be corrected surgically. You can’t do that with fillers or Botox or anything like that. So that’s a great question. Great options

  At times I live as the first sign of aging, the same way that dr. Shan was talking about that part of it could just be genetic and you may not even be maybe young. And those are the young ones that we can actually inject to make it look like, kind of make that shadowing go away. There’s some non-surgical ways we can treat lower eyelids. All therapy is one where we can actually treat this skin underneath a nonsurgically IE matrix is another one that we can treat the, a low light is non-surgically and something that we use a lot of nonsurgically, especially during our things is Thermi smooth, which uses it in a radio frequency to attain the lower eyelids. Again, it’s for somebody who doesn’t want a surgical result, it actually improves that area with that completely, you know, having surgery and in some patients, surgery is the real option and surgery is not doesn’t necessarily mean you have some big surgery and occasionally especially upper eyelid surgery we can even do on the local anesthesia.  

So that’s kind of a long answer to that question. Next question is whether or not we offer human growth hormone, we do not testosterone a human growth hormone are something that are somewhat controversial and it’s not something that we do in our practice. And that’s something that we do not do. I’m sorry. The next question is about CoolSculpting again, whether or not it causes nerve damage to the neck. So CoolSculpting does not CoolSculpting basically removes fat cells. So it doesn’t do anything to you or nerve. There is another procedure called or non-surgical injection called Kybella, which has gotten a lot of press recently because it’s the first non non as an injectable to melt fat cells. And it’s the NFE approved the Mac fat Melcher of the neck, and that has caused some not permanent, but temporary nerve. I hate to call it damage because it’s temporary, but just some weakness of the of the nerve of the neck, which over time improves, but not CoolSculpting. I think I answered most questions that are all questions already, I think was just,  

Did you, I don’t know if you answered about the, how long does the liquid rhino last for? Oh yeah, please go ahead juror. So to answer that question, really, it, it ultimately comes down to which type of filler works best for you. On average, I would say you probably get about a year to a year and a half out of it. If it’s something that you really aren’t sure about, and you would rather a lesser duration of time, we could actually tailor the type of filler. So it doesn’t last as long, and it would last probably closer to six months, but in general, everyone tends to want something that lasts a little bit longer. So we we go based on, on what you’re really looking for and to kind of parlay that into the, how much does it cost. Again, it costs the price of whatever filler we ended up going with. There’s no actual price for the liquid rhinoplasty otherwise, other than just whatever we decide.  

All right. Great. So Tatiana, if you want to do your raffle thing. Yeah, I think we can we can go there now.

  Sorry. It looks like we have some more questions.  

Oh yeah.

  So for dr. T is CoolSculpting more effective than laser light bulb?  

No. So CoolSculpting is a non-surgical treatment. Nothing non-surgical is as good as surgery. So CoolSculpting does not replace a surgical results. It’s for somebody who has had who doesn’t want to have surgery. So liposuction, even though it’s minimal surgery, it’s still surgery. You’re going to have bruising and swelling. Whereas with CoolSculpting, you don’t have any of that. You may have a little bit of bruising, but you, you kind of back to normalcy. And that’s one of the nice things about CoolSculpting is for somebody who truly has some stubborn areas that are otherwise fit and, or stubborn areas and don’t want to have surgery. So the results are, I can say they’re comparable, but so sculpting and liposuction is is a different animal. And then someone has go ahead,  

Oh, sorry about the CoolSculpt thing. They already had one round of CoolSculpting and they want to know, does it make sense to continue with CoolSculpting or would you consider light bulb in the future? And I guess that they’re saying maybe they don’t see as much of a result initially.  

Yeah. So if, if you’re not seeing a lot of a result with CoolSculpting, you should consider surgery and something that we need to examine you and take a look at. There’s a very, very small set of patients that have CoolSculpting that have this thing called paradoxal hypertrophy, or the actual fat cells go into this. Or I cannot actually overdeveloping, that happens less than 1% of the time, very rare, but it can actually be something that needs to be addressed. So it’s best to be able to take a look at each individual patient and be able to cancel them after a, after a consultation.

  Great. next question is Tara still with us? I, I can’t see, but people should, I guess you stepped out, but, so the next question is how long do lip injections last? And I can take that. I mean again, this really depends on the type of filler you use, but for the most part, I’m going to say it lasts if you’re, if you get to the point of six months, that’s excellent. I’ll say most people tend to come in before that six month Mark, because now that you’ve already built up your lips with a little bit of that lip filler, the best time to do it is while you still have a little bit in there. So then you can maintain that fullness. And it’s actually easier. I at least I find it easier to re-inject someone that has a little bit of filler in to really get that volume as opposed to having to rebuild it from scratch.

  So I’d say on average, we see people that do get lip fillers every four to six months. And it really, some people come in sooner, but that’s just because they love the way they look and they want to even add more volume. So you do always have the option. A lot of the time everyone’s a little afraid their first time, they don’t want to put too much in, so we always start off small. I always recommend start off with one syringe. You know, you have the option of coming back in a week or two. And when, and if, and when you do love it, we could always add more in, so you don’t have to commit to a higher volume right away, especially if it’s your first time.

  That’s actually a really good point. And it’s something that we do quite often. And probably after Botox lip injections is the number two thing we do. And the idea is being settled and the idea is adding volume and then adding bit less after time. That’s part of the reason why we actually carry half syringes. So we carry Volbella, which is a half syringe for not really a touch-up, but really a top off. So you coming for a little sprucing, nobody knows you did anything, and you get a little bit of a great result before it comes off all the way. And then you can have that done fewer times in the upcoming months. So it’s about doing subtle smaller improvements.  

And I think that’s all we have. Question-Wise right. We’re out. Yeah. That’s the last of it. Great.

  So now I would like to talk about our raffles. So we’re going to have two winners for this counted breast augmentation with dr. Terrani up to 2,700 off. Then we also have four cycles of CoolSculpting, and we’re also going to have two winners of one Botox treatment. So each winner will get one Botox treatment. We also have one syringe of Juvederm, ultra plus XC and appeal package. So two winners for appeal package one at NYC and the other one in great neck. We also have less Lee. We have one, a complimentary surgical consultation with dr. Turani. So you guys could take a look at this lights and right here, I’m going to show you guys or contact information. Please let us know which roughly you would like to participate on, and we will write it down and announce the winner for next week. You guys could also send us a message in in our chat just to let us know which raffle you guys would like to participate. So I’m going to go back to the raffle. So you guys could take a look and the side, which one you would like to participate. So please send us a message in the chat, or you can email us with your full name, contact number and the rapport that you guys would like to be

  Participate.

  So I’ll repeat the raffles again. So winters were this concept, breast augmentation without the tyranny of two 2,700 of four cycles of CoolSculpting, two winners of one Botox treatment, one syringe of Juvederm, ultra XC, one peel package and NYC one peel, packaging, gray neck, and one complimentary surgical consultation without the Terrani. So please let us know. I’m going to show you guys are emailing Ks. You guys want to email us instead of sending it into the chat, and this is our best contact, email [email protected] and let’s stay connected. Thank you guys for joining us today, dr. T I don’t know if you want to say,  

Where is it? Oh, I see the check.  

Okay, guys, I see that you’re writing. Which one you would like to participate on, but can you please write your full name, phone number and the rappel? That way we have the whole information so we can contact you guys.  

Yeah.  

How much per Botox w I see that you sent us your phone number, so I can certainly have one of our patient coordinators contact you and give you all the information in regards to this. Thank you guys. Okay. I see that you guys are sending the phone number now, so that’s great.  

No,  

For those of you who don’t want to send it in the chat, remember this is the email that you can email us at, and just let us know that you watched the webinar and which route will you would like to participate.

  Okay.  

All right, guys. So that was it for today. Thank you guys for joining us. Thank you for watching. Thank you for staying until the very end. We will definitely be announcing the winner next week. So we will keep you guys posted. Thank you for watching.  
Young woman receiving a non-invasive facial procedure