What do Plastic Surgeons do besides surgery?

All right, so if you're on my Instagram or new to my Instagram, you know me as a plastic surgeon. I've been in plastic surgery practice for the past 20 years here in Miami. So even my own patients, people I've operated on, been in my office a number of times, will sometimes be surprised to hear that I do fillers or Botox or Dysport. When I tell them this, they're like, oh my God, I know, I thought you only did surgery. I said, no, of course, that's part of my practice. You know, it's not something that I promote all the time, but I actually see those patients and do them every week. I've had some patients I've been injecting, same patient, for 15+ years. So, I do have sort of like, of course, you know, a group of patients that, you know, they're coming in fairly regularly once or twice a year to do that sort of thing. But I thought it would be a good idea to talk about a little bit because a lot of people don't realize that's part of my practice. In my practice, okay, unlike many practices out there, whether it be med spas or dermatologist's office or many plastic surgeons, I personally do all the injections. I don't have a PA, an assistant, a nurse that does injections. I do all the injections personally. That means you get me assessing you, deciding exactly what is going to give you the best result possible, and that's been a good formula for success in my practice. So I want to talk to you about a little bit about some of the different products that I utilize on a regular basis and the differences between them. So, the simplest thing— this is not a filler. This is what, you know, this is what is used for lots of different wrinkle modulation. This is Dysport. Okay, so Dysport would be an alternative to Botox. I like Dysport because it works very fast. Instead of taking like a week sometimes to take effect, it's really starting to work within the first day or two, and it also lasts probably about 20% longer on average. My patients are very happy with this. I've been using this exclusively for the past 12 years. So, things that you would utilize Dysport for. So, the most common things would be crow's feet, little wrinkles around the eyes, frown lines, or these wrinkles between the brows and the forehead. Those would be the most common reason, but there's lots of other things you can do with it around the lips, the neck, the jawline. I use it actually quite frequently for masseter muscle. It's like this big jaw muscle. When you bite down, you can feel it if you put your finger right on the angle of the jaw. A lot of people actually get headaches because they're grinding their teeth at night. A lot of tension does build up in that, and often at night patients are kind of constantly stressing and they're biting down, you know, really subconsciously. So actually use that not to paralyze that muscle, just to relax it a little bit. You're really directly affecting one of the causes of that tension and stress that can lead to pain and problems in the temporomandibular joint and TMJ and also headaches. So that's very, very effective for people. Another not as known use for it is for sweating, for people that have excessive sweating, especially for the axillary armpit area. So, Botox being a— blocks a neurotransmitter called acetylcholine. So, that same neurotransmitter is what is a signal from the nerve to the muscle to get it to contract. That's why it relaxes muscle because it blocks that. Well, the same neurotransmitter is what affects sweat glands to sweat, to stimulate them. So if you inject some into the armpit, that can be very effective for people that sweat a lot, or called axillary hyperhidrosis, excessive sweating. Basically blocks that for a 6-month period. So people that do that absolutely love it. So it works really well. Just a use that's been around for a long time, but not a lot of people even know about it. So dysport is a very big part of the practice, and oftentimes this is done in conjunction with fillers or without. And again, it's great for lots of little wrinkles. It can actually make people with really tired, heavy eyes really kind of open up and look refreshed. So, a nice sort of relatively simple, easy way to do it. And most people in my practice end up doing this around every 5 months or so. Okay, so that's Dysport, or muscle relaxant. Okay, now we have a whole bunch of fillers. So I'm going to go through the Restylane family of fillers. So hyaluronic acid is— hyaluronic acid gel is one of the main categories of fillers. Been around for a long time. I've been using them for 20 years. I like Restylane. They make a number of different products for different use cases. So I'm going to start with the sort of the thinnest or the least viscous. So this would be for things like really superficial lines. Works very well for the lips, and that's why they called it Kiss. Okay, so it's for the pucker, right? You're— when you, when you kiss, you use Kiss. Okay, so it's really good for the lips. I would say that, you know, most patients that are interested in lip augmentation, their biggest fear is it looking unnatural. So, in my patients, I can tell you with confidence that the majority of my patients, you will not even know that they had anything injected in their lips. Because it's done in a way that's balanced, it's natural looking. Of course, you're going to see examples of excessive use. You know, Housewives shows are always my example because they're so overdone. It just doesn't look good. So you see, you know, unnaturally big or the balance is off. You know, you have the upper lip, you know, much larger than lower. It should be the other way around. So keeping things balanced, using a conservative amount is going to be the best result in most cases. So Restylane Kiss works really good for that and also for fine lines, but that's a primary use. When I do lip injections, the lips are a very sensitive area, of course. So if you imagine putting a needle into the lip, it's going to hurt. So we use a combination of different things. Topical anesthetic, ice packs are very effective, especially done right before a needle injection, and also dental block. So just like you had a dentist, you go to the dentist, you get some dental work done, they do a little block with local anesthetic and it numbs the whole area around the mouth for about an hour or so. So patients do very well with that, and the idea is that they're not feeling any kind of pain while you're doing it. All right, so that's Restylane Kiss. Then we have the original Restylane. Okay, so you also see this one here, it says Restylane has L. A lot of them come pre-mixed with lidocaine. So in addition to all the other measures I mentioned regarding, you know, minimizing or eliminating pain during these procedures, Restylane comes with lidocaine, so as you're injecting it, it anesthetizes those areas. This is a great general use. I use it for lips as well, depending on the case, but most of the time using Restylane Kiss now. This was their original product and they still make it. It's great for using for tear troughs, for filling in sort of these puffy or hollowed-out areas, areas between the nasolabial fold, these little crease or smile line a lot of people have. Area around the jawline. So it's a really good general use for filling in wrinkles. Again, with Restylane hyaluronic acid, you're gonna, you're gonna get approximately 1 year out of these types of products. Okay, and then there's a few that are kind of in the in-between viscosity. So these are thicker, these are better for structural building. So Restylane Contour, Restylane Define, and Restylane Lift. Okay. So these are really good for those deeper lines. Maybe you have thicker skin, you need more volume, more structure to lift up that, that heavy wrinkle in a, maybe in a male patient. Also for cheeks, for building up the structure, cheekbone highlights, lifting, filling up tissues. Maybe patients lost a lot of weight, they have a little bit of loose skin, they've been on Ozempic. So you need to fill in some of that area, especially in the cheek. This, these products work very well for that. Now, another completely different family of products would be something that actually builds your own collagen. So the idea with this type of product is that it's going to last a lot longer. So the one I'm going to mention lasts up to 5 years. So this is great for building more structure, more volume, especially for like the cheek area, the jawline structure, chin augmentation. And a lot of times this is not the first filler this particular patient has ever had because they already know that, okay, this looks good, I like that. And I want something that's going to last a lot longer and give me more structural integrity. The way this works, completely different than hyaluronic acid gel. The gel is put in there. It's a natural product. It's found in your dermis and your body eventually breaks it down over the course of about a year. With this product, it's the opposite is happening. It forms a scaffold. These are tiny little particles. Your body actually forms its own collagen. That's why it lasts up to 5 years. So this one, is called Bellafill. So, for patients that want a longer-lasting augmentation, maybe better jawline definition, chin augmentation, cheeks, structural after weight loss, or just building up a cheek highlight, lifting of the cheeks in the lower to mid-face, Bellafill works very, very well. Again, taken out of a box, it's injected, lasts up to 5 years. The nice thing about this as compared to some other ones on the market is that you have to— some of those other ones, you have to mix them and you have to inject them multiple times, actually build it up over time. This you do it once. Now, can you add to it with future injections? Absolutely. But you don't need to do it multiple times. So this is another one. So again, don't forget, Dr. Simon for fillers, for your Dysport needs, you know, all those little things that kind of like— I call it maintenance of the face. You can go work out and I encourage you to do so and stay healthy and eat a good, well-balanced, healthy diet. But this is like working out and maintenance for your skin. So, need those little tune-ups, you got a special event coming up, holidays, just want to look your best. This is a great way to do once or twice a year in a relatively inexpensive way to take care of it. And again, I'll be the one seeing you, making the decisions along with you, and doing all the injections personally. Anyway, have a great day and rewind it. Take a listen again. I'm going to do little individual videos on each of these products so you can take a look. And next time you need something, give us a call. We'll be happy to take care of you. Have a great day.