Category Archives: Facelift

Aging and Car Exhaust

In sunny California, cosmetic procedures have a lot to do with fixing aging skin. The more wrinkles we have, the more we worry about how old we appear to others. To combat wrinkles I perform procedures and treatments such as face lifts, Botox and laser skin resurfacing. But have you ever wondered if it’s not just age causing your wrinkles?

Recent studies show that car exhaust and soot is now deemed the third major modifiable factor that causes skin to age early. The top factor is ultraviolet rays, while second place is taken by tobacco smoke. This means that living in a highly populated area could be part of the reason your skin has begun to wrinkle earlier than expected.

It’s been known that soot and car exhaust can be bad for the respiratory system and that it causes minor cognitive failure in the elderly. It even has been linked to type 2 diabetes and is now being studied to see if it is involved in the pathogenesis of Alzheimer’s disease. But the fact that it can induce skin aging is yet another strike against industrial areas.

Unless you literally live in the country, it’s hard to avoid excessive car exhaust and soot. But you can contribute to the environment by cutting back on the amount you drive, and walk or ride a bike instead. If you live in a heavily populated industrial area, be sure to take extra care of your skin. And when all else fails, there are treatments to combat those early wrinkles at my California plastic surgery practice.

To your health and beauty,

Dr. Vip Dev, MD


Thyroid Surgery Doesn’t Have To Be Ugly

A thyroidectomy is not a procedure I do, however, my California plastic surgery practice does see many patients that have undergone the procedure who want to fix their post-op scarring on their necks. In California, laser skin resurfacing is a great way of treating those scars. Interestingly enough, due to the high amount of thyroidectomy patients coming to plastic surgeons afterwards, otolaryngologists are now using a few plastic surgeon techniques to cut back the intensity of thyroidectomy scars.

One of the techniques being used is marking the incision sites while the patient is sitting up. By doing this the incision site falls in a more natural area compared to if the site was marked after the patient was lying down and gravity was pulling at the skin in a different direction. These surgeons are also working on trimming any traumatized skin edges to minimize scarring, as well as using surgical glue instead of sutures to close up. Of course, the main focus is to take care of the thyroid, so you cannot expect an extravagant plastic surgeon touch. Otolaryngologists are not specifically trained in plastic surgery, let alone facial plastic surgery, after all.

I, on the other hand, am a highly regarded facial plastic surgeon. I am highly qualified to work on those scars that you’d love to get rid of. Not only that, I can perform a facelift and get rid of your scars at the same time, giving you an overall better appearance after your thyroidectomy.

To your health and beauty,

Vip Dev, MD

How Young Will A Facelift Make You Look?

A number of my clients that come into my California Plastic Surgery office wonder just how young a facelift will make a person look. The truth is that the specific answer is highly subjective, and in reality, is in the eye of the patient. However, a new study may be able to finally shed some light on this subject.

Eric Swanson, M.D., recently published a study in Plastic and Reconstructive Surgery. He studied 82 women and 11 men, all relatively the same age, who had undergone facelift procedures between 2002 and 2007. Facelift surgical satisfaction results were comparable to prior results in which patients reported improved self-esteem, higher quality of life, and positive reactions to their new appearance.

When these same patients were asked how young they thought they appeared, the average answer was 12 years, while some patients went as far to claim they looked up to 27 years younger. It was reported that at least one patient did not think they appeared any younger.

It should be kept in mind that not all patients only received facelifts. Some received brow lifts and/or eyelid surgeries, meaning this could have caused a spike in an even younger appearance. The general consensus, however, is that facelifts do in fact cause you to appear younger, up to about twelve years, but also depends on how the patients perceive themselves.

Have you gotten a facelift? How young do you think it made you look?

To your health & beauty,

Vip Dev, MD

Survey Says: 30% of Women Over 40 Want a FaceLift

According to a new survey, over a third of women over 40 are concerned enough about their appearance that they would definitely consider plastic surgery if they could afford it. The average age the women surveyed believed was the best age for plastic surgery is 52, 41 weeks and four days. Also, according to those surveyed, 20% of the surveyed women between 40 and 60 said they would gladly get a face lift to smooth out the signs of aging if money were no object.

In my Bakersfield plastic surgery practice, women start coming to us on a regular basis in their early 30’s, principally to put off facial rejuvenation surgery, such as a face lift, by having dermal fillers and Botox injections, as well as facial treatments with our aesthetician, Terra. Through the judicious use of these facial treatments, patients can forestall the need for more invasive treatments for many years.

Did you know that dermal fillers, for example, can be injected to lift the cheek area, which also lifts the jowls, one of the first signs in an aging face? It’s true. You can literally have a “liquid facelift” through the proper placement of these fillers, all without surgery. Now, eventually, aging will continue to the point where even the best and best-placed fillers won’t do the trick, and at that time you’ll need to decide whether or not you want to have surgical face lift. However, as fillers become more and more advanced, that stage is put off longer and longer. If you aren’t certain whether your facial aging can be managed with fillers vs surgery, give Terra a call and ask for her consultation. I can also examine your face to help you understand your options.

What do you think about this? Are you taking advantage of skin treatments and dermal fillers to put off surgery until much later?

To your health & wellness,

Dr. Vip Dev

Can you have a face lift without a neck lift or vice versa?

Occasionally a patient here in Bakersfield will ask me if I’ll do just their face lift or just their neck lift instead of combining both of them in one surgery. Sometimes they ask this because they think only one area needs rejuvenation, and sometimes they ask because they’re trying to save a little money and plan to have one area treated now and the other treated later.

There are two reasons why face lifts and neck lifts are both done in one procedure:

  • In a neck lift, the neck skin is lifted and redraped behind the ears. While this area is open, I can undermine the cheek area (the SMAS) and lift that as well, all at the same time. Why not do that while I’m already in that neck of the woods (pun intended) instead of doing another procedure later?
  • When just the face or neck is done without the other, there is an obvious visual “disconnect.” The rejuvenated area becomes more pronounced as having had a procedure. Doing the neck and face together creates a more youthful result with the entire area in harmony.

Although I have occasionally done the face without the neck, it’s not my preference for the reasons above. If you’re considering facial rejuvenation, remember, most people “take in” your face and neck all at the same time; ie, it’s seen as one area. You can see from the before/after above, that the neck would look quite obviously older had this patient not had a neck lift along with her face lift.

To your health and beauty,

Vip Dev, MD

How Do Lasers Work?

Laser technology for cosmetic usage has been around for the past 40 years, but has come into its own in the past five years, offering men and women a variety of treatments including hair removal, body sculpting and skin resurfacing. Occasionally, a patient will ask me how the laser actually works. Truth is, until recently, nobody has known the exact underlying processes that occur with lasers! Is it the laser light that motivates the collagen to rebuild or is it the heat that the laser delivers?

A researcher by the name of Susanne Dams, with Philips Research Eindhoven, conducted her own studies on lasers to find the answers.

Dams treated cell cultures and human skin with heat shocks of 45 and 60 degrees Centigrade, without using a laser light. (This is equivalent to 113 to 140 degrees Fahrenheit. Water boils at 212 degrees Fahrenheit, so 113-140 is hot but not boiling hot.) Her results show that the heat shocks increased the production of collagen. When laser light was added, the only measureable difference was the ability of the laser to pinpoint the exact location of heat delivery. This is an important part of the treatment, inasmuch as heating smaller areas of skin is safer than heating larger areas of skin. In fact, her study also showed that heating the skin to 113 degrees Fahrenheit for 8-10 seconds was the optimal amount of heat to increase collagen. Above that temperature there is no added benefit and, in fact, causes skin cell damage.

Collagen is a skin protein that gives skin elasticity and firmness, the “bounce back” that young skin enjoys. Beginning in the mid-20’s, our collagen production begins to decrease, leading to wrinkles and sagging skin.

Three ways to increase your collagen levels

Studies show that there are 3 primary collagen-builders for those of us in the over-30 crowd:

  • Laser Skin Treatments:
    • Although the CO2 laser is considered the Gold Standard for skin resurfacing, the after-effects force patients to hide from the world for 2-3 weeks as their faces crust over and peel. Not a pretty site and most people don’t have 2-3 weeks to spend for recovery. Fraxel treatments and even chemical peels can obtain similar results, with little to no downtime. Instead of one big treatment, chemical peels and fractionated laser treatments are divided into 4-6 treatments, giving essentially the same results without the recovery time.
  • Retinoids:
    • Retin-A is the only topical skin treatment that is proven to increase collagen. No matter what they tell you on TV, this is a fact. For those in need of this, I can prescribe Retin-A.
  • Hyaluronic Acid Fillers:
    • Fillers made with hyaluronic acid, such as Juvederm, Restylane and Perlane, have been shown to increase collagen. This explains why, over time, you may need less filler each time you come in for a filler treatment. It’s not because you retain the filler from the last treatment, but because your own collagen is rebuilding.

Some things that damage collagen, by the way, are sun exposure and tobacco usage. If you want to keep your looks, use a good sunscreen and don’t smoke!

To your health & beauty,

Vip Dev, MD


Study Proves that Beauty is Bone deep, not Skin deep

Before/After Face Lift

Over the years, face lifts performed by a plastic surgeon in Bakersfield as well as plastic surgeons elsewhere, have focused on three primary tasks:

  • repositioning the muscles of the face,
  • lifting the fad pad of the cheek back to its original position, and
  • redraping the skin to create a youthful appearance.

Fat or dermal fillers are often used to fill out that part of that face needing a bit more substance, such as the temples and the nasolabial folds, the “parentheses” mentioned in the TV ads.

Recently, however, University of Rochester Medical Center researchers, joined by colleagues from Harvard and Stanford, discovered that the gradual erosion of bone over time may contribute to the aging facial appearance. We all know that as we age many of us become shorter. It’s not a stretch to imagine that other bones get smaller, too. These researchers contend, after studying the CT scans of 120 faces, that the facial bones also shrink with age. Apparently, beauty isn’t skin deep—it’s bone deep.

The 120 CT scans were divided by age into three groups: those 20-36, 41-64 and 65 and older. The facial bones were measured in each age group to see if the facial bones of the older individuals’ were smaller. They were.  This research may lead to future face lift procedures that include bone grafts to the jaw or the use of plastic prosthetics to “beef up” the lower face and create the more youthful results.

If you’re noticing bone loss in your face, come in and talk to me about bone restoration as part of your facial rejuvenation procedure.

To your health and beauty,

Dr. Vip Dev