Denver Plastic Surgeons

Radiesse for Sunken Eyes?

I'm 47 years old. I went for a consultation looking to find serums or products for my face. The lady I saw said not to waste time with products but said I look tired around my eyes and suggested getting Radiesse filler, Botox, and maybe Fraxel treatments.  Well, I can't afford it all but am considering the filler since my under eyes are a bit dark and sunken. Should I look at other fillers or would Radiesse be a good one to start with? Thanks for your advice!

While Radiesse is an effective treatment to restore volume loss in the cheeks and naso labial folds, I do not recommend Radiesse to correct volume loss in the tear trough area.

I would recommend using a hyaluronic acid based product such as Juvederm or Restylane to treat sunken eyes. Tissue around the eyes is very thin and there is a greater risk of developing a lumpy result when Radiesse is used. Hyaluronic acid based products are more maleable and, therefore, more forgiving. In addition, clients that are not satisfied with the outcome of their treatment have the option to use a product (hyaluronidase) to disolve the filler. This is not an option when Radiesse is used.

Joseph Serota, MD

Denver Plastic Surgeon

How Do I Know the Difference Between Sun Damage and Melasma?

I understand Melasma is untreatable (except for bleaching creams) but sun damage can be removed by fraxel lasers and/or photo facials. Both are large brown spots.

A lot of my patients have a difficult time seeing the difference between sun damage and melasma, so you are not alone!  Sun damage has a smaller, more random pattern on the skin, and is generally more superficial, whereas melasma looks almost like a shadow and covers a larger area.  When you actually see pictures (check some out online) you can tell the difference but it can be difficult without doing some research or having a professional diagnose you. 

Sun damage can be more easily remedied than melasma, as there is not a "cure" for melasma.  Melasma is hormone-induced, and sun damage is caused by previous years in the sun.  You can certainly quiet the melanocytes that cause melasma to look more prominent with in-office treatments by a doctor (or experienced aesthetician), or you can use creams that contain retinols and hydroquinone. 

Sun damage responds well to IPLs, lasers, or chemical peels on MOST skin types.  As always, before signing up to receive any treatments, do your research and make certain your skincare professional is experienced.   I hope this helps!

Joseph Serota, MD

Denver Plastic Surgeon

PIP Victim is Sub Muscular Implant AND Capsule Removal my Best Option?

I am 38 have had PIP submuscular implants I think 220 for 6 years I want them removed and not replaced I have read a lot about the capsule and would like advice. Should I insist on capsule removal because of the possible contamination through the faulty toxic implants that may have been absorbed into the protective capsule? I am concerned that even if I have the implants removed I will still be at risk from the industrial silicon.

I would add that I don't think it's possible to "clear" your tissues of microscopic silicone whether the implants are intact or not and whether the implant is intact or not. It's certainly not possible to know that all silicone and risk is removed although there's no solid evidence to support the supposed specific risk of the "industrial silicone". Removing the capsule if it is normal looking involves a bigger operation with more risk of bleeding and scarring and no assurance that this will remove all risk or all microscopic silicone. However, if the patient is properly informed as to the increased risks and costs of removing the capsule as well as the inability to completely clear all silicone from the tissues even with the capsulectomy, I would feel that the patient could make this choice. 

Scott L. Replogle, MD

Denver Plastic Surgeon