Lesser known cosmetic procedures can be helpful

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Everyone knows about facelifts, eyelid lifts, nose jobs, mommy makeovers and various breast procedures.

There are also some less well-known surgical and nonsurgical cosmetic procedures that can make a big difference.

Have you ever heard, "You can always tell a person's age by looking at their hands?"

There are multiple solutions for this depending on the individual: the atrophic skin revealing the veins, bones and tendons can be treated quickly with injections of fat or various fillers, such as Restylane or Juvederm products, and the difference is immediate and dramatic. For age spots the Fraxel laser or LaserGenesis can be effectively used.

For saggy brows, fillers can be used in the forehead and under the brow itself. Many brows sag because of loss of the youthful mound under the brow and into the forehead.

This takes just a few minutes, is relatively painless, and the result is immediate. The Fraxel laser, the ThermiSmooth and Laser Genesis are additional procedures that further raise the brow and augment the youthful appearance of the forehead.

Large earlobes seem to occur with age, and this is partly from heavy earrings constantly weighing the earlobes resulting in thin, droopy appendages. If too thin, a filler can suffice with Restylane or Juvederm.

If they are too large, a minor surgical procedure will reduce them. Often a combination might be necessary for optimum results.

Over-plucked eyebrows might result from the fad for pencil-thin eyebrows years ago. The treatment is a hair transplant from the back or side of the scalp. The brow hair will look very natural and is permanent. Anesthesia is local and down time is minimal.

As we get older, we lose size in our maxillary bone (the bone our upper teeth are attached to). This can result in a droopy nose.

A long term filler, such as Voluma, can be injected over the maxilla just under the center of the nose, and the nose will turn up beautifully. Crooked noses can often be treated effectively with fillers injected into depressions to create symmetry.

As one ages, upper lips get thinner and longer. This increase in length can be reduced with a "buck-horn" lip lift, an excision of about 0.5 to 0.6 millimeters of skin just under the nose to achieve the ideal length of 14 to 15 millimeters.

The name refers to the shape of the excision and is done under local anesthesia in a few minutes. Fillers and-or Fraxel lasers can be used for peri-oral wrinkles.

Non-surgical reduction of fat and skin tightening can be achieved with radio frequency, as in the ThermiSmooth, ThermiTight, or ThermiVA (for vaginal restoration and stress incontinence).

The fat reduction appears to be permanent, and the skin tightening lasts a year or longer. Treatments are typically to the neck, arms, eyelid wrinkles, abdomen, thighs and "love-handles."

It would be effective for mild to moderate "man boobs" (gynecomastia) as well. Either general or local anesthesia is needed with minimal recovery time.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. www.fingerand associates.com

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