News & Updates

Face Lifts

January 10th, 2014

Questions and Answers with Dr. Burns

Q: Is micro-liposuction to facial areas a viable step to take to remove some of the fat from previous fat injections? Has removal of placed fat in these areas been done successfully? Any other options?

A: I am sorry to hear of your situation, especially since it is so difficult to treat. Facial liposuction is to be avoided if at all possible as any irregularity is noticeable. With such treatment you might be changing one problem for another. The good news is that it doesn’t  sound like you have been out a full  year from your fat injection.  Usually there is quite a bit of fat resorption over the first year, which is one of the problems with fat injection, but in your case that could be a blessing.  If it does last a year then it is permanent. Liposuction with small cannulas in expert hands is certainly one option of treatment.

There is a new treatment of injection to melt fat, Kythera, but it is painful and causes swelling  temporarily that can be significant. Such treatment also has to be repeated multiple times reportedly. It is not currently approved in the US but should be shortly. You might look into this in the future, but hopefully the fat will resorb more to your liking.

For all the reasons mentioned above, I am not a fan of fat injections in general. Although this technique remains popular with many physicians, fat injection has many issues. There is a high variability in resorption rate. Granulomas(painful red nodules) can occur and obviously issues like the one you are describing for yourself can happen. You also have to deal with a sometimes painful harvest site location.
Today there are amazing alternatives with injectable fillers. Although they have to be repeated, several can last for 1 to 2 years and no general anesthesia is required.  A new filler, Voluma can last 18 months to 2 years and is reversible if too much is put in and you find yourself in a similar situation to the one you describe in your question. My patient population is growing exponentially each year with very satisfied patients who come in for the excellent filler and injectables offered today.

February 27th, 2013

Questions & Answers with Dr. Burns ~Isolated Neck Lifts~


Q: Best Procedure for Firming Neck and Chin?

I’m about to turn 50. The skin on my face is relatively firm and in great condition for my age so I don’t need a Facelift.

However, my neck and chin area doesn’t look nearly as good as my face. What are my options for firming up the neck and chin area?

A: Isolated Neck lifts

I do not believe most patients understand that the bands and looseness in the neck are connected to the face, In fact the SMAS (sub muscular aponeurotic system) is a fascia (like grissel on steak) runs from the cheekbone to the clavicle.  It is like a curtain.

It is hard to push a curtain up from below and make it look optimal. It is best to pull a curtain up from the top of the curtain, which is the face. This may not be what you want to hear, but the best way to treat the neck is a facelift in my opinion.

I see many surgeons perform an isolated neck lift because that is what patients want. However I see many patients who have such a procedure that are disappointed. In fact, I see patients who have their neck tightened toward the middle without doing a facelift. This approach can oftentimes actually bring the SMAS layer toward the middle and create a worsening of the jowl area.

I know many patients are afraid of facelifts because of a few bad results they have seen. However a well done face lift usually produces a result that is natural and youthful. A well done facelift actually should be very hard to detect. The ones that are detected are usually only the bad ones.

I would encourage you to go to an experienced Board Certified Plastic Surgeon and discover his or her approach. Thoroughly review their work in before and after photos to achieve a comfort level. Most facelift patients in my practice are extremely satisfied and have a much improved contour in the neck and face.