Nonsurgical Facial Rejuvenation: Botox and Facial Fillers

•

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An overview of injectable techniques of nonsurgical facial rejuvenation, focusing on Botox Cosmetic and Juvederm. Includes extensive before and after photographs.

Gesundheit & Medizin

New
Direc)ons
in

Plas)c
Surgery:

Non-‐Surgical
Facial

Rejuvena)on

Joshua
D.
Zuckerman,
MD

Joshua
D.
Zuckerman,
MD

•  Plas)c
and
reconstruc)ve
surgeon
at

New
York
Plas)c
Surgical
Group

•  Board
Cer)ﬁed
by
the
American
Board

of
Plas)c
Surgery

•  Aesthe)c
surgery
of
face,
breast,
and

body

•  Non-‐invasive
facial
rejuvena)on

•  Full
proﬁle:
hMp://www.lipsg.com/
about-‐our-‐prac)ce/our-‐doctors/dr-‐
joshua-‐zuckerman-‐new-‐york/

New
York
Plas)c
Surgical
Group

•  ManhaMan
division
of
Long
Island
Plas)c

Surgical
Group,
PC

•  Largest
and
oldest
Plas)c
Surgery
private

group
prac)ce
in
the
USA

•  Only
private
prac)ce
Plas)c
Surgery
group

with
an
academic
residency
program

•  6
oﬃces
in
the
New
York
/
Tri-‐State
area

Understanding
the
Aging
Face

•  Collagen
breakdown

–  Loss
of
skin
elas)city

–  Wrinkles

•  Fat
atrophy

–  Loss
of
volume

–  Thin
lips

•  Sun
damage

–  Texture
changes

–  Veins

–  Age
spots

Botox

SAFE
and
EFFECTIVE

in
both
the
short
and
long

term

Botox

How
does
it
work?

Weakens
muscles
by

prevenDng

neurotransmission

Botox

Where
does
it
work?

Glabellar
lines/Frown
lines

Horizontal
forehead
lines

Crow’s
feet

Bunny
lines

Neck
lines

Botox

Course
of
Treatment

Ini)al
injec)on
–
First
Consulta)on

Evalua)on
at
2
weeks

Return
when
the
eﬀect
BEGINS
to
wear
oﬀ
at
about

3
months

Hope
to
increase
injec)on
interval
by
prompt

retreatment

Tissue
Fillers

Natural
substances
that

ﬁll
wrinkles

•  Smooth
gel
ﬁller

•  Cross-‐linked
HA

•  Combined
w/
lidocaine

•  Instant,
natural
result

Nasolabial
Folds

Glabellar
Lines

Before

AHer

Nasolabial
Folds

Oral
Commissure

Before

AHer

Nonsurgical Facial Rejuvenation: Botox and Facial Fillers

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In this captivating lecture, Dr. Faiza, an esteemed Assistant Professor of Physiology, embarks on a comprehensive journey into the multifaceted realm of local blood flow regulation. With meticulous detail and clarity, she unravels the intricate mechanisms that govern the dynamic balance between tissue perfusion and vascular resistance, shedding light on both acute and chronic aspects of blood flow control. Beginning with an exploration of acute influences, Dr. Faiza elucidates how physiological factors such as metabolic demand, myogenic responses, and autoregulatory mechanisms orchestrate rapid adjustments in local blood flow. Students gain insight into the vasodilator theory, which elucidates the role of metabolic byproducts and vasoactive metabolites in promoting vasodilation, alongside the oxygen demand theory, which underscores the interplay between tissue oxygenation and nutrient demand. Delving deeper, the lecture delves into the fascinating realm of humoral control, where hormones and vasoactive substances wield significant influence over vascular tone. Dr. Faiza navigates through the intricacies of endothelial-derived factors like nitric oxide (NO) and histamine, alongside hormonal regulators such as angiotensin II and vasopressin. Through vivid explanations and illustrative examples, she unveils the intricate dance of vasodilation and vasoconstriction orchestrated by these biochemical messengers. Moreover, the lecture extends its gaze to the extrinsic control of blood flow, where sympathetic innervation exerts a profound impact on vascular dynamics. Dr. Faiza elucidates the role of sympathetic tone in modulating vascular resistance, highlighting its implications in diverse physiological and pathological scenarios. From skin perfusion to coronary circulation, students gain a nuanced understanding of how neural inputs shape local blood flow patterns. Enriched with clinical insights and contemporary research findings, this lecture equips students with a holistic understanding of blood flow regulation. By exploring concepts like active and reactive hyperemia, vascular remodeling, and collateral circulation, Dr. Faiza fosters a deeper appreciation for the adaptive responses of the cardiovascular system to changing physiological demands and pathological insults.

Control of Local Blood Flow: acute and chronic

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These are simplified slides discussing the regulation of cardiac output and venous return. Learning objectives: 1. Comprehend the determinants of cardiac output and factors affecting cardiac output 2. Comprehend the factors affecting stroke volume and heart rate and total peripheral resistance 3. Identify the factors regulating venous return 4. Discuss the causes of high and low output cardiac failure 5. Enlist the functions of veins and recognise the significance of venous reservoirs Study Resources: 1. Chapter 20, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 30 and 32, Ganong’s Review of Medical Physiology, 26th edition 3. Chapter 10, Human Physiology by Lauralee Sherwood, 9th edition 4. Physiology, Cardiac Output - StatPearls https://www.ncbi.nlm.nih.gov/books/NBK470455/

Cardiac Output, Venous Return, and Their Regulation

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Nonsurgical Facial Rejuvenation: Botox and Facial Fillers

1. New Direc)ons in Plas)c Surgery: Non-‐Surgical Facial Rejuvena)on Joshua D. Zuckerman, MD

3. Joshua D. Zuckerman, MD •  Plas)c and reconstruc)ve surgeon at New York Plas)c Surgical Group •  Board Cer)ﬁed by the American Board of Plas)c Surgery •  Aesthe)c surgery of face, breast, and body •  Non-‐invasive facial rejuvena)on •  Full proﬁle: hMp://www.lipsg.com/ about-‐our-‐prac)ce/our-‐doctors/dr-‐ joshua-‐zuckerman-‐new-‐york/

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5. What makes you look older?

6. Understanding the Aging Face •  Collagen breakdown –  Loss of skin elas)city –  Wrinkles •  Fat atrophy –  Loss of volume –  Thin lips •  Sun damage –  Texture changes –  Veins –  Age spots

10.

11.

12.

13.

14. Botox SAFE and EFFECTIVE in both the short and long term

15. Botox How does it work? Weakens muscles by prevenDng neurotransmission

16. Botox Where does it work? Glabellar lines/Frown lines Horizontal forehead lines Crow’s feet Bunny lines Neck lines

17. Botox Course of Treatment Ini)al injec)on – First Consulta)on Evalua)on at 2 weeks Return when the eﬀect BEGINS to wear oﬀ at about 3 months Hope to increase injec)on interval by prompt retreatment

18. Glabella Before Aber

19. Forehead, Glabella Before Aber

20. Crow’s Feet Before Aber

21. “Botox Brow Lib” Before Aber

22. Horizontal Neck Lines Before Aber

23. Platysmal Bands Before Aber

24. Tissue Fillers Natural substances that ﬁll wrinkles

25.

26. •  Smooth gel ﬁller •  Cross-‐linked HA •  Combined w/ lidocaine •  Instant, natural result

27. Nasolabial Fold Fillers Before Aber

28. Nasolabial Folds Glabellar Lines Before AHer

29. Nasolabial Folds Oral Commissure Before AHer

30. Tear Troughs Before Aber

31. Lip Augmenta)on Before Aber

32. Lip Augmenta)on Before Aber

33. Cheek Augmenta)on Before Aber

34. “Liquid Rhinoplasty” Before Aber

Nonsurgical Facial Rejuvenation: Botox and Facial Fillers

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Nonsurgical Facial Rejuvenation: Botox and Facial Fillers