Q. What are my options for reducing a prominent jaw?
A. We offer jaw shaving as well as non-surgical jaw reduction. Non-surgical jaw reduction involves the injection of BOTOX® (botulinum toxin type A) or Myobloc™ (botulinum toxin type B). This type of jaw reduction is a very good alternative to surgery because it carries fewer risks.
Q. How long will the effects of non-surgical jaw reduction last?
A. Results vary depending on the patient. On average, the effects of BOTOX® are visible for 6 months. If we inject you with a double or triple dose of BOTOX®, the results will usually last 9-12 months. Sometimes non-surgical jaw reduction can lead to permanent results. Permanent results are more likely in patients whose jaw muscles were not originally large, but grew thick with aging.
BOTOX® injections also appear to cause permanent results in those with a medical condition called benign masseteric hypertrophy, which is characterized by pain and enlargement of the jaw muscle. For most patients, I recommend two injections per year for about 3 years. After this point, the results of further injections last quite a long time.
Q. I do not live in the Los Angeles area. Will it be possible for me to schedule a consultation and the non-surgical jaw reduction procedure on the same day?
A. Yes. Most people come in for a consultation and proceed with the BOTOX® injection during the same appointment. I have many out of town patients who come in just for an injection in the jaw area. For these patients, I usually recommend a double or triple dose of BOTOX®, as it leads to a longer lasting, sometimes permanent result. Before traveling to Los Angeles for the jaw reduction procedure, I recommend that you send me a photo so I can evaluate your individual needs.
Q. What are the risks of non-surgical jaw reduction?
A. The risks are very minimal. Less than 1% of patients experience swelling and less than 0.1% experience partial paralysis that lasts up to 2 weeks.
Q. Will my face lose sensitivity following a BOTOX® injection?
A. No. Sensitivity and movement are affected by two different types of nerves, so the jaw area will not lose sensitivity following an injection.
A. For many Asian patients, lasers can cause skin discoloration. Therefore, we are very careful when we do decide to use laser treatment on Asian skin. We use a special laser and pay special attention to skin treatment before and after the procedure. Pretreatment with Retin A® and hydroquinone, a bleaching agent, helps to minimize the risk of skin discoloration.
Q. What is your preferred breast enhancement method for Asian women?
A. The usual incisions in the breast fold or areola lead to prominent scarring in Asians; therefore, we prefer to make an incision within the nipple itself when performing Asian breast surgery. When this method of Asian breast augmentation is used, the nipple usually heals with almost no scarring.
Q . I am interested in receiving facelift surgery but do not live in the Los Angeles area. Is really better to go all the way to L.A. to get high quality results, or can I trust a surgeon in my area to perform Asian plastic surgery?
A highly qualified surgeon can usually perform a facelift without problems, but he/she should be apprised that the cheekbone area should not be made wider (this can happen depending on the facelift technique used, especially the SMAS, or muscle tightening technique). The hard part is finding a good facelift surgeon, as the operation is already difficult, and even more so on Asians. Asians generally have sagging in the upper face (brow, upper lid, midface) while Caucasians have more problems with the lower face and neck area. A proper facial analysis will usually show that the main areas needing correction are the brow, upper, and midface, and often nothing needs to be done in the neck. I am sure there are good surgeons in your area; however, they should be familiar with Asian aesthetics, in which the cheekbones should not be augmented during the facelift procedure.
Q. Can you tell me more about calf injections with BOTOX® Cosmetic? My calves are really thick and I wish to have the muscle thinned out.
A. BOTOX® Cosmetic works by paralyzing your muscle, which shrinks it. It has exactly the opposite effect of exercise, which increases the muscle size. For best results, quite a bit of BOTOX® should be injected into your calves. The initial cost is $2000, then $899 every 3 months until you see an effect. Most people need about 3 injections to see a result, which will last about 9 months. After about 5 injections, the effect of the injections appears to last several years, and can sometimes be permanent. For out of town patients, I suggest getting all your doses up front, then returning if you need to about 6 months later. You may not need to return if the muscle is still small. I have not seen any complications with this procedure, though it is possible that you could experience temporary paralysis in a portion of your leg.
Q. How much will a browlift change my appearance? Will people notice that I've undergone surgery?
A. You will look refreshed, but there will be no visible scars for anyone to see, since the incision will be behind the hairline. Though people may notice that you look better, they probably won't be able to tell why.
Q. When is the appropriate age to get a browlift? I've heard that only older people get this done that's why I'm hesitant to undergo the procedure.
A. If you have deep horizontal forehead lines, it is appropriate to undergo this procedure no matter how old you are. Some people are born with naturally low eyebrows, which causes the forehead wrinkles. Often, forehead wrinkles occur with aging, especially soon after childbirth.
Q. Could you tell me more about cheekbone reduction surgery?
A. This procedure is frequently performed in Korea, although not as much in the U.S. I learned how to perform cheekbone reduction surgery from Se Min Baek's group in Seoul, Korea, the practice that developed the procedure. I performed it for the Discovery Health Channel in February 2005 - you might catch a rerun on "Plastic Surgery: Before and After."
All surgeries have risks, but on a relative scale, cheekbone reduction surgery is no more dangerous than a subperiosteal facelift or correcting a fractured cheekbone. There is a potential risk to your nerve that moves the eyebrow, but I have never damaged it. The procedure takes about one hour under general anesthesia with a one night nursing stay. You can expect some bruising that will turn purple, then yellowish to green over the course of a week or two. Swelling is acceptable by seven days but it may take almost a year before you see the final results. I would recommend taking 7-10 days off work and stay in the LA area for about a week. In most cases, patients are particularly sore following the procedure.
Q. I am an Asian male with chubby cheeks and a round face that lacks definition. I would like to have my nose a little sharper at the tip, and more definition around my jawline. What procedures would you recommend for me?
A. I would like to perform nose surgery to give you more definition in the tip area and refine it, but it is not always possible to refine the nose as much as most people want. Much will depend on the thickness of your skin, which can only be assessed by actually seeing you in person. Without seeing you, I think nose surgery, buccal fat removal, and BOTOX® Cosmetic to the jawline would be good procedures. In addition, I think a chin implant would help immensely.
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Asian Jaw Reduction