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TheSelfieThe Selfie. It’s an epidemic in the social media world and everyone from celebrities to politicians to toddlers is participating. Love them or hate them, they are here to stay. Despite tutorials from seasoned selfie pros like Kim Kardashian, we’ve seen far too many double or triple chinned self-portraits floating around on Facebook and Instagram.

The selfie craze is leading more people to seek cosmetic procedures. Among our patients at Chelsea Cosmetic, the eyes and neck area are the two body parts that they are most concerned about due to the way they look in photographs. According to the findings of a 2014 study by the American Society for Dermatologic surgery, 68% of American consumers are troubled by a double chin or other symptoms of submental fullness. To many people, this makes them look older or heavier than they actually are. This can have a serious negative impact on a person’s self-image, especially in today’s world of digital media.

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KybellaLogoThat is why many who live with double chins are rejoicing at a new decision made by the U.S. Food and Drug Administration to approve a drug that promises to melt chin fat without surgery. The drug is called Kybella and this first-in-class injectable substance dissolves fat around the chin that forms the dreaded double chin. This area is often resistant to the weight-trimming effects of diet and exercise.

Before Kybella, the only way to address this trouble spot was surgery such as a neck lift or liposuction. Both procedures, while effective, also have their fair share of risk and downtime. There have been some new technologies such as ThermiTight that Dr.Eviatar helped pioneer. ThermiTight uses radiofrequency to non-surgically treat the lower face and neck and permanently melts fat. While less invasive and costly than surgery, it is associated with some downtime (swelling) and requires a separate appointment. Kybella is truly a quick, safe and customizable procedure that can often be administered at the same appointment as Botox and fillers.   Dr.Eviatar believes this will revolutionize treatment to the chin area in ways injectable fillers have to other areas of the face.

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The active ingredient in Kybella is deoxycholic acid, a natural occurring molecule in the body that aids in the breakdown and absorption of dietary fat. When injected into subcutaneous fat, Kybella causes the destruction of fat cells, permitting dermatologists and plastic surgeons to resculpt the chin area without surgery. Once destroyed, those cells cannot store or accumulate fat.

KybellaBoxKybella is administered via a series of injections into the chin area. Treatments entail two to six monthly sessions of roughly twenty minutes each. Patients must commit to multiple visits. In studies conducted for FDA approval, the most commonly reported side effects were bruising, numbness, redness, pain and swelling which usually cleared up in 2-3 days.

Chelsea Cosmetic is excited to offer Kybella to patients who have moderate to severe submental fullness and are looking for a way to achieve an improved chin profile as well as a tighter neck. Dr.Eviatar believes the introduction of Kybella for removing chin fat is just the beginning. Using this injectable to melt fat in other areas of the face and body may be just around the corner.

VISIT OUR KYBELLA PAGE FOR MORE INFORMATION

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We are all seeking the “holy grail” of anti-aging and one of the most frequent questions I’m asked by patients for whom I recommend using fillers is, “what about injecting my own fat for that?”   Isn’t that permanent and therefore less costly?

The short answer is no.  The more intelligent response follows:

1. Fat injections are not permanent in most cases, at least not with a single treatment

Firstly, while you might think you wanta permanent filler, what looks good at 30 or 40 may look awful and unnatural at 50 or 60. We aren’t permanent.  Our faces and bodies are made of living tissue that is constantly changing as we age.  Something that looks great after your treatment today, in five years invariably doesn’t look as good, and can even look really bad, after mother nature does her bit on your face (if you’re lucky).  Nonetheless, the permanence of fat is a misconception:

When fat grafting is successful in the face, we consider it “permanent” after about 8-12 months.  Just like fat elsewhere in the body, however, if you gain or lose weight, those fat cells will enlarge or shrink. Watching your weight becomes that much more important, as you don’t want a face to get bigger in certain areas as your weight increases. But most patients require several treatment sessions until the grafted fat survives in quantities where it even makes a noticeable and natural improvement.

The reality I have observed over my 24 years of practice was summarized nicely in this month’s premier evidence-based medicine magazine on plastic surgery, “The Journal of Plastic and Reconstructive Surgery” wherein the authors reviewed all the research studies on fat grafting to date. They concluded that fat cells can resorb as much as 70% of the time. The results from injections may be replaced in some cases entirely by necrotic or dead cells, and that inflammation–mere swelling–may be the only real success of a fat injection at all. In short, fat grafting comes with no guarantees.

While there is one “permanent” FDA approved product in the US for cosmetic treatments of the face (now Belofill, previously named Artefill, useful in certain applications) it is not reversible, is not widely used, and I choose it only for selected treatments.To date, there is no non-surgical modality to correct unsightly fat (should it end up in your face) though several new injectable agents are in the FDA approval pipeline for selectively dissolving fat; should these prove effective in their applications, the indications for using fat may change.

Many of the common facial fillers such as Voluma, Restylane, Juvederm are both lasting, and easily reversible with an enzyme, hyaluronidase, that dissolves the product within several hours.  This group of Hyaluronic Acid based fillers are therefore ideal for first time patients who are nervous that they won’t like the results, or are comforted by knowing that some, or all, of the product can be dissolved if they are unsatisfied.

2. Fat injections are not more “natural”

The fat cells in your flanks, thighs and buttocks are all slightly different from each other, and from the fat that you have (and lose) in your face; injecting these fat cells from one body area to another is not exactly natural.  On the other hand, off the shelf fillers are usually designed to be well tolerated by the body because they are purified versions of the body’s own building blocks (hyaluronic acid, calcium and collagen, for instance, are all naturally occurring) making for a low risk treatment with high patient satisfaction, good bio-compatibility, and the ability to customize the procedure to the exact tissue response in the location of treatment.

Long-lasting injectable products like Sculptra can be a great solution for those who want a “natural” product, as it simply stimulates your body to form its own collagen in the locations where it is injected. To maintain the results and continue to look your best, a maintenance treatment every year or two is ideal, and during those treatments, the product is placed in the location it is needed at that time, thus ensuring the best, most natural looking result.

3. Fat is unpredictable

In addition to there being no guarantees that a fat graft will even take, fat is finicky. It needs to be “overcorrected” (due to its high resorbing rate), and after a fat graft your face will look very puffy for several weeks (or longer), bruised (the cannulas we use are larger than the fine needles and cannulas we can use with today’s fillers), and when it settles, hopefully enough of it will be viable to give a long term result.

Because it is so unpredictable, asymmetry, uneven contours and bumps usually require more surgery or hiding the imperfections with fillers.

On the other hand, fillers provide a wide selection of tools available to finely treat each area of the face:  some to lift, other to shape and contour, some to tighten skin, and yet others for fine lines. There is usually no down time, and the results are far easier to control and maintain.

When it’s a good idea to use fat

So when is fat a “good” idea?  In patients having liposuction for example, where we are already harvesting fat, it can be injected in areas of the face such as the cheek or chin or for asymmetry with the understanding that often areas won’t “take”, and that most patients require several treatment sessions until the grafted fat survives in quantities where it makes a noticable and natural improvement.  Additionally, in patients having face-lifting procedures where they’ll be very bruised and swollen anyway and volume is needed for a balanced result, using fat may be a viable option, (at least as far as recovery time, etc. for the patients).  We carefully counsel patients that it is common to either need more fat injections for the grafts to “take” in a natural appearing fashion, and patients should expect that we’ll be using other injectable synthetic fillers to treat surrounding areas as needed.

While adverse events are much higher with fat injections compared with the new injectables, both can result in rare but serious complications including blindness and skin or soft tissue death (if the product is injected into a vessel by mistake), and lumpiness or uneven results. Only skilled, experienced and artistically talented physicians or surgeons who are dedicated to treating the face should perform even these “minimally invasive” procedures.

Aesthetic medicine is an exciting and quickly advancing field requiring an artistic eye and a scientific mind.  It is ever changing, and brings great satisfaction for well trained, board certified doctors who are passionate about fusing art and science, and for patients who want to look and feel their best.  But both must be prepared to embrace the challenges and opportunities that each new decade brings.

 

Today, practitioners of many disciplines perform cosmetic procedures. Not all procedures are equal, however. At Chelsea Eye and Cosmetic Surgery, our expert team takes more than just one aspect into account when recommending procedures and treating patients.  With a holistic approach to face and body, our expert faculty can treat more than just what meets the eye.

Knowing that beauty isn’t about one thing alone, we have created for you a number of packages that treat the whole picture. Developed based on our long experience, each package uses a combination of various technologies and techniques to give you the best result, safely and effectively, with only minimal downtime.

Cellulite Treatment

Cellulite is universal and progressive, but can now be treated and improved. Chelsea Eye and Cosmetic Surgery has developed a technique using the Thermi 250 device, the most advanced non-invasive radiofrequency device for lifting and tightening the face and body–as well as the underlying soft tissue.

Sculptra is injected below the skin which begins the process of collagen stimulation, while disrupting the unflattering contour of cellulite bands. The treatment then utilizes the potency of the Thermi 250 device to treat both skin laxity and stubborn fat simultaneously, while also promoting the body’s natural production of collagen over time.

*For a more aggressive approach, Dr Elan Singer, MD, FACS is also available to administer the procedure using the minimally-invasive Thermi RF Tight device for treatment of more advanced cellulite.

 Hand Rejuvenation Treatment

Hand Rejuvination

Your hands work hard for you. They may be the first thing someone notices, and can be a giveaway of age, even more quickly than your face.  At Chelsea Eye and Cosmetic Surgery Associates we have created a hand rejuvenation treatment to combat the signs of ageing.

Using Radiesse to add volume back into the hands and Intense Pulsed Light (IPL) to treat sunspots and other telltale signs of age, our restorative technique can take years off the appearance of your hands.

Neck Rejuvenation Treatment

Neck Rejuvination

While there are many approaches to neck rejuvenation, our non-surgical approach targets both fine lines around the neck area, as well skin laxity and hyperpigmentation on the neck and jaw. with only minimal downtime, this program can achieve dramatic results in certain cases.

Radiesse is first injected under the skin to create volume, eliminating fine lines, while stimulating collagen production. A plan is then customized using either the Thermi 250 device to treat skin laxity, or IPL to target discoloration of the skin.

 

Getting in shape is easier, with a little help.

Most people resolve to get in shape for the New Year; a new year, a new you!   But after a holiday season that can feel like a non-stop marathon buffet,  you’re not alone if you need a little help realizing your physical goals.

Chelsea Eye and Cosmetic Surgery Associates can help you kick-start your 2015 agenda.  With a variety of non-surgical procedures to tighten and tone your body, you can even lose those love handles, just like you’ve always wanted!

Thermi Technology Tighter, smoother, trimmer!

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Whether your goal is a stronger jaw line or a smoother, tighter body, Thermi Aesthetics might be right for you.  Chelsea Eye and Cosmetic Surgery Associates now offers a variety of non-surgical Thermi procedures to tighten the body, minimize skin laxity, and even reduce stubborn fat.

We’re excited as well to be part of the latest study in Thermi Technology, a non-invasive radiofrequency treatment for wrinkles, skin laxity, and cellulite.

Schedule a consult with our office at 212-727-3717 and learn more about about how you can be chosen to participate in our incentivized study.

CoolSculpting Lose those love handles. Finally.

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Have you heard about CoolSculpting? It’s a great, non-surgical way to reduce areas of fat that don’t otherwise respond to changes in diet or exercise.

After just a few treatments, patients see noticeable, long lasting results. CoolSculpting is great for fat reduction on thighs and midsections, and with two highly trained aestheticians on staff–and two CoolSculpting machines–Chelsea Eye and Cosmetic Surgery Associates can have you beach-ready in no time!

Schedule a CoolSculpt consult with our office today 212-727-3717.

Chelsea Eye in the News Get your Chelsea Body started

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Want bigger biceps, but don’t have time for all those curls? If you missed Dr. Eviatar on CBS News last month, you may not know that bigger muscles are closer than you think! No longer is a defined physique only in reach for gym devotees. Now, using FDA-approved injectables like Sculptra, Dr. Eviatar has been able to give patients a more substantial, even bulging look. Patients are seeing half an inch or more on biceps alone

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You too can get a bigger, more defined physique–and get closer to your fitness goals–without ever setting foot in a gym! Call our offices at 212-727-3717 to get your Chelsea Body started.

Chelsea Eye & Cosmetic Welcomes Rebecca Weston, Aesthetician

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Chelsea Eye and Cosmetic Surgery Associates is pleased to welcome esthetician, Rebecca Weston to the practice. Rebecca is a licensed and certified laser technician with over a decade of experience working in the skin care industry. Her expertise in laser hair removal, skin resurfacing, tattoo removal, and skin rejuvenation–as well as CoolSculpting procedures–makes her an asset to us, and a remarkable resource for you!

In addition, Rebecca specializes in facials, makeup application, eye brow design, lash extensions and tinting. Her extensive knowledge of product ingredients enables her to provide a superior skin care regimen to complement and enhance your results in between visits.

To schedule an appointment with Rebecca, call 212-727-3717.

Chelsea Eye & Cosmetic Welcomes Dr. James Kirszrot, MD

kirszrotChelsea Eye and Cosmetic Surgery Associates is proud to welcome Dr. James Kirszrot to the Chelsea Eye team! Dr. Kirszrot brings to the practice his expertise in medical and surgical treatment of conditions affecting the eyelids, tear ducts, and eye sockets. His specialties range from eyelid malpositions, to ptosis and periocular growths.

In addition, Dr. Kirszrot  specializes in cosmetic eyelid surgery, he has extensive experience performing blepharoplasty surgery (“eyelid lifts”), midface lifts, and surgical procedures toremove lower lid bags. He is skilled at using Botox and fillers such as Restylane and Juvederm to treat facial wrinkles, working closely with Dr. Eviatar.

Please join us in welcoming Dr. Kirszrot!  To schedule an exam call 212-727-3717.

Chelsea Eye & Cosmetic Surgery Associates sees many men and women looking for improvements in lower lid dark circles, bags, puffiness and hollows that make them look older and tired.  This top-rated practice offers long-lasting treatments that can remove 10 years from the face–all with the option of no surgery and little or no downtime.  Dr. Eviatar, an oculoplastic surgeon with many years of experience (and someone who trains other doctors in these treatments and techniques), understands the complexities in dealing with the sensitive area under the eyes.  There are vast differences between visiting a less specialized and less experienced cosmetic practitioner versus seeing a specialized and skilled oculoplastic surgeon like Dr. Eviatar.  It can mean the difference between “okay” results versus excellent, youthful and natural looking results.   When it comes to being able to return to work or an active lifestyle, patients are looking for a minimally invasive procedure with little or no downtime.  This is what Chelsea Eye & Cosmetic Surgery Associates offers.

Watch the video to see procedures that Dr. Eviatar and his aesthetician, Jeannel Astarita, perform on patients using Restylane, Voluma, Intense Pulse Light (IPL) and Glytone Eye Peel.    You’ll also see the before and after results. Find out what they can do for you.  Please visit www.chelseaeye-cosmetic.com to find out more about the practice and schedule your appointment today online–or call Chelsea Eye & Cosmetic Surgery Associates at 212 737-3717.

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When it comes to the complex areas around the eyes, a cosmetic surgeon’s background and experience make all the difference.  As both an oculoplastic surgeon who specializes in the area around the eyes  and a surgeon who understands the nuances of ethnicity, gender, age and skin tone, Dr. Eviatar achieves excellent and natural looking results for his patients.    He also trains other doctors on these same treatments.  Chelsea Eye & Cosmetic Surgery Associates sees a lot of Asian patients who want to look more youthful and see aesthetic improvements with minimal or no downtime and the option of no surgery.  Watch the video to see Dr. Eviatar implement minimally invasive techniques using ThermiSmoth, fillers and BOTOX.
Please visit www.chelseaeye-cosmetic.com for more information about these and other treatments and schedule your appointment online–or call Chelsea Eye & Cosmetic Surgery Associates at 212 727-3717.

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Growing Your Biceps, Triceps, & Buttocks

Traditionally, there have been no good body fillers. Butt implants, calf implants, and bicep implants look unnatural and require major surgery. They almost always have to be removed, get encapsulated or infected, are very expensive, and tend to look overly dramatic (much like with facial implants). Growing Biceps

That’s why I found it necessary to pioneer this “off-label” usage of Sculptra, which is different because is based on the material used for medical sutures that trigger a healing response when they dissolve. During the initial FDA Clinical trials 15 years ago, doctors found that this material could be used to create volume in the face by stimulating collagen to treat Facial Wasting in AIDS patients.  Unlike silicone (which lasts permanently), the actual Sculptra product is absorbed by the body. In addition, because it’s your own collagen that is grown, it’s totally natural, and diminishes slowly over time. Treatment is considered to be “semi-permanent”. To maintain the results, usually a yearly treatment is required because it doesn’t stop the aging process. Maintenance can be accomplished with Sculptra or with other products; Sculptra doesn’t preclude the use of any other fillers or devices if you desire a greater change or require other treatments moving forward.

As our techniques have been refined, Sculptra has proven very useful. It can be used to lift, shape, and volumize the face, to improve skin tone and texture, to smooth fine wrinkles, to create a tightening effect, and even to address bone loss from the aging process. That’s what makes it such a top product. All of these things can be achieved with other products, but usually only in combination: a laser to tighten, a filler to give volume, and surgery to lift. Here, in one product and with the right technique, we’re often able to accomplish things that may otherwise require several different procedures to accomplish.

When we started using Sculptra in the face, one limiting factor to using it elsewhere was the high cost of product. I had always thought that in the buttocks you would need a lot of product to get it to work. What we learned in the face, though, was that the location of injection really can maximize the results. With the buttocks, we don’t really need to inject the entire area because the aging process creates a drooping effect, rather than a smaller booty. We can do what we do in the face, which is to inject the upper part to lift and shape the buttocks. This makes it affordable for the patient. So, in the face where you might standardly use two vials for a treatment, in the buttocks we use three or four vials – but because the buttocks treatment technique is faster and less complicated, the cost can be the same for the patient. Less product is usually needed for arms, biceps, calves, and other areas.

The important thing to keep in mind is that this treatment isn’t designed for emaciated or overweight people. It’s for the in-betweeners that have good body shape already but want a little help. You need the underlying muscle to augment in order to get a nice aesthetic result. It’s difficult to take a flabby arm and create a bicep. This treatment is for people who have some definition, but have thin arms or legs and want bigger muscles. It’s also for people who are getting older, whose pants are starting to sag, and who want a little bit of a lift and that appearance of a “shelf.” If you really want a big butt and you have no butt, you need a butt implant or you need fat transfer. If you are overweight, you need liposuction or abdominoplasty. It’s for everyday people who want to cheat the gym a bit yet want that sexy body without all the effort.