Optimising Injectables using Ultrasound

The Advantages of Ultrasound in Facial and Lip Injections: Enhancing Precision and Achieving Optimal Results. 

Ultrasound technology has revolutionized the field of aesthetic medicine, offering valuable insights and enhanced precision during facial and lip injections. In a live workshop conducted by renowned experts, Dr. Gabriela Casabona and Dr. Konstantin Frank, the numerous benefits of using ultrasound for injecting fillers and injectables were discussed. This article explores the advantages of ultrasound in these procedures, including its ability to provide detailed anatomical mapping, improve injection precision, guide toxin placement, analyze filler behavior, and tailor treatments to individual patient needs. Incorporating ultrasound into facial and lip injections can significantly optimize outcomes, ensuring natural-looking and customized results.

Precise Injections for Optimal Results

Ultrasound technology plays a crucial role in achieving precision during facial and lip injections. By utilizing ultrasound imaging, practitioners gain a comprehensive understanding of facial anatomy, allowing them to inject fillers and injectables with greater accuracy. Mapping the face and identifying key structures, such as muscles and arteries, enables practitioners to determine the most suitable injection sites.

The diffusion of toxins varies between muscles, making it essential to understand how each muscle affects placement and toxin spread. Ultrasound provides real-time visualization of the toxin's behavior, allowing practitioners to adjust injection angles and achieve precise results. This knowledge helps prevent the inadvertent blocking of unintended muscles, improving patient safety and reducing the risk of unexpected outcomes.

Moreover, by studying a diverse range of faces and using ultrasound mapping, practitioners can refine their injection techniques. This comprehensive understanding enables them to calculate the precise location and depth of injections for each patient, leading to improved overall outcomes. Ultrasound serves as a valuable tool for confirming injection accuracy, ultimately enhancing patient satisfaction.

Anatomical Mapping and Filler Behavior

Ultrasound's ability to provide detailed anatomical mapping greatly assists in determining optimal injection sites and evaluating filler behavior. By visualizing facial structures, including the nose, lips, temples, and fascia, practitioners can identify the areas that require treatment and develop a tailored approach for each patient.

When using fillers, it is crucial to understand how they behave subdermally or supraperiosteal to ensure the desired outcome. Ultrasound imaging allows practitioners to monitor filler distribution and evaluate its spread in real-time. This knowledge helps them assess whether the filler is spreading correctly and achieving the desired results. Additionally, different fillers may behave differently, and ultrasound enables practitioners to make informed decisions regarding filler selection and injection technique.

Furthermore, ultrasound facilitates locating and assessing the fascia, a key anatomical structure that contributes to facial volume and support. Identifying the fascial layers helps practitioners determine the most effective approach for treating patients, particularly when addressing concerns such as acne scars or restructuring the mandible. By combining ultrasound guidance with precise filler placement, practitioners can create a more defined and aesthetically pleasing V-shaped look.

Lip Injections: The Tripod Technique and Skin Assessment

Ultrasound technology offers valuable insights and guidance when performing lip injections, particularly with the use of the tripod technique. Each patient's lips are unique, and tailoring the treatment to their specific anatomy is essential for achieving natural-looking results.

Traditionally, following the muscle during lip injections leads to excessive projection. However, with the tripod technique, practitioners can achieve more balanced and harmonious results. Ultrasound imaging allows them to assess lip height, projection, contour, and the condition of the skin. This comprehensive evaluation ensures that all factors are considered, resulting in a harmonious and proportionate lip enhancement.

In addition to guiding injection depth and placement, ultrasound can also help assess the skin's condition. The upper lip, in particular, may require additional attention to address signs of aging. By incorporating ultrasound, practitioners can identify areas where the skin may benefit from complementary treatments, such as laser resurfacing or dermal fillers.

Bottom Line: The integration of ultrasound technology into facial and lip injections brings numerous advantages that benefit both practitioners and patients. Ultrasound provides detailed anatomical mapping, enhances injection precision, guides toxin placement, analyzes filler behavior, and aids in tailoring treatments to individual patient needs. By harnessing the power of ultrasound, practitioners can optimize outcomes, improve patient satisfaction, and achieve natural-looking results. The use of ultrasound in aesthetic medicine represents a significant advancement, empowering practitioners to deliver safe, precise, and customized treatments for facial and lip rejuvenation.

What is Forehead Reduction Surgery?

Discover more about Forehead Reduction Surgery

Forehead reduction, also known as hairline lowering or foreheadplasty, is an aesthetic surgical procedure with the goal to reduce the height of the forehead and reposition the hairline closer to the eyebrows, resulting in a lifted forehead, brow, eyelids, and eyes for a more balanced facial appearance.

The general steps of a forehead reduction procedure may include:

Consultation: The process typically starts with a consultation with the plastic surgeon, during which the patient's medical history is reviewed, and aesthetic goals and expectations are discussed. The surgeon will examine the patient's forehead, hairline, and facial proportions to determine if they are suitable candidates for the procedure.

Anesthesia: Forehead reduction is usually performed under local anesthesia with sedation or general anesthesia, depending on the surgeon's preference and the patient's comfort.

Incision: The surgeon will make an incision along the new hairline that they plan to create. The placement of the incision is critical to ensure that scars are well-concealed and hidden within the hairline. 

Tissue adjustment: The surgeon will carefully lift the scalp and underlying tissues, adjusting the hairline to the desired position. Excess skin may be removed, and the remaining tissues are sutured in place to secure the new hairline.

Closure: The incisions are closed with sutures or surgical staples, and the scalp is dressed with bandages.

Recovery: After the procedure, patients are typically advised to rest and avoid strenuous activities for a certain period. Pain medication and antibiotics may be prescribed to manage discomfort and reduce the risk of infection.

Follow-up: Post-surgery follow-up visits are essential for the surgeon to monitor the healing process, remove sutures, and address any concerns or questions the patient may have.

fig. 1. Example of forehead reduction in young female patient. 

Dr. Beatriz Berenguer, a skilled and renowned plastic surgeon who employs a meticulous approach during her live forehead reduction surgery recently performed at the MIPSS meeting hosted by Ocean Clinic, Marbella. She begins by removing the upper line of forehead skin and then reconnects the hairline to a lower point, carefully measuring and planning the reduction. In this particular case, she takes a patient's initial 7.5cm brow down to a new height of 5cm.

During the surgery, Dr. Beatriz is highly attentive to post-operative care instructions, which she explains to the audience. After the forehead reduction, the skin in the treated area remains numb, and the stitches need to fully heal. As a result, certain haircare practices are advised against during the recovery period. Patients are cautioned against using straightening irons or other hair appliances, going to the hairdresser, or styling their hair in ways that create tension on the forehead. High ponytails, for example, should be avoided for up to six months.

As Dr. Beatriz sutures the forehead together with the hairline after removing excess skin, she emphasizes the significance of avoiding tension in the sutures. Any tension during suturing could lead to pulling and result in an uneven scar. To ensure the best stitch appearance, Dr. Beatriz explains that she always sutures from the scalp to the forehead, a technique that she has found to yield superior results based on her previous experiences.

A question from the audience prompts Dr. Beatriz to discuss the "mat stitching" technique. She acknowledges the technique but confidently affirms that the procedure she uses consistently achieves the best results in her opinion, provided there is no tension during suturing.

Overall, forehead reduction performed by a skilled plastic surgeon can provide individuals with the confidence and appearance they desire, achieving a more balanced facial harmony and improved aesthetics.

Fig. 2. Example of a forehead reduction in young female patient. 

It's important to emphasize that forehead reduction is a surgical procedure with potential risks and complications. Like any surgery, there is the possibility of scarring, infection, and adverse reactions to anesthesia. Therefore, individuals considering this procedure should thoroughly research and consult with a qualified and experienced plastic surgeon to fully understand the potential outcomes and make an informed decision.

Contact Ocean Clinic’s highly skilled and experienced team of surgeons to discuss your options with forehead reduction surgery.  

What is a MACS Facelift?

 MACS Facelift Techniques Explained 

In this blog post, we will delve into the advancements in technique related to sutures, the use of a hemostatic net, and the direction of the skin lift, which contribute to the success of this procedure, as demonstrated at the 6th annual MIPSS meeting (organised and hosted by Ocean Clinic, Marbella). 

MACS Facelift Techniques:

The MACS facelift is a revolutionary surgical procedure that targets signs of facial aging, such as sagging skin, jowls, and deep folds. Unlike traditional facelift techniques that involve horizontal skin pulling, the MACS facelift employs vertical skin lifting, providing patients with a more defined and youthful appearance while maintaining the natural positioning of the facial hairline. This technique is equally suitable for male facelifts.

Sutures and Their Importance:

During a MACS facelift, sutures play a crucial role in achieving the desired lifting effect. Sutures are medical threads used to hold the repositioned facial tissues in place, providing support and ensuring long-lasting results. It is important to choose sutures that will gradually dissolve over time, preventing any reduction in the lift's effect as they dissolve.

Utilizing a Hemostatic Net:

In some cases, a hemostatic net is incorporated into the MACS facelift procedure. A hemostatic net is a fine mesh-like material made of biocompatible synthetic fibers or collagen. Its primary purpose is to aid in hemostasis, which involves stopping bleeding during surgery. By applying a hemostatic net over the surgical site, the surgeon ensures the sealing of small blood vessels, reducing bleeding and improving visibility during the procedure. This enables precise suturing and enhances the overall surgical outcome.

Addressing Excess Skin and Scarring:

During a MACS facelift, excess skin behind the ear and at the temple area is dealt with using incisions and sutures. The incision behind the ear will eventually be covered by the natural hairline, rendering the scarring virtually invisible. By carefully removing the surrounding excess skin, the surgeon sculpts the face, creating more defined and youthful features.

Fat Transfer for Facial Sculpting:

To further enhance facial sculpting, fat transfer techniques are utilized in a MACS facelift. This involves injecting the patient's own fat into specific areas of the face, such as the cheeks just below the orbital rim. The amount of fat injected varies depending on the patient's needs and desired outcome. The fat is treated using barbed and sharp cannulas, which ensure precise handling, dispersion, and embedding of the small fat particles. This technique results in natural-looking and long-lasting results.

Addressing Specific Concerns:

In addition to facial volume and sculpting, the MACS facelift technique can address specific concerns such as the nasolabial fold. Depending on the nature of the fold, the entrance point for the injection may vary. By strategically filling the area, a smoother appearance is achieved, effectively reducing the nasolabial fold. This approach has proven to be more effective than attempting to correct the fold through surgery, highlighting the versatility of the MACS facelift technique.

Considerations and Conclusion:

During the MACS facelift procedure, the surgeon takes into account various factors, including aesthetic outcomes, social aspects, angles of recovery and scarring, patient expectations, and patient reactions. By considering these factors and utilizing advanced techniques such as sutures, the hemostatic net, and vertical skin lifting, surgeons provide their patients with exceptional results and a positive surgical experience.

In conclusion, the MACS facelift incorporates several advancements in technique, leading to improved outcomes and patient satisfaction. The use of dissolvable sutures ensures long-lasting results without compromising the lift over time. The inclusion of a hemostatic net aids in controlling bleeding during the surgery, enhancing visibility for the surgeon. By lifting the skin vertically, the MACS facelift achieves a more defined and youthful appearance without altering the facial hairline. Additionally, the incorporation of fat transfer techniques allows for further facial sculpting, addressing volume loss and specific concerns. Surgeons' meticulous approach and consideration of individual patient needs contribute to the success of the MACS facelift procedure.

Get your youthful face back with this groundbreaking non-invasive treatment!

Revitalize Your Skin with EMFace: Harnessing the Power of Electromagnetic Energy

Are you searching for a non-invasive treatment to rejuvenate your skin and restore your youthful glow? 

Look no further than EMFace. 

This groundbreaking technology utilizes advanced electromagnetic energy to stimulate your skin's natural regenerative processes, resulting in a tighter, more radiant complexion. 

Say goodbye to fine lines and wrinkles and embrace a revitalized appearance this summer with EMFace. 

EMFace utilizes state-of-the-art technology to deliver targeted energy pulses deep into the layers of your skin. By gently heating the tissue, electromagnetic waves trigger a cascade of beneficial effects, promoting collagen production and tightening the underlying tissues. This controlled heating stimulates the essential protein collagen, responsible for maintaining skin elasticity and firmness.

One of the key advantages of EMFace is its ability to precisely target the treatment area while leaving the surrounding tissues unharmed. This ensures a safe and comfortable experience without any downtime or recovery period. Unlike invasive procedures, EMFace allows you to achieve remarkable results without the need for surgery or injections.  

The increase in collagen levels brought about by EMFace helps to plump and tighten the skin, reducing the appearance of fine lines and wrinkles. As collagen production is stimulated, 

your skin regains its natural elasticity and firmness, resulting in a smoother and more youthful complexion.

In addition to stimulating collagen production, EMFace generates heat that enhances blood circulation. This boost in circulation promotes the delivery of oxygen and nutrients to your skin cells, revitalizing them and promoting cellular renewal. The improved blood flow also contributes to a more even skin tone, smoother texture, and overall radiance.

With EMFace, you can achieve remarkable results while enjoying a comfortable and relaxing treatment. The precision of the technology ensures that only the targeted area is affected, leaving surrounding tissues unharmed. This means you can undergo an EMFace session during your lunch break and return to your daily activities immediately afterward, without any noticeable signs of treatment.

To experience the transformative benefits of EMFace, visit Ocean Clinic today. Our team of experienced professionals, including Dr. Kaye, Dr. Casabona, and Dr. Frank, is dedicated to helping you rediscover your youthful glow and regain your confidence. Let EMFace be your secret weapon in achieving a tighter, more radiant face this summer. Embrace your natural beauty and say hello to a revitalized appearance with EMFace.

MIPSS Meeting Marbella 2023, another huge success for the Aesthetic Plastic Surgery world

 6th Annual Marbella International Plastic Surgery Summer School (MIPSS) Meeting. 

With five successful editions already accomplished, the sixth annual MIPSS meeting was eagerly anticipated. And disappoint, it certainly did not! The MIPSS event has developed into a prestigious, international event in the world of plastic surgery enabling surgeons from around the globe to openly share their experience, engage in discussion, contemplate the benefits and challenges of the latest techniques, as well as deliver specialist presentations within their respective areas of expertise. 

MIPSS 2023 was hosted by Ocean Clinic, Marbella at the exclusive Hard Rock Hotel, five minutes from the illustrious Puerto Banus marina. With a scientific committee consisting of Mario Pelle Ceravelo (Italy), Kai Kaye (Spain), Gabriela Casabona (Spain), and Jesus Benito Ruiz (Spain) as well as a faculty of twenty-two distinguished speakers of international acclaim, the summer school was a highly-valuable opportunity for all attendees. The meeting covered the four core specialties as defined by the ISAPS; the International Society of Aesthetic Plastic Surgery and was granted 21 CME credits by EACCME. 

The schedule featured two days of a wide variety of live surgeries with an Aesthetic Forehead Reduction by Beatriz Berenguer, MACS lift by Alexis Verpaele, Chin Augmentation using polypropylene implants by Kai Kaye, Osseus genioplasty by Steve Cohen, Micro-ponytail lift by Constantin Stan, Breast Uplift by Reha Yavuzer, Lip Lift by Mario Pelle Ceravolo, and a Primary Rhinoplasty by Wolfgang Gubish.

Fascinating panels were held daily covering a vast array of topics and techniques within the brackets of Minimally Invasive Treatments, Body Contouring, Breast, Business and Best Practice, Upper, Lower and Mid Face, as well as Rhinoplasty. Lectures or videos and discussions were held by different specialists in their relative fields moderated by the allocated scientific committee members. 

On the second and third days, hands-on workshops with live demonstrations were also held by Dr. Gabriela Casabona and Dr. Konstantin Frank focussing on the use of Ultrasound for aesthetic procedures, lip filler techniques, gluteal augmentation using energy-based devices, CaHA and threads, as well as skin quality enhancement using threads, miconeedling, and biostimulator injectables. These workshops provided an invaluable close-up and personal experience for the advanced injectable trainees, from Ocean Clinic’s world-renowned and highly-experienced doctors. 

An incredible amount of knowledge and skill was exchanged during the three day event, resulting in the MIPSS 2023 being a great success. Ocean Clinic Marbella look forward to hosting the MIPSS 2024 and welcoming all participants to come and share the experience whilst embracing the unmistakable essence and pulsating lifestyle of Andalucían summertime in Marbella. 

MIPSS 2023 was endorsed by:

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Åsthetischen Chirurgen. 

AECEP - Asociación Española de Cirugía Estética Plástica

ISAPS - International Society of Aesthetic Plastic Surgery

VCÄPC - Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen 

MIPSS 2023 was sponsored by:

Argo Plasma

Human Med

Merz Aesthetics

BioScience

Clarius  emed

UpViser

Canfield

Brumaba

Motiva

croma

Dermapenworld

ST Endoscopia

makromed 

Germany International Medical 

How surgeons sculpt the face before a face lift - preoperative facial sculpting

Unveiling the Artistry of a Plastic Surgeon: Sculpting and Molding the Face and Neck Prior to Face or Neck Lift Surgery

When it comes to enhancing one's appearance, plastic surgeons possess a remarkable blend of medical expertise and artistic vision. Among the procedures they specialize in, face and neck lift surgeries stand out as transformative treatments that can turn back the hands of time. However, behind the scenes, a skilled surgeon will employ a range of techniques to ensure optimal results. In this article, we will explore how a plastic surgeon sculpts and molds the face and neck before face or neck lift surgery, unveiling the meticulous process that precedes these life-changing procedures.

Understanding the Face and Neck Lift Surgery

Before delving into the sculpting and molding process, it's important to grasp the fundamentals of a face and neck lift surgery. These procedures aim to combat the visible signs of aging, such as sagging skin, wrinkles, and loss of muscle tone in the face and neck. 

The surgery involves repositioning the underlying tissues and removing excess skin to create a rejuvenated and more youthful appearance.

Preoperative Evaluation and Consultation

The journey towards a successful face or neck lift surgery begins with a thorough preoperative evaluation and consultation. During this stage, the plastic surgeon engages in an in-depth discussion with the patient to understand their expectations, concerns, and desired outcome. The surgeon carefully examines the patient's facial structure, skin quality, and underlying facial muscles to devise a customized surgical plan.

Sculpting and Molding Techniques

Facial Analysis: Aesthetic harmony and balance are essential in achieving natural-looking results. The plastic surgeon conducts a detailed facial analysis, assessing the patient's unique features and facial proportions. This evaluation guides the surgeon in determining the areas that require sculpting and those that need structural support.

Marking the Incision Lines: The surgeon marks precise incision lines along the natural creases and contours of the face and neck. These lines serve as a roadmap for the surgery, ensuring minimal scarring and preserving the integrity of the surrounding tissues.

Underlying Muscle Repositioning: The surgeon carefully repositions and tightens the underlying facial muscles to restore firmness and a more youthful contour. Techniques such as SMAS (Superficial Musculoaponeurotic System) are commonly employed to address muscle laxity and sagging.

Liposuction and Fat Grafting: In some cases, excess fat deposits in the face and neck can be a concern. Liposuction may be used to remove unwanted fat, while fat grafting can be employed to restore volume to areas that have lost fullness. The surgeon expertly sculpts and redistributes fat to achieve the desired facial contours.

Tissue Removal and Redraping: Excess skin is skillfully trimmed away, ensuring a taut and smooth appearance. The remaining skin is gently redraped, allowing for natural-looking results while avoiding a stretched or unnatural appearance.

Suture Techniques: Various suturing techniques, including dissolvable and non-dissolvable sutures, are utilized to secure the tissues in their new position. These sutures help maintain the sculpted contours, provide support during the healing process, and minimize scarring.

Bottom Line: 

Face and neck lift surgeries are intricate procedures that require a delicate balance of surgical precision and artistic finesse. Before these surgeries, plastic surgeons meticulously sculpt and mold the face and neck, employing various techniques to achieve the desired results. By conducting a thorough preoperative evaluation, marking precise incision lines, repositioning underlying muscles, and artfully removing excess skin, these skilled surgeons can help individuals restore their youthful appearance and boost their self-confidence. Through their expertise and dedication, plastic surgeons continue to enhance the lives of countless patients, offering them the opportunity to look and feel their best.

To discuss your face and/or neck lift options, consult with our experienced team of highly-skilled professionals at Ocean Clinic, Marbella.