Asian blepharoplasty is a popular Asian eyelid surgery. Also called double eyelid surgery, this procedure aims to create a natural-looking upper eyelid crease.

The procedure can be executed either by using an incision or a suture (non-incision) technique to create a double eyelid fold. While most races have this fold, it isn’t present in about half of the Asian population.

In the suture technique, a stitch creates the fold. This noninvasive procedure works well for a very limited patient population. It’s a good solution for those with thin-skinned eyelids who aren’t looking for dramatic, full eyelid height.

The suture technique’s primary challenge is that there is a high incidence of failure and relapse. This is because the eye is an incredibly dynamic structure that opens and closes thousands of times, which weakens the sutures.

ESK Facial Plastic Surgery in New York City also practices a minimally invasive partial incision technique that uses two small incisions (6 to 8 millimeters in length) on each eyelid. This technique, while requiring a slightly longer recovery time than the suture method, creates better attachment and results in a more permanent and dramatic fold with more predictable long-term outcomes.

As with every procedure, patients interested in double eyelid surgery typically have questions about healing time and when they can return to work and social events. The partial incision technique requires just a slightly longer healing time than the suture procedure. Patients choosing the incision technique can expect swelling and bruising to disappear in under two weeks. In comparison, most people who opt for the suture procedure can return to work and social engagements within a week.

We invite you to make an appointment with ESK Facial Plastic Surgery in Manhattan to discuss both techniques and discover which is right for you.

Are you stuffed up a lot? Do you suffer from frequent nosebleeds or sinus infections? Do you snore?

Chances are you might have a deviated septum.

What Is A Deviated Septum?

The septum is the internal wall that divides your nose into its left and right sides. In an ideal world, both sides are equal, but this is often not the case. While a slightly deviated septum is not a problem, some septums are so crooked that they block airflow. Some people are born with severely deviated septums. Others find their septums shifting as they age. Septums can also be easily knocked out of place by sports injuries or traffic accidents.

What Surgical Solutions Are Available For A Deviated Septum?

Septoplasty, a surgical procedure to fix a deviated septum, is usually covered by insurance. Typically, a small incision is made inside the nose to separate the mucous membrane from the septum. The portion of the bone or cartilage that is causing the deviations to the septum is addressed to reposition the septum to the midline. Typically, surgery typically take one hour. In fact, people often schedule the procedure for a Friday as a weekend usually provides enough recovery time.

What Is Septorhinoplasty?

People can get aesthetic improvements made to their nose at the same time their septum is fixed. This explains why so many celebrities who go in for a deviated septum also emerge with new noses! Reshaping the external appearance of the nose is called rhinoplasty.When you get both the inside and the outside work done at the same time, it's called septorhinoplasty.  

Besides having a good looking nose, we want to make sure your nose can perform what it is intended to do which is to breathe.

My work with clients starts well before surgery in the pre-op consultation phase. It's important that I understand each person's aesthetic goals and expectations and take the time to communicate what's possible technically.

Rhinoplasty is a very technique-oriented surgery. Each change to the underlying cartilage and bone structure of the nose affects everything else. For example, increasing the height to the tip of the nose will change the way the nostrils appear. Each step needs to be discussed and planned before surgery, which typically takes 2.5 to 3 hours.

By the time patients enter surgery, they have a true understanding of how they will look post-surgery. Often times when I meet with a client for their six-month follow-up, I ask if they've run into friends they haven't seen for awhile. The comment people hear the most is that they look great, but they can't pinpoint what's changed. Their new nose has improved their appearance while maintaining their individuality and identity.

This natural and subtle improvement to their looks is an ideal goal for any plastic surgery and epitomizes my personalized--as opposed to mass production--approach. If you're looking for a plastic surgeon in Manhattan who can offer a natural, individualized, compassionate approach to looking like yourself, only better, call my office at Saint Vincent's Hospital to schedule a consultation.

Have you started doing that thing in the mirror? That private ritual where you pull the skin of your forehead or by your mouth and eyes with your fingertips so your face looks as smooth and taut as it used to be?

Your wrinkles may be getting on your nerves, but maybe the idea of surgery seems too extreme or permanent right now. You’re not there yet, but you’d love to say goodbye to these creases. You'd also like to start building a relationship with a plastic surgeon so that when you're ready for more permanent work, you have someone you trust. Injectable fillers or BOTOX could be the perfect solution.

There are several options available.

War on Wrinkles

BOTOX, the most famous cosmetic injection and produced by Allergan, can be injected into the forehead region, relaxing the muscles that cause wrinkles.  Recently a competitor to BOTOX was released by Ipsen SA and Medicis Pharmaceutical Corp. Called Dysport, it is intended for the same uses as BOTOX.

Medicis also distributes Restylane and Perlane—injectable fillers made of hyaluronic acid that plump up facial creases and laugh lines (also called naso-labial folds). These products typically start to break down in the body after six to 12 months.

Other hyaluronic fillers, such as Juvéderm Ultra and Juvederm Ultra Plus (made by Allergen, the makers of BOTOX), can be used similarly as Restylane and Perlane. These gel injectables also last about six to 12 months.

Longer lasting injectables have been introduced to treat deep naso-labial folds.  Radiesse is probably the most popular of these longer lasting injectables.  Radiesse is essentially a paste made of calcium hydroxylapatite (a substance found on bone).  This product is injected deeper in the facial soft tissue to increase the volume. Radiesse lasts about 12 to 15 months before being absorbed by the body.

Injectable fillers and BOTOX are performed in the doctor’s office and require minimal downtime. To learn more about how fillers and BOTOX may be right for you, we welcome you to come in for a consultation with Dr. Kwak.

"Redoing" a prior nose job that left you unsatisfied is a daunting task.  To help prospective patients with this process, I have included three factors you should know prior to considering revision rhinoplasty.

1.) How long ago was your prior nose surgery? And what region of the nose you are concerned about?

Complete healing from a prior nose surgery can take up to a full year. This is especially true to at the tip of the nose. This region is the most cosmetically sensitive and the last to completely heal. Anxious patients looking to remedy some expected postoperative healing by having another surgery could potentially cause more problems.  For patients concerned about the shape or position of their tip, I typically recommend waiting a full year before considering revising the nose.

The bridge of the nose is less gravity dependent than the tip and tends to
“settle” faster.  This region can be assessed earlier than the tip for revisions.

2.) You may need additional grafts or implants to achieve the revision you are looking for.

When a patient whose surgery was previously done elsewhere comes in for a revision nasal surgery, one of the first things I consider is how preserved is his/her nasal anatomy.  In the past, prior nasal surgeries frequently altered the underlying nasal cartilage, weakening the nose and ultimately distorting the shape of the nose.  This has potentially impaired the true function of the nose (which is to breathe).  When this occurs, the nasal framework needs to be reconstructed.  To do so, I recommend using cartilage grafts in the region of the tip. 

Ideally the source for this graft would be from inside your nose (the nasal septum) but frequently, prior nasal surgeries have used all available cartilage inside your nose.  Alternative sources for cartilage grafting material for revision surgeries can be from your ear, your rib, or banked/donated rib.

3.) How long will the revision rhinoplasty take to heal?

In general, revision rhinoplasties take longer to heal.  Factors that contribute to how long it takes to heal are: amount of grafts used during the surgery and the amount of work done.  In general, the nose for redo rhinoplasties takes about one year.

Have more questions about revision rhinoplasty that I didn't answer here? Then I invite you to contact me today to find out more information about correcting a nose job that you're just not satisfied with. 

Choosing the right surgeon can be a daunting experience to go through for a prospective patient. There is no shortage of options when choosing a surgeon yet not every doctor is the right one for you, especially if you're considering nasal surgery of any sort. 

Here are three reasons to consider a rhinoplasty specialist over other plastic surgeons. 

Reason 1: A Rhinoplasty Specialist Has Focused and Specific Certification

Only asking your consulting physician “Are you board certified?” , you could potentially be misled about the qualifications of the doctor. As there are many types of doctors, so too are there many types of board certifications. There are only two boards which credentials surgeons for plastic surgery to the face. These are the American Board of Facial Plastic Surgery and the American Board of Plastic Surgery.

Even choosing a surgeon who is board certified from these recommended groups does not verify the surgeon’s ability to do rhinoplasty surgery. When in doubt, choose a surgeon who does a large number of nasal surgeries in his/her practice.

Reason 2: Choosing a Rhinoplasty Specialist Means Less Risk Of Nasal Dysfunction

Besides sitting in the middle of our face, the nose has two very important functions that we take for granted, which are breathing and smelling. Even if you may have no problems with the function of your nose, changes done during rhinoplasty surgery may alter these functions. Besides having a good looking nose, its important to also have a nose that works!

Reason 3: A Rhinoplasty Specialist Has Lots of Practice

As mentioned above, it is important to choose a surgeon who specializes in this type of surgery. Rhinoplasty surgery is one of the most challenging surgeries to perform. Ending up with a nice looking nose that also is able to breath well is no easy task. Just like a lawyer who does murder trials versus business mergers, rhinoplasty requires a completely different skill set than doing breast augmentations or tummy tucks.

Many prospective patients interested in facial rejuvenation to the upper part of the face come in saying:

“I look sad and tired…and I think my eyes need to be addressed.”

This feeling may in fact be due to a lowering of the eyebrow position.

Aesthetic guidelines have suggested that the youthful aesthetic brow in a female taper out to the side of the brow, peaking at the arch.  The placement of the eyebrow arch has been suggested to be right above the eye socket rim.

However these are suggested guidelines, and cannot be applied to every individual.

To help achieve natural results, while still maintaining your facial personaility, I typically recommend patients to look at photos of their face in their twenties or thirties.  These photos allow me to understand where your youthful brow is.  Some patients may need a higher brow position than others.

I typically reference Kenny Rogers as a person whose brow was lifted higher than where his brow was twenty years ago.  As a consequence of setting his eyebrows higher than they have ever been in his life, his face takes on a different characteristic, resulting in an unnatural look.

As the rates of travel for cosmetic surgery procedures increase, so do the misconceptions that Korean plastic surgery is best performed abroad. But that's not always the case.

Here are three things to consider about traveling for your plastic surgery:

1. Surgeons in Korea are more qualified to do Asian cosmetic procedures.

The medical education here in the United States is globally regarded as the best in medical training. Surgical advances along with research in plastic surgery are still regarded as the best in the world. While it is true, surgeons in Korea only operated on “Asian faces” quality over quantity should be the ultimate factor when choosing a plastic surgeon.

2. It will be cheaper to have the surgery done in Korea.

While fees for surgery maybe slightly lower in Korea, one must factor additional costs associated with traveling to a foreign country to have surgery. Airline tickets, hotels fees, and meals can easily push the cost of the surgery higher than prices here in the US. Additionally, stress of traveling to a foreign country and the risks of potential complications are also inherent costs associated with having surgery in Asia.

3. I can fly into Asia and come back home soon after without any worries.

A major role in achieving optimal results is having close postoperative care with your surgeon. Having the ability to reach your surgeon and freely communicate your concerns is one of the most important things I recommend for a prospective patient.

Choosing a cosmetic surgeon in Manhattan requires plenty of research. You have to know the right questions to ask in order to avoid choosing a surgeon who may not have your best interest in mind. To help with that I've come up with 3 vital questions to help you choose the right plastic surgeon for you.

1.) Are you board certified in facial cosmetic surgery?

More specifically I would recommend only going to surgeons board certified by the American Board of Facial Plastic and Reconstructive Surgery or the American Board of Plastic Surgery.  Although choosing a board certified surgeon will not guarantee a competent surgeon skilled in your surgery of interest, it will insure that the surgeon meets a minimum requirement.

2.) If I am getting a nose job should I go to a facial plastic surgeon or a general plastic surgeon? 

The gamut of cosmetic surgery is pretty large.  So a surgeon may have a practice that is largely focused on bodywork, (liposuction, breast augmentation, or tummy tucks) while only performing a few facial cosmetic surgeries a year.  If you are looking at a facial cosmetic procedure, it makes sense to seek a surgeon that focuses only on facial cosmetic surgery.

3.) How many of these surgeries do you do a year? 

Even though all cosmetic procedures are viewed individually, this question will give you an impression of your surgeons area of expertise.   

BOTOX NYC

Taken from PARIS & SCOTTSDALE, Ari.--(BUSINESS WIRE)--March 17, 2008

Ipsen and Medicis announce submission of Reloxin BLA in aesthetics to the FDA

- Medicis and Ipsen today announced that Ipsen has submitted a Biologics License Application ("BLA") for the botulinum toxin type A, Reloxin(1), in aesthetic indications (glabellar lines) to the U.S. Food and Drug Administration's ("FDA") Division of Dermatology and Dental Products, within the Center for Drug Evaluation and Research...

As of October 2007, Ipsen's botulinum toxin type A is approved for aesthetic indications in 21 countries: Argentina, Australia, Belarus, Brazil, Columbia, Ecuador, Egypt, Germany, Honduras, Israel, Kazakhstan, Mexico, Moldova, New Zealand, Philippines, Slovak Republic, Ukraine, Uruguay, Venezuela, Vietnam, and Russia (in Russia, it is the first botulinum toxin type A approved in this field). Ipsen is also pursuing regulatory approval for medical indications for the product in certain additional key international markets.

Dysport is a neuromuscular blocking toxin which acts to block acetylcholine release, hence reducing muscular spasm and was initially developed for the treatment of motor disorders and various forms of muscular spasticity, including cervical dystonia (a chronic condition in which the neck is twisted or deviated), spasticity of the lower limbs (heal) in children with cerebral palsy, blepharospasm (involuntary eye closure) and hemifacial spasm. It was later developed for the treatment of a wide variety of neuromuscular disorders and aesthetic medicine. Dysport was originally launched in the United Kingdom in 1991 and has marketing authorisations in over 70 countries (at 31 December 2006). Ipsen has just recently filed a BLA for Dysport in cervical dystonia to the FDA.
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Basically these two products work similarly, preventing transmission of muscle signals.  There are differences in the pharmacological behavior of the two products,  which allows for different companies to brand, distribtue, and market each product.  

RELOXIN has been noted in scientific studies to work faster and longer than BOTOX.  Patients treated with RELOXIN can anticipate seeing the effects 1-2 days after treatment while the effects of BOTOX typically takes about 5-6 days.  Also, the effects of RELOXIN can last up to 4-6 months longer than BOTOX (BOTOX typically last for about 3 months).

What does this mean for you?  Once RELOXIN is approved patients can expect a decrease in the price.  (It seems that FDA approval for RELOXIN will take at least another 10 months from now.