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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	
  
What	
  makes	
  you	
  look	
  older?	
  
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	
  
Glabella	
  
Before 	
   	
   	
   	
  Aber	
  
Forehead,	
  Glabella	
  
Before 	
   	
   	
   	
  Aber	
  
Crow’s	
  Feet	
  
Before 	
   	
   	
   	
  Aber	
  
“Botox	
  Brow	
  Lib”	
  
Before 	
   	
   	
   	
  Aber	
  
Horizontal	
  Neck	
  Lines	
  
Before 	
   	
   	
   	
  Aber	
  
Platysmal	
  Bands	
  
Before 	
   	
   	
   	
  Aber	
  
Tissue	
  Fillers	
  
Natural	
  substances	
  that	
  
fill	
  wrinkles	
  
•  Smooth	
  gel	
  filler	
  
•  Cross-­‐linked	
  HA	
  
•  Combined	
  w/	
  lidocaine	
  
•  Instant,	
  natural	
  result	
  
 Nasolabial	
  Fold	
  Fillers	
  
Before 	
   	
   	
   	
  Aber	
  
Nasolabial	
  Folds	
  	
  
	
  Glabellar	
  Lines	
  
Before 	
   	
   	
   	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  AHer	
  
Nasolabial	
  Folds	
  	
  
Oral	
  Commissure	
  
Before 	
   	
   	
   	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  AHer	
  
 Tear	
  Troughs	
  
Before 	
   	
   	
   	
  Aber	
  
Lip	
  Augmenta)on	
  
	
  	
  	
  	
  	
  Before 	
   	
   	
   	
  	
   Aber	
  
Lip	
  Augmenta)on	
  
Before 	
   	
   	
   	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  Aber	
  
 Cheek	
  Augmenta)on	
  
Before 	
   	
   	
   	
  Aber	
  
 “Liquid	
  Rhinoplasty”	
  
Before 	
   	
   	
   	
  Aber	
  
Nonsurgical Facial Rejuvenation:  Botox and Facial Fillers

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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  
  • 2.
  • 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/  
  • 4. 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  
  • 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  
  • 7.
  • 8.
  • 9.
  • 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