BOTOX
The cosmetic form of botulinum toxin, often referred to by its product name Botox®, is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases, crows feet near the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. Studies have also suggested that Botox is effective in relieving migraine headaches, excessive sweating and muscle spasms in the neck and eyes 

INJECTABLE FILLERS
As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow's feet or facial creases over the areas where this muscle movement occurs.

Soft-tissue fillers, most commonly injectable Restylyn or fat, can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift.

Injected Restylyn and fat are primarily used to improve the appearance of the skin's texture. They can help fill out deep facial wrinkles, creases and furrows, "sunken" cheeks, skin depressions and some types of scars. They can also be used to add a fuller, more sensuous look to the lips.

Injectables are usually not sufficient for severe surface wrinkles on the face, such as multiple vertical "lipstick lines" that sometimes form around the mouth. Instead, your plastic surgeon may suggest a resurfacing technique, such as chemical peel, dermabrasion or laser treatments. Rather than filling in facial lines, resurfacing methods strip away the outer layers of the skin to produce a smoother appearance.

Deep folds in the face or brow caused by overactive muscles or by loose skin may be more effectively treated with cosmetic surgery, such as a facelift or brow lift. Injectables are sometimes used in conjunction with facial surgery procedures; however, injectables alone cannot change facial contour the way surgery can.

The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. You should not expect the same long-lasting results that may be gained from cosmetic surgery.

In some individuals, the results may last only a few weeks; in others, the results may be maintained indefinitely. Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the injected material's "staying power." However, the precise reason for the variation of results among patients has yet to be identified.

If you've had short-lived results from fat injections, you shouldn't necessarily assume that Restylyn injections will work better for you. And, conversely, if you've had disappointing results from Restylyn, don't assume that injected fat is the answer. Although it's true that some individuals' bodies are more receptive to one substance than the other, others may find that neither substance produces long-lasting results. Sometimes one substance may work better than the other for a specific problem.

Restylyn
The procedure: Treatment with Restylyn can begin after a skin test determines that you're not allergic to the substance. The Restylyn is injected using a fine needle inserted at several points along the edge of the treatment site. If a local anesthesia has not been used, you may feel some minor stinging or burning as the injections are administered.

Since part of the substance is salt water that will be absorbed by the body within a few days, your doctor will slightly overfill the area. You may be asked to hold a hand mirror during the procedure to help your doctor decide when you've had enough.

After treatment: Immediately following treatment, you may notice some minor discomfort, stinging or throbbing in the injected area. Occasionally some bruising or swelling will occur, but it is usually minor. Any redness that appears in the injected site usually disappears within 24 hours. However, in some individuals, particularly fair-skinned patients, this redness may persist for a week or more. Tiny scabs may also form over the needle-stick areas; these generally heal quickly.

No bandaging is needed and you are free to eat, drink, and wear makeup with sun block protection shortly thereafter. There may be some temporary swelling and redness in the treated area which should dissipate within a few days. If these symptoms persist, contact your surgeon.

Results: As stated earlier, the duration of results from Restylyn injections is variable. Restylyn's longevity depends on the patient's lifestyle and physical characteristics as well as the part of the body treated. In general, the injected material is likely to disappear faster in areas that are more affected by muscle movement.

Fat
In the medical world, the fat-injection procedure is known as autologous fat transplantation or microlipoinjection. It involves extracting fat cells from the patient's abdomen, thighs, buttocks or elsewhere and reinjecting them beneath the facial skin. Fat is most often used to fill in "sunken" cheeks or laugh lines between the nose and mouth, to correct skin depressions or indentations, to minimize forehead wrinkles and to enhance the lips.

The procedure: After both the donor and recipient sites are cleansed and treated with a local anesthesia, the fat is withdrawn using a syringe with a large-bore needle or a cannula (the same instrument used in liposuction) attached to a suction device. The fat is then prepared and injected into the recipient site with a needle. Sometimes an adhesive bandage is applied over the injection site.

As with Restylyn, "overfilling" is necessary to allow for fat absorption in the weeks following treatment. When fat is used to fill sunken cheeks or to correct areas on the face other than lines, this overcorrection of newly injected fat may temporarily make the face appear abnormally puffed out or swollen.

After treatment: If a larger area was treated, you may be advised to curtail your activity for a brief time. However, many patients are able to resume normal activity immediately. You can expect some swelling, bruising or redness in both the donor and recipient sites. The severity of these symptoms depends upon the size and location of the treated area. You should stay out of the sun until the redness and bruising subsides - usually about 48 hours. In the meantime, you may use makeup with sun block protection to help conceal your condition.

The swelling and puffiness in the recipient site may last several weeks, especially if a large area was filled.

Results: The duration of the fat injections varies significantly from patient to patient. Though some patients have reported results lasting a year or more, the majority of patients find that at least half of the injected fullness disappears within 3-6 months. Therefore, repeated injections may be necessary. Your doctor will advise you on how to maintain your results with repeat treatments.

 PLASTIC SURGERY
To be a good candidate for plastic surgery, you must have realistic expectations about what the procedures can do for you. It's important to understand that plastic surgery can enhance your appearance and self confidence, but it won't necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Cárdenas.

You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.

Plastic surgery carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.

Dr. Cárdenas will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed.

LIPOSUCTION
 Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. During the past decade, liposuction, which is also known as "lipoplasty" or "suction lipectomy," has benefited from several new refinements Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don't respond to traditional weight-loss methods.

The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used.

Liposuction is a procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon's preference. If many sites are being treated, your surgeon will then move on to the next area, working to keep the incisions as inconspicuous as possible.

.ABDOMINOPLASTY
Abdominoplasty, known more commonly as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

THIGH LIFT
A thigh lift is asurgical procedure to remove loose skin from the thighs. Successful and sustained massive weight loss can lead to extensive redundancy of skin in the inner thigh area. Constant rubbing together of the redundant inner thigh folds predisposes to areas of skin irritation and infection and interferes with personal hygiene. Clothing may be difficult to fit and there may be psychosocial concerns of a disfigured appearance. Comfort and appearance improve by the plastic surgery procedure known as the thigh lift.

 A thigh lift involves resection of redundant thigh tissue. Redundant thigh tissue may extend to involve the buttocks and back of the thigh. Removal of excessive skin and fatty tissue of the inner thigh, a thigh lift, uses incisions that parallel the groin crease. The thigh lift is usually performed on the inner surface of the thighs but can include the outer thigh area and buttock if indicated.

BRACHIOPLASTY – Arm Lift
An arm lift, also known as brachioplasty, is a surgical procedure to remove loose skin and excess fat deposits in the upper arm. With age, upper arm skin can become loose and flabby. Plastic surgeons will discuss brachioplasty with patients who want to tighten this skin and look as good as they feel. In some cases your plastic surgeon may suggest that liposuction be used alone or in conjunction with an arm lift to remove excess fat in the upper arms.

MASTOPEXY- Breast Lift and or Reduction      
Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman's breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts--at least, for a time. (No surgery can permanently delay the effects of gravity.) Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume--for example, after pregnancy--breast implants inserted in conjunction with mastopexy can increase both their firmness and their size.

Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions  If you're having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.

The best candidates for mastopexy are healthy, emotionally-stable women who are realistic about what the surgery can accomplish. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.

Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you're planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn't interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.

BREAST AUGMENTATION       
Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons:

• To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
• To correct a reduction in breast volume after pregnancy.
• To balance a difference in breast size.
• As a reconstructive technique following breast surgery.

By inserting an implant behind each breast, surgeons are able to increase a woman's bustline by one or more bra cup sizes.

FACE LIFT
As people age, the effects of gravity, exposure to the sun and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jaw line grows slack and jowly; folds and fat deposits appear around the neck.

A facelift (technically known as rhytidectomy) can't stop this aging process. What it can do is "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.

Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.

In general, the skin is separated from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The Dr. then tightens the underlying muscle and membrane, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp.

The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well.

A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can't give you a totally different look, nor can it restore the health and vitality of your youth.

FACIAL IMPLANTS
Plastic surgeons use facial implants to improve and enhance facial contours. Frequently, these implants will help provide a more harmonious balance to your face and features so that you feel better about the way you look.

There are many implants available, manufactured from a variety of materials. They may help strengthen a jaw line or bring the chin or cheekbones into balance with the rest of the face.

Facial implants can enhance your appearance and bolster your self esteem. If you are looking for improvement, not perfection, in your appearance and are realistic in your expectations, you may find that a facial implant is the right choice for you.

Plastic surgeons will frequently use such implants to bring better balance to the features of a younger patient. For instance, a teenage girl may want her nose reshaped or her chin brought forward so that these traits are better proportioned. The more mature patient may choose to have an implant placed in conjunction with another cosmetic procedure. For example, during a facelift, a patient may wish to have implants placed over the cheekbones to help restore a more youthful appearance. Implants may also be selected to fill out a face that appears "sunken" or tired.

BLEPHAROPLASTY
Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat--usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes - features that make you look older and more tired than you feel, and may even interfere with your vision. However, it won't remove crow's feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows. While it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage. Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or brow lift.

Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you're having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.

A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; check with your ophthalmologist before you have surgery

RHINOPLASTY
Rhinoplasty, or surgery to reshape the nose, is one of the most common of all plastic surgery procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.   Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes-to correct birth defects or breathing problems.

Age may also be a consideration. Many surgeons prefer not to operate on teenagers until after they've completed their growth spurt-around 14 or 15 for girls, a bit later for boys. It's important to consider teenagers' social and emotional adjustment, too, and to make sure it's what they, and not their parents, really want.