Safety, Comfort, Quality, Discretion
When a patient consults a surgeon specializing in aesthetic surgery, he is looking for an answer to his desire to correct a perceived flaw, blemish or imperfection.
Sometimes, the patient is certain that the problem can only be solved by way of surgical intervention but we can offer him a simpler and less invasive solution. In these cases we advise a far softer means of intervention, such as treatment by injections of a filling product, or by exfoliation or by botulinum toxin. Sometimes, the contrary is true and we need to persuade a patient who at first seeks a treatment by way of injections or Botox that the better and at times the only solution to achieve the desired result is a surgical technique.
We aim to respond to a patient’s needs using the mildest means available. The art of the doctor is to determine the boundary between a non-surgical procedure and the beginning of a surgical intervention. In addition, in order to help patients we need to be able to determine when a request may be illusory or exaggerated.
Botulinum toxin is the purified protein extract from Clostridium Botulinum. Botulinum toxin injections can lead to the mitigation or removal of expression lines on the face, in particular the lines which mark the forehead and at the sides of the eyes (“crows feet” or “laughter lines”).
The result could be similar to a real face lift, without the surgery! The face regains a relaxed and rested appearance but retains all its expressive qualities. These injections can also be used on other regions of the face, the neck and “décolleté”. The treatment consists of a series of micro injections made with a fine needle into the muscle of the area to be treated. It is a quick and precise method which does not require any anesthetic. Nor does the treatment require any time off from social or professional life.
The treatment can be repeated once or twice a year. This can be done in Dr Pierre Quinodoz’s clinic. Botulinum toxin has been used in medicine for more than 20 years and its tolerance and effects have therefore been well tested. There may be undesirable side affects associated with the substance itself or as a result of the injection technique.
The treatment is not to be carried out on pregnant women nor on patients suffering from neuromuscolar disorders. Side effects, rare and often minor and transitory, may include headaches, bruising, redness or swelling at the injection site etc.
The treatment may be administered by specialist, trained and experienced doctors following a prior consultation. A second check, which is offered at no cost, is recommended from the 10th day following treatment. If injected in the underarm area or palms of the hands, the botulinum toxin may reduce sweating and bad odour. Effects may last between 6 and 8 months.
This treatment is characterized by the sublimation (passage from the solid state to the gaseous state) of the air, which is then in a state called plasma in which the particles are mixed instead of being organized into molecules. The passage from this state is accompanied by energy production and the plasma uses this energy to perform wrinkle treatment through localized skin retraction.
There are different types of machines but the most frequently used is the PlexR. The suites are different depending on the type of handpieces used because there are three types of power. This treatment is not suitable for all skin types and as with laser treatments the sun should be avoided one month before.
After the operation your skin will present small black spots that will disappear between five and seven days to give way to moderate redness that will persist between one and four months depending on your skin condition and the intensity of the treatment. We frequently use this treatment to treat wrinkles around the eyelids and mouth but never to treat excess skin on the upper eyelids because the results are not totally controllable in this location and can lead to irreversible asymmetry.
We frequently use the patient’s own fat in plastic and aesthetic surgery as a natural and autologous filler to correct volume losses, whether to restore the effects of aging in the face or to correct relief after trauma or surgery.
In recent years, a major discovery has been made following the observations made on the improvement of the cutaneous texture in relation to the areas corrected by fat injection: Fatty tissue is rich in stem cells (ADSC: adipose derived stem cells). These cells have a very important role in tissue regeneration. Injected into the skin, they turn into fibroblasts and begin to make new collagen and elastin and structural proteins.
A new fat injection technique stems from these discoveries. Recently, grease is no longer used only to correct volumes, but also to improve the texture of the skin, as has been done for a long time with mesotherapy, for example.
The procedure is performed under local anesthesia or mild sedation. The fat is removed using a cannula and a syringe. A few milliliters are needed. It is centrifuged and then passed through a microfilter to break all the fat cells and keep only the fraction rich in stem cells (Stromale vascular fraction). This preparation is very liquid and allows the surgeon to inject it with the fine needle in a very superficial layer, close to the skin, directly in the wrinkle to treat without risk of irregularity.
This exciting treatment, without the risk of significant complications, is indicated for the improvement of the texture of the skin, to diminish the fine lines of the face, to improve the appearance of a scar or to treat the tear through.
Deeper lines/wrinkles which mark the face can become blurred over the course of several months thanks to injections of an absorbable/resorbable filler, hyaluronic acid.
Hyaluronic acid is a substance that is naturally present in the skin. It is important to the skin’s structure because it hydrates the tissue. Over time, the quality of this hyaluronic acid deteriorates; the quantity diminishes, bringing with it a weakening of the structure of the dermis. The tissue collapses, the skin dries out, little wrinkles, then lines appear and the face sags.
Unlike other techniques which use non absorbable filling products, this product presents no risks whatsoever. The treatment can be used to boost the volume of the lips or to smooth out acne scars.
Hyaluronic acid revitalizes the skin. In fact, whether used on its own or in conjunction with other active substances, such as vitamins, amino acids or even micronutrients, it has a hydrating and firming effect on the skin and leaves the skin looking more toned. Hyaluronic acid is not an allergen and is absorbed entirely. The treatment can be carried out at the surgery in Cologny or at the Hospital de la Tour in Meyrin.
The treatment consists of a series of multi puncture injections or tracing injections into the superficial dermis. Recently, the careful use of micro cannulas has improved even further the comfort of the patient. This improvement is immediately apparent and side effects are minimal. There is no need for time off from social or professional life. Effects last from 6 to 12 months and even up to 18 to 20 months if injected at depth into less mobile tissue. As for undesirable effects, occasionally a patient may encounter redness or bruising at the injection site. These effects, however, are short lived and can easily be camouflaged. It is essential first to consult a specialist doctor in aesthetic medicine in order to discuss other possible contraindications for the treatment (eg auto immune diseases, allergies, etc.).
What doctors sometimes call a “soft face lift” is not a real face lift, as the term face lift implies the actual removal of tissue. Non-surgical face lifts involve the use of filling products which can be more or less volumizing together with Botox to restore volume to the face on the one hand and on the other to improve the quality of the skin.
As the result is often spectacular it has been described a light face lift. The result is immediately visible and side effects are minimal. It is a “return from holiday” effect and no time off from social or professional life is required.
It is a technique of placing tensor threads that contain small resorbable cones designed to pull up or support the tissue. Tensor threads are resorbable and their composition is similar to that of sutures used in surgery. They contain microscopic notches. The tensor threads remain in position in the subcutaneous tissue and form a supporting mesh. These threads are inserted through an incision in the scalp in the temporal area. They have several names: suspension threads, tensor threads or notched threads.
These have been used for a long time and are perfectly tolerated. They allow sagging tissue to be lifted in patients with the onset of facial sagging. Significant sagging (ptosis), or skin that has lost its tone, are more indications for Dr Quinodoz`s Short Scar Lift (SCL) or Camouflaged Short Scar Lift (CLL), otherwise the results may be disappointing in poorly informed patients. In this context, the experience of the doctor is essential because he will have to explain to you which is the best solution in your case: injection with hyaluronic acid, mini-lifting or possibly installation of tensor or notched wires. Ideally, your practitioner should know how to perform the whole range of interventions, both medical and surgical, without delegating, in order to advise you in a neutral way without influencing you and to propose the best choice in your particular case.
Their installation is not easy because too superficial they can be visible to the skin and too deep they can have no effect. They lead to an improvement in the face and neck with a social eviction of about 3 days. Their duration of action is quite limited with an effect that lasts between 12 and 18 months. The result depends on many parameters, the main one being the doctor’s experience: type of threads (size, material, notching, length…), quality of manufacture, number of implanted threads, positioning…
This is a recent technique which is used to rejuvenate the skin. The idea is to use platelets in the patient’s own blood to avoid any risk of allergy or rejection. A blood sample is taken, as is done during routine medical tests, and this blood is immediately centrifuged to separate the plasma from the red blood cells. In this plasma there is a part, rich in platelets, which contains a multitude of growth factors. This plasma which is rich in platelets is harvested and then injected into the area to be treated. The aim is rejuvenation of the skin by way of tissue regeneration. This recent technology is also used in orthopedics to heal burnt skin tissue.
Most often PRP is applied by way of shallow injections on the face, or the “décolleté”. There are various possibilities but it ought to be repeated once every month for 3 months, then it is advisable to boost the treatment once a year. PRP may be administered alongside autologous fat injections (lipofilling or lipostructure) because certain doctors believe that if you combine PRP with the fat the rate of absorption of the fat is reduced and the long term result is improved.
The idea is to remove layers of damaged skin and replace with a better quality, smoother and younger looking skin. The Egyptians already thought about this 3500 years ago as is revealed in a papyrus text which boasts the benefits of an abrasive paste made from a mixture of milk and honey mixed with particles of alabaster.
Since then, abrasion techniques have improved! Today, they can be mechanical – dermabrasion, chemical – exfoliation/scrubs (peeling), or even thermal – laser abrasion. They all have the same number one objective, which is the elimination of wrinkles,Their disappearance even, especially of superficial lines. The treatments are less effective on deeper or expression lines.
Dermabrasion – mechanical abrasion – consists of the elimination of the superficial layer of the skin, that is to say the epidermis going as far as the superficial dermis. Its depth depends upon the size of the defect it is to correct, the area to be treated and the quality of the skin. Dermabrasion is achieved using a grindstone or a metal rotating brush or even abrasive paper. It must be differentiated from microdermabrasion which is only very superficial dermabrasion. The result is a “coup d’eclat”, an assault on the skin which produces a refreshing but not resurfacing effect.
Exfoliation/scrubs (peeling) act chemically. Whatever their depth of penetration the principle is always the same: after a specific preparation of the skin, one or more exfoliating agents in the form of a liquid or a mask are applied. The treatment is completed by the application of topical regenerating preparations. The result is a true coup d’eclat as brown marks and other problems in pigmentation can be eliminated. The disturbance to social-professional life is varied, from zero to about 15 days depending on the depth of the exfoliation.
Superficial exfoliation (peelings) works at the level of the epidermis and the external layer of the dermis. It is usually made up of a glycolic acid. It may sometimes cause mild burning, such as “sunburn”. The redness disappears usually within a week and treatments can be repeated to achieve greater results.
Deep exfoliation based on phenol is able to reach the deeper layers of the dermis. It is prudent to discuss a deep exfoliation carefully with your surgeon as these treatments do not suit all types of skin and the healing process may be prolonged which may explain why they are sometimes associated with facial aesthetic surgery.
Laser abrasion, whether by laser Fraxel, CO2, pulse or Erbium laser, uses controlled photovaporisation to destroy the epidermis, the papillary dermis and the superior part of the reticular dermis. Thanks to the great range of parameters of these apparatus, lasers offer a wide scope of utilisation which can have an optimum effect for every part of the face
This is a medical technique which involves the injection of products under the skin. Usually, the product is hyaluronic acid but other products include multivitamins such as A, C and E. The treatment is carried out by micro injection using very fine needles. It is almost painless. The injections are either made by hand or using an electric gun.
This is actual mechanical sanding of the skin. It is carried out under local anaesthetic. The aim is to remove a superficial layer of the dermis to achieve the smoothing of, for example, wrinkles around the mouth and to correct certain unsightly scars, such as acne scarring on the face and body. As with the medium and deep exfoliation treatments, the dermabrasion is not suited to all types of skin and it is advisable to discuss treatment with your surgeon.
Hi-intensity focused ultrasound (HIFU) is a new technique aimed at introducing immediate skin rejuvenation. It is non-surgical, non-invasive and non-invasive (FDA approved). Nevertheless, it remains a medical procedure that must be performed by a doctor trained in this technique. Indeed, the way it is used is very important and the indications must be well defined beforehand.
The principle is to use ultrasonic energy which, through coagulation points, will induce rejuvenation by recreating new collagen.
The main indications are sagging skin on the face, especially the oval but also drooping eyelids and eyebrows, double chin and décolleté. It can also be used on various areas of the body.
Taking anticoagulants or aspirin and pregnancy are contraindications. On the other hand, it is possible to use the device on all skin types and at any time of the year. No skin preparation is required and sunlight is not a contraindication.
The duration of the session varies according to the areas to be treated (30 minutes or more). The practitioner applies a gel to allow the conduction of the ultrasound and then the device can perform several passes (various depths depending on the area) using a handpiece.
A tingling sensation and small electric shocks may be felt depending on the area treated and the sensitivity of each patient.
The effect is natural and immediate. After the session, the skin may be slightly pinkish with a tingling sensation. For a few days, skin sensitivity may be felt. The skin is firm and taut. The lifting effect increases after a fortnight and is optimal after three months due to cell regeneration.
One session per year is sufficient but a second session can be scheduled after at least two months depending on the degree of skin slackening. The price varies between 1200 and 3500 chfr depending on the areas to be treated.
The cryolipolys a technique which consists in cooling fat cells and to create a decomposition of those fat cells (lipolysis). The cryolipolyse destroys only the fat cells without damaging the muscles, the nerves and the skin which are less sensitive cold. It should be noted that this technique address only to patients with a normal weight. This not-invasive technique offers an alternative to the lipoaspiration for those who wish to avoid a surgical operation. The zones to be treated are mainly the belly, the love handles and the back, but it is also possible in certain cases to treat the « culotte de cheval », the thighs, the arms and the double chin.
The treatment lasts between 30 and 60 minutes, during which the zone to be treated is pinched between the cooling panels of the applicator. Pain can be perceived during the first minutes.The temperature is of approximately -7°C.
The result after three months (sometimes less) shows an average reduction from approximately 30% thickness of the pad. During this period, released fat is evacuated by the metabolism of the body. Sport, healthy food and good hydration contribute to optimize the result.
Good to know:
Redness, bruise, some oedema, pain or loss of sensitivity can persist a few weeks. These effects are not systematic but must be known.
Cryotherapy is different:
Be careful not to confuse cryolipolysis with cryotherapy. Cryotherapy consists of exposing the entire body to extreme cold (between – 120 and – 140 °C) for 1 to 3 minutes. The benefits: elimination of tiredness, improvement of blood circulation and muscular recovery, reduction of oedemas and articular pains. But it does not act on fat overloads.
Fat under the chin frequently persists despite dieting, resulting in a double chin effect If you are under 40 years of age with still toned skin and blocked fat under the chin, it is possible to correct this problem with a non-surgical solution, with deoxycholic acid injections.
The deoxycholic acid will destroy the fat cells, preventing them from re-forming afterwards. This drug treatment sometimes avoids liposuction but requires several sessions and the results are less controllable than liposuction.
The post-treatment follow-up by injections is simple with however transient pain and swelling lasting several days.
You will have to discuss with your plastic surgeon other minimally invasive treatment options such as neck and double chin liposuction. Liposuction consists of aspirating the fat blocked under your chin with a micro cannula under local anaesthesia on an outpatient basis. This light intervention has the advantage of giving predictable results and very simple consequences.