DENVER, CO—One of the standard features of any physician’s office in the last half of the last century as a waiting room.  Yet waiting at all anymore isn’t what patients expect –even when it comes to the results from their treatment.

A lot of that has to with the rejuvenating cosmetic treatments that doctors like Dr. Jeffrey Raval are able to perform that make an immediate improvement—and require no downtime.

At the office of triple board certified Dr. Raval, some of those immediate treatments include the liquid facelift. Using filler materials, like Juvederm and Restylane plus BOTOX, Perlane and Restylane in different combinations, Dr. Raval is able to concoct a customized and immediate facelift of sorts for patients. Within 45 minutes to one hour, the patient leaves the doctor’s office looking years young. In most cases, Dr. Raval, a facial plastic surgeon who concentrates on the head and neck exclusively, doesn’t even have to numb the patient first, saving even more of the patient’s time. (When anesthesia is used on a patient, the patient is required to come early to the appointment to allow the numbing effect to take hold, that’s true even of topical numbing ointments.)

No two people receive exactly the same amount of filler in the same location in the same quantity. But two rules generally apply: BOTOX is used only in the top half of the face including the forehead, between the eyebrows and around the eyes; while fillers are generally used in the lower half of the face.

“It’s the grape to raisin theory,” explains Dr. Raval of the newly popular liquid facelift. “The face starts out on a young person as full and firm. Over time, the face loses its elasticity and its ability to produce collagen. The skin becomes lax and droops and wrinkles and creases begin to form as the jowl or jaw line drops too.

Instead of going under the knife, more patients are opting for non-invasive procedures like fillers and BOTOX to extend the years before a facelift would be the optimum recommendation that Dr. Raval would make.

In a recent liquid facelift performed in 45 minutes or less in the office, Dr. Raval used one syringe of Restylane around the eyes to and in the cheekbone area to plump up the area under the cheekbones that had become sunken. He used one syringe of Radiesse in the lower face along the jaw line to fill in where gravity had begun to pull downward on the face, making the jaw line uneven and aged looking. And he used 45 units of BOTOX around the eyes, forehead and frown area (10 units to the forehead, 10 around the eyes and 15 in the frown area) to smooth away wrinkles. In some cases, Dr. Raval says, these kind of frown wrinkles especially can leave a person looking angry; just a small amount of BOTOX smoothes away the years and the negative expression.

Immediately after a liquid facelift, the patient can reapply makeup and resume routine activities. “No waiting for results and no downtime make this a treatment that renders immediate gratification,” adds Dr. Raval, who has performed hundreds upon hundreds of liquid facelifts since fillers and BOTOX were approved by the FDA.

Patients are scheduled for a recall visit with the doctor two weeks after a liquid facelift at which time Dr. Raval touches up any areas that require more filler or BOTOX.

Dr. Raval finds that the fillers are optimum over a fat transfer which was the superior treatment only years ago. “Fillers have come such a long way in recent years plus they last longer than natural fat transferred from one area of the body to another. There is very little if any discomfort and the results are so impressive that patients leave their appointment looking refreshed and feeling younger.”

My mid-50s girlfriends got together last week for dinner—something we’ve been doing for nearly 30 years every couple of months. It had been half a year since I’d been able to join them and while this is a group of women that’s healthily interested in keeping up their looks, I could see a lot of difference—more wrinkles, deeper frown lines, dull complexions. It caused me to take a good hard look at myself in the mirror the next morning and while there’s plenty more I could elect to do for myself, I’m thoroughly pleased that four years ago I underwent a blepharoplasty in Dr. Raval’s care.

As Dr. Raval pointed out to me then, the eyes are the first place on the face to give up our age as a rule. My eyes had begun to have thicker lids, and when I smiled for family photographs, my eyes then looked more like narrow slits than the eyes I had as a much younger woman.

Besides the blepharoplasty for upper eyelid surgery, Dr. Raval performed an under-eye surgery to re-build the wall of fat under my eye that had in the course of aging drooped, allowing my lower eyelids to show slight bags on most mornings. Five years later, my eyes are the youngest looking part about me when I get up in the morning. I don’t have any of the “cat-eye” look that some of my acquaintances seem to have after their eye surgeries either, and I’m so glad for Dr. Raval’s skill as a surgeon. He explained to me prior to my lower eyelid surgery that the cat-eye look is a matter of technique versus more than anything else. One of my friends had surgery performed by an eye doctor who advised her to forego the under-eyelid surgery because the cat-eye look would be the result. She now says she’s disappointed that she didn’t go ahead with the under-eyelid surgery by Dr. Raval instead.

It’s amazing to me after five years time that the eyes-wide-open look that blepharoplasty can afford me is still as becoming as it was a month after surgery.

This is a procedure I would never regret and will recommend to anyone who asks!
–Mid-50s and seeing clearly.

To make a consultation appointment with Dr. Jeffrey R. Raval, triple-board certified facial plastic surgeon, call 303-744-2300. Dr. Raval has practices in Denver and Lone Tree, Colorado.

Q: While the optimists refer to wrinkles and creases in their faces as “the marks of a good life,” I want them gone. What causes my wrinkles and is there a way to make them disappear?

A: Over time, sun and other environmental factors cause skin to break down. The skin loses its volume and shape and unwanted wrinkles and fine lines appear. With today’s technology,  Jeffrey Raval, Md, FACS, a leading Denver facial plastic surgeon, one of only a handful in the state who is triple board certified, uses the latest technology and FDA-approved injectible fillers to reverse the signs of aging and eliminate unwelcome wrinkles. A facial filler like Juvéderm can help smooth wrinkles by adding volume and structure to the sunken areas of skin.

Q: I am constantly bombarded with different cosmetic creams and fillers. What is Juvéderm and how is it different from all of the others?

A: The main component of Juvéderm is hyaluronic acid. Hyaluronic acid is a natural sugar complex that is already present in all living cells. It is one of the main counterparts of the dermis connective tissue matrix as well as with collagen and elastin. Hyaluronic acid is similar to a sponge; it attracts and absorbs water increasing the skin’s volume and density. Because the acid absorbs water, it promotes duration for up to 6 months or longer setting Juvéderm apart from other dermal fillers.

Q: I have very sensitive skin and have experienced reactions to topological creams previously.  Can I still receive Juvéderm injections?

A: In a word, yes! The main component of Juvéderm, hyaluronic acid is a sugar compound naturally found in the body. Since it is already present, the chances of an allergic reaction are eliminated.

Q: I want to get rid of the wrinkles around my mouth and nose but I am squeamish when it comes to needles. Is the procedure painful?

A: Because of its smooth consistency, Juvéderm gel is injected easily and smoothly under the skin’s surface. In some cases, a mild numbing cream may be applied to the area beforehand.

Q: As an African American woman, not all procedures work for my skin. Can I be treated with Juvéderm without adverse side effects?

A: As the first FDA-approved hyaluronic acid dermal filler that is proven safe for use in different skin tones, Juvéderm is extremely safe for all skin tones and colors. While mild side effects such as redness, firmness, swelling, bruising and itching are common they occur in all skin tones.

Sculptra® makes you look years younger without surgery or down time

Q. There are so many dermal fillers on the market. What is Sculptra® and what makes it different from the others?

A. Sculptra is the only dermal filler in the United States approved for the restoration of facial fat loss or lipoatrophy most commonly seen in people with human immunodeficiency virus. Lipoatrophy is the loss of fat beneath the skin that results in sunken in cheeks, eyes and a hollow, gaunt look. Sculptra is a safe, biocompatible material that is injected into the skin where the fat loss occurs. The filler provides a gradual and natural increase in the thickness of the skin resulting in a full and healthy appearance. Sculptra® is also used in those who do not have HIV and have lost facial fat through aging.

Q. I want to receive Sculptra injections to reverse the hollow, sunken in parts of my face. Are the results immediate? How many treatments will I need and how long do they last?

A. Immediately after receiving Sculptra injections, you may appear swollen due to the injections. A few days later, the swelling subsides as your body absorbs the water. Sculptra takes time to fully develop and correct the hollows in your face. Dr. Raval will determine how many treatments you need; patients with severe facial fat loss will require between 3 and 6 treatments to have satisfactory results. Results last different lengths of time for each person, but in clinical studies they lasted up to 2 years. However, touch-up treatments may be needed to maintain the desired results.

Q. I am terrified of needles and worry about the Sculptra treatment. What can I expect during the procedure?

A. Prior to the treatment, all makeup and facial products should be removed to create a clean, smooth surface. The area of the injections will be thoroughly cleaned with an antiseptic and Dr. Raval will determine whether a topical or local anesthetic is required. Sculptra is then injected in small amounts into the skin through an extremely fine needle. Following the procedure, an ice pack should be applied to the area to reduce swelling and the area of the injection will then be massaged to distribute the product evenly.

Q. What can I expect to happen after treatment? Will I be able to return to my daily activities immediately?

A. Immediately following treatment, there may be some swelling, bruising, pain, redness or all of the above. These after-effects will usually subside in a few hours or, at most, a few days. Dr. Raval recommends that you massage the area for several days following treatment as well as apply an ice pack. It is also important to avoid direct sunlight until any redness has been resolved.
The after-effects differ from patient to patient but most patients feel well enough to return to their daily activities immediately afterwards.

Q. Lately I have noticed that the lines around my mouth are deepening. My friend told me that they’re called marionette lines. It’s making me feel old, worn and extremely self-conscious. I have heard about Restylane®. Is this something that would give me a “lift”?
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