Colorado’s own Heidi Montag Pratt of The Hills MTV reality series now in its sixth season underwent comprehensive plastic surgery earlier this year generating endless news feeds and paparazzi coverage. “This situation should not be perceived as reality,” says Jeffrey Raval, MD, FACS. “Reputable plastic surgeons do not engage in performing surgery to gain notoriety.”

While undergoing 10 plastic surgery procedures performed in one day – a mini brow lift, Botox injections, a nose job, fat injections in her cheeks and lips, a chin reduction, liposuction to her neck, her ears pinned back, buttocks augmentation, liposuction to her waist and thighs, and revision breast augmentation—Montag had the surgeries taped purportedly to use in a future reality show.

Post-surgical photos of Montag reveal a Barbie-shaped physique. “Truly, the responsibility of any cosmetic surgeon is to vet elective surgery options with a patient prior to surgery. Consults with the doctor would routinely identify what surgical procedures are indeed going to enhance an individual’s lifestyle and improve their health. A perceptive plastic surgeon will be able to assess whether an individual is seeking surgery for all the wrong reasons, i.e. to please a partner or to gain notoriety. From the outside, it would appear that this particular celeb pursued surgery to generate media attention rather than to correct physical flaws.”

Dr. Raval has gained a reputation among fellow surgeons in the Rocky Mountain West of being The Nose Doc, particularly proficient at revision rhinoplasty surgery, repeat nose jobs that are more complicated than first-time nose surgeries because of the scar tissue that develops in any surgical area.

Dr. Raval pioneered the use of Dermamatrix in nose surgeries resulting in a smoother, more natural shape to the nose. Introduced in 2006, this dermal matrix is preferred over others because of its uniformly soft and pliable consistency and its increased tensile strength.

To see a video on the benefits of Dermamatrix, go to www.ravalmd.com/rhinoplasty.html.

Denver, Colo.— As an injector trainer, one of a handful of surgeon trainers in the state, Dr. Jeffrey Raval has pioneered a new process to make the injections in this liquid facelift painless. He combines fast-acting lidocane, a numbing agent, with the injectable fillers, a practice that the FDA approved in 2009.

Injectable fillers are used on the face to turn back the clock, plumping up the face to look fresh and young, juicy even.

“I liken the face as we age to a grape that slowly over time turns into a raisin,” says Dr. Raval, who is a double board-certified facial plastic surgeon and otolaryngologist. He performs surgery on the head and neck only.

One of the greatest contradictions in aging is the loss of fat in the face while simultaneously gaining in the hips and mid-section. Well, there is a solution and it can take years off of one’s appearance, according to Jeffrey R. Raval, MD FACS. The answer is in combining diet and exercise for weight control to retain a firm mid-section with infusions of fat and filler in the face to keep it looking plump and, yes, juicy.

Of the two missions, the one that’s more painful and time consuming is definitely the diet and exercise piece. Dr. Raval explains that around the age of 35 (some studies suggest 30), the average woman loses 1/2 to 1/3 of a pound of muscle each year while gaining an equal amount in body fat. Each pound of body fat burns an estimated 5 calories per day while each pound of lean muscle mass burns approximately 50 calories per day. The result of carrying around fat vs. muscle mass is a drastically slower metabolism. A slower metabolism means weight gain, even when you don’t change eating habits.

“Keeping your physique young looking means an investment of time into regular workouts and it means relentless attention to caloric intake and healthy food choices,” says Dr. Raval, who fits a serious workout session into his busy life a minimum of three times weekly. “Keeping fit and trim as you age means giving up the burgers and fries you might have enjoyed as a teenager. Carbs show up on your waist and hips. Even diet sodas with artificial sweeteners can trigger the cephalic phase response—the sweet taste on the tongue stimulates the brain to eat and overeat.”

On the other hand, successful weight loss will most often result in the face looking thinner, even gaunt.

That’s because our bodies manufacture less natural collagen as we age. The skin loses its elasticity, jowls begin to droop and creases and wrinkles deepen.

At his clinic in Cherry Creek North, the upscale shopping and entertainment district in Denver, Dr. Raval performs several kinds of mini facelifts using a customized combination of facial fillers including Restylane®, Juvederm®, Hylaform, Perlane, Radiesse and collagen in combination with Botox®, Dysport® and PureTox®, three injectable products that smooth away wrinkles and creases by effectively numbing the underlying facial muscles that contract to make natural wrinkles and folds.

Using fillers, Dr. Raval is also able to correct aging jowls, filling in the areas that have receded to create a smooth jaw line, reinserting the definition that is seen on a much younger face. Additionally he can correct aging eyes by inserting filler underneath the lower eyelid where the eye begins to wrinkle and the tissue sometimes appears sunken. Filler plumps up the area, erasing lines and wrinkles and returns the eye to a much younger appearance.

The beauty in the injectable facelift, adds Dr. Raval, is that it can be performed in less than 30 minutes without general anesthesia in his office. The patient may experience a small amount of bruising, but there is no weeks-long recovery as in a traditional facelift.

For information on the One-Hour Facelift, call Dr. Raval’s office at 303-381-3223 (FACE) or read more about age defying treatments at www.ravalmd.com.

The trend used to be if you had a wrinkle, indentation or a sag in your skin, especially excess skin, pull it taut or take it off. Those procedures were just as invasive as they sound. The newest treatment is a lot easier on the face and the wallet: Simply fill it. Call it recession chic. Then call The Filler Guy, Dr. Jeffrey Raval, an expert on injectable fillers and a facial plastic surgeon.

“We all go from a grape to a raisin as we age,” says Jeffrey Raval, MD, FACS, who practices in Cherry Creek North in Denver, CO. “That’s where the fillers are coming in. Instead of pulling and cutting, the newest approach is to replenish the loss of volume with injections of non-invasive fillers. There are so many filler products on the market today that the friendly competition between manufacturers has led to a reduction in price, a reduction we’re passing along to the patient.”

Competition drives down pricing in any product-technology to housing. Until recently, there were not as many players with products in the cosmetic industry, keeping prices high.

Some of the recent price cuts mean beauty comes at a reduced cost. Radiesse now comes in a larger syringe-up to 1.5 cc from 1.3 cc in size. The larger size syringe is sold to surgeons at the same price as the smaller syringe. The size of a Restylane syringe has doubled, from 1 mm to 2 mm and the price of each syringe sold to doctors only increased 70% vs. 100%. The cost savings on materials (in this case filler materials) allows Dr. Raval to pass that savings along to the patient.

The Filler Guy, Dr. Raval, is the top doc in Denver who specializes in this type of cosmetic enhancement.
He first consults with you to put together a tailored solution based on your desired results and your particular skin’s needs. Your skin is unique to you, explains Dr. Raval, which is why a cookie-cutter treatment just won’t work. It is important to carefully select the right product for your face. The Filler Guy, Dr. Raval, uses multiple types of filler injectables to achieve the most natural rejuvenation treatment possible.

Juvederm is the injectable best for the mid-to-deep dermis of the face. This is the layer that contains nerve endings, sweat and oil glands and blood vessels, so it is a product you would like to have injected by a double-board certified doctor like Dr. Raval instead of at your local spa. Results can last up to one year and it can treat nasolabial folds (also known as parentheses lines or smile lines) in the lower portion of the face. Juvederm is also used to fill the back of the hands, restoring the hands, a dead-giveaway of age, to a younger look.

The benefit in Juvederm is its hyper-tenacity. The product, once injected, tends to draw in water creating a nice plumping effect, explains The Filler Guy, Dr. Raval. “That’s particularly nice for the lips and folds in the face. But we don’t use Juvederm around the eyes because can make eyes look puffy. The eye area is where we use Restylane.”

Restylane restores volume and elasticity to the face. It can be used to treat wrinkles, fill lips, shape cheeks and smooth the glabellar lines between the eyebrows. Pumping up your pout or contouring facial features with filler will not only take years off your face, it will safely be absorbed into your skin the way your body’s natural hyaluronic acid would. It is long lasting, but not permanent.

Perlane is similar to Restylane but gives a patient a more robust correction, says Dr. Raval. Perlane is made up of larger particles which take longer than Restylane to naturally absorb into the skin. Perlane can be implanted to add facial volume to wrinkles and folds in any area of the face as well as to the lips. “Each syringe of Perlane contains a little more correction than does a syringe of Restylane,” notes Dr. Raval. It lasts about the same length of time as Restylane, one year.

Radiesse is the best product for volumizing. “It’s great for treating jaw lines, cheeks and under the cheek,” says The Filler Guy, Dr. Raval. Radiesse stimulates your body’s natural production of collagen so it not only creates a younger you, it prompts your body’s natural collagen-producing function to generate more collagen, enhancing the facial fullness even more. Radiesse is a calcium-based product and the injections require little or no downtime.

Denver’s Filler Doc, The Filler Guy, Dr. Raval is the expert of enhancement. Call Dr. Raval at 303-985-8520 for an appointment.

Once again, news headlines claim that Botox® injections can be lethal. The news reports are not only exaggerated, but inaccurate in that the news stories logged don’t differentiate between injections of BOTOX for medicinal purposes and the injections for cosmetic purposes-a big difference.

“Bottom line, all the reported cases of adverse events using Botox come from injections of BOTOX for medical purposes, not cosmetic,” says Jeff Raval, MD, FACS, American Board certified facial plastic surgeon who is ear/nose/throat board certified too. “The high level of doses of Botox used for medicinal purposes can be too much. For example, there have been cases that doctors injecting Botox in the neck muscle to treat torticollis, abnormal spasms of the neck muscle, have injected too much of the toxin. The patient’s throat can close up and he/she can have trouble breathing.”

But there are no reported incidences of lethal or near-lethal use of Botox for cosmetic treatments, Dr. Raval confirms.

The dangers in Botox use surface in the press every year or so. “There is no truth to the rumor that Botox Cosmetic is dangerous,” adds Dr. Raval.

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.”

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. I have a bump in my nose that makes me extremely self-conscious of anything that highlights my facial profile. The idea of someone going at my nose with a chisel is unappealing. I guess I am too squeamish to undergo traditional rhinoplasty. Are there any other less invasive options for me?

A. Yes, there are options for correcting your nose vs. rhinoplasty. Referred to as the “15-minute nose job” using the dermal filler, Juvéderm™, Dr. Raval is able to smooth out any imperfections without surgery. Most commonly used to fill facial wrinkles, Juvéderm™ has now been approved to correct nose imperfections.

Q. I have heard Juvéderm™ can be injected into certain places of the nose to disguise odd shapes and bumps. Would the filler move around in my nose over time and the shape become distorted? How exactly does this procedure work?

A. During the procedure, Dr. Raval carefully injects Juvéderm™ into certain areas of the nose to give it a symmetrical shape. The filler is used to fill in depressions and give the nose a smoother, even appearance. To correct a bump on the nose, Juvéderm is injected on either side of the bump to even out the surface. If the tip of the nose is annoyingly fat, filler is added to the tip to create a narrower look. Once the filler is injected into the nose, Dr. Raval manipulates it until the desired result is attained.

Q. I am allergic to collagen. Will I experience an adverse reaction from Juvéderm?

A. Collagen is made from a bovine derivative while Juvéderm is made from hyaluronic acid. Hyaluronic acid is a sugar molecule that is naturally occurring in the human body. It helps to add volume and hydration to the human system. Unlike collagen, there is no chance of an allergic reaction to Juvéderm.

Q.How much of a price difference is there between Juvéderm and traditional rhinoplasty? How long does it last?

A. Juvéderm injections are much cheaper than a traditional rhinoplasty. Injections cost about $500 for one syringe, several thousands of dollars cheaper than rhinoplasty. The procedure is extremely quick and easy, lasting only 15 minutes at the longest and results are immediate. Following the procedure, the nose will be slightly sore and red at the injection site but all the side effects will be gone within a week. The results of the procedure last over a year and when the effects begin to dissipate, they can be easily redone.

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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