Asian

Western culture has greatly influenced Asian society and at one time the standard of beauty was redefined in favor of more Western features. However, as the Asian population in the United States continues to grow, the tide has turned. The desire to possess an eyelid fold or a well-shaped nose should not be misinterpreted as wanting to look Caucasian. Most Asian patients seeking cosmetic surgery want to improve their appearance with subtle changes while retaining their ethnic identity. The most popular procedures requested by Asian patients are nose reshaping, eyelid surgery and breast augmentation.

Asians have different skin colors and textures when compared to Caucasians. Therefore, the skin needs to be treated differently. Asian skin tends to be smooth and poreless and more prone to irritation. Today, there are a wide variety of treatments available for Asian patients which include laser, dermabrasion, and chemical peels.

Face

Facial features in Asians are different from Caucasians. The forehead is flatter, the eye socket is shallower and the cheek bones are more prominent. In addition, the eyelid fold is smaller or absent and the skin is much thicker. This leads to differences in the aging process. The upper eyelid area ages much earlier due to the eyebrows falling which can lead to the crowding of the upper eyelid area and onset of forehead wrinkles. While the Mid Face ages gracefully, due to its characteristically high cheekbones, Asian patients benefit from a brow lift at an early age.

Eventually, the aging process finally does catch up to the face, and the mid and lower face areas begin to sag. By performing a facelift, the effects of gravity on the face are reversed, pulling those structures back into place. The muscle layer under the skin is tightened and the skin is redraped. The neck is also tightened. All this is done through incisions that are well hidden around the ear. Liposuction of the face and neck can be done simultaneously to improve facial and neck contour.

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Profile

Many Asian patients are unhappy with their profile. They see their profile as flattened, with the mouth as the dominant feature. This facial imbalance can be corrected by inserting small facial implants in the Mid Face and chin. This simple procedure can have dramatic results.

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Eyes

Double Eyelid Surgery (blepharoplasty)
Asians naturally have more fat in their upper eyelid which can cause overhanging upper eyelid skin. Because of this, many Asian patients request double eyelid surgery or Asian blepharoplasty. Double eyelid surgery can have a huge impact on ones appearance because it can diminish a sleepy appearance and create a more open-eyed look.

Many Asians are born with a double eyelid while others are born with a single eyelid, or an eyelid without a fold or crease. The majority of patients seeking double eyelid surgery want a natural looking fold. The most attractive fold in an Asian patient starts very close to the lash line and gradually enlarges across until it achieves a consistent size. Some patients may need to have upper eyelid fat removed while others may lack upper eyelid fat. A good candidate for this procedure is usually a young patient in their teens to twenties but certainly older patients can also benefit tremendously from eyelid fold surgery.

Medial Epicanthal Fold
The medial epicanthal fold is a veil of skin draping in the inner segment of the eye.
A large fold gives the illusion of being cross-eyed and makes the eyes look farther apart. Medial epicanthoplasty is done by removing a wedge of skin at the inner portion of the eyelid. This can open up the inner corner of the eye and greatly improve the appearance. However, the resultant scar can be prominent in some patients and is therefore reserved only for severe cases.

Brow Lift
Asian patients often request upper eyelid surgery because their upper lid area appears puffy and crowded but they may be a better candidate for a brow lift. This is because sagging eyebrows can crowd the upper eyelid area. A brow lift procedure can correct drooping brows and improve lines and creases on the forehead. The result is a more youthful and refreshed look. A brow lift procedure involves removing excess tissue and redraping the skin to smooth the forehead, minimize frown lines and lift the upper eyelids. Brow lifts are most commonly performed on older patients to minimize the effects of aging, but it may also be appropriate for younger patients with droopy brows or creases above the nose.

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Nose Surgery (Rhinoplasty)
An ethnic nose is different from a Caucasian nose in almost all aspects. Patients seeking improvement of their nose appearance generally have similar complaints. They usually want a better projecting nose with an improved shape. Although the general principle of an Asian rhinoplasty is similar to that of the Caucasian, the approach and the technical execution is quite different.

In selected cases, breaking and narrowing the nasal bone will yield an attractive nose. However, nasal implants are more commonly used. Nasal implants have proven to be extremely successful. They are safe and precise and have a low occurrence of complications. During the consultation process, the nose is measured to determine the size, shape and thickness. The implant is then customized to fit the individual patient. The thickness of the implant should be conservative to maintain ethnic identity.

Cheekbone Reduction
Cheekbones can be very prominent in some Asians and this is an area of great concern. Many patients are often very self conscious of a widened face. Having extensive experience in treating facial fractures, Dr. Kwan has developed a special technique in narrowing the face.

For patients with very wide and prominent cheekbones, breaking and resettling the bone in a reduced position will result in a narrower face. This is done through a small incision which is hidden in the scalp, and inside the mouth. There is no need for plates and wires and the bone heals in this new position. For patients with slightly wide and prominent cheekbones, filing down the cheekbone through an incision in the mouth may be all that is required. This is a less invasive surgery with faster recovery and satisfactory results.

Jawbone Reduction
The size of the jawbone determines the width of the lower face. If the bone is thick and wide or the muscle is thick and bulky, it will result in a widened face. This can often cause some patients to become very self-conscious and try to camouflage the lower face with their hair.

To reduce the size of the jaw line, the bone is filed down and a portion of the muscle is removed. The muscle will still function properly but the fullness will be reduced. This will create a more oval shaped jaw line with a softer and smoother angle. Botox can also be used to provide a more temporary result. An adequate dose of Botox can be injected into the jaw muscle shrinking the size of the jaw line for approximately 6 months.

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Breast

Breast augmentation has become increasingly popular among Asian patients. Many Asians possess small breasts. This poses an obstacle in finding clothes that drape the chest aesthetically. As the standard of beauty shifts, the demand for breast augmentation increases. The amount of enhancement should be modest, to match the generally narrower body frame. Smaller implants often give a better, more natural-looking result.

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SKIN

Non-Invasive Procedures

Dermabrasion
Dermabrasion helps to smooth out irregularities on the skin by gently abrading the skin’s top layers. The procedure is most commonly done to remove sun-damaged skin and to remove or lessen the appearance of scars and dark spots on the skin.

Temporary side effects can include itching, tingling, burning, swelling, redness. Lightening of the treated skin, sensitivity to the sun and loss of the ability to make pigment (tan) can also occur. Risks involved with the procedure can include abnormal color changes, whiteheads, infection, scarring, skin flare-up, allergies, fever blisters and cold sores.

Chemical Peel
Chemical peels improve the appearance of the skin and is typically performed on the face, neck or hands. The treatment restores youthful skin by eliminating the topmost layer of skin, which is often damaged by weather and other external factors. The new, regenerated skin is usually smoother and less wrinkled than the old skin.

Botox^® Cosmetic
Botox^® Cosmetic is a popular non-surgical injection that temporarily reduces or eliminates frown lines, crow’s feet, laugh lines and forehead creases. The Botox^® Cosmetic procedure temporarily paralyzes the muscles that cause wrinkles while giving the skin a more smooth and rejuvenated appearance. This simple treatment must be repeated every 3 to 4 months.

Thermage^®
The Thermage^® procedure is a revolutionary non-surgical technique that tightens aging skin with no incisions. Thermage^® employs a patented capacitive radiofrequency (CRF) technology called ThermaCool™, which has been clinically proven to tighten and gently lift skin to smooth out wrinkles and renew facial contours. The incision-free procedure is fast, easy and requires no downtime from regular activities. Unlike lasers, the procedure can be performed on patients of all skin types. The ThermaCool™ device has been cleared by the FDA for the non-invasive treatment of facial wrinkles.

The ThermaCool™ device uses a special treatment tip called ThermaTip™ that delivers a controlled amount of CRF energy. With each touch of the skin, the ThermaTip™ evenly heats a large amount of collagen in the deeper layers of the skin and its underlying tissue while simultaneously protecting the outer layer of the skin with cooling. Immediately following the Thermage^® procedure, skin should feel lighter, smoother and more youthful with additional tightening over time.

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Fat Injections (Autologen)

There are various fillers that infiltrated the market, several of which have become very popular. Despite the availability of these fillers, our clinic prefers fat transplantation as the filler of choice. Your own body fat is removed, usually from the thighs or buttocks, and is transferred to another area of the body. The fat can be used to fill in grooves and wrinkles in the under eye area, crow’s feet, cheeks, lips and nasolobial folds (the lines between the nose and the corners of the mouth).

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Fillers

Juvéderm® (Hyakuronic Acid)
Juvéderm® is an injectable gel that is considered the “next-generation” dermal filler. Juvéderm® helps to add volume and hydration to the skin while smoothing away facial wrinkles and folds. It is also the first FDA approved hyaluronic acid filler that is proven to be safe and effective for persons of color. Juvéderm® provides long-lasting results for up to nine months.

Restylane^® (Hyaluronic Acid)
Restylane® is a cosmetic filler that restores volume and fullness to the skin to correct moderate to severe facial wrinkles and folds. Restylane® is made from an acid that occurs naturally in the human body. It is best used for cheeks, under eye area, lips and nasolabial folds (the lines between the nose and the corners of the mouth). The effects of Restylane® generally last for approximately six months.

Sculptra^® (Poly-L Lactic Acid)
Scupltra^® is approved by the FDA for the restoration and correction of the signs of facial fat loss in people with human immunodeficiency virus (HIV). Sculptra® is a biodegradable substance used in dissolvable stitches. Sculptra® is best used for frown lines, cheeks and nasolabial folds. The effects of Sculptra® generally last for up to 2 years.

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Lasers

The Erbium-Yag laser has been effectively used to reduce fine wrinkles around
the eyelid and the face. The laser can also be used to remove small marks, lesions and smooth out scars. With the Erbium-Yag laser, the risk of hyperpigmentation is much less.

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Skin Cancer

Skin cancer is more common among patients who have a history of heavy sun exposure. Patients with fair skin and lighter hair are at higher risk for skin cancer.

There are three different types of skin cancer; basal cell carcinoma, squamous cell carcinoma and melanoma. Basal cell carcinoma is the most common type of skin cancer and is also easily treated. Basal cell carcinomas usually appear early on as small ulcerating lesions. These cancers generally do not spread to other parts of the body. Treatment of basal cell carcinoma usually includes removing the cancer from the skin and stiching with a fine closure. This will result in the smallest scar possible.

Squamous cell carcinoma is a more serious type of skin cancer but can be easily treated when identified promptly. Unlike basal cell carcinoma, squamous cell carcinoma can spread to other parts of the body. Squamous cell tumors appear as thick and rough ulcerating lesions when they develop and usually appear on sun-exposed areas of the body. Treatment for squamous cell carcinoma is similar to that of basal cell carcinoma and is highly successful with early detection.

Melanoma is the most serious form of skin cancer. The first sign of melanoma is a lesion on the skin that resembles a mole or a change in the size, shape or color of an existing mole. Any suspicious lesion with an irregular shape and color should be closely monitored. It is important that melanoma be detected as early as possible. Surgery to remove the melanoma is standard treatment for this disease.

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