Photo Credit: drdeankane.com
Dr. Dean Kane and Lauri Kane are the co-founders of Â Center for Cosmetic Surgery and Medispa in Baltimore, MD.
Dr. Kane is a board certified plastic surgeon and an associate clinical professor for the Division of Plastic and Reconstructive Surgery at the renowned Johns Hopkins Hospital. At the Center for Cosmetic Surgery & MediSpa, they offer a full menu of non-invasive medical spa treatments. An â€œanti-agingâ€ medical practice that helps patients who are interested in enhancing their appearance and lifestyle. Dr. Kane’s expertise in cosmetic surgery and Lauriâ€™s management and education skills have allowed the Kanes to expand their business beyond traditional plastic surgery. The result is a unique practice and medispa that encompasses fitness, stress reduction, weight management, and other aspects of body/mind medicine.
1. What is your favorite filler?
Fillers are an art and a science all to themselves. They became particularly popular during the time of the recent recession and continue to appeal to the public for their cost, value and short downtime. Fillers can be divided into Hyaluronic Gel and others. Gel characteristics are due to their molecular linking. Those with more linking in general are stiffer, more projecting and longer lasting like Voluma (lasting 2 years) and Perlane (lasting 1 year). These are better for cheeks and jawlines or chins. Those with less linking such as the newest introduction of Restylane Silk are water-loving and best for creases and lines like those around the mouth or eyes and glabella creases. In between are Juvederm Ultra and Restylane which stay approximately 8-12 months and work well for lips, nasolabial and marionette folds. In the Other category are semi-permanent fillers such as Radiesse which I like best next to bone along the nose and orbit or jawline. Permanent fillers such as silicone and BellaFill have more chance to develop nodules and more long lasting irregularities which are not easily fixed so I do not tend to use them.
2. You didnâ€™t mention Sculptra. How does this filler compare to those you mentioned?
Sculptra is quite unique and while it fell into the Filler category two decades ago, it has been resurrected in a different function. Sculptra is not a filler per se but a stimulator of your own skin tissues.Â Â In its present form, Sculptra Aesthetic is reconstituted to achieve a very slow but steady firming and thickening of facial skin. Rather than adding volume as in the gels, radiesse or more permanent fillers, Sculptra stimulates the production of collagen, hyaluronic acid, elastin and fat depending on the layer it is injected in. In my hands, Sculptra has been revolutionary in patients who desire subtle tightening of the skin with firming of the folds and creases. It is complementary to fillers in that, fillers provide a immediate improvement by plumping the hollows or sunken areas of face skin and soft tissues. Sculptra provides rejuvenation by firming, tightening and thickening the texture and improving the laxity of aging skin. If you combine a retinol skin cream with this combination, you achieve a trifecta of fill, firming and exfoliation with pigmentation improvement.
3. Why not use laser tightening to firm the skin?
Lasers, radio-frequency and ultrasound wavelength energy therapies have been clinically underwhelming for me. These technologies use energy focused into the different levels of the skin and fat to achieve warming and denaturation of collagen. Much like UV wavelength sun energy, the injured protein undergoes inflammation to form new collagen. Like a sunburn, youâ€™re back to the same skin texture you were 3 months earlier.Â Laser tightening is a good non-surgical adjunct to Sculptra but does not replace it.
4. Are there any other non-surgical rejuvenation enhancement?
Yes, I mentioned retinoids as a terrific adjunct to rejuvenate skin. The use of Retin A, the acid form of vitamin A has exfoliated and stimulated skin from the epidermis down for over 4 decades. Today, there are new retinols, the alcohol form of vitamin A.Â I consider themÂ the Gold Standard in skin rejuvenation as it penetrates the cell and stimulates up-regulation of the gene directly. With Zein Obagi, MDâ€™s second generation of therapeutic levels of plant based anti-oxidants, anti-inflammatories and more targeted skin care, ZO Skin Health products are now available for a larger range of patient care for pigmentation control, cleansing, regulation, inflammatory control, reverse of disease and stimulation over his distant but revolutionary products. As a daily regimen, ZO promotes renewal and rejuvenation to keep the skin healthy and glowing.
5. Is there a way to tell if a patient needs more than a non-surgical approach?
This is a very excellent question as patients hope the lesser invasive procedures will tighten, lift or suspend aged and lax skin and underlying soft tissues whether of the face and neck or the trunk and extremities. If you can â€œpinch more than an inchâ€ of skin along the jawline toward the earlobe, there is no current technology or physiologic options to anti-age this amount or more skin laxity of the face. Combinations faceÂ lifts and mini-tucks with lipo-contouring for the forehead/brow, face and neck are recommended. Similar surgical options are available for the trunk and extremities.
6. It seems like your practice offers the entire range of options for a patient. What makes you so unique?
Our practice is based on the personality of Lauri, my wifeâ€™s, â€œcan doâ€, family style attitude and my tried and true, face forward use of current and past surgical and physiologic options best selected for each unique patient. With a complete armamentarium of options, the patient obtains the least bias base on our Practiceâ€™s wide skill level. The Kane Practice is a warm, friendly and caring team. When you come into our contemporary but homey office, you feel as if you have slipped into our personal home and become part of our family. We treat all of our patients as we would wish to be cared for ourselves.