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  • New Article: Complications of Facial Trauma of the Fronto-orbital Region

    This is a review article we published on our vast experience treating facial trauma. The article covers common complications in facial trauma of the upper third of the face, and suggests methods and techniques to use to prevent such problems from occurring.

    Link to Article PDF

  • Platelet Rich Plasma and Stem Cells for Hair Rejuvenation: A Non-Surgical Option

    Platelet Rich Plasma and Stem Cells for Hair Rejuvenation: A Non-Surgical Option

    Platelet Rich Plasma (PRP) has been used for years in orthopedic injuries to heal joints, tendons, muscle tears, and many other maladies with great success. PRP activates alpha granules of platelets that can release many healing factors such as: platelet derived growth factor, transforming growth factor, vascular endothelial growth factor, insulin like growth factor, epidermal growth factor, and interleukins. Recent studies using PRP in the scalp have given many hair loss patients a non-surgical option with great hope. The PRP initiates and prolongs the hair growth cycle, so that hair not only comes out of dormancy, but also grows out and stays out for longer periods. PRP also increases blood flow to the scalp, thus increasing vital nutrients to both existing and dormant hair follicles. This can mean a significant increase in hair count, and hair density and thickness. Some studies show as much as a 20-25% increase in hair density and thickness within a 6 month period after treatment.

    But now, we take it a step further; recent advances in cellular biology have allowed us to safely and efficiently harvest stem cells, so that they can be readily added to the PRP mixture for even more amazing results. Stem cells can then act in concert with PRP to elevate and release other growth factors and cytokines. This results in even greater improvements in hair density and thickness over time. Many patients have seen results last for up to two years after a single treatment episode. Results usually become evident by the end of the forth to sixth month after injection. Laser therapy can further enhance these outcomes as well.

    The treatment usually takes about 45 minutes to 1 hour, and can be done in the office. The downtime and swelling are usually minimal.

  • A Natural Appearing Lift

    A Natural Appearing Lift

    Have you ever looked in the mirror and used your fingers to elevate the skin and structures of your neck? Did you like what you saw because it reminded you of a more youthful-looking you? If you answered yes, you may be a candidate for facial or neck rejuvenation. You may also be pleasantly surprised to find that you may not need surgery to look younger.

    Navigating options in neck rejuvenation.

    Four components of the face and neck change with age: skin, muscle, bone and fat. Skin loses elasticity and luster, bone loses volume, and muscles and ligaments become weak, contributing to sagging appearance. Every person has a different mix of these factors and correcting them requires each one to be addressed in a special way. As we age the cheeks descend, exacerbating and deepening lines and hollows. Many surgeons have attempted to alleviate these problems with lifts alone; however, the primary issue can be volume loss that needs to be restored. There are a variety of products currently available to help, including: Fat Grafting, Sculptra, Juvaderm, Voluma, Vobella, Vollure, Belotero, Radiesse, Restylane, and many others. These are non-surgical options that can be done in the office. Correcting volume loss alone can take years off of a person’s appearance, and we commonly use these products in combination to produce the Liquid Face and Neck Lift. The Liquid Facelift restores volume to hollows, while lifting the cheeks, jowls, temples, and forehead, thus, restoring a natural, youthful appearance to the face and neck.

    Until recently, most neck lifting techniques consisted of extensions of skin-only lifts, which resulted in a somewhat unnatural and un-refreshed appearance that seemed to be “pulled too much.” Beneath the surface of the skin runs a thin sheet of fiber called the superficial musculoaponeurotic system, or SMAS. This forms a critical support network for the face and neck and actually stretches with time, leading to laxity of the overlying skin. The effects of gravity result in drooping of the facial skin because of decreased elasticity and stretching of the underling structures. Surgeries with “SMAS plication” techniques (also known as “S” lift or “J” lift) yield somewhat better results than simple skin-lifting in most individuals.

    In most patients though, a “deep plane” neck lift will provide the most natural appearing results. This surgery involves broadly elevating the muscle and fiberous layer (SMAS) of the lower face and neck, and re-draping it at a higher area, where it was in more youthful times. Only a small amount of skin is excised during a deep plane neck lift, as opposed to skin-lifts where large amounts of skin are removed. Since most of the patient’s skin can be preserved with deep plane face and neck lifts, there is a minimal possibility for the “wind tunnel” look of older style lifts, and minimal scaring because there is less wound tension.

    Deep plane neck lifting is more technically challenging and not all surgeons feel comfortable with this technique. The recovery time is slightly longer than with simple skin-only lifts or their cousin, the mini-lift or lunchtime lift. The results, however, are more natural and long-lived.
    Recently, the use of small cameras, through camouflaged incisions within the hairline and inside the mouth, has allowed for effective, minimally-invasive lifts to be performed. These allow for enhancement of the central neck, making it an ideal procedure for the patient in his or her 40s and early 50s. Endoscopic techniques are often combined with rejuvenation of other facial features as well.

    Often combinations of the above techniques are needed to turn back the clock in a natural, long-lasting manner, making modern face-lifting techniques quite gratifying for the patient. A tailored approach must be made for each patient to offer the best possible results. There are so many reasons why people put off cosmetic improvements. Some worry about taking time away from their hectic schedules to undergo a surgical procedure. While time is a precious commodity for all of us these days, stop and think about how much your beauty and health are worth to you. Would you be able to accomplish more with a fresh perspective and younger feel? Would it be easier to succeed at work and at home when you’re feeling great about your appearance? Many patients say “absolutely” and wish they had done their surgeries sooner. Others worry about focusing on themselves. It is simply not self-centered or vain to take care of you, or to want to feel youthful and self-confident. Having a positive self-image certainly benefits you, but it can also improve your interactions with others.

  • How to Break All the Makeup Rules to Look Younger

    How to Break All the Makeup Rules to Look Younger

    You’ve probably seen plenty of tips for using makeup to look younger. Lightening up your lip color, adding fullness to the eyebrows, going with a softer eye look, and aiming for a dewy skin complexion, are all things that we hear day after day. But looking younger doesn’t always mean looking the same as everyone else trying to do the same. Here’s how you can break all the rules, and still get that youthful glow you’re after.

    Contour Your Lips – Embrace Mismatched Lip Liner!

    Do you remember the days when lip liner was darker than lipstick? Most of the beauty rules say that this look is a fast way to look older. But that doesn’t mean you’re stuck with perfectly matched liner and lipstick. Grab a darker shade and use it to contour your lips for a fuller looking smile. Line with the darker shade and fill in the inner corners of your lips, and then use a brighter lip liner inside your lips. Then apply lipstick all over. This will make your inner lip look plump and distract from any lines you may have in the corners.

    Bring Back the Blush

    Many people have been told that blush makes them look older or clownish, but these days, blush is everyone’s guilty pleasure. Forget this rule and bring it back! When used correctly, blush gives you a glowing appearance that can take a few decades off your look. Even a brighter pop of color than you’d normally be drawn to can bring energy and warmth to your face. And despite popular makeup rules, it is A-Okay to use blush with your bronzer. That extra pop of color makes the bronzer look more natural in comparison.

    Embrace What Makes You Feel Good

    In addition to smooth, clear skin and an alert, bright-eyed look, there is something about confidence that makes people appear more youthful. Trying to follow makeup rules to look the same as others doesn’t always make you feel your most beautiful. That’s why we say that you should embrace whatever trends make you confident – even if the rules say you’re too old for them. If you love a heavy contour, a bright lip, electric blue eyelashes, or any other makeup trend, go for it!

    Breaking the makeup rules to look younger isn’t only advisable, it’s also fun! Give it a try – nothing is more young and fresh than a sense of daring.

  • 5 Skin Detox Myths We All Fell For

    5 Skin Detox Myths We All Fell For

    The word “detox” has become a buzz word for more than just the health industry. It seems that we are being encouraged to detox in all areas of our lives, whether that is literal or figurative. In the skin care industry, many detox myths are floating around, starting from the most basic (that you need to detox your skin) to some bizarre rumors. Here are five detox myths that even we fell for, and why your skin doesn’t need any of them to look flawless:

    1. Detoxing your skin is important.

    The simple truth is that there’s no need for us to detox our skin. The types of chemicals that detox pushers suggest are invading our skin are things that our bodies naturally filter out through the kidneys, liver, and even the lungs. There’s little chance for toxins to leave the skin; they are naturally sent to the organs to be removed. Therefore, we don’t need products to get rid of them.

    2. You can detox with water.

    Most of this myth revolves around the fact that water helps hydrate the skin. However, many detox believers suggest that drinking water will “flush” toxins out of the skin. The truth is that even as a moisturizer, water really isn’t that effective for the skin itself. Water is essential for a healthy body, which in turn helps your organs flush away toxins better. But beyond recommended water intake, the best way to get hydrated skin is to use a moisturizer.

    3. Detoxing gets rid of acne.

    Many people think that detoxing the skin will help get rid of acne that is caused by a build-up of dirt or elemental debris. The fact is that after a certain age, acne is more likely related to your hormones, and it’s impossible to detox those away.

    4. Sunscreen should be used sparingly.

    Believe it or not, there are detox pushers who believe that because it’s a chemical, sunscreen should only be used on sunny days. Your skin can burn any time of the year, and any time the sun is out. Don’t be fooled by this myth. Use sunscreen!

    5. Wrinkle creams can work as well as Botox.

    Finally, there’s another myth that all-natural wrinkle creams can work just as good as chemical fillers like Botox. Creams simply can’t stop muscle contraction, which is primary cause of wrinkles. They can reduce the appearance of wrinkles, but not as effectively as something that paralyzes muscle movement to reduce wrinkles.

  • Skin Rejuvenation Supreme: Dry Facial Brushing

    Skin Rejuvenation Supreme: Dry Facial Brushing

    Would it surprise you to know that the outermost layer of your skin, the one you see as you look in the mirror, is comprised of dead skin cells? The stratum corneum, aka the ‘horny layer,’ is made up of flat cells that have around 20% water and 80% protein. However, our bodies shed around a million cells per hour, and our skin sloughs away cells in a 30 day cycle.

    That means there are a lot of dead skin cells on our bodies, and faces, at any given time. Even more interesting, though, is this: our body’s skin cells stop dividing if they come into contact with neighboring cells. This is why the elimination of dead cells is key to healthier skin.

    By now, you can probably see just why the process known as exfoliation is so significant. It hastens the speed at which our skin can renew itself, giving skin cells room to grow and to let us look our very best. Exfoliation is nothing new, and almost anyone who reads articles or books about optimal skin health is familiar with the many ways exfoliation, and even exfoliant products, are put to use.

    The Rise of Dry Brushing

    One of the newer innovations in exfoliation is the process known as “dry brushing.” It is noted by experts for its ability to quickly remove dead skin cells, help the lymphatic system to detoxify itself, and boost circulation.

    It is also a process that can be used on the face. Now, before you panic and think we are advocating the use of the coarse body brushes on your soft, smooth face, give it a minute. That dry brush you use for your legs, arms and torso is not the same one you’d use on the face. Instead, the dry brush for the face is soft and often described as “ultra fine.” It is similar to a makeup brush, but a bit stiffer.

    Can you expect the same benefits to be gained when dry brushing the face as when you dry brush the body? Actually, there are even more to be enjoyed. Just consider what one beauty expert says about the process. “Gentle manual facial brushing will speed up cell turnover, maximize oxygen intake, strengthen the skin’s inner structure, and eventually reverse some of the effects of aging. The trick is to use a good nurturing and healing cream to accelerate the skin recovery time and to allow you to use the brush daily.”

    So, right there we have some incredibly valuable information. The first piece is that there are direct as well as anti-aging benefits to be gained. The next is that you will need a repairing and restoring cream that aids in skin recovery, and the third is that you get the best results when you do this each day.

    This makes it a lot like the dry brushing of the body, but it is something you should only do for two to three minutes at the most. That makes it something you can easily do in the shower or as part of your daily skincare routine.

    How to Dry Brush

    You can easily go online and discover resources for the brushes designed for dry brushing the face, as well as a cream ideally suited to your skin type. Then, you can follow this simple protocol:

    1. Wash the face to open the pores

    2. Starting at your chin, begin using upward motions that encourage circulation. Move from the chin towards the hairline first on one side of the face, and then start at the chin and do the other. Always use gentle strokes.

    3. Don’t forget to do dry brushing from the upper chest and neck, finishing at the bottom of the chin

    4. If you have time, this is the moment for a facial mask. If you are just doing the morning routine, use your healing moisturizer or oil. If you are a serum user, this is also the time to apply

    5. Finally – always clean the dry brush!

    It is that easy to make dry brushing a daily activity and doing so eliminates puffiness, detoxes the skin and boosts circulation; ensuring you look and feel your best.

  • Broccoli as Hair Care Miracle

    Broccoli as Hair Care Miracle

    If you thought about clicking away from this article because you are not a big fan of vegetables, rest assured, this is not about adding broccoli to the diet. No, instead it is about the use of brassica seed oil (the very seed oil that comes from broccoli seeds) to improve your hair.

    For many years, most of us have made a habit of turning to silicone based products when we wanted to make our hair as silky smooth, soft and shiny as possible. Everything else aside, silicone is not really a great compound to use anywhere on the body, including the hair.

    Not only is silicone dubious by nature, but it also has a nasty reputation for leaving behind heavy residues and oils that left hair lifeless and even a bit greasy in appearance.

    Enter broccoli oil that works just as good – if not better than silicone. Just consider that it can be used for:

    – Priming hair
    – Heat protecting for those who use a blow dryer on a regular basis
    – Shine enhancing
    – Protecting from UV light

    In fact, the experts point out that there are eight very solid reasons to use it in cosmetics and hair care products. Experts like Organic Authority say that it has “silicone slip,” which is unique in hair care products. This gives hair texture but also the same silkiness and the control of silicone.

    They also talk about its amazing hydration properties that penetrate quickly, lock in moisture, and yet leave no heavy residue. The same is said for its moisturizing properties that allow essential fatty acids to hydrate the hair cells and keep it hydrated for a very long time afterward.

    Of course, you have to consider the scalp in addition to the hair itself, and broccoli oil is noted for its natural retinol that encourages the sloughing of dead skin, its antioxidant and anti inflammation properties, and its overall ability to boost skin health while also possibly fighting skin cancer.

    Using Broccoli Oil Products

    So, which kinds of products are you going to find if you wish to add it to your hair care regimen? One of the smartest ways to use it is as a blow out crème. The natural heat protectant properties of broccoli oil ensure that you get a shiny and stylish result, but without any harm to the hair. It also helps to cut down on the time spent with the blow dryer – especially if you apply it to wet hair.

    You should also explore options for non-aerosol styling sprays. These can provide you with optimal levels of shine as well as hold, and all without that dreaded “crunchy” feeling so common to most sprayed hair styles. Be sure that the manufacturer has not done anything sneaky and slipped in any parabens, phthalates or sulfates. You can even use such a product on straightened hair to give it a bit of support and added moisture.

    Another of the nice ways to add broccoli oil to your hair care regimen is to find it as a leave in, silkening conditioner. This is going to also work as a moisturizer and detangler; further protecting the hair from damage. Currently, one of the biggest names for the broccoli oil hair care is the Madam CJ Walker name, but you can also find other products that rely on such a healthy and beneficial alternative to silicone.

    If you are tired of using compounds that leave your hair heavy or covered in questionable products, the broccoli oil phenomenon is one for you. Natural and beneficial, it is an option for those with curly or straight hair who just want a better way to maintain their style.

  • Hair Exfoliation: Detox Your Hair This Year

    Hair Exfoliation: Detox Your Hair This Year

    Are you a fan of dry brushing? This skin care practice really exploded when Gwyneth Paltrow advocated for it, saying it helped lymphatic drainage as well as reduced cellulite. It is also something people do to their faces, using special brushes to remove dead skin cells and undo a lot of the earliest signs of aging. The point of any dry brushing, though, is exfoliation.

    To exfoliate is to remove dead skin cells for the purpose of triggering the skin to create newer cells and obtain a much healthier look. It is actually an essential component to the clearest and healthiest skin. Yet, we fail to exfoliate one of the most significant parts of our bodies…our hair and scalp.

    If you take the time to scrub your skin in order to get rid of oily residues, dead cells and all of the rest, why aren’t you also exfoliating your hair and scalp? After all, it is the residue of hair care products, dead cells and natural oils that is the underlying cause for limp or fragile hair. As one beauty writer said, “Most of the things that touch our hair each day—conditioner, styling products, our grubby fingers—leave behind dirt and oils that can’t always be removed by shampoo alone. Just as a good facial cleanser can’t get as deep into your pores as a good exfoliating treatment can, shampoo is no match for a gentle scrub meant to purge the scalp of impurities.”

    So, perhaps it is time to introduce your hair and scalp to the many benefits of exfoliation. Of course, that begs the question of just how you go about exfoliating the scalp and hair.

    How It Is Done

    The good news is that exfoliating the hair and scalp is easy. If you had visions of brushes and lots of elbow grease spent scrubbing the scalp, rest assured that this is not how it is done. Instead, you will need only to find one of the many hair or scalp exfoliating products. They may have names like washes or rinses, but the goal is to find one that relies mostly on natural ingredients that will not strip the scalp of essential natural oils or leave the hair brittle.

    Interesting enough, it is the “purifying” scrubs that rely on sea salt that can often yield the best results. This is because salt is so great at eliminating build up but without removing anything from the hair follicle. There are also some scalp treatments marketed as remedies for those with dandruff, but which are also great for exfoliating the hair and scalp, leaving the hair shiny and clean and full of bounce and body. These should never be medicated formulations, and if you can find them with natural apricot seeds or argan shells, they are much better for your scalp.

    Keep in mind that natural ingredients like tea tree oil, peppermint, cinnamon and other fragrant oils also typically have volatile compounds that work well to cleanse the hair and scalp without actually stripping away necessary oils.

    Once you find the product ideal for your needs, it is important that you use the exfoliant product, then wash the hair with a natural shampoo or rinse and then use a safe and effective moisturizing treatment. Though exfoliating is meant to improve the overall health of the hair and scalp, it requires a brief period of recovery.

    Remember that exfoliating means massaging the product all over the scalp. This stimulates the sloughing of dead cells, improves circulation and allows the pores to be cleaned of debris. You won’t have to do this on a daily basis. Many people find once a week or even less frequently to be enough to keep their hair looking and feeling amazing.

  • Men’s Trends: Anti-Grooming

    Men’s Trends: Anti-Grooming

    To the women of the world, it may seem wildly unfair that the latest grooming trend for men is…not to groom! Known as anti-grooming, it emerged on runways in 2016 and is now a big deal in the world of men’s health and fashion trends. As one expert explained it: “Think messy, unwashed hair and bushy, un-plucked eyebrows teamed with a healthy, natural glow; this look is the lazy person’s approach to grooming, and it requires very little effort.”

    Yes, guys can now rock the “I just fell out of bed look” and keep in line with the trend.

    Yet, it may not be as simple as all that. This is because the look is defined by hair styles that look a lot like bed head, but which are the end result of careful styling. For example, one writer delving into the whole anti-grooming trend explained that it “requires multiple products” and went on to list facial lotions, eye creams, hair treatments, lip balms, hand creams, shave balms…In the end, the “Total retail price for looking like you stayed out all night? $183”

    In fact, it was an actual “all-nighter” that inspired the look. It began at the autumnal London Fashion Week in 2016, when designer John Elliott styled garments and male model hair and makeup based on his look after he pulled an all-nighter at his favorite club. The original runway look used makeup to give the models shiny skin, dark circles beneath their eyes, out of control hair, and a general “disheveled, hungover aura”. Clearly, this is not something the average male could or should attempt to pull off.

    It is not the “artfully-disheveled look, enhanced through artificial means” that appeared on the runway that is meant for the everyday men. Instead, it is just a less polished look that has already started appearing in major cities. In London, reporters began scouting the streets to see if men really were using this look. The result? There were many who were aware of it and taking advantage of it. While one man said that he did nothing but showering and brushing his teeth, most agreed that they did a bit more than that.

    The most common step noted was the use of moisturizing products to keep the skin in good condition. As one man noted, it was okay to have the unkempt look, but unhealthy would never be fashionable.

    The Details

    If you are eager to begin following the anti-grooming trend, it starts with the hair. The famous “bed head” look is easily done with the right products. The key is to get it looking disheveled, bushy and maybe even unwashed. Feel free to skip one of your usual trims or cuts, allowing hair to grow a bit less groomed and managed.

    The next part of the process is to consider the eye brows. Men who regularly pluck or shape their brows may find it hard to skip this habit, but the anti-grooming look is all about the thicker and un-plucked brow.

    The experts all agree on the overall “health” of the skin, though. With one saying, “to pull off the look, there needs to be that natural, healthy glow on the skin. This is where the cleaning and moisturizing parts of your regular routine will remain in place.

    If you are eager to sleep in an extra ten minutes each morning and redirect some of your hard earned cash to things other than skin and hair care products, the anti-grooming look is probably for you. It is expected to reappear at upcoming runway shows since it was such a hit last fall, so be sure you keep up with it too!

  • A Primer Primer

    A Primer Primer

    You’ve heard of them, and maybe you’ve even watched a few YouTube videos or social media posts that showed you details about a facial primer. Still, a lot of people have yet to incorporate this into their regular beauty routines.

    And that is really a shame, because it is one of the best ways to get predictable and well-controlled results with makeup application.

    Let us spend a bit of time looking at just what primer is, why everyone should use it, and how you can get started with it.

    What Is Primer?

    If you listen to the pros over at Maybelline, you see that a primer is defined like this: “Makeup primers prep your skin by creating a smooth and even canvas to use with or without makeup.” They go on to say that is the application of a primer that will “Set the stage for your flawless look”.

    Now, before you say something along the lines of “But, I don’t wear full face makeup every single day”, let us just say this – whether you do the full face or you just use a totally basic routine, the use of primer should not be overlooked. It is an ideal way to fight shiny skin and an even greater way to even out the skin tone, texture and color before you use a foundation.

    Let’s not forget that primer also:

    – Makes your makeup application last longer
    – Makes your makeup supplies last longer because you use less makeup after you have used primer
    – Smooth fine lines, larger pores and wrinkles, meaning it reduces signs of aging
    – Corrects skin color for those with acne, rosacea or skin redness
    – Comes in formulas meant for eyes only, if you wish to avoid creasing
    – Fights harsh weather such as heat and humidity or freezing cold temperatures, holding the makeup in place even if you are perspiring or the weather is blistering cold
    – Can be worn alone and gives a fresh faced look and even skin tone
    – Comes in tinted formulas that can be used to overcome specific concerns. For example, green tints neutralize redness, lilac hues brighten sallow skin and pink hues add a healthy glow

    With so many benefits and uses to its credit, it is amazing to hear just how few people will incorporate it into their regular routines. Makeup experts often hear people complain that it is probably nothing more than an extra step, but once many people use it, there is no turning back.

    Getting Started

    So, how do you go about using primer? There are a few basic concepts to keep in mind.

    The first is that old adage – less is more. Primer may sound as if you need to lay it on fairly heavily, but here’s the thing about most primers, they are meant to be applied in small amounts and then rubbed into the skin.

    You do not need any special brushes or applicators. You can, as one makeup professional said, just “apply primer with fingertips … massaging primer onto skin with fingertips helps to get the blood flowing underneath.”

    While you can also use it like a spot treatment, applying it as a sort of concealer, it is best to apply small dots that you rub in gently. The eyes do need a bit of extra attention, and you will want apply it on the lids and directly beneath and around the eyes to reduce oils, soften lines and adjust redness.

    You can also find primers specifically for the lashes, which you apply before regular mascara to keep the lashes protected and to hold the makeup in place longer. There are also primers (some even work as plumpers) that stop the unwanted lipstick feathering and which work well to set the makeup in place.

    Whether you go for the full face or a natural look, you will find primer is your new favorite.

Contact Us

Jesse E Smith, MD, FACS

923 Pennsylvania Avenue

Fort Worth, TX 76104

Phone: (817) 920-0484

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