Neck wart treatment with raiowave device

Many of the small brown dots and protrusions that can be formed in the neck are those called soft fibroma, acrochordon, skin tug, or seborrheic keratosis, Most of them are not infectious. Although it may be exacerbated by the stimulation of a necklace or clothing, most of what is seen after the middle age is due to the aging phenomenon of the skin.

Treatment at our hospital eradicates such skin lesions using equipment called radio- waves commonly used in the United States. Radiowaves are less noticeable than the other methods of remediation, and recovery is prompt. Since we remove local lesions after local anesthesia, there is no pain.

Treatment expenses are from 5,000 yen plus tax, but discount system is available when there are many pieces.

About “slack of upper eyelids” and “double eyelid operation without cutting”

We see that there are more people advanced with sagging of the upper eyelids with age. There are various ways to improve the slack of the upper eyelids. Ultimately it may be necessary to remove extra skin and make it clearer. However, there are problems with the recovery period, so in many cases, people who choose methods that do not rely on cutting surgery are increasing. There is also lifting by laser, but we will write about double eyelids that will not cut today, sagging by our original DST method.

The DST method is a method of fixing three points using two special buried threads used for blood vessel suturing and the like. It has a strong anchoring force and is suitable for lifting up a drooping eyelid. Design for lift-up and treat with local anesthesia. Details of treatment are on the double eyelid’s page of this homepage, but since it is not an incision method, swelling is small and you can feel lift-up effect promptly. This method has no age restriction and can be used by people in their 80s and also for Caucasian patients with advanced sagging.

Botox and wrinkles

“the treatment to erase wrinkles with Botox”

Our clinic is in a small town in Tokyo but with many foreigners here in the town of Hiroo. As mentioned in this homepage, Botox is currently widely used for treatment other than wrinkle, such as slimmer of muscle of jawline, hyperhidrosis of armpits and limbs, migraine, and the like. In our clinic, in particular, there are many patients who use Botox for treating headaches.

Today we will talk about Botox treatment example for wrinkles. The unit used here is discussed based on Botox of Allergan Inc.

Frown lines: wrinkles between the eyebrows are types of vertical wrinkles (also called 11 o’clock signs) that can only be made when expressing difficult expressions, or types that always exist irrespective of facial expressions. In the former case, Botox often works, the effect usually appears within one week after treatment and the effect lasts for 4-5 months. Botox works at the site of the nerve endings, making the muscles paralyzed by not transmitting mediators between the muscle junction and making it less likely to wrinkle.

The target muscle is the muscles running parallel to the eyebrows called the corrugator muscle and the muscles running up and down at the base of the nose called the procerus muscle. Normally 4-6 places slightly above the eyebrows, 1 injection at the root of the nose (to the procerus muscle). The dose is 15 – 20 units. Furthermore, when injecting, the outside of the eyebrow shall be shallow and the inside will be treated deeply. Even if you do not make a difficult expression, if there is always vertical wrinkles between the eyebrows, injected materials such as hyaluronic acid may be better (though extreme caution is required for hyaluronic acid injection at this site). Avoid lying down for about 4 hours after injection, avoiding swimming and other exercise, the effect will appear after 4-5 days. It is said that the peak of the effect appears after two weeks, but we check the result after one week and if necessary, carries out additional touch-up injections for free (the guarantee system one week later ). The cost will be 30,000 yen plus tax when only eyebrows wrinkles.

Wrinkle of the forehead: The transverse wrinkle of the forehead can be made when looking upward, and this is due to the frontalis muscle which is one of the expression muscles, the muscles running above and below the forehead, 90 degrees to the wrinkle lines. Wrinkling of the forehead may also always exist regardless of facial expressions, or it can only be seen when making facial expressions. Botox will be a good application in the latter case, and we will inject a total of 15-20 units to the eight forelocks of the forehead.

The point to pay particular attention to in terms of the procedure is that it is often better not to treat the sideways of the forehead at the part near the outside of the eyebrows. If Botox is effective in this part, the eyebrows will drop. Another problem is that when you open the eyes, sometimes you use forehead muscles (forehead muscles) for some people. If Botox treatment is given to the forehead of this type, eyelids become difficult to open. In order to prevent such problems, block the action of the frontal muscle by putting your fingers above the eyebrows in advance and check how much the patient uses the frontalis muscle to open the eyelids. When the frontalis muscle is heavily involved, avoid botox injection in the lower part of the forehead.

By the way, even with the same botulinum toxin preparation, products made in Europe are more likely to diffuse and seem to be prone to the problems described above. Treatment expenses are 30,000 yen plus tax in case of forehead only, but if you join the frown lines or the crows feet, somewhat cheaper on 50,000 yen in two of these parts. The effect is longer than the eyebrows and often lasts more than 5 months. Like the eyebrows, there is a guarantee system one week later. Another thing to note when injecting Botox on your forehead is that you can change the shape of the eyebrows in the way of injection. This method is also used when you want to fist up the crawl outside the eyebrows. This method is also suitable for patients whose eyelid slack is progressing.

Wrinkles in the corner of the eyes (crows feet) can be made fan-shaped from the outer corner of the eyes when laughing with eyes, there are types that can be upward from the outer corner of the eye, downwards, and upwards and downwards. Also, like wrinkles in other parts, there are deep wrinkles that are made even when you are not smiling with your eyes, and not so obvious types of wrinkles when not laughing. The type that Botox shows effective is the latter type. If you have deep wrinkles even when you are not laughing, hyaluronic acid may be injected into that wrinkle.

The treatment amount depends on the number of wrinkles, but it is about 18-25 units on the left and right. The addition of one more thing in the treatment of Botox to the wrinkle part of the corner of the eye can change the shape of the eyebrows. Sometimes it is possible to lift the outside of the eyebrows slightly upwards by Botox injection to the oculi anterior muscle beneath the outside of the eyebrows (it is not a method that everyone can do).

Wrinkles in the upper lip: Longitudinal wrinkles occurring in the upper lip are common in women over the age of 60, but this is caused by the action of the orbicularis muscles surrounding the mouth. This phenomenon is not seen much in men because there is a beard in this part.

When treating, have the patient pucker the mouth, especially marking the vertical wrinkle which occurs strongly with a pen, then inject 10 to 15 units into 4-5 places. Being careful with Botox’s injection to the lips, when the balance between the left and right collapses, the shape of the lips may change or it may be difficult to pronounce correctly.

Injection to other facial sites: Botox is also used for treating temporomandibular disorder by thinning the face line by injection into the muscle of jawline on the face. In addition, Botox’s injection may show a remarkable effect in the uneven surface like the oranges that can be made to the chin. On the other hand, Botox has no effect on the nasolabial lines or Marionette lines (wrinkles extending obliquely downward from the outside of the mouth). Hyaluronic acid injection is recommended for these sites.

“Side effects and failure cases in Botox wrinkle treatment”
Side effects: Although side effects related to Botox treatment are extremely rare, as a example, the eyelid becomes difficult to open (eyelid ptosis is seen less frequently than 1%. It is a complication especially seen in treatment to the frown lines. Even if this condition happens, it will return to its original state naturally in about 3-6 weeks. However, once this condition has occurred, there is a tendency for the situation to become the same again. The next time to be seen is in the treatment section, but the shape of the eyebrows may change or drop down when treating the forehead.

Those who are taking fish oil, DHA, EPA, aspirin or a pain killer tend to have a bruising tendency. In addition to the above, it is not recommended to egg allergy, those who have suffered facial paralysis in the past, those who are pregnant, breastfeeding, those who are planning to become pregnant within the next 3 months. Botox is also used for the treatment of migraine, but as a very rare complication, it may cause a headache to a healthy person. Also, when you have a cold, you may not be able to treat because your condition may get worse when you do not have physical fitness. Even those who are taking some antibiotics are considered to be cautioned.

Failure cases: Extreme failure example does not occur easily, but as we have mentioned, treatment of facial wrinkles using Botox has been used to paralyze muscle groups called facial muscles to make it more attractive. It is a treatment that expects a good effect, so it would be difficult to produce results that you expect to not understand facial muscles and nerve anatomy well. In the United States, Botox’s treatment is usually performed only by a doctor who has received proper training from a plastic surgeon or a dermatologist.

Tummy tuck combined with other procedures

Surgery called Tummy tuck is a surgery to correct sagging of the abdominal skin and subcutaneous tissue, which is associated with extreme weight loss from postpartum and obesity. Because it is a relatively large-scale operation, it is a treatment to be done after hospitalized.

At the same time as the tummy tuck, there are occasionally those who wish to perform liposuction surgery in the abdomen or correct the drooping of the breasts. However, we do not recommend doing two or more such operations together (compound surgery). The reason is that the risk of complications increases significantly.

It has been reported in the United States that necrosis of the tissues of the abdominal wall is likely to occur when Tummy tuck and liposuction are performed at the same time. In addition, when Tummy tuck and breast surgery are performed together, the operation time also becomes longer, the rate of causing deep vein thrombosis increases, water accumulates subcutaneously also in the site of tummy tuck (seroma), the healing of wounds said to be poor.

If you wish to do some of these surgeries, we recommend that you consider the next operation after a period of recovery from each surgery for safety.

Liposuction of abdomen

Our clinic director has carried out liposuction of many patients in the United States and Japan for many years. Although liposuction is already recognized such an effective treatment in the United States as an established cosmetic medical technology, but there are reports of serious complications such as fat embolism, abdominal perforation and death besides a mild complication such as unevenness of the skin surface. We do not have experience of such serious complications in our practice, but unfortunately there was report of such a case in Japan very recently.

We have repeatedly explained how to make a safe and effective liposuction for many years by invited lectures and papers at academic meetings, but unfortunately there are many self-proclaiming “cosmetic surgeons” in Japan who are not board-certified in plastic surgery, it can be said that in some cases it may be an extremely dangerous procedure.

First of all, careful counseling is essential for liposuction. Depending on the types of the supplement or prescription medicines, it may become easy to bleed, and it may be impossible to carry out safe liposuction unless these medicine are stopped ahead. Also, in preoperative examinations, especially in the case of abdominal liposuction, it is necessary to determine whether there is an umbilical hernia or scar of past abdominal surgery. Small umbilical hernias may be difficult to find even with a specialist. In our hospital, we are trying not to make a hole around the umbilicus in such a case to improve safety.

Next, during the treatment, it is a technical problem, but in case of a right-handed doctor, how to use the left hand becomes important. It is necessary to perform the treatment while checking with the left hand where the tip of the liposuction tool called cannula is heading.

Finally, close all the holes used for suction and fix it under compression. Also, in case of day surgery, after surgery, we request an escorting person to be accompanied to see the patient’s conditions until next day. If that is impossible, you will be hospitalized at a university hospital and do the procedure there.

By observing the above guidelines, liposuction can be safe and effective even if it is a stomach operation. I think that the expenses are never higher compared with slimming surgery using laser or ultrasound.

Wrinkles and Botox

Many people know that botulinum toxin preparations (such as Botox injection) are used to treat wrinkles. In the United States, it is widely used for treatments other than wrinkles, but I think that it is mainly used in the eyebrows, foreheads, crow’s feet, and hyperhidrosis of armpits in Japan.

Botox had been used in Japan and the US against the state where the eyebands are twitching more than before but in the United States it gets used for various facial expression wrinkles in the upper half of the face and then jaw muscle (slendering the face), temporomandibular disorder, hyperhidrosis (side arm and limb), and so on.

Details of Botox’s side effects and mechanism of action are described in detail on our website, but serious side effects are rare and representative ones include injection in wrinkles between the brows, it is found below 0.5% that eyelids are difficult to open (ptosis of the eyelids). Also, we can not treat pregnant, nursing or those planning to get pregnant.

Many patients are receiving this treatment because the treatment of wrinkles that can be easily done with a clinic easily and the price is relatively affordable (from 30,000 yen). In our clinic, patients with migraine also receive Botox treatment well (from 20,000 yen).

About double eyelid procedure / upper blepharoplasty

The method of double eyelid is roughly divided into non-cutting(stich-burial) method and incision method. Among them, we are doing a special 3 point fixation method called DST which is durable for a long time. For details, I think that you would like to see this homepage, but the director of our clinic has been using this method for more than 20 years (including the experiences in the US), for well over 1000 people, not only for many Asian people, but also recently for even Caucasian patients to treat as a non-incision method of eyelid’s slack removal.

There are so many attractive people in single eyelids, so it is not recommended to anyone, but the burial method is safe, it is a method to effectively increase the opening of eyes. I think whether you used the tape or glue, but the opening of eyes looks different by slight eyelid change. In our DST burial method, not only in Tokyo, many patients from oversea come to receive the treatment.

On the other hand, if there is a lot of fat on the upper eyelids or if sagging of the eyelid is conspicuous due to aging, it may be clearer to remove extra skin and eyelid fat by the incision method. In that case we recommend incision method from the beginning.

Currently, our office is located only in Tokyo, but many people are coming from afar. Because it is a treatment that can be safely done even for a stay of about 2 days, please consult us.

Medical laser hair treatment

Although there are various methods for hair removal, it is generally said that hair removal using “medical laser” is most effective. Laser equipment used in our clinic is a widely used model in the United States and has proven track record of providing safe and effective treatment.

There seems to be various methods depending on the clinic for laser hair removal treatment method, but we are carrying out multi-directional repetition of Crisscross fashion as multi-direction. Even with only one pass in one direction you can expect a certain degree of effect, but it may end with marginalization or insufficient treatment effect. In the Crisscross formula, we will treat it in two or more passes in different directions. The problem with this method is that if the practitioner does not recognize the reaction of the skin of the patient well, there is a possibility that it may become a surface burn in some parts, so only medical staff who received solid training are allowed to perform such treatment.

Board certification

In the US, we call the plastic surgeon specialist “Board Certified in Plastic Surgery” or “Board Certified Plastic Surgeon“.

The word “Board Certified” has a special resonance, which is used to think that everyone in the United States understands its meaning. It is an idiomatic expression. Even in television and other media, scenes like “Is your doctor board certified?” Are often heard, and it is thought that whether you have this title is the first step to judge whether it is a reliable specialist or not.

By the way, in the US, in the place of postgraduate education, the choice of course is not free, past results and appraisal are greatly concerned. In general, it is said that it is the narrowest gate to go to brain surgery and plastic surgery among surgical systems and surgical systems, and the word “Board certified Plastic Surgeon” has a special sound in such a meaning I think there is.

plastic surgery and systemic management

Many of the surgery in the field of cosmetic plastic surgery are day trips and I think that there are many relatively small scale cases of 1-2 hours. However, sometimes there are cases where you need to be systematically monitered after being hospitalized, with breast reconstruction, massive liposuction, or surgery using free tissue.

As mentioned in this blog before, patients need to stay away from blood thinning agents such as Vitamin E, fish oil, aspirin, etc., and during the surgery we use devices to prevent deep venous thrombosis by intermittently massaging instruments in the lower limbs.

When considering the risk factor of the patient side, factors such as age (65 years old and over), obesity index (30 or more), presence of smoking, presence of other basic diseases (diabetes etc.), etc. become a problem.

In addition, in case of surgical procedures for cosmetic purposes, when considering the balance between risk and benefit, it is required that the risk be lower than when treating disease.

Those things are difficult to understand for the general public, but since it is important to life, if you are planning for big surgery, please consult with your plastic surgeon once again.

On removal operation of breast implants

About several years after breast augmentation surgery, thick capsules are made around the implant with a considerable probability (up to 25%). This is called capsular contracture of a breast implants, and it is classified in three grades in the United States. Grade 1 has a slight wrinkle feeling when touched, but no visible abnormality; Grade 2 is one with wrinkles emerging on the skin surface, Grade 3 is a painful addition in addition to that, requires a removal operation.

Regarding the removal technique of the breast implant, it is not a easy surgery. Simply removing the bag may result in inadequate results. It is necessary to remove capsules that are in close contact with the surface of the bag at the same time. In particular, capsules on the front of the bag should be removed. Otherwise, the capsule will remain around the entire circumference and become a cyst (Seroma).

Upon removal of the capsule, it may cause considerable bleeding. Therefore, at our office, we do not recommend doing such surgery as an outpatient surgery. Our doctor becomes your doctor, we recommend to operate at university hospital.

Cosmetic procedures at an university hospital

People considering about beauty care often think that they are often consulted at private clinics. As a director of our clinic, many of the patients are still seen by us at the outpatient clinic, but there are cases where we recommend doctor’s examination and treatment at an university hospital. It is when you are planning to use a special laser equipment not installed in the clinic or think about a large-scale surgery that would be better if you went to hospitalized.

In the university hospital, being hospitalized and undergoing surgery is actually quite secure and safe. For example, there are more than 20 operating rooms in the university hospital where our director is part-time attending. They do many cases of surgeries which are extremely difficult and surgery for seriously ill patients with weak body. This means that, even in surgery for cosmetic medical care, even if unforeseen circumstances should happen, there is a system that can respond. There are also a number of specialist staff of plastic surgery, many anesthesiologists and nursing staff. In the worst case, you can also arrange a ventilator and blood transfusions. Also, even if the condition gets worse after surgery, medical staff will come soon.

As such, our doctor may recommend care at a university hospital on a case-by-case basis, which seems to be a better choice for patients.

Treatment of scars

There are various reasons for scars, but as you look at changes in color. There are reddish objects, brown ones, and white linear ones. Although red and brown ones if you can avoid getting ultraviolet rays, they will gradually get better gradually even if conservative treatments are done, but if it does not become so or if it is already white, it is quite difficult to improve with normal treatment I will not.

Our clinic sometimes treats such scars by using a fractional carbon dioxide laser made in the USA in collaboration with a university hospital where doctors are part-time staff, so if you are interested please ask .

Botox for treatment of headaches

For treatment of migraine using botulinum toxin (Botox etc.), it is a subject of insurance treatment in Europe and the United States. If a patient is not abnormal by MRI or CT and a headache expert such as neurological department confirms diagnosis. Then, those people are being treated with peace of mind at almost all specialized medical institutions.

In Japan, it is unauthorized as an insurance treatment, so the doctor’s decision is left to the discretion, but our clinic’s guidelines are similar to those in the West. However, if local treatment is desired with mild migraine, we will also conduct partial treatment on a trial basis, so please consult us. In that case, the treatment cost is from 20,000 yen.

About liposuction

In Japan, there are few patients who desire liposuction even if they say slimming surgery, and if possible, they seem to be interested in partial slimming by laser or injection. Also, even with cases with a lot of fat and non-invasive methods that can hardly be treated, it may be giving the impression that ultrasound or liposuction using internal laser is better.

In the United States where the aesthetic medicine is advanced, there are still many methods of liposuction using old-fashioned hands (more than 250,000 cases per year), and there are not many methods using laser or ultrasound in combination. There may be reasons for this, and may have been written before, but in such a way, many burns (burns) due to the heat of the tip of the equipment have been reported, especially for patients with not much fat It is getting not used. Considering Japanese patients with American standards, there are not many people with a lot of fat, so it is our thoughts of our hospital that it is better not to use these devices.