Friday, April 25, 2025

Proven Paths: What REALLY Works

Elevating Your Facelift: The Deep Neck Lift is the Essential Starting Point


The Deep Neck Lift Divide: How Skill Gaps Shape Surgical Biases

A concerning pattern emerges among surgeons lacking expertise in deep neck lift techniques. Those unable to perform this advanced procedure sometimes dismiss it as a passing trend rather than addressing their own skill limitations. However, evidence from Real Face’s video archives demonstrates that surgeons proficient in deep neck lifts – which target muscles, glands, and connective tissues – rarely compromise their reputation with superficial approaches unless patients lack deeper structural issues like submandibular gland protrusion or significant platysma banding.The distinction between procedures is critical: mini lifts address skin and superficial fat through limited incisions, traditional lifts tighten the platysma muscle, while deep neck lifts comprehensively reshape the neck’s architecture by repositioning digastric muscles, reducing salivary glands, and excising deep fat. Surgeons mastering these advanced techniques recognize their superiority for complex cases involving heavy neck anatomy, as reflected in their before/after portfolios and procedural preferences. This professional evolution highlights how technical capability informs ethical treatment recommendations – those dismissing deep lifts often expose their own limitations rather than the procedure’s validity.

Unlike temporary fixes, a properly executed Deep Neck Lift delivers results that last a lifetime.

Inferior procedures make a mockery of what a real neck lift should accomplish. They fail to address the root causes of neck aging, leaving patients with disappointing results and wasted money.

Only a proper Deep neck lift, targeting fat beneath the platysma and repositioning deeper structures, can deliver genuine, lasting rejuvenation. Don't be fooled by imitations - demand a true Deep neck lift from a qualified surgeon.

A deep plane facelift does NOT mean a surgeon can perform a deep plane neck lift—they are separate skills. The neck requires precise work on muscles, glands, and bands that most facelifts don’t address.Don’t guess—verify. Check before-and-after neck lift results, ask about training, and demand proof of expertise. Facelift experience alone isn’t enough. Never assume. Always confirm.

Deep Plane Neck Lift surgeons are typically those who continuously improve their skills, not standing still.



Exploring Neck Lift Options

In the left-hand column, navigate to the "Neck Lift" section. There, you'll find detailed information on three types of neck lifts:

Deep neck lift, Direct neck lift, Traditional neck lift.

Each option is accompanied by links to surgical videos, providing a vivid look at the procedures. After reviewing this information, you'll quickly grasp why the deep neck lift stands out as the superior choice for most patients.

The Real Face Take on Neck Lifts: Depth Matters


The Importance of a Neck Lift in Facelifts

It's crucial to remember that without a well-executed neck lift, even the most meticulously performed facelift can leave you with less-than-desirable results.


The following plastic surgeons perform Deep Neck Lifts:




Plastic Surgeon EXPOSES the Facial Aesthetics Industry


Disclaimer: This video is shared for informational purposes only and does not constitute an endorsement.





Let's make your evening skincare routine work harder! 

Here's what the science and studies suggest:

1. Start with this powerhouse product (Trentinoin)
2. Give it a 10-minute break to sink in
3. Seal with your chosen moisturizer for optimal nighttime skin care.

This 1-2 punch is designed to give your skin the TLC it deserves while you sleep!


Here are a couple of moisturizing ideas:

CeraVe Intensive Moisturizing Lotion is highly regarded for its ability to deeply hydrate and soothe the skin, making it a favorite among users. Its rich yet lightweight formula works exceptionally well over retinol or treatments like tretinoin, helping to counteract dryness and irritation. This lotion is particularly effective on the neck and is ideal for nighttime use on the face to calm and restore the skin's barrier while you sleep. However, due to its richness, it may not be the best choice for daytime use on the face.

Dr. Brenner's Triple Lipid Restore is ideal for daytime use when you're not planning to be in the sun. This moisturizer contains ceramides, natural cholesterol, and fatty acids, which help restore the skin's barrier and support natural self-repair. It improves skin smoothness, elasticity, and radiance, making it a great choice for nourishing aging skin. It is also paraben, dye, and fragrance-free, suitable for all skin types.

If you're planning to be outside, choose a sunscreen that also moisturizes. For facial sunscreens, consider the following:

CeraVe Hydrating Mineral Sunscreen SPF 30: Offers hydration with ceramides and broad-spectrum protection. It blends well into various skin tones and provides a natural glow without a white cast.

Eucerin Sun Sensitive Mineral Sunscreen Lotion SPF 50: Provides higher SPF for sensitive skin with added moisturizing benefits. However, it can leave a white cast, which may be more noticeable on darker skin tones.

Real Face goes into more detail about these sunscreens in the right-hand column.

For particularly dry spots like elbows, apply your chosen moisturizer and then seal it with Aquaphor for extra hydration. Aquaphor creates a protective barrier that helps retain moisture and can be beneficial for dry or irritated skin.










TRETINOIN VS. TAZAROTENE?  ------ click here 


Alternative to Tretinoin: 

If tretinoin doesn’t suit you, consider switching to tazarotene, which offers similar benefits.


General Advice: 

Keep your skincare routine simple and consistent. Expensive products aren’t always more effective; focus on what works for your skin. Real Face advocates simplicity over branded products.


* Ready to Take Your Skincare to the Next Level? Elevate Your Skin with Real Face’s Advanced Routine

         

One More Reason to Love Lasers: UltraClear's Superiority in Skin Rejuvenation


When evaluating skin rejuvenation treatments for maintenance, it's clear that all effective procedures—whether microneedling, Ellacor micro-coring, Morpheus8, IPL, or BBL—require a financial investment. However, UltraClear laser emerges as the superior choice for several compelling reasons. Given this reality, isn't it wise to stick with one versatile and effective procedure? UltraClear laser not only addresses a broad range of concerns but also poses less risk of infection compared to devices that mechanically break the skin.

Why UltraClear Laser Stands Out


Versatility and Effectiveness

UltraClear laser tackles a wide array of skin concerns, including fine lines, wrinkles, acne scars, sun damage, pigmentation, uneven texture, and age spots. Its ability to address multiple issues in a single session makes it a cost-effective and comprehensive solution for skin rejuvenation.

Collagen Stimulation for Long-Term Benefits
By promoting collagen production, UltraClear helps restore skin elasticity and firmness while reducing signs of aging like sagging and wrinkles. Since collagen levels naturally decline with age, frequent UltraClear sessions can maintain youthful skin over time, making it ideal for semi-regular maintenance.

Minimal Downtime and Comfort

Unlike invasive procedures or traditional lasers like CO2, UltraClear offers quick treatments with minimal discomfort and recovery time (typically 24–48 hours). This makes it perfect for those with busy lifestyles who want visible results without extended downtime.

Safe for All Skin Types

UltraClear is FDA-approved for all skin tones and types, including darker complexions that are often at higher risk for hyperpigmentation with other lasers. Its advanced cold fiber laser technology minimizes thermal damage while maximizing safety and effectiveness.

Customizable Treatments

The laser settings can be adjusted to target specific concerns, from mild resurfacing to deeper collagen remodeling. This flexibility allows for highly personalized treatment plans tailored to individual needs.

Frequent Maintenance for Ongoing Results

Unlike more aggressive treatments like CO2 lasers—which are better suited for severe concerns but require significant downtime—UltraClear can be performed regularly to maintain collagen levels and tighten the skin over time. This makes it an excellent option for ongoing rejuvenation as part of a proactive skincare routine.

How It Compares to IPL and BBL

IPL (Intense Pulsed Light) and BBL (BroadBand Light) are popular light-based treatments that address pigmentation issues, sunspots, rosacea, and broken capillaries by using light energy converted into heat. While effective for surface-level concerns:

IPL: Requires more sessions (3–6) to achieve results and is less precise in targeting deeper layers of the skin.


BBL: Offers better precision and fewer sessions than IPL but focuses primarily on pigmentation and vascular issues rather than comprehensive rejuvenation.

Both IPL and BBL are valuable tools but are more limited in scope compared to UltraClear’s ability to treat not only pigmentation but also fine lines, texture irregularities, acne scars, enlarged pores, and overall skin laxity—all in one treatment.

The Best Option Beyond Basic Skincare

For those looking to go beyond a basic skincare routine without overcomplicating their regimen or budget, UltraClear laser is the clear winner. Its ability to address age spots and stimulate collagen sets it apart from IPL/BBL while providing more comprehensive results with minimal downtime. Combined with a good skincare routine that includes sun protection and hydration, UltraClear offers a long-term solution for maintaining radiant, youthful skin without the need for multiple separate treatments.

Whether you're addressing early signs of aging or looking for ongoing maintenance, UltraClear delivers consistent results that justify its cost—making it the best investment in your long-term skincare journey.



Navigating Facial Rejuvenation: A Patient's Guide


Stick to Your Plan: Don't let practitioners pressure you into unplanned procedures. Some doctors, especially those with inflated egos, may view you as a practice opportunity.

Research Thoroughly: Understand the differences between treatments like fillers and neurotoxins. Knowledge is your best defense.

Consider Long-Term Effects: Certain treatments, like excessive fillers or Sculptra, can complicate future surgical procedures.

Set Realistic Expectations: Non-surgical options offer quick results but have limitations and may impact future treatments.

Understand the Full Treatment Plan: Some procedures require multiple sessions. Be wary of overhyped solutions.

Know the Risks: Discuss all potential side effects and complications with your practitioner. Some procedures, like direct brow lifts, may leave serious scars.

Communicate Concerns Immediately: If dissatisfied, speak up promptly. Remember, reversing some treatments can be challenging or impossible.

Start Small: A conservative approach with non-surgical procedures often yields more natural-looking results.

Get Second Opinions: If unsure about recommended treatments, consult another professional.

Evaluate Combination Treatments: While caution is advised, sometimes a multi-modal approach can be beneficial. Discuss thoroughly with your practitioner.

Budget Carefully: Consider both immediate and long-term costs of treatments.

Remember: It's your face and your choice. Stay informed, advocate for yourself, and prioritize safety throughout your rejuvenation journey.

Caution on Reversals: Hyaluronidase treatments for filler reversal aren't always ideal. They can affect natural hyaluronic acid, potentially leading to tissue wasting. Results can be unpredictable, and there's a risk of not fully restoring your pre-filler appearance.




To prolong the results of laser skin resurfacing, particularly after treatments with Fraxel CO2 lasers or the new UltraClear laser, follow these essential tips:


Sun Protection

Diligent sunscreen use is crucial. Apply a broad-spectrum SPF 30 or higher sunscreen daily and reapply frequently, especially on sunny days. This helps prevent UV damage that can break down newly formed collagen and elastin, preserving the results of your laser treatment.

Hydration and Nutrition

Stay well-hydrated by sipping water throughout the day. Proper hydration supports skin health and helps flush out toxins.

Supplement with antioxidants, particularly time-released vitamin C, to combat free radicals that contribute to premature aging.

Skincare Routine

Tretinoin use and Proper moisturizing  10 minutes after Trentinoin application.

Maintenance Treatments


Consider annual laser resurfacing sessions to maintain results. The UltraClear laser, in particular, offers:

Comprehensive treatment for both superficial and deep skin issues

Faster results with significant improvements often visible after one session

Minimal downtime compared to traditional ablative lasers

Precision targeting of specific skin concerns


Maintain a healthy lifestyle with a balanced diet and regular exercise to support overall skin health.

By following these guidelines, you can extend the benefits of your laser skin resurfacing treatment, whether you've undergone Fraxel CO2 or UltraClear laser therapy. 


Revive Your Radiance: No Face is Ever Too Far Gone, No Age Too Old






Plasma Pen: Separating Fact from Fiction in Dermatology


Effective Uses


Wart removal

Mole removal

Age spot treatment

Cherry angioma removal

Skin tag removal

The plasma pen is particularly useful for these conditions as it can precisely target and destroy small areas of tissue without affecting surrounding skin.

Limited Effectiveness


Despite marketing claims, plasma pen treatment is not ideal for:

Skin tightening: While some immediate tightening may occur, the uncontrolled energy output of plasma pens can lead to unpredictable results and potential scarring, especially on facial and neck areas.

Scar removal: The risk of iatrogenic scarring makes this treatment unsuitable for scar removal or collagen induction therapy.

Dermatologists and plastic surgeons acknowledge that plasma pens have their place for specific skin conditions but caution against their use for broader skin rejuvenation purposes due to the lack of regulated energy output and potential for adverse effects.


Comprehensive Ranking of Scar Removal Lasers: From Gold Standard to Cutting-Edge Technology


Standard CO2 Laser


Considered the gold standard for deep scar treatment

Highly effective for surgical scar removal

Can produce excellent overall improvements with a single treatment

The standard CO2 laser remains the gold standard for surgical scar treatment due to its ability to deliver high-energy, deeply penetrating laser light. This causes significant thermal damage to the scar tissue, triggering a robust healing response and collagen remodeling. The intense ablation and heat generation lead to more dramatic results, especially for deep, stubborn scars.

DEKA SmartXide Tetra CO2 Laser


Advanced fractional CO2 technology

Multiple emission modes for precise control

Effective for deep surgical scars

Promotes collagen remodeling

Faster recovery compared to standard CO2 lasers

It's crucial to note that the DEKA SmartXide Tetra, due to its advanced settings and multiple emission modes, requires a seriously experienced operator for patients to achieve maximum results. The system's versatility and precision can lead to superior outcomes, but only in the hands of a skilled practitioner who fully understands how to optimize the various parameters for each specific case.

UltraClear Cold Ablative Laser


Cold technology minimizes thermal damage

Suitable for all skin types

Less pain and faster healing

Can be used without topical numbing in some cases

For surgical scar treatment, the choice depends on scar severity, skin type, and desired recovery time. While the DEKA SmartXide Tetra offers advanced control and the UltraClear provides a gentler approach, the standard CO2 laser's intense ablation and thermal effect still make it particularly effective for severe surgical scars.

Ultimately, the best choice should be made in consultation with a qualified dermatologist or plastic surgeon, considering the specific characteristics of the scar, the patient's individual needs, and the practitioner's expertise with each technology.

Summary of Laser Options for Scar Treatment: Benefits and Drawbacks


Standard CO2 Laser: Highly effective for deep scars, but costly due to longer recovery time and potential need for anesthesia.

DEKA SmartXide Tetra CO2 Laser: Offers precise control and promotes collagen remodeling, but requires an experienced operator for optimal results.

UltraClear Cold Ablative Laser: Suitable for all skin types and ethnicities with faster healing, but may be less effective for very deep scars compared to traditional CO2 lasers.

Balancing Efficacy and Risk in Laser Scar Treatment


The effectiveness of laser scar treatment generally correlates with its intensity: more aggressive treatments often yield more significant improvements. However, this increased potency also brings a higher risk of adverse effects, including potential scarring or alterations in skin pigmentation. Therefore, selecting the appropriate laser treatment involves carefully weighing the desired outcomes against the associated risks.

Worth noting:


The Erbium. :YAG laser was not included in the previous comparison because CO2 lasers generally outperform it for scar removal. However, when comparing Er:YAG to the UltraClear Cold Ablative Laser for scar treatment:

Ablation depth: Er:YAG typically achieves shallower ablation than UltraClear, which may limit its effectiveness for deeper scars.

Thermal effect: Er:YAG produces less thermal damage than CO2, which can result in faster healing but potentially less collagen remodeling.

Pain and recovery: UltraClear's cold technology offers less discomfort and faster recovery compared to Er:YAG.

Versatility: UltraClear is suitable for all skin types, while Er:YAG may have limitations for darker skin tones.

Efficacy: Studies show Er:YAG can improve acne scars by 26-75% after four sessions, while UltraClear's effectiveness for scars is still being evaluated but shows promise for various scar types.

Overall, while Er:YAG has a longer track record, UltraClear's advanced technology may offer advantages in terms of comfort, recovery, and versatility for scar removal.


Skin Tightening Solutions: Effective Treatments for a Youthful Glow



A full epidermal renewal, including deeper layers, takes approximately:

28 days for young adults

45-60 days for middle-aged adults

60-90 days for older adults

This complete renewal cycle is crucial for understanding the timing of treatments like laser therapy, which can be safely performed every 90 days to allow for a full skin renewal between sessions.


Regarding the interventions for skin tightening in order of efficacy:

1. Surgery - Surgery is the gold standard for skin tightening, offering dramatic, long-lasting results. Procedures like facelifts and neck lifts effectively remove excess skin and can make you look years younger, though they come with risks, downtime, and higher costs.

Neogen - uses the same technology as Renuvion only is deployed topically.   Won't be as effective as Renuvion deployed this way. 



4. ATTIVA - the system employs a microcannula—a thin, flexible tube—to deliver radiofrequency (RF) energy beneath the skin.

5. Precision Tx - A non-surgical procedure aimed at tightening the jawline and neck while offering the option to remove excess fat through liposuction, if deemed necessary or desired.

6. Laser treatments - CO2 lasers stimulate collagen production to tighten loose skin and treat wrinkles, fine lines, and sun damage.

7. Tretinoin -  It works by stimulating collagen production, increasing glycosaminoglycan (GAG) levels, and accelerating cell turnover. These processes improve skin elasticity, firmness, and texture, making the skin appear smoother and more youthful over time. Long-term use of tretinoin, typically after six months, can result in noticeable tightening and thickening of the skin, significantly reducing fine lines and wrinkles.

8. Autophagy - See the video below.

These remain effective for skin tightening and rejuvenation.


You may have astutely noted the omission of red light therapy. This treatment is often left out of top recommendations because its results, compared to the time invested, don't provide as significant benefits as the other methods mentioned. The effort-to-outcome ratio for red light therapy isn't as favorable, making it a less prioritized option for those seeking efficient skin tightening solutions.




In this video, microneedling is mentioned. However, at Real Face, we recommend focusing on treatments proven to deliver significant skin tightening results. Options like Renuvion, FaceTite, and laser treatments are more effective for noticeable improvements.







4 comments:

  1. My Cosmetic Surgery Journey: A Tale of Caution and Hope


    It all began with a simple desire to enhance my appearance. As a retired man, I thought a little cosmetic touch-up might boost my confidence. Little did I know, this decision would lead me down a path of disappointment, frustration, and ultimately, a hard-earned lesson in self-advocacy.

    My first misstep came when I agreed to a "direct brow lift" instead of the upper blepharoplasty I had initially considered. The surgeon was persuasive, and I trusted his expertise. However, the result was far from what I had hoped for. My brow shape was completely altered, and I was left with noticeable scars that made me feel disfigured. The $6,500 procedure had decreased my self-confidence instead of enhancing it.

    Feeling disheartened but not defeated, I decided to explore less invasive options. I scheduled an appointment for Sculptra treatment, primarily to address my temple area. I was clear about my goals when I walked into the clinic, even bringing a small list of areas I was curious about treating.

    However, history seemed to repeat itself. The doctor, much like the previous surgeon, began steering our conversation away from my intended treatment. Before I knew it, I was receiving extensive filler injections in my jawline and neck - areas I hadn't even considered treating. The procedure involved two practitioners working simultaneously, and I felt rushed and overwhelmed.

    When it was over, I was shocked to find I had spent $6,000 - far more than the $1,600 to $1,800 I had budgeted for Sculptra. Worse yet, I had only received one vial of Sculptra amidst all the other treatments I hadn't asked for.

    Looking in the mirror, I didn't recognize myself. My face looked less natural, my jawline overfilled. Once again, I found myself less confident than before the treatment.

    The experience left me feeling vulnerable and taken advantage of. I realized that in both instances, I had allowed the enthusiasm and marketing of the practitioners to override my own instincts and desires.

    However, this time, I decided to take action. After much deliberation, I consulted with a lawyer about the possibility of a malpractice suit regarding my brow lift. It was only after mentioning this that I received a full refund of the $6,500 for that procedure.

    These experiences taught me valuable lessons about the importance of self-advocacy in cosmetic procedures. I learned to stick to my original plans, ask more questions, be wary of upselling, and trust my instincts. Most importantly, I learned that it's okay to say no, even to a medical professional, if I'm not comfortable with a suggested treatment.

    I'm sharing my story in the hope that others can learn from my experiences. If you're considering cosmetic procedures, remember to research thoroughly, communicate your goals clearly, and don't be afraid to seek second opinions.

    And today? Thankfully after navigating through these challenges I've found a trusted plastic surgeon who truly turned things around positively restoring both appearance and confidence.

    In the end, true confidence comes from within, and no cosmetic procedure can replace the power of self-acceptance and informed decision-making.

    ReplyDelete
  2. A Nurse's Nightmare: Lessons Learned from a Cosmetic Disaster


    I should have known better, being a registered nurse myself. I made a serious mistake by getting cosmetic injections from an unreliable source. A friend, who was a nurse practitioner, talked me into visiting a traveling doctor who offered inexpensive cosmetic procedures without appointments. Despite my previous adverse reaction to hyaluronic acid fillers, I agreed to injections near my eyes to address hollowness in my upper cheeks. The doctor told me he had something different that would make my eyes look better and not hollow, so I paid $400 for the procedure.

    Two weeks after the procedure, I awoke to severe swelling around my eyes, resembling giant worms. Various home remedies proved ineffective. Later, I learned the doctor had been arrested for injecting an unknown substance into a patient's genitals, resulting in emergency surgeries.

    Attempting to rectify the situation, I tried hyaluronidase injections. However, this not only failed to reduce the swelling but also caused significant tissue loss under my eyes, giving them a skeletal appearance. Hyaluronidase is known to dissolve natural hyaluronic acid as well as what was injected and is commonly used to reverse hyaluronic acid fillers.

    I've since explored various treatments, including doxycycline and steroids, but the swelling persists, fluctuating unpredictably. This experience has been a nightmare, and my eyes remain in a terrible state.

    The crucial lesson here is to never receive injectables from questionable practitioners, even if recommended by someone in the medical field. I should have paid more attention to the poor reviews I had read about this doctor. Always choose a reputable, board-certified professional for any cosmetic procedures to avoid potentially dangerous and long-lasting complications.

    ReplyDelete
  3. please add me to FOLLOW, nacarney@gmail.com

    ReplyDelete
  4. My husband had a lower blepharoplasty with a board certified plastic surgeon in Sarasota (NOT Sarasota Plastic Surgery). He has delt with conjunctival chemosis since March of 2024, as well as fat protrusion and veining under his eyes....and they're turned out. It has been a complete nightmare and we are searching for an Oculoplastic facial surgeon for a revision. The results of the surgery has ruined the last year and a half of our lives......do your research and choose wisely.

    ReplyDelete