New Permanent Filler Bellafill in Santa Barbara

Dermal fillers are one of the most common and popular aesthetic treatments done worldwide. Restylane, Restylane Lyft (formerly Perlane), Juvederm, Voluma and Radiesse are some of the well-known fillers available today. Fillers are used to restore volume to an aging face, correct imperfections such as acne scars and wrinkles, and are also used to enhance features (cheeks, lips, jawline). The result of a filler treatment is seen instantaneously and last 6 months or more. The drawback of most fillers are that they are not permanent.
The good news is that there is a new permanent injectable fillerBellafill – now available in the USA and at our Cosmetic Surgery Center practice.
What is Bellafill and how does it work?
Bellafill is composed of a collagen “carrier” and PMMA (polymethylmethacrylate) microspheres. The collagen immediately adds volume to the skin for correction while the PMMA microspheres create a matrix that supports your body’s own collagen production in the skin for lasting improvement.
Is Bellafill safe?
Bellafill has been proven safe through 5 years for correction of nasolabial folds or smile lines in the largest and longest prospective dermal filler study ever completed.
What do people have to say about Bellafill?
In a consumer survey, 91% of patients were likely to recommend Bellafill. In a 5-year-post-approval study, 83% of patients said they were “satisfied to very satisfied” with their correction at the end of 5 years.
Actual Bellafill patient (from left to right: Baseline, 3 months, 5 years)
If you are looking to turn back the clock or treat skin imperfections without surgery, dermal fillers are an excellent option. At our Santa Barbara cosmetic surgery practice we offer Restylane, Restylane Lyft (formerly Perlane), Juvederm, Voluma, Radiesse, and the new permanent filler, Bellafill.
Call us today (805-563-0000) to schedule a consultation to discuss which dermal filler would be best for you. 


Solutions for An Aging Face

CSC_Jan_2016As we age, our body changes and our facial features tend to lose their youthful shape. The production of collagen and elastin slows and the skin’s ability to repair itself starts to slow down. Gravity also plays a roll in an aging face as fat starts to shift downward.

The good news is that nowadays there are multiple ways to treat facial aging. In this blog post I will touch upon a few of the most popular facial aging concerns that I see and discuss aesthetic treatments or plastic surgery procedures that can help turn back the clock.

Problem: The ligaments along the jawline have weakened and the jowls are sagging.
Solution: A natural, youthful appearance can be restored with Facelift surgery by returning fullness to the cheeks, lifting the jowls and smoothing the neck.

Problem: Facial volume has decreased and settled, resulting in the lower face becoming “heavier” or more prominent.
Solution: The Layered Liquid lift is a non-surgical solution for volume loss. A variety of injectable fillers (such as Radiesse and Restylane) are done in a “layering” technique to plump the skin from the inside out. Wrinkles are filled and fullness is restored.

Problem: Cheeks have lost their volume and appear flat which lengthens the face.
Solution: Deflated cheeks can be treated with a minimally-invasive Cheek Lift with fat grafting. A cheek lift elevates the fat pad in the cheek to re-establish fullness to the eyes and cheeks. A small amount of fat is harvested (usually from the abdomen or thighs) to add additional volume where it may be needed, such as in the nasolabial lines (the lines from the side of the nose to the corners of the mouth) or the “comma” lines around the mouth. A Cheek Lift can also be done without fat grafting.

Problem: Wrinkles and uneven pigmentation, usually from sun damage.
Solution: Chemabrasion involves a medium-depth chemical peel with a light dermabrasion (not microdermabrasion) which usually gives a person 70 to 80% improvement in the appearance.

Over my 30 years of cosmetic surgery practice, I have learned that there is not a one-size-fits-all solution for aging concerns. While the solutions above may be ideal for some, others may benefit from a different cosmetic surgery or aesthetic treatment.

If you are interesting in restoring you appearance, I invite you to schedule a consultation appointment at my Santa Barbara Cosmetic Surgery office (805-563-0000). 

Cosmetic Surgery, Dermal Fillers, and Botox for Men

Recently Yahoo! News published an article about Brazilian men and cosmetic surgery. The article stated that a study by the Brazilian Society of Plastic Surgery reports, “Plastic surgery quadrupled among men from 72,000 to 276,000 operations annually from 2009 to 2014.” According to the news article, that is approximately one cosmetic surgery every two minutes for Brazilian men.

Before and After Photo via

The number of US men having cosmetic surgery has not risen as dramatically as in Brazil, but it is certainly not uncommon for men to have a procedure done. At our Santa Barbara Cosmetic Surgery Center practice, we have quite a few male patients, some of whom are repeat clients. However, we have seen a lot of growth in men seeking minimally-invasive procedures such as Botox and fillers. This goes hand-in-hand with the 2014 Plastic Surgery Statistics published by the American Society of Plastic Surgeons that reported over 410,000 men had Botox or Dysport treatments in 2014 (up 337% from the year 2000).

Why are Botox and dermal fillers becoming more popular amongst men? There may be many different reasons why a person decides to use Botox and/or fillers but I will speak only from my experience as a Santa Barbara cosmetic surgeon who regularly treats both men and women with Botox, Dysport, and dermal fillers. While many women seek out these aesthetic treatments to look more youthful, men seem to be less concerned with looking young and more interested in looking “refreshed” or not looking tired or angry. Botox and Dysport will temporarily soften forehead frown lines and the “crow’s feet” around the eyes and the result will be a more approachable look. Dermal fillers can subtly add volume to areas where volume has been lost (cheekbones, eyebrows, under eyes, jawline). The result is a more defined appearance. There is a difference between how and where fillers are used in men and women so it is important to see a person who is experienced and educated in using fillers in men’s faces.

Botox and/or fillers are also easy to have done. Treatment time can take between half an hour to an hour and does not require any down time. Men and women can return to their normal routines right after their appointment. Men tend to share less about these treatments (and cosmetic surgery procedures) amongst friends, family, and colleagues, so having a Botox or dermal filler treatment can be easily be done without anyone else knowing about it.

I have been doing Botox and dermal filler injections for men and women for many years. I strive to have my patients look “naturally” rejuvenated so no one suspects they had anything “done”.

If you are a man or woman interested in having Botox, Dysport, or dermal fillers done, please call my Cosmetic Surgery Center office in Santa Barbara at (805) 563-0000 to schedule an appointment. 

Lip Enhancement in Santa Barbara

Kylie Jenner’s “secret” is out. After months of saying she created her noticeably puffier pout with lip liner and lipstick, she finally admitted to having had dermal filler injections to enhance her lips, at the age of 17 (this means that a parent had to sign the consent form for her). This has stirred a debate on social media about what age is appropriate for lip enhancement and what is a valid reason to have it done. At Cosmetic Surgery Center in Santa Barbara, we are not here to judge. Instead we see this as a great opportunity to discuss different types of lip augmentation procedures, why someone would have it done, who is a good candidate, and what you can expect from a lip enhancement procedure.

Types of Lip Augmentation Procedures
Lip enhancement can be done surgically using a soft implant or by grafting the person’s own fat or tissue. This is usually considered for someone who is seeking a more permanent solution. Temporary enhancement is done using dermal fillers (such as Restylane or Juvederm) that are made from hyaluronic acid – which is a naturally-occuring substance in your skin that provides fullness and elasticity. Lips injected with dermal fillers may see results for 6 months (on average).

Reasons for Lip Augmentation
Plump lips are considered a sign of health, beauty, and youth. As we age, volume in the lips (and face and skin) diminishes. Lips may begin to look “deflated” and may develop wrinkles, for many reasons. Genetics can be part of the reason but also environmental damage (sun damage, smoking, air pollution) may play a role. Thinner lips may look unbalanced in comparison to the rest of a person’s features or may seem to disappear when they smile. On the other hand, some people are just born with thinner lips and may feel more self-conscious about their appearance. Lip augmentation is usually done to replace the lost lip volume. In some cases, it may be done to make lips more symmetrical or to give thinner lips additional volume.

Who is a Good Candidate for Lip Enhancement?
Good candidates for lip enhancement include people whose lips have become very thin when they smile, who have uneven lip symmetry, and those who have lost volume due to aging. Candidates should also be in good general health and have realistic expectations about the outcome.

About Lip Enhancement Procedures
A surgical lip enhancement will require downtime for proper healing. The timeframe should be discussed with your surgeon. If you are having lip enhancement done temporarily, using dermal fillers, there is not any downtime. Bruising may occur at the injection site but will fade. Results are instantaneous.

Lip enhancment in Santa Barbara, both surgically and using dermal fillers, can be done at Cosmetic Surgery Center. Our approach to lip enhancement, and other cosmetic surgery procedures, is to give you a rejuvenated, “non-operated” result. Call us at 805-563-0000 for a lip enhancement or cosmetic surgery consultation.

Help for Hollow Eyes by Santa Barbara Cosmetic Surgery Center

Your eyes can convey many messages without a word being spoken. If your eyes are sunken or hollow, people may think you are tired or overworked, even if you really aren’t. Hollow or sunken eyes may result from a genetic disposition or from the loss of soft tissue in the face which happens to some people as they age. Either way, sunken or hollow eyes may dramatically alter the appearance of a face, resulting in an “unhappy” look.

Fortunately, there are several ways to address hollow eyes. Santa Barbara cosmetic surgeon Dr. Terry Perkins, who is an expert in natural-looking facial augmentation, can help determine the severity of the issue and may suggest one or more of the following options:

  • Use medical grade skin care products to help the skin around the eyes. A vitamin C product (such as Obagi’s C-Serum) can boost collagen synthesis and slow down aging, resulting in firmer, plumper skin underneath the eye. If the skin is thin and delicate, using a retinol (such as Retin-A) can help the skin become stronger. Dark shadows, that often accompany under eye hollowness, can be lightened with hydroquinone.
  • Plump under the eyes with a dermal filler. Restylane and Juvederm, popular dermal fillers, contain hyaluronic acid to replace volume that is lost in the face as we age. A dermal filler can effectively fill the area temporarily (lasting 6 months or more depending on the filler used).
  • Permanently fix the under eye area with lower eyelid surgery (blepharoplasty). Removing a small amount of skin under the eye through lower eyelid surgery can rid the patient of hollow or sunken eyes and result in a smoother contour from the lower lash line to the mid-cheek. Patients of Dr. Perkins who have had this surgery are pleased with the positive difference this surgery makes.
Purchase medical grade products for the under eye area at Evolutions Medical & Day Spa. If you are interested in fillers or under eyelid surgery, contact Dr. Perkins at his Santa Barbara Cosmetic Surgery Office – 805-563-000 – for a consultation

Santa Barbara Cosmetic Surgery That Can Help You Look Younger

We start aging from the day we are born and visible signs of aging start to show, for most people, in their twenties although the severity depends upon a variety of factors including genetics, sun exposure, lifestyle habits, and skin care maintenance. Unfortunately, many of us will end up with wrinkles and sagging skin that makes us look older than our actual age but we don’t have to live with these age-accelerating culprits! Find out which facial areas are more prone to making us look older and, most importantly, what we can do about them.

Age-Accelerating Culprit: Sagging Forehead and Forehead Wrinkles
Sagging foreheads and forehead wrinkles can greatly affect how old we look. Over time the forehead relaxes downward causing the eyebrows to flatten and crowd the upper eyelids. The result is a “heaviness” or “hooded” look to our eye area. Forehead wrinkles also form due to environmental damage and aging. Together, or alone, forehead wrinkles and a crowded upper eyelid area can make us look much older than we really are.

What Can Be Done About Sagging Foreheads and Forehead Wrinkles?
If forehead wrinkles, vertical or the horizontal “frown” lines between the eyebrows, are your biggest concern, these can be easily addressed with Botox or Dysport. These are injectable treatments that relax the muscles causing the frown lines. The treatment lasts about 3 to 4 months. Sagging foreheads are more successfully treated with cosmetic surgery.  Dr. Perkins approaches the Forehead Lift Surgery in a conservative manner so that the result is a natural, alert, and rested appearance which avoids a “surprised” look. Forehead surgery benefits include raising the eyebrows to their normal position (which often removes some excess upper lid skin), tightening of the temporal area to improve crow’s feet, smoothing the horizontal forehead lines and softening the frown lines between the eyebrows.

Forehead Lift: Actual Patient of Dr. Terry Perkins

Age-Accelerating Culprit: Wrinkles Around the Mouth
Wrinkles naturally form around the mouth from talking, laughing, smiling, eating, sun exposure, and especially, smoking. The deeper the wrinkles are, the more they give an aged appearance. In addition to wrinkles around the mouth, the lips can become deflated and sag, giving a person an unhappy and tired look. Smoking and sun can also cause vertical wrinkles above the lip, causing lipstick to bleed.

What Can Be Done About Wrinkles Around the Mouth?
Lip enhancement is a popular procedure but it is important that it is done to restore the volume that was lost and not to inflate the lips out of proportion from the rest of the face. Santa Barbara cosmetic surgeon Dr. Terry Perkins can perform lip enhancement in a variety of ways, including permanent enhancement using a soft implant or grafts of a patient’s own fat (or other tissue) or temporary volume can be added with an injectable filler such as Restylane. Fillers can also be used to provide structure at the corners of the mouth so the lips won’t look down-turned and they can be used to fill deep lines around the mouth especially the nasolabial lines that run from the nose to the corners of the mouth.

Lip Enhancement: Actual Patient of Dr. Terry Perkins

Whether you choose to do temporary enhancements or more permanent cosmetic surgery in your mouth or forehead area (or maybe both!), you will be amazed at what a difference it will make to your overall appearance.

Dr. Terry Perkins performs facial cosmetic surgery in Santa Barbara at his Cosmetic Surgery Center practice located near Cottage Hospital. View more of Dr. Perkins’ before-and-after cosmetic surgery pictures on his website. Schedule an appointment with Dr. Perkins by calling 805-563-0000.

Restore a Youthful Appearance Non-Surgically with Radiesse Dermal Filler

Wrinkles come but, unfortunately, they don’t “go” away without some help. There are quite a few types of cosmetic surgeries that can help soften or eliminate wrinkles and bring back a more youthful appearance, but some of our Santa Barbara Cosmetic Surgery Center patients who are not ready to undergo surgery ask us, “What is the next best solution for appearing younger through non-surgical means?” The solution that we suggest is trying dermal fillers and/or Botox or Dysport for a temporary solution.

Although this article is primarily about Radiesse, a certain type of dermal filler, we will give you a quick overview of the difference between fillers and Botox/Dysport for those who may not be familiar with either. Dysport or Botox are neuromodulators that relax the muscles causing the wrinkles. They are primarily used in the top half of the face (crow’s feet, forehead wrinkles, frown lines). Dermal fillers are usually used in the lower half of the face and they add volume to the face by filling in depressions and wrinkles (for example, they can be used to fill in the nasolabial lines from the nose to the corners of the mouth to soften the deep grooves that make the face appear older).

How, exactly, can Radiesse bring back my youthful appearance?  

As we age, our appearance changes because the aging process causes loss of facial volume and a decline in skin elasticity. The result is facial sagging and deepening of lines and wrinkles, which can make a person look tired and older than they really are. Radiesse, an FDA-approved dermal filler that contains calcium-based microspheres, restores fullness in your face by adding volume and smoothing out lines and wrinkles. The increased volume and decrease in deep lines and wrinkles can turn back the clock dramatically.  An added benefit of Radiesse is that it has been clinically proven to stimulate production of your natural collagen for a longer lasting result. The average person sees results for 12 months, sometimes more.

Popular treatment areas for Radiesse are the oral commissures (corners of the mouth), jowl area, marionette lines, and nasolabial folds (although it can be used in other areas of the face).

There are several FDA-approved dermal fillers on the market today that we also use (Perlane, Restylane, Juvederm) and these are made from hyaluronic acid. Radiesse is the only calcium-based filler available and because it is longer-lasting, it may be a more affordable wrinkle correction option for patients.

What else do I need to know about Radiesse?

Radiesse is an injectable filler that is ideal for a broad range of patients and a great choice for those wishing to smooth out severe to moderate lines and folds. Radiesse has been FDA-approved to be mixed with lidocaine for a significantly more comfortable treatment. There is virtually no downtime with Radiesse although for best results it is recommended that no excessive sports are done after the treatment (it is okay to resume normal athletic activity the day after treatment). Radiesse is biocompatible and there is virtually no risk of an allergic reaction or rejection of Radiesse. There is the possibility of bruising, redness at the injection area, and swelling, but varies from patient to patient. To this date, over 4 million Radiesse treatments have been performed worldwide.

How do I schedule a Radiesse treatment?

Radiesse can be done by Dr. Perkins at his surgical practice, Cosmetic Surgery Center (805-563-0000), or at Evolutions Medical Spa (call for a complimentary consultation: 805-687-0212), both located in Santa Barbara. An aesthetic nurse practitioner at Evolutions Medical Spa can also perform your Radiesse treatment. All nurses at Evolutions have been extensively trained by Dr. Perkins.

Cosmetic Surgery Highlight: Facial Augmentation

Cosmetic Surgery Center in Santa Barbara offers facial augmentation which is not to be confused with a face lift surgery. Facial augmentation is done to change the contours of the face to add a more balanced, youthful appearance. A youthful face typically looks like an upside down triangle, with plumpness and volume in the upper half of the face. As we age, the face shape may change to more of a triangle where the heaviness lies in the lower half of the face (due to gravity and skin laxity). This can result in a tired, or unhappy looking, appearance. Facial augmentation can help counter the effects of age.

There are a variety of facial augmentation methods available:

  • Implants: Soft-solid alloplastic implants can offer permanent changes.  Unlike gel-filled implants, the soft silastic material can be custom cut and shaped without the possible complication of leakage. Areas commonly treated are the nose, cheeks, chin, angle of the jaw, and lips. Augmentation can be done as a stand-alone procedure or in combination with various surgical procedures. The soft-solid alloplastic implants are very well tolerated and, if ever desired, reversible. 
  • Fat Transplantation: Fat transplantation offers long lasting benefit although the percent of “take” varies with the individual. The ideal area to obtain fat from is the abdomen, although the inner thighs or knees can also be used. What does take is in place for years.  The face or breasts are the most popular areas to receive the fat transplant.
  • Dermal Fillers: Restylane, Perlane, Radiesse, and Juvederm provide excellent, temporary facial augmentation. Depending on the product used, fillers can last 6 to 18 months. They can “fill” facial creases, wrinkles, flattened cheeks, lower eyelid grooves, lips, and the list goes on. 
All methods of facial augmentation listed above can be performed by Dr. Perkins. Schedule an appointment with him by calling his office at 805.563.0000.

Lip Enhancement in Santa Barbara at Cosmetic Surgery Center

This month Santa Barbara cosmetic surgeon, Dr. Terry Perkins, is highlighting temporary and permanent Lip Enhancement.

Enhancement of the lips often involves adding volume that one loses in the aging process. Dr. Perkins feels that it is important to keep the lips looking natural and not overdone.

The enhancement can be done on a temporary basis with a dermal filler such as Restylane or Perlane and results can last up to a year. These treatments are done at Evolutions Medical Spa Santa Barbara (Dr. Perkins is the founder and Medical Director of Evolutions).

A more permanent solution can be done with a soft implant or by grafting your own fat or other tissue. Sometimes surgical excision of tissue near the lip line or under the nose can be combined with augmentation to further expose the lips. These surgical options are performed at the Cosmetic Surgery Center Santa Barbara by Dr. Perkins.

For an appointment with Dr. Perkins for permanent Lip Enhancement, call Cosmetic Surgery Center Santa Barbara at 805.563.0000.

Santa Barbara Facelift Without Surgery

Yes, you can turn back the clock without going under the knife! Santa Barbara cosmetic surgeon Dr. Terry Perkins, in conjunction with Evolutions Medical Spa, will be hosting an educational event on Wednesday, April 27th, on dermal fillers – injectables that contain naturally-occurring substances in your body and are used to fill wrinkles, or any other depression, in the skin.

Dr. Perkins will also discuss his unique protocol of layering dermal fillers, aptly named the Layered Liquid Lift, that can take years off a person’s face – all done in a procedure that takes about 90 minutes, without surgery, and with very little downtime, with immediate results that last 12 to 18 months! Watch a video of Dr. Perkins’ doing a Layered Liquid Lift on a patient and see the amazing transformation for yourself:

Learn more about dermal fillers (such as Restylane, Perlane, Juvederm, Radiesse, and Prevelle Silk) and the Layered Liquid Lift at the Dermal Fillers 101 event at Evolutions Medical Spa Santa Barbara, on Wednesday, April 27th, 6:30pm – 8:30pm. See Dr. Perkins do a live filler demonstration! Refreshments, raffle and exclusive specials for attendees! Please RSVP to Evolutions at 805.687.0212.