Youtube News: Youtube daily report Jan 25 2018

Thank you for your question.

You submitted several photos with your question.

And you describe the state of confusion you're in after going to 3 facial plastic surgeons

and getting options about improving the area that involves the nasolabial folds.

And essentially you were advised to have a cheek implant, mid facelift and lower eyelid

blepharoplasty.

And you state your question as if it's one or the other for each individual choice.

And certainly I can appreciate why you are confused as to what to do.

You also state in your question that you had Bellafill a few years ago, about 5 years earlier

and that you didn't like the result because it made your cheeks look too full when you

smiled.

Well, I can certainly share with you based on the photos you submitted my impression

of what the issues are and hopefully, it will give you some guidance that may or may not

have been clear from all the recommendations that were made.

A little bit of background, I'm a Board-certified cosmetic surgeon and Fellowship-trained oculofacial

plastic and reconstructive surgeon.

I have been in practice in Manhattan and Long Island for over 20 years.

It's actually the specialty of oculofacial plastic surgery were amongst the first doctors

to introduce mid facelift in the mid to late 90s.

And certainly, helping this particular area has been a very big part of many different

specialty practices.

And I can certainly give you some ideas as to the thinking behind some of these recommendations.

So to begin with, let's start with first the issue about the lower eyelid blepharoplasty

because I think that's fairly straightforward.

The one photo where your face is kind of in a three quarters view, it appears that you

have puffiness under your eyes.

So I think that undergoing a lower eyelid blepharoplasty to help the puffiness is a

separate issue and not one that would address the nasolabial fold.

This lower eyelid puffiness being lower eyelid prolapse, I think from that perspective, lower

eyelid blepharoplasty is a reasonable procedure.

I would typically perform this procedure in what's called a transconjunctival approach

doing it from the inside of the eyelids to help the puffy area.

Now when it comes to the question about cheek implants versus a mid facelift, well certainly

I think that one of the impressions that I think that every doctor has been making about

your appearance is that there appears to be lack of projection of the midface.

And so to one doctor, there is an opportunity to lift tissue and to another doctor is an

opportunity to restore volume.

Now understanding that from my perspective with the experience that I have with the concept

of face lifting, I think that in your scenario, the mid face has not dropped and therefore

I would respectfully disagree with the doctor who was recommending lifting.

As far as the choice of a cheek implant, I could tell you that, again from my impression

from your appearance that certainly midfacial volume augmentation can be performed and a

cheek implant is certainly a reasonable option.

I would also introduce to you another option which may be a choice to make before moving

forward with a procedure which is surgical and placement of an implant and this procedure

is called Structural Volumizing.

Now understanding that you had Bellafill placed in your cheek 5 years ago, the distinction

that I would help you try to make was that the Bellafill was placed where typically most

fillers are placed.

Whether it's a filler like Radiesse or a filler in the hyaluronic acid family, Restylane

and Juvederm, it's placed in the soft tissue of the cheek and it is a common complaint

of people especially those who have thin faces, when they get a filler placed in their cheek

which is well intended to add structure, it ends up hanging in the skin.

And when you smile, it goes upward.

Well with Structural Volumizing, we're actually placing a long lasting filler such as Juvederm

Ultra Plus and Juvederm Voluma at the level of the bone where the structure needs enhancement.

When it's placed at the bone level, the skin actually glides over the cheekbone.

Therefore, when you smile, the cheek doesn't look too full but rather when you are relaxed,

you look more balanced.

Now how is this beneficial to the nasolabial fold?

Well, the nasolabial fold is not always sagging or deepened because of overlap but rather,

it is a reflection often times of the balance between the cheek projection and the lower

third of the face.

So a lot of times when we place volume in the cheek, the nasolabial fold doesn't look

so deep.

So this is more of truly the art of balance and creating what is harmony in the facial

appearance.

So my approach to a situation like yours would be to consider doing a lower eyelid blepharoplasty

and volume augmentation of the cheek with Structural Volumizing.

This way you reduce the puffiness which takes away the tired looking eyes and improve the

volume of the midface.

Further, it's less invasive.

As far as the choice of cheek implant, I can tell you that certainly the healing time for

the cheek implant and the stabilization of that appearance takes much longer than doing

an injectable.

When you do an injectable like Structural Volumizing, people look pretty good immediately

and we see our patients in follow-up 2 weeks later.

And further, for someone who has a relatively thin face and relatively thin skin, it is

also important to try to do something where the skin doesn't show the outline of the implant.

Now generally speaking, that's not much of an issue when the implant is placed.

But I caution people to understand that as you get older, the soft tissue and skin thins

and that issue can become problematic later on.

Again, I would say that there are probably equivalent options of doing fillers compared

to cheek implants.

But I would say that reflective of my own practice where patients want to have enhancement

of the cheek area but often are averse to a facial implant, they love the idea of doing

Structural Volumizing.

Especially when you're using a long lasting filler which can essentially be sculpted and

placed very precisely in a way that I would argue is very different from placement of

a facial implant.

There is nuance in asymmetry in everyone's face that with injectables, you can control

much more readily and in a real time without the confusion that occurs when there is swelling

from anesthetic.

So I think that this is another opinion that might be worthwhile considering in determining

what's optimal for your facial appearance.

I think that you are seeing what is truly the art of medicine and that it is always

going to be the case that doctors will look at the same patient with a different set of

experience or different perspectives based on their own experience and their own aesthetics.

And I think this is just why you can't think of anything as being a commodity or equivalence

between doctors.

And so I think that if you're not quite sure, get additional opinions.

And since it wasn't discussed with you by any of the doctors so far, the idea of lower

eyelid blepharoplasty with Structural Volumizing is worth discussing with another doctor so

you can get additional opinion.

So I hope that was helpful, I wish you the best of luck and thank you for your question.

For more infomation >> Treating the Mid Cheek and Nasolabial Folds When too Young for a Facelift, and Without Surgery - Duration: 11:30.

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Brian Tracy| Secrets Of Self Made Millionaires part 2 - Duration: 13:32.

- right and when you ask self-made millionaires what sort of work do you do they'll often

say I've never worked a day in my life I just do what I like to do I had a graduate of my

course once it came out to me it said you know that's interesting he said when I was

a little boy I loved to study airplanes he said I got an airplane books and I had airplane

models and I had their toy planes and then and then I got into competitions with the

remote-controlled planes he said when I grew up and went to school I studied aeronautical

engineering he said today said I'm 35 he said I own three companies one builds a small aircraft

another one repairs and services small aircraft in other words in leasing and chartering smart

okay he said I've never worked a day in my life he said I just played with planes since

the time I was a kid so one of the things that you can do is go back to the time when

you were young as a child between the ages of 7 and 14 before you discovered boys or

girls and what is it that you really love to do and you'll often find that within that

is something you're supposed to do as an adult number three is commit to excellence now this

is really really important and I had a hard time with this as a young man because I was

never good at anything I was never picked for any team and if I was picked I was the

first person cut I got lousy grades in every class I got fired from multiple jobs I even

got fired from a job Tommy gasps once ok can imagine that being fired for pumping gas because

you're no good that came and said you're no good at pumping gas how can you be no little

old ladies can pump gas and here was I was no good at pumping gas anyway so I got fired

I went from job to job and then I discovered that all people who are successful are excellent

at what they do you know the old question they asked Willie Sutton the bank robber why

do you rob banks he said that's where the money is well being in the top 10% is where

the money is so what you have to do is you have to pay any price and make any sacrifice

to get into the top 10% in your field now here's the good news if you're doing what

you love to do you will want to be in the top 10% in your field if you don't want to

be excellent at what you're doing it means you're in the wrong field it just means that

you're marking time you're treading water and there's a lot of people are in their field

they their job and you know they go home at night they don't think about their work and

so on and this kind of an attitude means that you have no future you have a very shaky present

that crackling sound you hear is the ice breaking under your feet okay and you have a very you

have no future because if you're not doing what you love to do and throwing your whole

heart into it you're just marking time but everybody is designed so that there is something

that you love to do that you can do well and the fact that you love it means that you probably

have the ability to excel at it so make this decision to get into the top 10% let me tell

you how what changed my life here I was struggling in my late 20s and I learned this it was a

breakthrough thought is that everybody's in the top 10% started in the bottom 10% everybody

who's doing well was once doing poorly everybody who is the top of your field today was once

not even in your field at all and didn't even know what existed what that means is that

if you're willing to pay the price and work hard and make the sacrifices you can get into

the top 10% now how long does it take it doesn't take a week or a month most people are really

impatient and to achieve mastery in your field takes five to seven years we will say five

to seven years geez I'll be five to seven years old or before I start enjoying the big

rewards well how much older will you be in five to seven years anyway now here's an important

point are you ready the time is going to pass anyway the time is going to pass five to seven

years from now five to seven years will have passed the only question is there are you

going to be at the top of your field or you're still going to be down there with a with the

mediocre 80% and the wonderful thing is this is nobody's better than you and nobody's smarter

than you if anybody else is at the top of the field it means that you can be at the

top of your field just go to them and find out how they got there because they started

at the bottom now it may take longer for some people and less for others but everybody who

puts one foot in front of the other and keeps moving eventually gets there and that's where

all the rewards are and not only that that's where all the joy in life is when you're really

good at what you do you feel wonderful about yourself you're respected and esteem but everybody

around you you can you can write your own ticket you can open any door when you're good

at what you do because you get up in the morning and you know you're good and and and and that

is more important than the rewards that go with it the next key is to develop your unique

talents and abilities every single person is designed from infancy with special talents

and abilities that if you develop them to their height can enable you to accomplish

anything you want in life everyone is genetically structured to be able to do something superbly

to do something they enjoy to do it well and to get great satisfaction from it Peter Drucker

often asks the question what are you good at what are you good at today what should

you be good at what could you be good at what will you be good at and so one of the questions

that we ask is looking back in your life what has been most responsible for your success

up to now what has been most responsible in the past what is it that you have done that

has gotten you the best results because we as we said before success leaves tracks and

if you look back into your past you'll often find indicators that guide you to your future

do you remember that fellow that one current 300 million dollars in the lottery he was

a high school physics teacher and they asked him what he's gonna do with it he said he's

gonna take a week off and then get back to work because he doesn't want to give off his

job teaching high school physics because he loves his work so much that is a person was

in the right place for him and now he can just drive to it in a nicer car anyway now

the next key to the next key to becoming a self-made millionaire is to see yourself a

self-employed what we found is a top 3% of adults in our society see themselves as self-employed

they see themselves as in charge of their own lives when I started off my career as

a young man there's twenty one years old working as a construction laborer living in a one-bedroom

apartment broke taking buses two hours every morning to get to work and buses two hours

to get back I still remember that and I still remember a light going off one evening I was

sitting there in my little apartment of my little kitchen alcove and I suddenly realized

that I was responsible is that I was in charge of my own life that no one was coming to the

rescue and it was one of the great turning points in my life so what you find is that

all exceptional people are highly responsible people they look upon themselves as self-employed

sometimes I'll ask an audience I'll say how many people here are self-employed and some

people will raise their hand and some won't I'll say I know what's the true answer to

this question and the true answer is that everyone is self employed the biggest mistake

you can ever make is to ever think you work for anyone else but yourself even if someone

else signs your paycheck for you all your life the most valuable people in any organization

are the people who treat the company as though it belongs to them they see everything that

happens is affecting them personally they're not the nine-to-fivers that no-hoper Zitz

a yellow I go to work when I'm out of work I don't think about my work these people somebody

has told them that's a clever way to think it's the way losers think winners think about

their company and when they're not there they think about how they can do it better when

something happens in their company they take it personally because they see themselves

as highly responsible as a result they're paid more they're given more educational opportunities

that promoted faster and these are the people that eventually like cream rise to the top

of every organization and every industry the top 3% the next key to becoming a self-made

millionaire is to develop a clear sense of direction developing a clear sense of direction

means that you need to become intensely goal-oriented we find that all successful people are goal-oriented

there's an old saying you can't hit a target that you can't see you've got to know what

you want in every area of your life some years ago I worked with the hot oil company in Texas

the hot oil company was founded by HL hunt who became the wealthiest self-made multi-millionaire

billionaire in the world at his peak he owned 200 companies and had a royalty income of

3 million dollars a day most phenomenal man by the way and he was interviewed by a friend

of mine on television before he died in the early 70s and he was asked what are the secrets

to success he said the keys to success have only been to through all my life and I will

tell you what they are he said number one he said decide exactly what it is you want

and write it down and make a plan to achieve it and number two is determine the price you're

going to have to pay to get it and then resolve to pay that price now where the law of sowing

and reaping cause and effect I learned an additional point to that learned that your

current life today is the result of the price you have so on up to now is whatever you've

put in you get out so whatever you're getting out today as a result of what you've put in

if you don't like what you're getting out what you have to do is you have to put in

something different what I found is this is that life is always just in the long run so

therefore life says this is it as a price you have to pay and there's two qualities

first of all you have to pay the price in full for your success of study preparation

hard work and so on and second of all you have to pay the price in advance you don't

get it afterwards where the world works is first to put in what you need to put in and

then you get out the rewards so you have to ask yourself what is the price that you have

to pay to achieve the success that you desire and you have to write it down and make a plan

and work on it every day now let me give you a quick exercise which is my only take home

or homework exercise for our time together I want you to take a piece of paper like this

and write down ten goals that you'd like to accomplish in the next 12 months write the

word goals and today's date at the top of the page write down ten goals you'd like to

accomplish and then ask yourself this great question if you could only accomplish one

goal on this list but you could accomplish it within 24 hours which one goal would have

the greatest positive impact on your life now this is a great question because it'll

usually jump out at you you say that's the one if I had this that would have more of

an impact on my life than anything else sometimes it's a financial goal sometimes it's a health

goal sometimes it's a relationship goal but whatever you put a circle around that goal

and then turn the page over and write it at the top of the page set a deadline on the

goal make a list of everything that you could think of to do to achieve the goal and then

begin working on your list and here's the kicker do something every day do something

every day that moves you one step forward towards your major goal my promise to you

that this exercise selecting your most important goal making a plan and working on it every

day will change your life in ways that you cannot imagine they say that people begin

to become great when they did when they determine their major definite purpose their number

one goal and work on it everyday it is the secret to becoming a self-made millionaire

it's the secret to great success in life my promise to you is a week a month a year from

now you'll look back and you'll be absolutely staggered at the difference it makes I was

giving a seminar not long ago and a gentleman came up to me he said you know that goal said

in exercise it changed my life ten years ago he said I was broke I was divorced he says

I was an alcoholic and somebody dragged me to one of your seminars he said I did that

exercise and I picked my major go I said it changed my life I said in what way he said

today he said I'm worth 40 million dollars I said well Wow he said yes and I owe it to

that lesson next is refused to consider the possibility of failure it's the most amazing

darn thing is that the fear of failure is the greatest single obstacle to success in

adult life and it's not failure itself because each one of you is a professional failure

each one of you has failed over and over and over again is that true all of us fail all

human beings fail over and over nine out of ten things that we try don't work out the

way we expect it we have failures in relationships and in jobs and in careers and investments

and everything it's not the failure that holds you back the failure makes you smarter we

say that it is the fear of failure not failure that holds you back and the way that you overcome

failure is you never consider the possibility of failure the rule is this is there's no

such thing as failure there's only feedback is when you try something it doesn't work

to get feedback not failure and recognize that most things you try aren't going to work

the first few times so what you do is you say oh that's an interesting bit of feedback

and you pick yourself up and you move forward and you have more feedback and you move forward

to become a self-made millionaire you're going to fail over and over again year after year

after year but your brain has a cybernetic mechanism which means that everything sometimes

you try something you get feedback which makes you smarter and when you try something else

you get feedback which makes you smarter and eventually you reach the point where you're

too smart and you stop making mistakes you start to do more and more things right and

fewer and fewer things wrong but you can't get there unless you have experienced the

failures Henry Ford once said that failure is merely an opportunity to more intelligently

begin again now let me pass on one great rule to you which has been discovered in interviewing

self-made millionaires self-made millionaires look into every failure for something good

they say there's got to be something good in this that I can benefit from and surprise

surprise they always find it second is self-made millionaires always seek the valuable lesson

For more infomation >> Brian Tracy| Secrets Of Self Made Millionaires part 2 - Duration: 13:32.

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