Whether they are blue, brown, myopic or astigmatic, they are our connection to the world and to the others! They are often neglected, and yet they are essential and they deserve to be closely taken care of. Here are several professional tips to solve small problems and prevent big ones.

Surgery, the solution with permanent results.

After 40-45 years, you can see signs of aging in the eyes area. Above the eye, the skin of the upper eyelid and the orbicularis muscle becomes loose, and the fat forms a pocket, which makes the eyes look drooping, tired or sad, and sometimes even reduces the visual field. The dark circles become more visible, because the area under the eye loses volume, it widens, the little swellings become pockets. These phenomena are aggravated if you smoke, work a lot on a computer or cry very often…

“No make-up can totally hide these signs of aging, and moreover, make-up becomes a difficult task when the upper lid is heavier and sagging, says Dr. Hervé Raspaldo. If the problem is treated early enough, botulinum toxin can be a solution, we inject it into the eyebrow to relax the underlying muscle and liftthe tip of the eyebrow by 3 to 4 mm: this makes the eyes look wider and younger.

We can combine this product with hyaluronic acid injections around the eye, in order to restore the volume where needed”.

Hyaluronic acid is also used against dark circles, not to modify the dark color (which is only possible with laser or peeling, with various results), but to restore the muscle’s volume: the visual result is good, but is not always enough, and doesn’t last forever.

These are all treatments that can be easily performed in amedical office, withtemporary results (botulinum toxin lasts four to six months, hyaluronic acid twelve to eighteen months), and you can get them as often as necessary.

”However, when the signs of aging are deeper or more present, the ideal solution is eyelid surgery.

The excess skin and fat are removedon the upper eyelid, the skin is then stitched back, resulting in an invisible scar: it’s an outpatient procedure in a surgery block, under local anesthesia, painless. Bruising can occur for four or five days.

If necessary, an “eyebrow lift” is performed endoscopically using a small incision in the scalp. If the lower lid needs to be treated, we remove the fat and tighten the skin through the inside part of theeyelid, or, if the skin is very loose (which is often the caseafter 60 years) by an incision under the eyelashes. Again, there will be no visible scar”. The upper and lower eyelids can be treated simultaneously. The procedure has perfectly natural results, and makes your eyes look more fresh and rejuvenated. Moreover, it doesn’t require any touch-ups.

After the procedure, many women feel like they have a larger visual field, because the eyes are no longer obstructed by the heavy eyelids.

Dr. Hervé Raspaldo, plastic surgeon who specializes in surgery of the face and neck, in Geneva

(This article was published in ”Tetu”, fall/winter 2011)

A college of experts have developed aglobal approach to facial treatments, a revolutionary method to help restoring the dynamics of youth. The four practitioners who created this project explain how we can reduce signs of aging, but still preserve our natural look.

How do you explain that more and more men are getting facial injections?

First of all, because theprocedures are more simple! When men realize that their age leaves visible signs on their face, they take action. It’s not a taboo any longer.

Was this method validated?

We based our work on the opinion of around hundred practitioners, with whom we discussed practical situations, according to the methodology of the Health Authority. Several works will be published in scientific journals in the coming months.

How do you analyse the structure of the face and manage to preserve its expressions and personality?

The clinical analysis and the touch are essential. I also try to examine pictures of the patient in a younger age, to see how the face looked back then. I use a lot of morphing, 3D imaging and I compare expressions at rest and in movement.

What are the indications for hyaluronic acid and botulinum toxin?

Botulinum toxin stretches the muscles and changes their balance; it reduces the muscles’ contraction and helps preventing the sagging skin. As for the hyaluronic acid, it fills the hollows and rehydrates. Combining the two of them is a very efficient solution: the results are almost as good as those of surgical procedures.

How is you approach as a surgeon different from a dermatologist’s?

We both aim for the same result, but I would say that a surgeon is more used to considering all the elements of the face: muscles, bones, fat,and not onlythe skin. My aim as a surgeon is not simply to correct flaws, but to restore global beauty.

What gives you the greatest satisfaction?

Seing my patients happy and confident again. This difficult and very demanding profession also offered me an artistic expression. I work with different materials, just as a sculptor does, in order to bring out the beauty and provide confort to my patients.

”My aim as a surgeon is not simply to correct flaws, but to restore global beauty.”

(Interview published in ”Perfect Beauty”)

What is botulinum toxin?
The botulinum toxin is produced by the clostridum botulinum bacteria and was introduced in France in the early 1990s by the name botulinum toxin®. It’s main characteristic is that it blocks the nerve connexion under the skin and consequently preventsmuscles from contracting. As a result,the skin is smoother and more tense.

How does it work?

After a first consultation with the practitioner, the following session consists in performing five to ten injections, on the targeted areas. The procedure takes fifteen minutes and is completely painless. During the following week, it is recommended to avoid touching your face too much or sleeping on your stomach, as this may move the product which is not yet completely fixed in the muscles.

Advantages of using botulinum toxin

Botulinum toxin® has progressively replaced the frontal lift. It avoids all the inconveniences of  surgery under general anesthesia. In addition to this, the product’s effect slowly disappears in 5 to 6 months, which can be a relief for patients who are not happy with the results.

Downsides of botulinum toxin

The result is not permanent, so we must perform newinjections about twice a year. Like any other treatment, it should be used in a reasonable way, unless you want to take the risk of ending up with a ”poker” face, due to the paralyzed muscles. Moreover, excessive botulinum toxin® injections might create new wrinkles, because the facial muscles will need to find a way to express themselves. Luckily, today’s trend is to really adjust the quantities injected and avoid the ”paralyzed” look.

Results

A few days must go by before the product can act on the forehead wrinkles and the lion’s wrinkle and before the crow’s feet start to disappear. When it comes to treating the other face areas, the results are not conclusive. The mouth, for example, responds poorly to botulinum toxin®injections. Once you get the desired result, only a deep skin hydration can correct the old wrinkles’ traces.

What is hyaluronic acid?

Hyaluronic acid is obtained industrially, but it’s actually already present in the body, as a natural element of theskin and cartilage. It has a viscous consistency, it drawswater and therefore improves the hydration and elasticity of theskin.

How does it work?

A session takes about thirty minutes, and local anesthesia may be performed. Today’s new,flexible needles, such as Magic Needles or SoftFil with foam tipswill drastically reduce the pain. Moreover, laboratories producemore and more hyaluronic acids mixed with local anesthetics, which means we can have completely painless procedures. Asurgeon or anaesthetic practitioner will inject the targeted areas, generally the nasolabial folds and the wrinkles around the mouth.

Advantages of using hyaluronic acid

It’s a completely safe product, with natural origin. No recovery is needed, patients resume normal activity immediately andfinal results can be seen in aweek.

Downsides

Some patients can develop small hematoma after the injection. After 6 to 8 months, the body completely eliminates the product in a natural way, therefore injections must be repeated once or twice a year. There are a small risks of infection and small cysts, but these are kept to the minimum  by an experienced practitioner.

Results

A week after the session, wrinkles are filled. The natural volumes and elasticity of the face are restored.

By Dr. Hervé Raspaldo – Article published in ”TETU” Fall / Winter 2011

Have you had injections yourself?

Yes, I started with BOTULINUM TOXIN on the forehead 7 years ago, and I repeat the procedure every 5months. At first, I used to ask my colleagues to do the injections. Then I started doing it myself in front of a mirror. It’s not very pleasant, but injecting myself allows me to really understand what my patients feel, so I use an even finer needle. When I was 35, I used to say, just like many other people, that “I would never do injections“. However, I have never had hyaluronic acid injections.

Do your friends ask for your advice at a dinner table, for example?

Yes, three-quarters of them ask for my advice openly. Some of them prefer to come to my office for a more private consultation.

Why is it so difficult to find a man who admits having a facelift?

I treat men frequently. Actors or politicians among other patients.The demands concern mostly the enhancement or reshaping of the lower face area and the neck. Mens’ skin is thicker, there are fewer bruises. Scars are easily hidden by the sideburns. Men started with injections, then they started undergoing eyelid surgery and now they are more and more interested in facelift procedures.

Experts in Plastic Surgery
Dr. Raspaldo quoted in a recent releaseabout “The Experts of Cosmetic Surgery”

For the first time, around 50 of the best cosmetic surgeons open the doors of their luxury universe. In Parisor the other french regions, in Switzerland, in Belgium and in Morocco. They are all good, many are very good, some are world-class experts. 

This is an unprecedented document addressingthe most complexe medical aspects but also the well-known health scandals. In these portraits, surgeons take the opportunity to reveal the mysteries of theirfascinating job but also to confess their professional doubts.

Halfway between applied science and the ”devil’s potion”, this publishing takes you behind the curtains of this peculiar medicine and reveals a list of techniques, a product table, an enlightening glossary and several essential advices. It’s a practical andanalytical guide that answers all your questions and offers a contemporary reflection on this double-edgedsword, the widely spread phenomenon of plastic surgery. Useful for both patients and public health …

 By Josseline Abonneau and Marie-Guy Baron, published by Alphaée

Heart of face romanian magazine Esthetiq
ARTICLE PUBLISHED IN THE ROMANIAN MAGAZINE”ESTHETIQ”

 Article by Dr. Hervé Raspaldo published in the romanian magazine”Esthetiq”, presenting the Heart of face® concept created by Dr. Raspaldo and concerning the three-dimensional facial rejuvenation with Botulinum Toxin and Hyaluronic Acid.

Article du Dr Hervé Raspaldo dans le magazine Beauty Woman

This article was published in the ”Quotidien du médecin”, 10th November 2011.

This couldn’t be more organic.

”Votre Beauté” reveals its readers the”Rhino-Bio” concept, a technique developed by Dr. Hervé Raspaldo, plastic surgeon, specializing inthe face and necksurgery. According to the review, the concept combines the “respect for the physiology of the human body, but also for the nature and the environment”.

According to this approach, the nose must be adapted to each person’s morphology, skin texture, personality and expectations. This is made possible by a morphing software, that helps avoiding stereotypes and preserving the“human diversity”. As for the technique itself, it is minimally invasive (endonasal) and uses only “natural materials such as the patient’s cartilage harvested behind the ear or on the nasal septum”.

 The sutures are made with biodegradable and absorbable threads and “instead of the painful nose packings, we use absorbable padswhich prevent bleeding but still allow you to breathe,” says Dr. Raspaldo. Thanks to the cryotherapy performed during and after the procedure, “there is almost no bruising or edema”.

THE BIGGEST CHALLENGE FOR AESTHETIC AROUND THE WORLD IS to creat a universal language of beauty.

The pace of technical development is stable enough to provide materials and devices to create new templates for modern aesthetic and face sculpting, which is particulary useful for the new artistic advanced approach of facial beautification.
As an international key opinion leader, I feel safe and effective using the new generation of hyaluronic acids around the eyes, in the lips end the nose.
There are lot of good products available on the market. My experience is mainly based on the use of Juvéderm® VOLBELLA® and VOLIFT®, developed after the success of VOLUMA® (using the same VYCROSS® technology). The results one can achieve are effective, natural, safe, and have a minimal downtime. All this only serves to increase patient satisfaction.
The level of sugical skills-such as rhinoplasty, facelift, and blepharoplasty-enable the modern practioner to operate new protocols in a completely new way ; fulfilling the expectations of patients on a global scale.
In fact, this is the most crucial part for the industry’s development : the expectations of our patients have changed completely. The modern language of beauty is more unified.
I have had the chance and priviliege to be in touch with and to learn from a number of different cultures, and find that the influence of Asia-Pacific is continually growing.
Despite this, patients from China, Japan, India, Australia, America, Europe, the Middle East and South Afica seem to look for the same template with regard to design (from surgical perspective). However, notwithstanding their inherited deffirences in bone and tissue structure, the result is always very natural.
Hervé Raspaldo
Facial Plastic Surgeon, France

DR HERVE RASPALDO

The impeccably turned-out Dr Raspaldo is a surgeon who is also one of the world’s top injectors (he is a master at employing filler around the delicate eye area).

He’s famed for his Faceculpture – a liquid facelift that uses expertly placed botulinum toxin and fillers to eradicate a weary face in less than an hour.

The effects last up to 18 months. And for his surgical Velvet Lift he uses endoscopic instruments to pull up deep soft tissue, which reduces scars. Post film festival, actresses flock to him for an organic rhinoplasty – dissolvable dressing and natural, biodegradable grafts reduce the risk of injection and speed up healing. And… cut !