Adam Augenstein, MD, Plastic Surgeon in Charlotte, NC, Discusses Popular Male-Focused Procedures

The latest statistics for the past year from the American Society of Plastic Surgeons (ASPS) show that more and more men in the country are dipping their toes into cosmetic procedures, increasing by nearly 30 percent since 2000. Adam C. Augenstein, MD, dual board-certified plastic surgeon in Charlotte, NC, and founder of Aesthetic Surgery of Charlotte, explains how awareness is spreading among men about the benefits of both surgical and minimally invasive aesthetic procedures.

The latest techniques practised by plastic surgeons today tend to be quick and require little to no downtime. This has also led to plastic surgery becoming much more accessible and offering benefits to men from a variety of backgrounds. Men are also taking more interest in their physical appearance, as exhibited by the metrosexual and hipster grooming habits of today.

The competitive job market often propels men to opt for facial rejuvenation procedures such as BOTOX® Cosmetic (often dubbed “brotox”), dermal fillers, or facelift surgery, due to a fear of encountering ageism in the workplace and wanting to appear more fresh-faced and energetic. Additionally, cosmetic procedures can provide men with a shot of confidence as they increasingly become single later in life and re-enter the dating pool.

Non-surgical methods, such as Kybella® (to reduce chin fat) and the above-mentioned facial rejuvenation injectables, are very convenient options with minimal treatment and recovery time, and provide subtle but effective improvements without the average person being able to tell they had a procedure performed.

Surgical procedures tend to be performed quite differently for male and female patients. Popular cosmetic surgeries for men include:

  • Liposuction: The most often-treated areas in men include love handles and the “beer belly”. Liposuction for the neck and chin area is also becoming popular as a way to achieve a more chiseled jawline.
  • Chin augmentation: Along with reducing chin fat, an augmentation can strengthen the look of the jawline. In 2016, 55 percent of surgical chin augmentations were performed on men.
  • Rhinoplasty: In men, the overlying skin on the nose is typically thicker, which will affect the extent of change surgery can produce. Men’s noses also tend to have a higher bridge and greater width. Men often prefer a more prominent, angular nose with a less delicate tip. Many are also looking to correct injured noses or a deviated septum to improve both form and function.
  • Gynecomastia (enlarged male breast) reduction and pectoral implants: A sculpted and toned chest is the ideal for most men.
  • Eyelid surgery: Skin, muscle, and fat can be tightened, or skin and fat may be removed from the eyelids if they are in excess and cause drooping (which can also cause obstructions to a clear field of vision). Eyelid contours may also be improved. The result is a more wide-awake, youthful appearance.
  • Facelift: As the gold standard in facial rejuvenation, this procedure can tighten facial tissues, remove excess, sagging skin and fat, and boost volume in deflated areas. Brow lifts and eyelid surgeries are often performed in conjunction with a facelift.

Both surgical and non-surgical cosmetic procedures can carry an element of risk, which is why it is important to conduct your own research on both the procedures you may be interested in, as well as potential doctors you plan to visit (ensure they are board-certified in plastic surgery and experienced in the procedures of your interest).

The consultation is the first step to determining what treatment plan would be most beneficial for you. Be prepared with information about your personal and family medical history, which areas of the face or body you would like to improve, and any questions you may have for the surgeon.

Adam C. Augenstein is one of the few plastic surgeons in the Charlotte, NC, area to be certified by both the American Board of Plastic Surgery and the American Board of Otolaryngology – Head & Neck Surgery. He would be happy to advise anyone looking to learn more about cosmetic and reconstructive surgery or non-surgical cosmetic procedures. To request a consultation with him, contact Aesthetic Surgery of Charlotte online or by phone at (704) 837-1150.


Statistics on Facial Plastic Surgery: The Bay Area’s Dr. Stanley Jacobs Notes Increases

The face has been an object of attention for as long as humanity has been around: It graces ancient pottery, fills museums of antiquities, and now is presented virtually on countless smartphones and social media platforms each day. In addition to driving technology’s ability to capture and preserve someone’s looks for posterity, the world’s collective fascination with the face has also given rise to a growing desire to adjust individual features, an endeavor possible now like never before via facial plastic surgery. Bay Area facial cosmetic surgeon Dr. Stanley Jacobs has studied the long and fascinating history of facial aesthetics, which is why he noted with interest the recently released statistics from the American Society of Plastic Surgeons.

According to the published numbers, plastic surgeons in the United States performed about 17.1 million total cosmetic procedures in the United States in 2016, an increase of three percent over the year before.

While the most commonly performed surgery was breast augmentation, three other surgeries in the top five—rhinoplasty, blepharoplasty, and facelift—are focused solely on the face, and the other—liposuction—is frequently used to shape specific regions of the face. Given that the numbers for each procedure were higher in 2016 than 2015, it’s safe to say that facial plastic surgery is on the rise.

Liposuction—a surgical fat-removal technique that can be used on the neck, cheeks, and elsewhere—is in the second slot, with 235,237 procedures reported. That’s an increase of six percent in one year.

The next three most commonly performed procedures ranked as:

  • Nose reshaping, up two percent to 223,018
  • Eyelid surgery, up two percent to 209,020
  • Facelift surgery, up four percent to 131,106

Breast augmentation was the most commonly chosen cosmetic surgery procedure among women. Not surprisingly, this didn’t register at all on the list of male-chosen surgeries. For men, facial plastic surgery ruled the year, with nose reshaping and eyelid surgery taking the top two spots. Liposuction and facelift were at places four and five, respectively, with male breast reduction sitting at No. 3.

As facial plastic surgery is proving increasingly popular, so, too, are minimally invasive procedures that focus on temporarily rejuvenating and refreshing the skin. The uncontested top procedure overall—dominating over all other options, nonsurgical and surgical alike—is an injectable form of botulinum toxin type A. The 7,056,255 injection sessions in 2016 are up four percent from 2015’s 6,757,198.

There are several brand names available in this category (Dysport® and Xeomin® among them), but the most prominent is BOTOX®. Injections reduce muscle contractions. If properly applied with precision by a trained and experienced injector, BOTOX® can slow activity in the specific muscles that cause noticeable frown lines on the forehead, as well as crinkly crow’s feet.

Second to botulinum toxins, but still far surpassing surgical choices are soft-tissue fillers, tallying 2.6 million applications in 2016. This is followed by chemical peels with 1.3 million

Often, patients can combine the effects of facial plastic surgery and nonsurgical options to get a benefit unattainable from a single procedure or treatment. Dr. Jacobs, for instance, combines a surgical facelift with a the carefully controlled application of chemical peels to address both the skin and its underlying architecture in what he’s called a SynergyLift™.

The American Society of Plastic Surgeons compiles its statistics annually by sending out a survey to member surgeons, combing a dedicated database, and extrapolating the resulting aggregated information. The results are considered by many to be the most comprehensive statistics exploring cosmetic and reconstructive plastic surgery in the United States each year.

Dr. Stanley Jacobs is a triple board certified doctor specializing in facial plastic surgery. Bay Area residents may recognize him from his segments on KRON4, as well as his frequent appearances at events in the greater community. For more information, call his office in Healdsburg at (707) 473-0220 or in San Francisco at (415) 433-0303. He also has an online contact form.

A Los Angeles Dermatologist Explains BOTOX® and Its History

For men and women alike in Los Angeles, BOTOX® is an everyday reality. While the injectable made headlines a decade or so ago as a novelty, its widespread acceptance in the United States and the world (it remains the most commonly performed cosmetic treatment on the planet, according to a variety of surveys) has since transformed it into a household name. Celebrities, office workers, and anyone looking to relax some wrinkle-forming facial muscles chooses it for its quick application, safety, and proven results.

How did BOTOX® achieve its chart-topping status? The injectable traces its roots all the way back to the 1890s, where a Belgian food poisoning incident first led to the discovery of the Clostridium botulinum bacteria. Researchers quickly learned of its paralyzing effects, but it wasn’t until about 60 years later when scientists began finding that they could develop helpful applications based on the bacteria. In the United States, the Food and Drug Administration saw sufficient promise in the research and gave doctors authorization to run trials involving humans.

The first official reports on what the formula later to be known as BOTOX® could do came in 1981, when an ophthalmologist announced that patients suffering from involuntary crossed eyes or walleyes—a condition known as strabismus—found temporary relief from the vision-disrupting symptoms when injections were made into the muscles that pulled the eyes in one direction or another. More eye-related research followed, leading to a pair of FDA approvals in 1989.

From that point on, BOTOX® could be officially marketed and used to stop the involuntary muscle action behind strabismus, as well as a similar culprit causing involuntary blinking known as blepharospasms.

Since BOTOX® demonstrably prevented signals from triggering muscle contractions—and did so safely—research continued in this vein. The next FDA approval was also for involuntary muscle action, centralized just a bit farther down from the eyes: in the neck. Cervical dystonia can be an uncomfortable-to-painful problem, causing the neck to twist and turn, then stay frozen that way so that patients have to carry their head at an odd angle. This FDA approval came in 2000.

An FDA approval given in the year 2002 stood out as the act that launched BOTOX® into international popularity, and newspapers ran with the headlines for years after, along with photos of needles sticking out of patients’ foreheads. The injectable had branched out from medical to cosmetic applications, cementing its position in the spotlight as it allowed anyone willing to try it to enjoy a relaxed, more youthful appearance.

Just two years later, the FDA gave its nod for the first non-muscle-related use of BOTOX®: treating excessive underarm sweating, known as hyperhidrosis. Six years after that, in 2010, it voiced approval for the treatment of chronic migraines, bringing a chance of some relief to people who spend at least 60 hours a month reeling from the pain in their head. Involuntary muscle action took another blow that same year, when the FDA also provided approval for using BOTOX® to treat upper limb spasticity.

2013 was another two-for-one year, with BOTOX® gaining approval to smooth out crow’s feet on the cosmetic side and help curb an overactive bladder on the medical side. Dr. Derek Jones served as an investigator for the crow’s feet study.

Most recently, in 2016, treatments for the lower half of the body were welcomed into the official FDA-approved fold when the agency announced its green light for doctors using BOTOX® to treat lower limb spasticity.

While board-certified dermatologist Dr. Derek Jones and the other physicians on his team use BOTOX® only for cosmetic applications, they do so knowing that the injectable is backed by decades of careful research, rigorous testing, and FDA-led scrutiny designed to ensure that the product is both safe and effective. Learn more about BOTOX® in Los Angeles from the team at Skin Care & Laser Physicians of Beverly Hills by visiting or calling 310-246-0495.

South Jersey Skin Care Sees a Rise in Botox® Popularity, Including in New Jersey Men

Earlier this year, results from an annual survey by the American Society of Plastic Surgeons revealed that the most popular cosmetic procedure in the United States in 2014 was not plastic surgery, but the minimally invasive cosmetic Botox®. New Jersey patients who come to Dr. Robin Levin’s South Jersey Skin Care & Laser Center for their Botox® treatments should know that they’re not alone. More than 6.5 million people chose last year to have their wrinkles smoothed by Botox® or similar cosmetics, such as Dysport®. These injectable cosmetics temporarily prevent wrinkles from showing by blocking nerve impulses that would otherwise cause wrinkle-revealing muscles to contract.

Botox® is FDA approved to treat lines that form on the forehead, primarily known as glabellar lines, which frequently appear as an “11” between the eyebrows, and to treat the fine web of lines that fan out on the side of either eye, known as crow’s feet. Other cosmetic uses have been developed, too, but haven’t been officially recommended by the FDA.

Botox®, Dysport®, and other such cosmetics—often collectively referred to by the technical-sounding name of “neuromodulators”—far surpassed the next most popular procedure of 2014: soft-tissue fillers, which were used by about 2.3 million people to fill in wrinkles and add volume back to hollow or sunken areas of the face.

To be precise, 6,673,608 neuromodulator sessions were reported for 2014, which represents a 6 percent increase in the procedure over 2013’s numbers, and a staggering 748 percent increase over 2000’s numbers.

Part of that leap forward can be attributed to more men seeking out cosmetic treatments, owing to a growing male focus on putting a youthful face forward into the highly competitive workforce, as well as other factors. In South Jersey, dermatology experts are seeing more interest from men investing in their skin health and aesthetics, which has led to what some media outlets have described as a “bro-tox” trend.

Others have described the jump in male Botox® popularity as a “Menaissance.” No matter the clever name industry watchers are applying, the shift has been happening,

One of the reasons for the continuing increase in the popularity of Botox® among men and women alike may be how easily the cosmetic can be administered. Skilled and trained experts focusing on both safety and aesthetics, like those at South Jersey Skin Care & Laser Center, can perform the procedure in as little as 15 minutes, and there’s essentially no recovery time to plan for. Many people return to their daily routine, from work to social activities, on the same day as they get Botox®.

Another reason for its popularity is the fact that Botox® is minimally invasive, taking years off of a person’s appearance without the need for any surgery. Many New Jersey patients who do not want to face the risks, recovery time, or scars of a more invasive lift turn to Botox® to get the results they’re looking for.

Botox® can also be tailored to the individual, since some men may want to address their glabellar lines on their forehead, but leave the crow’s feet on the sides of their eyes. Getting a look that’s more “refreshed” seems to be a common male goal, as many men who opt for Botox® say that they want to regain a relaxed look that’s not overdone. The idea is to not erase the signs of aging, but to soften them. Just a few wrinkles and gray hairs seem to be preferred over none at all.

Neuromodulators can also be combined with those aforementioned dermal fillers to bring about an overall balanced look, customized to each patient’s unique facial structure, aging, and desired goals.

Call (856) 810-9888 to learn more about Dr. Robin Levin, South Jersey Skin Care and Laser Center, and Botox®. New Jersey residents and visitors are also welcome to stop by one of two offices: 101 Gaither Drive in Mount Laurel or 856 S. White Horse Pike, Suite 6, in Hammonton.

Botox® procedures on the rise nationally

With the economy on the upswing and consistent advances in medical technology, the nation saw a significant increase in cosmetic procedures—Botox® in particular—in 2014. More than 6 million Botox® procedures were performed in the United States in 2014, including at Dr. Stanley Jacobs’ San Francisco and Healdsburg facilities.

According to the American Society of Plastic Surgeons’ annual plastic surgery procedural statistics, there were 15.5 million cosmetic procedures performed in 2014—a 3 percent increase from 2013. Nearly half of these were Botox® procedures, which saw a 6 percent rise from 2013 to 2014.

While Botox® has long been a popular minimally invasive option for patients looking to minimize crow’s feet and other fine lines around the face, an increasing number of nonmedical facilities, including salons and spas, are offering the procedure as well, which may account to some degree for the overall increase in the number of Botox® procedures being performed.

Minimally invasive procedures saw the largest increase, with 2.3 million soft tissue filler procedures marking a 3 percent increase, 1.2 million chemical peels marking a 7 percent increase, 1.1 million laser hair removal procedures marking a 3 percent increase, and 881,905 microdermabrasion procedures marking a whopping 9 percent increase. Of course, none of these comes close to the 6.7 million Botox® procedures performed in 2014.

Surgical procedures had an overall 1 percent increase, with liposuction seeing the steepest increase at 5 percent.

Among the positive developments revealed by the statistics, an increasing number of men are turning to cosmetic procedures to help boost confidence and feel more comfortable in their own skin. A doctor quoted in the release said, “Male plastic surgery rates have significantly increased since 2000 and the notion that cosmetic procedures are just for women no longer exists. Men are seeking to regain a more youthful look, improve their self-image and feel better about their appearance. It is great that plastic surgeons have procedures to meet and often exceed their expectations.”

The study primarily cites pectoral implants (which increased 208 percent from 2013 to 2014) and male breast reductions (which have increased 29 percent since 2000). But for patients across the United States, including at Dr. Jacobs’ San Francisco and Healdsburg facilities, men are turning out for Botox® in much higher numbers, lured by curiosity, a fear of encountering ageism in the workplace, and the ease and speed of the procedure. A CNN Money article that ran in November 2014 cited Botox® as a good way for men to gain a competitive edge in the job market. But the article also cites women as a major contributing factor to men seeking Botox® across the United States, including in San Francisco and Healdsburg. Doctors cited wives who had invested in cosmetic procedures offering a strong incentive for husbands who are impressed by the results and also want to look their best.

While the increase in procedures might suggest a positive increase in patient access to procedures that make them look and feel better, the Mayo Clinic advises that “Botox® must be used only under a doctor’s care” because “it can be dangerous if it’s administered incorrectly.” Different states have different laws about who is allowed to administer Botox®,, and in California, including San Francisco and Healdsburg, it’s not uncommon to encounter salons and medical spas offering cosmetic procedures including Botox®, often administered by people with only a weekend of training.

But medical practitioners and respected institutions recognize the importance of ensuring that any procedure takes place in a safe and sterile environment under the guidance of a trained professional like Dr. Stanley Jacobs.

Dr. Stanley Jacobs is triple board certified by the American Board of Facial Plastic and Reconstructive Surgery, the American Board of Otolaryngology Head and Neck Surgery, and the Royal College of Surgeons of Canada. He is an elected house delegate for the California Medical Association, a member of the European Academy of Facial Plastic Surgery, and has written numerous articles on the subject of cosmetic surgery. To schedule a consultation to learn more about the Botox® in San Francisco and Healdsburg, as well as the other procedures Dr. Jacobs offers at his San Francisco facility, visit or call the San Francisco facility at 415-433-0303.

Botox® in St. Louis: An Alternative to Not Smiling for 40 Years

There are many reasons people come to West County Plastic Surgeons of Washington University. While cosmetic surgery is a frequent choice, patients also seek out the popular injectable Botox®. St. Louis patients choose the cosmetic for its ability to temporarily reduce facial lines and wrinkles, particularly on the forehead, between the eyebrows. A reduction of crow’s feet on the side of either eye is another reason people opt to get Botox® in St. Louis.

Patients seeking a more long-term solution via cosmetic surgery can decide on a brow lift, which addresses forehead wrinkles, among other features. The procedure is more involved than a Botox® injection, but the results also last much longer.

There is another option, too, when it comes to combating the signs of aging.

Britain’s Daily Mail recently ran a story about a woman who decided to keep her face youthful and unlined by not smiling for four decades. The 50-year-old made a commitment to herself while in her teens, vowing to avoid showing emotions and laughing as a way to keep from developing the sort of wrinkles that form through repeated muscle use. She told the reporter that people often ask her if she’s had Botox®, but she attributes her fresh face to nothing more than a commitment to a lack of expression.

This is obviously an extreme tactic, though she is not alone. Several women interviewed for the story revealed that they practice the blank-face strategy, choosing to smile only rarely or never as opposed to showing happiness or other emotions throughout the day. Even celebrity Kim Kardashian has said that she tries to keep smiling and laughter to a minimum in an effort to avoid contributing to the formation of wrinkles.

The main source in the article, named Tess Christian, said that her method has drawn criticism from people who feel that she should lighten up, but she puts stock in the decision that she cites as more natural than Botox®.

Other critics have pointed out that smiling is a beneficial activity that contributes to a beautiful face, and a range of expressions and emotions are important to everyday human interaction. While a select few people may have decided that living an expression-free life is the best choice for them, it is not a realistic option for people who do not want to hide their feelings from childhood on.

Smiling and frowning are not the only factors that contribute to facial lines, either. Wrinkles form for a variety of reasons, including repeated muscle use, sun exposure, stress, and the natural loss of components in the skin that keep it hydrated and pliable. Botox® works to combat some of those combined effects by blocking the successful transmission of signals sent to specific muscles. If the message can’t get through, the muscles won’t contract. If the muscles don’t contract, wrinkles are less visible.

The results from most of the Botox® treatments from St. Louis’ West County Plastic Surgeons last for about three months, during which time the skin will appear smoother and less wrinkled. Some of the areas where Botox® is used to treat lines include between the eyes, known as the glabellar area; the forehead, where creases can run horizontally across the entire width; the bridge of the nose, where what is known as a “bunny line” can form; and the sides of the eye sockets, where webs of fine wrinkles known as “crow’s feet” develop.

Beyond Botox®, the more involved cosmetic surgery options include a minimally invasive endoscopic brow lift to treat wrinkles; a transpalpebral brow lift with corrugator resection, which eliminates certain muscles that create wrinkles; and a traditional open brow lift.

Learn more about Botox®, cosmetic surgery, and other wrinkle-fighting options available to St. Louis-area patients at West County Plastic Surgeons of Washington University. To speak to someone or set up a consultation, call (314) 996-8800.

The Many Uses of Botox®

Botox® is famous for its cosmetic use: treating the area between eyebrows where frown lines develop, as well as the sides of the eyes where crow’s feet form. Since moderate to severe wrinkles show up where muscles are particularly active, Botox® improves the appearance of wrinkle-plagued areas by limiting muscle activity in precisely targeted areas.

The injectable cosmetic works by preventing chemical messages sent by the brain from arriving at their intended destination in the facial muscles that contract when we frown, scowl, or squint.

Those signal-blocking properties also make it ideal for a range of other medical issues, including fighting migraines, excessive sweating, and muscle spasms. Read on to learn more about the many FDA-approved uses of Botox®.

Botox® and Migraines

Migraine sufferers know the torture of what’s more than just a bad headache. Just one migraine can involve throbbing pain, visual and aural disruptions, light sensitivity, and nausea. The whole event can last a few hours or a few days.

Chronic migraine sufferers are people who have at least 15 such episodes a month, each lasting at least four hours.

For patients in that category, Botox® can help by cutting that number in half or more. Studies have shown that injections can stop up to nine headache days before they start in a single month. This is known as a preventative treatment, as opposed to an acute treatment that merely manages the symptoms.

For patients seeking this treatment, a doctor will inject Botox® into key areas once every 12 weeks. Patients have reported a reduction in the number of days they experience migraines a month after two sessions.

Botox® and Hyperhydrosis

Excessive sweating-technically known as hyperhidrosis-is an uncomfortable and often embarrassing condition that can interfere with day-to-day life. While someone who suffers from this medical problem has many options when it comes to treating it, from prescription anti-perspirants to surgery, a doctor may recommend Botox® as a means of controlling the symptoms.

Patients who receive this treatment to combat hyperhidrosis will receive 15 or so injections in their underarm area. The actual injection process should take less than 20 minutes, while the results can last for more than six months.

This works similar to the way Botox® acts as a wrinkle-fighting injectable, in that the treatment prevents signals sent by the brain from arriving at their intended destination. In this case, the message isn’t to prompt muscles to contract, but to tell glands to produce sweat. If the glands don’t get the signal, they simply don’t do their job-reducing the amount of sweat produced under your arms.

Keep in mind that this treatment is only for underarm sweating, and patients who get the injections will still continue to sweat normally everywhere else they typically sweat.

Botox® and Muscle Spasms and Spasticity

The medical term for neck muscles that uncontrollably spasm and tighten is cervical dystonia. The problem can range from uncomfortable to painful, and can get worse over time.

It should be no surprise by now to learn that the signal-blocking properties of Botox® make it an ideal treatment in this case, since injections of the drug in key areas keep most or any muscle-contracting signals from getting through to their target.

Botox® is such a proven treatment for cervical dystonia, many doctors consider it to be the go-to solution, recommending it before and above other options.

The prescription injectable is also a treatment for eyelid spasms, known as blepharospasms, as well as upper-limb spasticity, which is an often-painful series of muscle contractions that cause sufferers to involuntarily tighten muscles in their elbow, wrist, and fingers.

More to Learn About Botox®

Botox® has other uses as well, including as an FDA-approved injection to combat incontinence. Talk to a doctor to learn more about Botox® in its many forms, from cosmetic to medical.