The use of Botox ® Cosmetic as a neuromodulator to treat hyperfunctional lines helped spark a cosmetic revolution with regard to minimally invasive approaches to creating a youthful appearance.  However, in the early years, while creating a more “youthful” look, practitioners were not always yielding a very “natural” look.  Often patients were treated to the endpoint of having a totally immobile upper face while the medicine was working.  Adding to this, patients were requesting this look and complaining if even a hint of muscle movement was evident at the site of injection.  It was not difficult to identify the “Botox look” by the seemingly “frozen” look of the upper face.

After this, much attention was paid to avoiding injection at the lateral forehead and keeping all injection points along a relatively central corridor.  This allowed for some animation at the lateral forehead, but often at the expense of an unnatural peaking of the eyebrows, again yielding a certain “Botox look”. 

Now, the science and delivery of Botox ® Cosmetic has become quite an art appreciated by cosmetic surgeons and patients alike.  Patients understand the stigma of looking unnatural, or injected, or “done”.  This phenomenon has become true even across surgeries, as many patients now prefer less invasive facelifting and volumizing techniques over more invasive approaches.  Patients often know exactly what they want their Botox to do, and expect a precise pattern of results with an uncompromised natural look.  I view this “customization” as part of the art of delivery and it has made for successful outcomes.

Dr. Sparano is a Double Board-Certified Facial Plastic and Reconstructive Surgeon.  Please call to schedule a FREE consultation 732-202-FACE (3223).

Female hair restoration is one of the fastest growing subspecialties of surgical aesthetic medicine over the prior seven years.  Unlike many hair restoration clinics which perform the occasional female hair transplantation, our team has a focused interest on medical and surgical female hair restoration.

Performing successful female hair restoration requires a breadth of knowledge of the various underlying causes of female hair loss.  Female hair transplantation is not indicated in the setting of certain hormonal and skin conditions affecting hair loss in women.  Understanding such conditions, as well as their manifestations and causes, is as important as being able to make the appropriate diagnosis and treatment recommendations as a hair restoration surgeon.

Aside from the different causes and patterns of female pattern hair loss compared with that of men, the transplantation technique for females can be different as well.  The frontal hairline on a woman often has several subtle nuances; a man’s hairline does not.  There is frequently a pattern of downward rounding and there is often a cowlick that can demonstrate hair angles in distinctly backward- or sideward-tilting directions unique for the female hairline.  This is one of the reasons I enjoy performing female hair transplantation so much, as it often affords a set of artistic and surgical challenges that culminate in gratifying results for patients.  I create every single recipient site angle myself and assign hairs for each site to recreate a youthful and natural appearing feminine hairline customized to each individual patient.

The customization of optimal hair density, recipient site size and precision of placement are also factors the plastic surgeon must consider with female hair transplantation.  This is true given the diffuse pattern of hair loss that often affects the female patient population, as well as the diversity of hairstyles women can have.

Female hairline lowering has become a frequent request among women at our practice.  Achieving this through hair transplantation techniques is rewarding because it is achieved without frontal hairline scarring and with a much more natural design and shape than alternative surgical techniques.  This is performed in younger and older women alike, usually for a more feminine hairline, sometimes even without evidence of any other hair loss.