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what type of doctor is best for filler treatment injectable filler placement

for a wide range of cosmetic issues is very popular it has resulted in a wide

range of practitioners offering these types of procedures question which is

often heard is who do I go to for the best results of filler treatment I'll

discuss the principles of safety and after treatment management which I

believe are important to understand when you're looking for the right doctor to

perform your injectable filler treatment I'm Dr. Amiya Prasad I'm a

Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic

and reconstructive surgeon I've been in practice in Manhattan and Long Island

for over 20 years I'm well known for cosmetic surgery such as upper eyelid

surgery under eye bags surgery eyebrow lifts face lifts and other surgeries to

treat the effects of facial aging I'm also known for my work with cosmetic

filler placement for the eyes and face related to the genetic and aging issues

wherever there is volume deficiency a common belief is that results are

dependent on the brand of the filler although the choice of filler is

important it's the doctors technique that is critical to a desirable result

boils down to experience expertise knowledge and the aesthetic style of the

practitioner safety is the highest priority injectable fillers have become

so popular that most people don't view them as invasive particularly in

contrast to surgery once you enter the skin the procedure is

invasive with this principle in mind I treat placement of injectable fillers

with the same level of care as I do with surgery as with surgery you begin first

with the plan you should have a clear understanding about what you should

expect after the procedure in terms of results and longevity there are common

issues after filler placement such as swelling and lumpiness which are

generally resolved with conservative therapy since these are common and more

severe complications are less common both patients and practitioners can be

inattentive to the risks of more serious complications these complications

include different types of infections such as biofilm a biofilm typically

occurs when bacteria from the skin surface is carried past the skin and the

bacteria attaches to the surface of the filler material since the filler

material does not have a blood supply infection can occur which can be very

difficult to treat another potential complication is when the filler material

is injected into a vessel specifically an artery this can result in severe loss

of large areas of skin and soft tissue and even blindness just like our

approach to surgery where we perform every procedure prepared for an

emergency it's important to have the necessary

equipment training supplies and it always be prepared for any filler

related emergency as a surgeon I'm available to my patients 24 hours a day

including my patients who I perform injectable fillers for when it comes to

filler placement I believe that the knowledge derived from surgical exposure

is unparalleled since you cannot see through the skin

the placement of filler is dependent on how the different levels of tissue feel

I often see patients who are dissatisfied with filler placement

around the eyes consistently the practitioner who performed this

procedure is not someone who is a surgeon who operates in the eye area the

eye area is a very small and very delicate area a surgeon like myself who

specializes in eyelid surgery and performs filler placement in this area

routinely is less likely to have issues no doctor is above having complications

or dissatisfied patients but I would argue that higher level of expertise and

experience is always to a person's advantage I've also observed that the

scope of a doctors specialty very often biases the doctors recommendations for

example in the case of under eye bags slight eye bags can be blended and

camouflaged effectively with filler however if I bags are too prominent then

filler can actually make the eye bags look worse in such cases I would

recommend to the patient to have surgery instead of filler even if the patient

states that they are not interested in surgery I'd rather not treat the person

than treat them incorrectly I've seen many non surgeons use fillers

resulting in a way to make the under eye bags look significantly worse I see

patients in this type of situation and dissolve the fillers to reveal the true

underlying Anatomy filler placement under the eyes is often associated with

bruising because of the eyelid area being very vascular as a cosmetic eyelid

surgery I apply my knowledge and experience to place fillers with minimal

trauma using blunt cannula this approach results in less recovery

time and more immediate results the same principle applies to treating hollowness

in the upper eyelids as an oculofacial plastic surgeon I place fillers in a way

which creates a natural and stable appearance with avoidance of common

problems such as the filler getting lost in the eye socket a frequently requested

facial filler treatment is to restore volume or to enhance the cheeks most

doctors place filler in the soft tissue space which is just below the skin

placing cheek filler in this area may look good at first but the filler will

shift making this added volume in your face look soft and doughy instead of

being defined the skin can't hold too much filler material before it weighs

down the cheeks contributing to a rounded or pillowy unnatural appearance

as a facial cosmetic surgeon who performs procedures like facelifts and

facial implants I know the anatomy of the face in the cheeks this knowledge

and experience has aided my ability to place filler at a deeper level of the

face between the bone structure and the overlying muscle this is called

structural volumizing placing filler at this structural level gives a more

defined natural-looking contour to create a more youthful appearance

nothing inspires more concern about an unnatural look than the subject of lip

fillers I have this discussion every day with patients who are considering lip

enhancement it always begins with the phrase I don't want duck lips or I don't

want lips like place the celebrity name there although this discussion is

light-hearted complications from lip filler placement can be quite serious

lip injections have resulted in vascular compromise and resultant tissue loss as

a surgeon before the introduction of modern hyaluronic acid fillers I book

augmented the lips with fat that's mass tissue during the facelift surgery and

alloderm the principles applied to these procedures are also applied when I place

filler for volume enhancement with blunt cannulas lip enhancement involves

several areas which can be enhanced to create natural and attractive looking

lips the ease of finding a practitioner for cosmetic filler placement makes it

seem like an easy non-surgical procedure without risk filler placement is not to

be taken lightly and it should be seen as invasive as surgery proper analysis

planning adherence to standards for sterility and preparation for

complications are critically important this means the practitioner you choose

should be held to the same high standard you would apply if you were to undergo

surgery I hope you found this information helpful thank you for your

question

you

For more infomation >> How to Choose the Right Doctor for Cosmetic Filler Treatment - Duration: 10:59.

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Behavioral Activation: Treatment of Adolescent Depression - Duration: 6:46.

>> KATHRYN DELONGA: Hi, my name is Dr. Kathryn DeLonga.

I am a licensed clinical psychologist and director of the psychological treatment program

with the Mood Brain and Development Unit.

Our lab is located within the Emotion and Development Branch of the National Institute

of Mental Health at the National Institutes of Health in Bethesda, Maryland.

I have nothing to disclose.

All the opinions I am presenting are my own.

And all this work is supported by the National Institute of Mental Health Intramural Research

Program.

This is a picture of the NIH Clinical Center here at our Bethesda location.

The Mood, Brain and Development Unit is led by psychiatrist Dr. Argyris Stringaris.

And we have a research and clinical team and together we work to improve understanding

and treatment of adolescent depression.

In this short webinar, I'll be talking a little bit about psychological, or "talk therapy"

treatment for clinical depression in adolescents - specifically, I'll be sharing information

about a type of talk therapy called Behavioral Activation, that we offer in our outpatient

clinic to teenagers enrolled in our studies.

Depression is an illness of brain circuitry and chemistry that causes and is caused by

changes in mood, thinking, motivation and behavior.

When you review the scientific research on most effective treatments for depression in

adolescents, what comes up again and again is that the behaviors we engage in make a

difference and can help us feel better or can lead to feeling worse.

Take, for example, Sally, a hypothetical 15-year-old girl who had a fight with a friend.

She's failing in school while her parents are separating.

These are some of the stressful events and the daily hassles that she's been dealing

with.

She gets into this negative mood spiral because she feels sad, worthless, overwhelmed and

angry.

She copes with these big feelings in a pretty natural way.

She skips classes because she is overwhelmed by school and she avoids her friends so not

to be as anxious.

She starts spending a lot of time alone in her room listening to sad music.

So the ways that she is coping actually has some negative consequences as well.

So her friends stop calling, she gets further behind in school, her parents are upset and

get on her case.

So these negative consequences led back to some of these stressful daily hassles.

She feels lousy and it starts this negative mood spiral.

Behavioral Activation is a type of talk therapy that helps teens get unstuck from negative

mood spirals.

With your clinician you work to reverse the negative spiral by noticing the connection

between what you do and how you feel, and gradually adding more small and enjoyable

actions back into your life.

Behavioral Activation is an evidence-based treatment that helps teens engage in mood-and

confidence-boosting activities.

With the goal of decreasing avoidance, bolstering peer connection, and improving engagement

in rewarding activities and incorporates parent involvement so parents gain tools for supporting

their adolescent.

So instead of the negative spiral when feeling depressed and following unhelpful actions

- avoiding, withdrawing and then having those negative consequences and things get worse.

Through behavioral activation you could work with your counselor to start looking at helpful

actions that could help boost your mood.

For Sally, at the start of her treatment her goal was to get out of her pajamas and to

shower every morning.

She noticed that she actually felt a little bit better, more like herself, just by taking

that step.

Then, with her parents support she reached out to her counselor to get excused from some

of the homework she had missed and to get extra support catching up in subjects where

she had fallen behind.

She started spending more time outside her room and reduced the number of hours she spent

on her phone and signed up for a rec basketball league through which she ended up making some

new friends.

Through the treatment her parents also worked with her therapist to learn new ways to encourage,

praise and support Sally for her efforts and progress.

Overall, Sally learned that through taking small, incremental steps, she could do things

that would lead to feeling better, more resilient, more like herself, and that she again felt

hopeful about the future.

So in Behavioral Activation instead of mood directed behavior where you might feel bad

and you don't do anything much because you feel so lousy and then you feel even worse,

we focus on goal directed action.

We focus on goal directed behavior.

Even though you might be feeling bad you will do something fun and you do something because

you set the goal to do it.

For Sally, she got up and showered because she had set that goal even though she didn't

feel like showering.

Then she noticed she felt a little better after that.

So the heart of Behavioral Activation is that action can help you feel more motivated.

So rather than waiting to feel better, do things that align with your values that will

lead to feeling better.

Parents receive coaching and what's helpful to know is that depression makes teens irritable,

angry, oppositional.

As the depression is treated, and with the right kind of support, your child will again

feel interest, joy, motivation and connection.

You can learn skills and ways to support your child to prevent future bouts of depression.

So next steps could be to seek professional assessment for your child and encourage adherence,

work with your child�s treatment team to learn new skills, seek emotional support or

treatment yourself, remove guns from the home and keep medicines or other lethal means in

a safe manner, set appropriate limits on social media, on electronics, on sleep, support sleep

hygiene, and to stay positive and supportive.

Here are 8 things to do to support your teen in general but in particular for those with

depression.

Listen, show your concern and that you are trying to understand your child's perspective,

acknowledge all positive or healthy choices you see, praise steps in the right direction,

express confidence in your teen, model healthy problem-solving, facilitate/support your child's

engagement with healthy activities and a positive peer community, and allow your teen to have

autonomy and independence, while also monitoring and setting appropriate limits.

For more information on talk therapy, what to consider when looking for a therapist,

online resources, federal resources, and a listing of professional organizations with

clinician directories, please visit: https://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml

And for more information about The Mood, Brain and Development Unit's teen depression study,

please feel free to call 301-827-1350.

Find us on the website.

And if you have a child or teen who may be depressed and may be interested in participating

in our study or interested in the inpatient or outpatient treatment program, please get

in touch.

Thank you.

For more infomation >> Behavioral Activation: Treatment of Adolescent Depression - Duration: 6:46.

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Ground Breaking Acne Treatment - Duration: 1:16.

> Okay groundbreaking acne treatment, this is a good one

this is really good acne is the number one reason people go to a dermatologist,

yes and not only in our teenagers but one of the highest populations to get

acne is adult women, so a third of women have severe acne from the ages of 18

until they're 99 1 0, no one talks about this so there's a couple of my most

exciting a trial that we're working on right now is a gold nanoparticle, this is

a treatment in the office and I'm gonna use quotations that cures acne, so you

come for anywhere from one to four treatments of this and it's really neat

these are gold nanoparticles, so tonight a nanoparticle is a teeny tiny particle

you rub it on the skin, activate it with a laser, and it destroys the oil glands

and you can see that clinical photo, it's about 75% improvement, actually he had

87% improvement with just three treatments in the office boom, you don't

have to deal with pills antibiotics co-payments senior dermatologists 100

times, voila and we are starting a study for this in September we've

already done two trials for this company, very exciting, nanoparticles,

it's cool.

For more infomation >> Ground Breaking Acne Treatment - Duration: 1:16.

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Ashanti Billie's accused kidnapper responding to treatment - Duration: 0:59.

For more infomation >> Ashanti Billie's accused kidnapper responding to treatment - Duration: 0:59.

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Hermione Halman Osteopath Explains Dance Injuries and Achilles Tendonitis treatment - Duration: 1:55.

Today we are going to be talking about dance related injuries

I've grown up with dancing, particularly ballet.

Common injuries we see in clinic are ankle, knee, hip and lower back.

Today we are going to focus on achilles tendonitis.

So generally what we would expect to see is pain at the back of the ankle usually made

worse with walking or dancing itself.

If you are part of a ballet class then you might feel this more when going up in to demi-pointe.

So in clinic, we look at the ankle and foot to make sure there are no restrictions.

We will focus on the calf muscles themselves and reduce any tension.

We will also look at the knee and hip to ensure that bio-mechanics are optimal.

So if you have achilles tendonitis what I would advise is to apply ice to the area to

reduce any inflammation, take great care in warming up the area, before and after classes

and also do this at home if you are practicing a move.

Ensure that your calf muscles are stretched and warm.

Yes absolutely.

If you are suffering from any injury, dance related or general please come and see us.

You can book in online via www.hampsteadosteopathy.com or call our reception.

All our links are below.

For more infomation >> Hermione Halman Osteopath Explains Dance Injuries and Achilles Tendonitis treatment - Duration: 1:55.

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Laser Skin Treatment's Benefits - Duration: 1:49.

> Can you explain to our viewers what cutting-edge technology you're using

because, everybody's coming to you for these burns you know if we could go back

to Kim's back, you know they're coming to dr. Weibull because you're using these

lasers that I don't think many people have.> Right well one of the the blessings

of lasers, lasers came to medicine in 1980 to treat poor wine stains of

birthmarks on children, and the particular laser I'm holding here is

called the fractional ablative laser, and that laser was brought to market to

treat wrinkles and we have helped innovate we were the first to treat a

burn patient in the world with these lasers so we have a lot of experience in

artwork it's really what it boils down to,

but these lasers vaporize the scar tissue into tiny little holes so it's

like boiling water on the stove with the tea, it starts as water and it turns into

steam, we steam off the scar and it rebuilds to almost normal skin, and

there's really no wall if you know most of our patients will get between two and

four treatments, but we treated patients 7 to 10 times ,we can make skin almost

look normal, yeah but it's not just how it looks

again with Kim, she didn't care about how it look, she wanted to feel better we

have patients that just want to move open their mouth wider so they can brush

their teeth, page people that if this part of your hand gets stuck I have a

you know a chef and other people that they have to move their hands, so it's

about function, it's about quality of life, pain and itching is another big one

the laser root is like a magic wand I call it, it sort of normalizes that scar

tissue back to almost normal skin, and I think most scar patients don't know

about it, I think a lot of physicians don't know about it because it's new,

and it doesn't just work on burn scars it works on acne scars, surgical

scars, any type of traumatic scar.