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

By Dr. Hervé Raspaldo, article published in the ”Anti-Âge magazine” #1

The signs of aging will show up as dynamic wrinkles and linesin the upper face, and as volume loss changes in the middle and lower partof the face. Fillers (such as hyaluronic acid) and botulinum toxin have led to the development of minimally invasive procedures and a three-dimensional approach to facial rejuvenation: it’s a faster, less painful and less expensive alternative to the face lift; this approach can also be a perfect complement tosurgery,if the later is needed. Today the aesthetic face care is global and no longer focuses on removing wrinkles alone. The global purposeis to reshape the volumes and recreate a well balancedface, according tothe following criteria: soft and round face contours, convex cheekbones and well-drawn mandibular contour.

Using innovative products, we cangive the face its ideal shape, a heart-shaped contour, with the heart base inthe upper face area, while the tip points downwards (this shape is usually reversed with age).

As a facial esthetics specialist, Ihave developedaprocedurecalled Faceculpture®, based on a natural approach to facial rejuvenation and acting on 3 levels,the face dynamics (expression lines, mimicry), the heart-shaped volumes (HeArt of face®), and the skin texture: the botulinum toxin injections are meantto erase hyperdynamic wrinkles, restore harmonious volumes and fill wrinkles and lines, but also to hydrate the tissues.

 There are 2 types of injectables:

The Botulinum toxin

It relaxes the muscles, restores the esthetic balance of the face and stops the progression of the expression lines. For the upper face area, it is injected into the hyperdynamic muscles (which are responsible for the horizontal wrinkles on the forehead), the glabella, the nose, the crow’s feet (at the outer corner of the eyes), and the lower eyelid. It can also help repositioning the saggingeyebrows and improve their shape. As for the lower part of the face, botulinum toxin helps repositioning the tip of the nose, or treating dilated nostrils, fine lines, mouth lines, a gummy or an asymmetric smile,other asymmetries of the face, prominent masseters, the orangepeel aspect on the chin or the dewlap.

Dermal fillers

They restore volumes. There are several types of derma fillers: some of them are temporarily effective andresorbable, like the hyaluronic acid, the collagen, the calcium hydroxyapatite and the polylactic acid. Others are non resorbable and permanent, like the polymethacrylate, and the silicone.

The hyaluronic acid(HA) is currently the most frequentlyused filler, because it has a highfilling quality,natural resorption and it’s perfectly safe. Injections compensate for the age-related volume loss. There are different ranges of hyaluronic acids with different viscosity levels, adapted to different treatment areas and they can be used simultaneously for one patient:

 – The low viscosity products are particularly adapted to the so-called ”topping” technique, usedfor the treatment of fine lines,dark circles or hollow eyes.

– The medium viscosity products can reduceface wrinkles (perioral wrinkles, lip contour, nasolabial folds, mouth lines, forehead wrinkles).

– The high-viscosity products restore volumes in the cheekbones, cheeks, temples, nose and chin.

The Botulinum toxin and the different hyaluronic acids each have a specific and complementary effect. Therefore, they are often used together, which leads to better results than those obtained with each product separately. This is especially true for cheekbones, the glabella or the corners of the mouth. The results last longer, the HA is resorbed slower due to aprior injection of botulinum toxin, and the facial natural expression is preserved, because the procedure uses lower doses of toxin, supplemented by HA in residual wrinkles.

This global therapeutical approach also takes into consideration the epidermis (superficial peel, mesotherapy) and the dermis (pulsed light and photodynamic therapy, radiotherapy or radiofrequency, carboxytherapy).

It is recommended to start with botulinum toxin injections, in orderto relax the muscles and restore their natural balance. The face looks more openand relaxed. The cross-linked hyaluronic acid restores the three dimensional facial volumes (heart-shaped, HeArt of face®) and provides a more harmonious face contour. Amonth later, the hyaluronic acid injectionswillhelp filling the residual lines.

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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”.

At a congress in Paris, we deliver injections of hyaluronic acid Juvederm into the temples of a patient to fill the hollow and give a younger look to the face. At the same time, we also injections above the eyebrow to bring back the tip.

Following the drawings before injections of the previous video, we show here that it is possible to practice local anesthesia before injecting botulinum toxin and hyaluronic acid into the cannula. We use a cannula and not a needle, in order to offer total comfort to the patient.

We can see in this video how we give volume to the cheekbones through injections of hyaluronic acid.

As we consider the neck rejuvenation, we should not neglect treating the cleavage, which is its natural extension and just as important. We can combine several techniques for the neck and décolleté rejuvenation, but whatever the technique, the purpose is to provide a natural looking result.

The unwanted chest wrinkles on the cleavage can be treated using the Mesolift technique, which is very effective for treating fine lines and wrinkles but also sagging skin on the face and neck.

This procedure uses very thin mesotherapy needles to inject a nourishing and revitalizing mixture of hyaluronic acid, vitamins, trace elements and minerals. It is a very appropriate rejuvenating care for dry and dull skin, that was affected by sunburn, aging, cold or tobacco.

You can see the results immediately, as the skins gains a more radiant look, but a series of 6 sessions every 2 weeks are required in order to really improve the skin’s tone and vitality.

I want a natural-looking nose

Article from ”L’officiel chirurgie esthétique”

Respect the harmony, the unique personality of a face and the natural anatomy, commit to embellishingthe nose withless invasive products and techniques, this isDr. Raspaldo’snew concept of rhinoplasty. By Paule Cornille.

1.WHO IS THIS FOR?
For women who prefer anatural-looking nose, as well assimple and soft techniques that take physiology into consideration.

 2. BEFORE THE PROCEDURE
Just as any other rhinoplasty, this procedure requires two consultations, as well as a complete blood test. Then, you will have to wait for at least 15 days, a mandatory waiting period because you might want to think your decision over. After a complete analysis of the nose and the tissues, the surgeon takes photos with front views, profile and three-quarter views. He will then use the morphing technique to simulate the different reshaping possibilities, that you will be able toseeon a screen.

3. THE SURGERYPROTOCOL
The procedure is performed under general anesthesia only if the nasal septumis concerned, otherwise a neuroleptenalgesia will be enough. “It is almost always an outpatient procedure,” says Dr. Herve Raspaldo. To reshape the nose, mask hollow areas or deformities, heuses cartilage harvested from the patient herself (himself) rather than synthetic products (silicone, goretex, coral) – he will not inject synthetic products either. Instead of using the classic occlusive splints made out of plaster, he prefers thermoformable models, whichare well ventilated, more solid and easier to reshape. And to keep them in place, he chose a biocompatible surgical varnish rather than using plasters,which are often allergenic. Also, when it comes to fixing the cartilage or the mucous membrane in the nose, heuses a biological glue, preventing any inflammatory reaction.

4. POST–OPERATIVECARE
The recovery time is shorter than with conventional rhinoplasty. In 80% of cases, edema and bruising disappear after eight days. Their resorption can be accelerated by cryotherapy sessions – a gas at 70° C is sprayed all over the face for a few days. The splints are removed after six days. The old nasal packings that cause so much discomfort are now replaced by painless,resorbable pads. They prevent bleeding, but allow patients to breathe almost normally and can be removed after 12 to 24 hours. Thanks to the less invasive instruments and technique, this rhinoplasty is almost painless.

5. AFTER THE PROCEDURE
The patient will be advised to sleep on the side or on the back for a while and torefrain from sports or any physical activity for at least a week.

6. SCARS
They will be invisible,because all sutures – made with absorbable threads – are located inside the nose.

 7. RESULTS
The final result is usually visible after one week, but it continues to refine for several months.

8. RISKS
They are kept to a minimum: the cartilage, muscles and mucous membranes will be protected and respected.In addition, thanks to the prior morphing, there is no risk of having a dramatical change in your face or not having the expected result. However, small imperfections can appear, but they can be corrected after 3months to one year.

DOCTOR HERVÉ RASPALDO’S OPINION
“I have been practicing aesthetic rhinoplasty since 1986 and my long experience allowed me to develop this”new way of conceiving the nose”. The “Rhino-bio” is inspired by the general organic trend, starting with bio-ethics. This approach involves guiding the patient towards the nose shape that will best suit him or her, refusing a surgery that is considered unsuited, providing the best analyzeand understanding by usinga morphing software that shows the expected results. It also involvestaking biodiversity into account – reshaping different noses adapted to the patient’s personality but also his or her racial origins.

This is also about biotechnology and biocompatibility: we only use natural materials that are not likely to be traumatic or harmful in ashort or long term. Rather than introducing foreign components, westrive to keep as much original cartilage as possible,by refining orreshaping it as needed. In a word, it’s an innovative process, totally adapted to the latest evolutions in our society.”