Barbed Sutures: Again, Prove Disappointing

The history of barbed sutures (threadlifts, PDO threads) has been disappointing. The newest generation has promised increased safety and longer duration. Unfortunately, a recent study in the Aesthetic Surgery Journal shows otherwise.

The study followed 160 patients who underwent facelifts with barbed PDO threads. The good news is all patients did see some improvement initially as well as at one month. Unfortunately, by 6 months the benefits had markedly declined. No patients had any improvement by one year.

In addition, the threads had a high rate of complications, with over 34 % experiencing at least one serious side effect. Superficial displacement of the threads occurred in 11.2% and infection in 6.2%. Other significant side effects included prolonged erythema (9%) and skin dimpling (6%).

Threads were not a marked savings compared to surgery. Most patients spent around 40% what a facelift would cost. This for a procedure with results that last less than a year compared to 10 plus years on average for a facelift.

We at Hamilton Facial Plastic Surgery have seen some serious side effects including prolonged infection from threads placed elsewhere. Dr. Hamilton recommends patients considering placement of threads understand all the risks and the limited benefits.

Jeuveau: The New Neuromodulator on the Block

Jeuveau is the newest neuromodulator(neurotoxin) to go along with the other products that we have had for some time, Botox cosmetic, Dysport and Xeomin. While there are a few studies out there on Jeuveau and it is FDA approved, we are still just beginning to figure this product out and what it can do.

Jeuveau like the other neuromodulators works to relax muscles temporarily and results in softening of wrinkles and creases. We are using it for the many of the same areas we have been using Botox Cosmetic, such as frown lines, forehead lines and crow’s feet, although technically it’s only FDA indication at this point is the glabella (frown lines). It is injected in the same fashion as the other products in the office with little discomfort or downtime- patients can do this on their lunch break.

We have now been using this product for about 6 weeks and the results so far have been similar to what we have seen with other neuromodulators. There may be a quicker onset of action and a few of our patients have reported this as well. We have had, however a few nonresponders- patients who had done well with Botox Cosmetic in the past and did not see any improvement with Jeuveau.  Otherwise to date we find this product to be very similar to the others that we have been using.

The big question is how long does Jeuveau last?? There are a few studies that suggest this product may have a comparable duration to Botox Cosmetic, but they were limited and not of the same size or duration as previous studies for injectable neuromodulators. In addition, as with all new products, regardless of the studies, we really do not know until we try it ourselves. Lastly, all patients have different responses to medications, and we expect the same to hold true for Jeuveau; some may find this a better product, others may find better results with the product they are using.

The real advantage to date that Jeuveau may have is pricing. Based on what we are seeing so far, we do expect this to be a less expensive product than Dysport or Botox Cosmetic. At present, it appears this product will cost our practice 10-20% less than the others to purchase.

So is Jeuveau right for you? I think it is too early to tell. If you are having great results with Botox Cosmetic, Dysport or Xeomin, then I am not sure yet there is a great reason to switch. For those looking for a bargain and willing to try something new, however, Jeuveau might be a good option. 

Look for more updates as we get more experience with Jeuveau.

HydraFacial®, It’s More Than Just a Facial

“Just don’t call it a facial!” Those words in bold print were the first thing I read when I first picked up the Hydrafacial® pamphlet. After experiencing the Hydrafacial® myself, I can tell you first hand that it is not just a facial. It is so much more!

A few years ago, while living in California, some of my girlfriends started talking about this new thing called the Hydrafacia®l. They all raved about how it made their skin glow and how it was the new “go-to” treatment for Hollywood’s A-List. Frankly, it all sounded too good to be true, but I was dying to try it for myself!

Thanks to Dr. Hamilton, I finally got to see what all the hype was about! When I walked in to the treatment room, the first thing that impressed me was how high-tech the Hydrafacial® machine looked. It’s definitely a step up from steam and cucumber slices.

My esthetician, Michelle, explained to me how Hydrafacial® works. By using vacuum technology to remove impurities , it also infuses the skin with different solutions to exfoliate, hydrate, cleanse and brighten. The suction is similar in feeling to that of microdermabrasion and is not at all uncomfortable.

There are four basic steps during a Hydrafacial®:


Hydrafacial® uses ACTIV4. Their proprietary blend of lactic acid, glucosamine HCI and antioxidant rich algae leaves the skin super soft.


Two different vacuum tips are used for this. At the same time, a combination of Salicylic and Glycolic acid is administered. Different strengths are available for this step (7.5%-30%).


Say bye-bye to blackheads! Another suction tip is used during this step to remove any unwanted visitors from your pores. Soothing and calming extracts are then used to soothe the skin and minimize inflammation.


Now that your skin is clean and clear, the peptides and antioxidant infusions can do their job leaving your skin hydrated, plumped and glowing.

More Options for Hydrafacial®:

During my Hyrdrafacial®, I learned that each treatment can be customized for each individual skin type or concern. Hydrafacial®’s super serums can be added to give your skin that extra boost it needs.


This minimizes the appearance of discoloration and brightens the skin to give you a gorgeous glow!


This minimizes the appearance of fine lines and wrinkles and revitalizes the skin.


This minimizes any signs of aging using peptides to bring life back to dull skin.


This minimizes the appearance of dark spots and sun damage. It also helps to even out skin tone creating healthy glowing skin.


This soothes the skin and stimulates cell turnover.


This kills bacteria that could be causing acne.

During my Hyrdafacial® we opted for the Britenol Boost & finished off with some time under the blue LED light!

I fully expected my skin to feel great and look nice when I was finished, but I had no idea that I would see a notable difference in my skin tone after just one session! I noticed my dark spots were significantly less dramatic and my skin was seriously glowing-even a week later!

If you want to get your glow on I strongly recommend giving Hyrdafacial® a try!

Hamilton Facial Plastic Surgery
317-210-4339 Greenwood
317-614-0639 Indianapolis

Indianapolis Facial Plastic Surgery and MedSpa

What’s In A Nose? Indianapolis Plastic Surgeon Discusses the Rhinoplasty Craze

It’s that time of year again when women everywhere start discussing how they are working on their summer bodies. Thoughts of bikinis, shorts, pool parties, and beach vacations might lead you to think that breast augmentations and liposuction would be the most popular plastic surgeries this time of year, but that’s actually not the case. It might surprise you to know that during the summer months it is rhinoplasty that takes the lead as the most popular surgery.

Why is Rhinoplasty a Popular Summer Procedure?

There are a number of reasons why people choose to schedule a rhinoplasty during the summer. For one, many patients undergoing this procedure are in their late teens or early twenties so having summer break from school allows for ample healing time. Contact sports and rowdy summer fun can also lead to a broken nose.

If you have ever considered rhinoplasty you are not alone. It is the most common facial plastic surgery procedure. In fact, the American Society of Plastic Surgeons says that more than 220,000 nose jobs are performed every year.

What is Rhinoplasty?

Rhinoplasty, or nose surgery, is performed for a number of different reasons. These reasons include repairing nasal trauma, correcting difficult breathing or changing the aesthic to achieve a better look. Nasual trauma could be the result of a sports injury, broken nose or other injuries. Insurance may be able to help offset the cost in this situation.

A functional rhinoplasty may be performed to change the way you breathe. During a cosmetic or reconstructive rhinoplasty, it may be possible to correct structural issues at the same time making it much easier for the patient to breathe. A cosmetic rhinoplasty can be performed to reduce a nasal hump, refine the size or shape of the nasal tip or to give a more flattering symmetrical look to the face.

What is a Consultation for Rhinoplasty Like?

Because the nose is literally the center of one’s face, it makes sense that thinking about changing the shape or size can be a little unnerving. It is for this very reason that Dr. Hamilton uses video imaging to help show his rhinoplasty patients what results they may expect to achieve after their surgery. This is an important step in the consultation to ensure that both the patient and doctor are on the same page in regards to goals and expectations.

What is the Recovery from a Rhinoplasty?

Patients undergoing rhinoplasty should expect to take a week off from work or school to allow for the initial swelling and bruising to subside. After the outpatient surgery is complete, patients will wear a splint on their nose for the first week. Many patients are able to manage the pain with over-the-counter medication and cold compress, but the doctor may provide pain medication to use if needed.

Dr. Hamilton asks that his patients refrain from strenuous activities for the first two weeks and contact sports which could cause nasal trauma for six weeks. The initial swelling should subside within a few weeks revealing the successful results however, it can take up to a full year to see the complete finished product.

Is Financing Available for Rhinoplasty?

Dr. Hamilton and his staff at Hamilton Facial Plastic Surgery seek to make facial plastic surgery, including Rhinoplasty, affordable for everyone and offer financing options to help in that effort.

Mark M. Hamilton, MD, FACS, is recognized as one of the “top physicians” in America for facial plastic and reconstructive surgery. As a double board-certified plastic surgeon, specializing solely in cosmetic facial procedures, Dr. Hamilton provides his Indianapolis patients with exceptional skills and results that last. For more information on rhinoplasty or to schedule a private consultation at Dr. Hamilton’s Carmel or Greenwood office, please contact us.

Click here to view Dr. Hamilton’s Rhinoplasty before and after photos.

Is Natural Lip Augmentation Possible in Indianapolis, IN?

When patients come in for a consultation for facial rejuvenation, one of their top concerns is that they want the results to look natural. This is especially important with the lips. Many patients have seen stars or media personalities who have taken their lip injections to the extreme, and this is what most patients think about when they consider a lip enhancement.

The reality at Hamilton Facial Plastic Surgery, however, is vastly different from what people see in Hollywood. Most of Dr. Hamilton’s patients want a very subtle enhancement that looks natural. Creating an aesthetically pleasing, slightly fuller lip is possible for most of Dr. Hamilton’s patients. For a small percentage, the lip structure does limit what can be achieved. But for the majority of patients, the choice of how they want their lips to look is an extremely personal decision.

During a consultation, Dr. Hamilton will discuss a patient’s goals and his or her lip anatomy with them. Injections are typically done with a hyaluronic acid filler (such as Juvederm®or Restylane®) that is naturally found in the body and is very well tolerated. If a patient is concerned about a filler being overdone, it is possible to under treat the lips and then re-examine the results in a few weeks. For patients who desire a fuller, more dramatic lip augmentation, it is possible to achieve such a result.

The best part of lip augmentation is that the fillers are reversible. If a patient is unsatisfied with his or her results, Dr. Hamilton can inject a small amount of reversal agent to undo the fillers.

If you are considering lip injections, but are concerned about them looking natural, consult with Dr. Hamilton or one of our experienced nurse injectors to explore your options for natural lip augmentation.