Episode 34 - Dr. Andrew Jacono: Lip Expert

Transcript

Announcer:  This Program is brought to you by Personallifemedia.com.

Teri:  I’m Teri Struck, host of “Beauty Now.”  A weekly show on lashes, lasers, lifts and guess what; today we haven’t done a show yet on lips.  We have a lips expert, Dr. Andrew Jacono.

Music

Dr. Jacono:  Unfortunately there has been a long history of trying to insert lip implants into the lips and those are things that are made of plastic and over time they tend to push through the lips and you can see the implant in the lips.  Now they’ve come out with other lip implants that are basically like, almost like a breast augmentation shell.  And you can put it in the lips and you can blow it up with saline.  Unfortunately, these kinds of hard structures, no matter how you try to make them and engineer them, over time the lips will and the body tissues will contract around them, causing lots of irregularities, and causing difficulty with normal function and motion.  I’m always leery about these kinds of implant because it just doesn’t work in a mobile area. 
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And I don’t do breast augmentation, I specialize in facial surgery, but what happened was, is there were some patients who had silicone leakage or ruptures from their breast implants and then what happened was it was assumed that caused all these bad diseases and problems.  They did a lot of study and research and they found that that really wasn’t the case.  And, that’s different then having just a little bit of silicone put in your lips ‘cause it doesn’t go anywhere.  It stays where you put it.  It’s different when you have, you know a liter of silicone in a breast implant and it ruptures inside your body. 
*  *  *
There are so many great treatments that are available now ‘cause there’s been an explosion in laser therapy.  Obviously you can always do something extremely quick and easy which is with fillers.  Fillers are fabulous to fill in those little lines around the lips.  So you don’t necessarily need to go to a more aggressive laser treatment.  You could do something like when you’re getting your fold done or your lips done you can ask a doctor to put a little bit of the filler into those lines.  It doesn’t take very much, ‘cause those lines tend to be very fine or very hairline like.  But in terms of lasers, there’s been a revolution and quite honestly the lasers that are available to us today are so much safer and have such minimal downtime compared to what’s been used in the past.

Music

Teri:  Welcome Dr. Jacono.

Dr: Jacono:  Thanks for having me.

Teri:  Now you’re based Manhattan and you’re a facial plastic surgeon, correct?

Dr: Jacono:  Yes

Teri:  Great, let’s get started.  I heard that you’re doing something called “The French Lips?”  What’s that?

Dr. Jacono:  Yeah, well, “French Lips” is a new concept of how we do injectable lip augmentation.  And I know that everybody’s heard of collagen injections in the lips.  And over the years everybody has this vision of lip augmentation as very unnatural, stuffed almost like lips that look like a sausage stuffed with meat. 

Teri:  Right, that’s the worst look ever.

Dr. Jacono:  Yeah, it’s like the “trout pout,” it’s like, you know, Goldie Hawn in “The First Wives Club.” (Laughs)

Teri:  Yes!  Exactly, and that’s when everyone goes “Oh my God, who did she go to, we don’t want to go to that person.”  (Laughs)

Dr. Jacono:  Yeah, it’s amazing, because it permeates everybody from Park Avenue all the way to Beverly Hills and we see celebrities all the time with these very unnatural overly stuffed lips that it doesn’t look good, and then it looks quite irregular.  And that’s because of antiquated techniques.

Teri:  And they get, end up in the cover of “The Enquirer.”  “Who’s Had Plastic Surgery?”  And you know that have.

Dr. Jacono:  Or “US” weekly, or “Life” and “Style” weekly or you know, whatever, you know whatever weekly magazine that covers a celebrity’s appearances.  But what the reality is, is that there’s a way to be able to avoid those issues by, by looking at the lips differently.  And that’s what “French Lips” is all about.  It’s really about an injection technique which customizes what you’re trying to accomplish as opposed to just stuffing the lips full of something.  So what I basically did was I looked at the lips and I, and this all kind of came out of the way that I do lip injections.  And I broke them down into 15 different anatomic segments or zones that I inject individually with different types of fillers. Which creates a lip that’s natural, more volumized and more pouty, but without looking irregular, just naturally sexy. 

Teri:  What are your favorite fillers to do this procedure?

Dr: Jacono:   Oh, well there’s just so many.  Quite honestly, most of the fillers are pretty good with this.  It’s just a matter of how long you want it to last.  When I have my druthers I think about, and this is in terms of bang for your buck, the best one out there is Juvederm and the reason why that is is because it lasts long and it’s not as expensive as the more long term or permanent fillers.  And it’s very smooth, not as bumpy; it’s just a pleasure to work with.  So, for most of my patients if they don’t have a desire, a specific desire I tend to gravitate to Juvederm. 

Teri:  So, how long does Juvederm last?

Dr. Jacono:  It’s interesting because all the fillers are different, but there are a lot of fillers of that category, they’re called Hyaluronic Acid.  It’s basically sugar.  And there are different companies that make the same kind of sugar, but they formulate it differently.  So, on average, Juvederm, in my impression, lasts about six to seven months.  Where as other fillers, like Restylane, which is sort of the one that started the whole sugar injection, is more like three to four months.  So, if you get half a year that would mean you would have to come in twice a year to be able to maintain this kind of a look with your lips. 

Teri:  So what is the type of filler that you could use that could last longer for people, more bang for your buck, but, or less bang for your buck obviously, so that you would actually have to come in once a year.  Is there anything that you could do for that?  Or is that not really feasible since you get lumpy?

Dr. Jacono:  Yeah, well that’s the problem, is that a lot of the other fillers that are available do tend to get a little more lumpier, lumpy because they’re more durable or hard.  So the long, the ones that last the longest tend to be a little bit thicker and a little more granular.  So there’s a filler called Radiance, it tends to last about a year, but the drawback to using that is, is that you tend to see and feel more bumpy irregularities with the lip when you use that.  Other then that there are actually some permanent fillers like silicone injections.  And people are very skittish about it, not doctors, but patients because they think of silicone as having, you know, all the media and all the bad press that came out with silicone breast augmentation.  People are a little bit leery about getting silicone injected into their face, but for the lips it’s actually a wonderful treatment. 

Teri:  But didn’t with the silicone, didn’t that like drip and stuff like that?  Didn’t they have horrendous…

Dr. Jacono:  Yeah, but that was the thing, it’s kind of interesting.  What happened with breast augmentation, and I don’t do breast augmentation, I specialize in facial surgery, but what happened was, is there were some patients who had silicone leakage or ruptures from their breast implants and then what happened was it was assumed that caused all these bad diseases and problems.  And what actually happened was they did a lot of study and research and they found that that really wasn’t the case.  And, that’s different then having just a little bit of silicone put in your lips ‘cause it doesn’t go anywhere.  It stays where you put it.  It’s different when you have, you know a liter of silicone in a breast implant and it ruptures inside your body.   So it’s not really a similar equation and there’s definitely no problems with injecting small amounts of silicone into the lips.  Quite honestly, it’s probably, bang for your buck, the best you could do because it’s permanent.  So, if done well, it’s a treatment that you’ll do once and enjoy it for the rest of your life.

Teri:  Is that FDA approved now?

Dr. Jacono:  No it’s not.  Yeah, but there are a lot of treatments that we use as plastic surgeons that are not FDA approved.  For example, before Botox got FDA approval, doctors were using it for decades for wrinkles. 

Teri:  Right

Dr. Jacono:  But it never had an FDA approval.  A lot of the fillers that we use in the lips don’t have FDA approval for use in the lips.  Like, for example, Juvederm.  Juvederm only has an FDA indication to be injected into the grooves called the nasal labial folds between the corners of the nose and the mouth.  But, that doesn’t mean that the doctors don’t inject it into the lips every day.  So, it really has to do with the physician who looks at the history of plastic surgery and has been using the product for many, many years and having good success with it.  And silicone is something like that and it’s not that most people do it, but it is and option. 

Teri and Dr. Jacono talk over each other for a second.

Teri:  …somebody like you or somebody that is board certified because I did hear of people getting their lips injected in nail salons and that’s a huge No No.

Dr. Jacono: Yes.

Teri:  So that’s probably where some of the problems came from.

Dr. Jacono:  Yeah, and not only that but you know what tends to happen that even if a doctor’s board certified there are a lot of plastic surgeons  who’ll travel and go to beauty salons or department stores to inject these things.  You have to kind of scratch your head and question why a surgeon would leave the productivity of his practice to go to these places.  They probably don’t have much of a practice.  It doesn’t make a lot sense for a surgeon who is successful to go to a department store to try to get patients. 

Teri:  I completely agree I would totally warn our listeners not to go to places like that to get your lips done and it’s usually a disaster.  Even though, there are qualified doctors doing that and I agree with you, there has, something has to be wrong with their practice. 

Dr: Jacono:  Yeah, it doesn’t really make sense.  But what the wonderful thing is now, is that there are things you can inject to dissolve away the fillers if you get a bad job.  So say you go and you get Juvederm injected into your lips or Restylane and it doesn’t turn out well, you can actually inject an enzyme into that area and it’ll eat it up so that it’ll go away.  Which is wonderful, because when we had collagen you had to live with it until the collagen dissolved.  With these fillers we can actually take it away and start over again.  And I do that regularly because there is a lot of finesse to doing lips and there are a lot of irregularities that are created by lots of doctors.

Teri:  Yeah, let’s clarify that.  You do that regularly when you’re correcting work of other people, right?

Dr. Jacono:  Yeah, yeah, well that’s no doubt.  Yeah I don’t have to do it with my own patients:

Teri:  (Laugh)

Dr: Jacono:  But the thing is, people call with an issue and they say “I had my lips augmented, it doesn’t look right, it looks sausage like, it looks, you know, asymmetric.”  You can actually dissolve away the material that some other doctor put in there and then you can start anew and create the look that you want. 

Teri:  Well you brought up a really, really good fact in that, and when we were at the plastic surgery convention the speaker said that lips were probably one of the most complained about procedures of women being unhappy. And so, I think that this show basically, you can get so much information about what you should and should not do for your lips.  Tell us about lip implants.

Dr. Jacono:  Yeah, and this is something you shouldn’t do.  (Laughs)

Teri:  Shouldn’t do, right.

Dr. Jacono:  And I’ll be very clear about this, unfortunately there’s been a long history of trying to insert lip implants into the lips and those are things that are made of plastic.  There was something called Gortex that used to be placed into the lips and routinely patients, you know, when initially put in place, they would be happy, but then when all the swelling went down they were feeling rod like plasticky structures in their lips that made it feel weird when they spoke, kissed or ate.  And over time they tend to push through the lips and you can see the implant in the lips.  People pretty much stopped using that.  Now they’ve come out with other lip implants that are basically like, almost like a breast augmentation shell.  And you can put it in the lips and you can blow it up with saline.  Now, it’s the same essential problem.  Unfortunately, these kinds of hard structures, no matter how you try to make them and engineer them, over time the lips will and the body tissues will contract around them, causing lots of irregularities, and causing difficulty with normal function and motion.  I’m always leery about these kinds of implant because it just doesn’t work in a mobile area.  Your breasts don’t move, you know, they don’t flex, they don’t kiss, they don’t do things.  So, with something like a breast augmentation it’s an acceptable treatment because it works, it’s satisfactory, it doesn’t move, it doesn’t shift if placed properly.  Because your lips are moving all the time, you put an implant in there, it’s going to eventually work its way out and go into a position that feels unnatural.  It’s just the nature of the location.  So what kind of implant, the best thing to do is use your own body tissues, which are soft, supple, natural and become incorporated into the area so that it feels and looks natural.

Teri:  So do you inject fat into the lips?

Dr. Jacono:   Well there’s many different ways to do it. One thing you can do is inject fat.  Unfortunately, fat injections are not as predictable.  What I meant by that is that, you know, 30 or 40 percent of the time when you inject somebody’s lips with fat it’ll be reabsorbed.

Teri:  And it goes away pretty fast, doesn’t it?  It’s pretty disappointing.

Dr. Jacono:  Yeah, it can be.  I mean there are patients I talk to, and I tell them it’s like flipping a coin.  50% of the time your fat will take, 50% of the time it won’t.  You have to be willing to roll the dice and I can’t control that.  It has to do with the way the body incorporates tissue.  There are more reliable or predictable fat implants that are called dermal fat implants and it’s a lot of doctor language.  But basically, what it means is, is that you use a layer of the skin as well as the fat and it’s usually harvested from another part of the body, and it’s spread through the lips.  When you do that, you don’t just liposuction fat and then spray it in.  It actually incorporates, essentially 100%.  So it’s a much better way to do it, because it’s reliable, in the end.  When they, either one of them take, they give great results.  It’s just that you don’t want, in my mind, it makes more sense to do something that’s going to give you a predictable and reliable out come and not put you back in the same position where you started. 

Teri:  Well you are really a lip expert, and we need to take a break for a commercial to thank our sponsors like, Echo wine and we will be right back with Doctor Andrew Jacono to find out more how you can get those Angelina Jolie lips like I want, but I can’t have.  We’ll be right back.

Break

Teri:  Hi, we’re back with Beauty Now and I’m interviewing Dr. Andrew Jacono on lips.  How can you get those big beautiful lips?  Well if you listen to this show, you’re going to find out.  Welcome back Andrew.

Dr. Jacono:  Hi how are you?  I’m back. (Laughs)

Teri:  (Laugh)  Well, ok, I also wanted to talk about, and I’ve done a show on Artefil.  But how do you feel Artefil does with the lips?  Do you use Artefil on the lips?

Dr. Jacono:  Yeah, I don’t like, Artefil, I’m still a little bit hesitant about.  And the reason why is that it’s still relatively new.  In terms of its new formulation and what’s being presented in the US.  It is FDA approved, but the problem is that the FDA studies that were done with the filler were on a very small number of patients.  Literally I think it was less then one hundred patients that they looked at safety and ethicacy.  And when you’re using a permanent filler you really need to look at thousands and thousands and thousands of patients, because even if, you say “well two percent of patients have a reaction to it,” two percent of a thousand is still 20 patients.  And in a busy practice like mine, where I literally inject a thousand of patients a year, I don’t want 20 patients a year having a severe reaction to a material because permanent fillers, once they’re in the only way to correct a problem is to cut it out.

Teri:  And Artefil is a permanent filler.  But,…

Dr. Jacono:  Yeah, it’s a long complicated name it’s called Polymethylmemethacrylate.  And basically it’s just a synthetic plastic…

Teri: Oh

Dr. Jacono:  …that’s suspended in, with, you know, usually with some other biologic filler, so they’re kind of combined.  But what you’re left with are these little microspheres of this polymer.  So the thing is that it can be an effective treatment, I know there are some doctors that are starting to use it regularly.  The reality is, is that I think that in order to be able to use it regularly in my practice I want a little bit more of a track record.  And when it was used in Europe it was a different formulation and there were more problems.  So the question is whether this new formulation that we have is more effective then the one that was used previously in Europe.  And if it is, then that’s wonderful and I will start to use it.  But for right now I think it is something that we should look at with caution and wait a couple years to see how the studies show that people are doing with it. 

Teri:  So, it actually is like a plastic?  I thought, so it’s not a sugar at all?

Dr. Jacono:  No, it’s usually combined.  It depends upon the formulation.  Many times it’s combined with collagen.  And what happens is, is that you know, you get injected with the material, which is plastic and collagen mixed.  The body reabsorbs the collagen but then your body incorporates the plastic and as it incorporates the plastic it ads more collagen around it and then that creates the volume.  The question is, is whether those little plastic spheres that you’re injecting, is that patients have reactions to them.  And the old formulation, there were a lot of what are called “granulomas” or reactions against the plastic.  So…

Teri:  I’ve heard a lot about that with Radiesse.  I’ve heard you’re really not supposed to do Radiesse in the lips.  Do you agree with that?

Dr. Jacono:  Yeah, I don’t like to use it in my practice.  You know, it can be, if you’re very careful with it.  There is a good chance that you could get a satisfactory result.  But unfortunately, because of the nature of the material, it tends to get bumpy and you have to be extremely precise.  The margin for error with that is very, very small. 

Teri:  In the lips, ‘cause I actually love it for the nose to the lips.  So it’s your navial lines?

Dr. Jacono:  Yeah, it’s fabulous, and it lasts so much longer then the other fillers. 

Teri:  It’s amazing, for there.

 

Dr. Jacono:  Yeah, and it’s wonderful for a non surgical face lift, because as we get older, things kind of droop and deflate.  Even when we are in our thirties, people start to get little folds and hollows in certain areas.  And instead of having to do any kind of aggressive surgery, radiesse will last you a year, year and a half.  You volumize those areas, and add that structure back and it can really make you look like you lose 10 years without doing much of anything except for going for a quick 10 minute injection treatment. 

Teri:  And that’s a perfect example, ladies, or men, it’s a little bit more expensive as a filler, but if you use that, it’s gonna last a lot longer and you’re gonna be pretty happy.  But, you have to listen to the doctors and find out where you can and cannot use it.  You know, even good doctors don’t really do their homework and have injected it into lips and it’s been really, I’ve heard really, horror stories about it.

Dr. Jacono:  Yeah and it can be problems with any filler especially when not injected the proper way.  And it’s interesting, I see so many men these days.  It’s not just for ladies. 

Teri:  No, no it’s not just for ladies, I, we do know a lot of men too.

Dr. Jacono:  Yeah, and a lot of, you know, a lot of very successful young people, you know who are stock brokers, financial bankers, you know people who have made a success.  You know they’re embracing these treatments at a very young age, ‘cause we also have to get these little lines and little wrinkles, folds and grooves.  And it’s just part of leading a very, you know, a very healthy successful life to maintain your skin.  And you can do that with just very minimal five minute treatments. 

Teri:  Yeah and you can look so rested with Botox.  I know a lot of men that have Botox.  They love it.

Dr. Jacono:  Yeah, yeah, I do it. (laughs)

Teri:  That’s great, see that’s good to admit it.  The funny thing is my ex-boyfriend, who is a body builder, goes in to my husband and gets injected.  For his face, like they really care.  So you just have to care about your appearance that’s great.

Dr. Jacono:  Yeah, a lot of it’s prophylactic too. That’s one thing that’s really nice about treatments like Botox, is that if you start doing it at a young age, it’ll last, actually decrease how quickly your skin lines. It’ll actually decrease aging; it may even obviate the need for some surgeries as you get older. 

Teri:  I believe that…

Dr. Jacono:  Oh, it’s actually true.  In everything in life if you can do something to be proactive, why would you want to be reactive and have to do something more aggressive at a later time?

Teri:  It’s like the hem of your dress.  Don’t wait until the whole hem falls out; just do a little bit at a time.

Dr. Jacono:  (laughs) 

Teri:  It’s a lot easier for the doctor anyways and a lot easier on you.  You don’t want to have to go get the whole shebang done so just do a little bit at a time.  And that’s also a great way to introduce yourself to some procedures that are, that maintain your beauty.

Dr. Jacono:  Yeah and also, you know, it’s a natural way to maintain beauty.  Often when people wait a little bit too long and they get too much aggressive surgery done at one time, that’s what makes people look irregular and unusual.  Taking a graduated approach if things come your way, always makes you look much more rested and natural.  And at the end of the day, the people that I’ve seen in their 80s and 90s who look the most beautiful and young are people who started in their 40s and slowly and progressively worked up to different treatments.  Like eye lid lifts and they’ve had a couple of face lifts and they didn’t have them when they were tripping over their neck, they had them slowly, every 10 years and they maintained what they already had.  I think that’s the key to success in looking naturally good.  

Teri:  I do too. And I think that that’s really the key to my show.  Is that I really want everybody to be naturally beautiful on the inside and the outside.  So let’s talk about lasers too, around your lips.  What can you do for those lines around your lips that ladies get?  Like, hopefully nobody smokes anymore, but smokers lines and those kinds of lines around your lips.

Dr. Jacono:  Well there are so many great treatments that are available now ‘cause there’s been an explosion in laser therapy.  Obviously you can always do something extremely quick and easy which is with fillers.  Fillers are fabulous to fill in those little lines around the lips.  So you don’t necessarily need to go to a more aggressive laser treatment.  You could do something like when you’re getting your fold done or your lips done, ask the doctor to put a little bit of the filler into those lines.  It doesn’t take very much, ‘cause those lines tend to be very fine or very hairline like.  But in terms of lasers, there’s been a revolution and quite honestly the lasers that are available to us today are so much safer and have such minimal downtime compared to what’s been used in the past.  People sometimes get, like, chemical peels, they get microderm abrasions.  These are ways of resurfacing the skin that although they make the skin feel smoother they don’t really get rid of wrinkles.  So, you just need to keep that in mind.  You can do 30 microderm abrasions, but at the end of the day if you have a pretty deep wrinkle around your lips it’s not going to go.  So it’s a way to save…

Teri:  Yeah.

Dr. Jacono:  So, it’s a way to save money.  Just sometimes they are over sold.  But the two major treatments that are out there right now that I think that people should be aware of are something called, it’s a treatment, laser treatment called Fraxel. 

Teri:  I love Fraxel.  I’m a Fraxel addict.

Dr. Jacono:   Yeah, I know, and so am I, I have to tell you, it’s one of the most amazing things you can do for your skin.  But it’s called fractional laser resurfacing and there are definitely many companies who do it.  Fraxel is the main company who started the whole revolution.  I own a Fraxel machine.

Teri:  Oh, yea. (laughs) so do we.

Dr. Jacono:  Yeah, I know, and there are so many other fractional laser companies but the bottom line is, is that these laser treatments are done, and they have to be repeated three or four times, but the reality is that if you do four treatment you will wind up with the same results as the people who have the bad nasty laser burns that people used to get that took them a month to recover from.  And most people usually get red and puffy for a day or two after Fraxel, but there’s no open wound or sores or skin sloughing off.  Which is fabulous.  So on a Friday you get off of work, you get a Fraxel treatment, you could be, lay low on Saturday.  You could still go out, you know, it just looks like you have a bit of a sun burn. 

Teri:  Yeah, I have friends who can actually go out the next day, but me, I get really swollen…

Dr. Jacono:  Yeah some people do.

Teri:  …for like a day or two.

Dr. Jacono:  You know what I do for patients like that, though?  I give them a diuretic the day of, you take some lasics the day of and the day after and they don’t puff up.

Teri:  Oh yea, ok, good advice, good advise for me.  Thank you.

Dr: Jacono:  Yeah, you know it’s fabulous because I tend to puff up, so when I it I do that.  But, Fraxel is a fabulous thing and there is another laser that’s out there and it’s called a pearl laser.  It’s more aggressive, because it gets done in one treatment, but unlike the old style lasers where it took you that two or three week phase of healing, these new lasers, this pearl lasers are something called a YSGG laser, what it does is it resurfaces the skin at the same time as it cauterizes the skin, so it only takes four to five days to recover from it.  And you still get the same results as one of the old style CO2 lasers.  You know, the problem with these treatments are that they’re very expensive and it’s not because the doctors are trying to charge so much money…

Teri:  Right, right it’s because the machines are expensive.

 

Dr. Jacono:  …it’s because the machinery,  so expensive and you know, it’s understandable.  It’s just like buying the newest and latest of any technology.  The research and development that’s put into it by these companies, in order not only to create it, but to get it FDA approved, unfortunately, is so expensive that they have to charge and exorbitant fee for the machines.  And unfortunately it’s passed on to the patients.  That’s the only way that they can exist. 

Teri:  No it’s true, but I also really think it’s worth it, if you’re somebody like me who loves the sun, and I’m pretty careful with my sunscreen but I actually really do go out there and get tan and have fun and then…

Dr. Jacono:  Yeah, but, you gotta do something to continue to fight some of the damage you’re doing.

Teri:  Yeah

Dr. Jacono:  and if it’s something you’re doing so in an unabandoned way, you put your 50 on, you go outside and you try to shield yourself from the sun, but if you’re somebody who’s an outdoors person you can put, you can reapply sunblock all day, wear a hat and wear protective clothing you’re still going to get sun exposure.

Teri:  Right

Dr. Jacono:  That’s reality.  So, you know thankfully we live in a time and an era where all these great new technological advances are available to us.  So, you know, if you can afford them and you have the focus, why not take advantage of it, and that’s the way I see it.

Teri:  And if you can’t afford them, then I would actually put a little account aside and try to put a little money aside …

Dr. Jacono:  Yeah, just like (?) did. 

Teri:  …because so many women want them and do work them and the other option is to get a group of your girlfriends and go to your local doctor whose board certified in plastic and reconstructive or dermatology, I mean, please don’t go to an OBGYN…

Dr. Jacono:  (laughs)

Teri:  …but you know, if you go to the doctor and say hey I have five girlfriends that are going to do this I think they can actually give you a price break.

Dr: Jacono:  Yeah, give you a price break or you know, plan ahead, get a little coffee can and you know, put a couple bucks in a week, you’d be surprised.

Teri:  Yeah, keep your market money, I mean ladies it’s worth it.  It is worth it.

Dr. Jacono:  Yeah, cut your coupons, put 20 or 30 dollars a week away if you can do that, you’d be surprised, a year and a half, two years later you’re able to afford just about anything you want to do. 

Teri:  And then you’ll feel great all the time about yourself, and look great and …

Dr. Jacono:  And it could all help feeling confident about your appearance.  Whether at work or in your personal life it’s wonderful to feel great about the way you look.

Teri:  It’s so true and so we have a couple more minutes and I know that this isn’t on lips, I think we’ve pretty much covered the lips, unless you have any other last minute things to say about that?

Dr. Jacono:  Yeah, well there is one simple thing, and this is something that’s very rare, you know we talk about Angelina Jolie lips, but there is a procedure called a V to Y lip augmentation which is a very stylized lip augmentation procedure that I do regularly in my practice because I do take care of a lot of models and actresses.  And this V to Y lip augmentation is a treatment that’s permanent, it doesn’t require adding filler from your body or any kind of plastic and what it does is it places incisions on the inside of the lip and rolls the lip out it makes the lips extremely pouty.  It makes them very full on the sides like Angelina Jolie’s, and it can be dialed up or down.  So it doesn’t have to be as big as Angelina but you can get that general shape and poutiness to your lips.

Teri:  And you don’t have to cut underneath your nose to do that? 

Dr. Jacono:  No, you don’t, that’s called a lip lift.  This is called a, it’s literally from incisions that are on the inside of the lip by the teeth.   It’s a very rare procedure; there are probably only a handful of us who do it across the country.  Probably about you know, a dozen and a half or so.  But it is a wonderful, wonderful treatment, and it’s something that you can look into because in any region, whether you’re in the west, the northeast or the Midwest, you can always find a doctor within, you know a one to two state radius who does this operation.  It is great because it is permanent and it has an incision that hidden on the inside of your mouth.  So, as a result there are no external scars and you can enjoy it for the rest of your life. 

Teri:  And what’s it called again?

Dr. Jacono:  It’s called a V, meaning the letter V, to Y, means to the letter Y.  It’s a type of flap that plastic surgeons do, V to Y lip augmentation. 

Teri:  Oh, that sounds really good.

Dr. Jacono:  Yeah, it’s really cool stuff…

Teri:  But you don’t get that horrible look like the duck look or the fake look that some of these people have?

Dr. Jacono:  Yeah, duck lips are generally done from over filling.  Whether it be with injectable fillers, fat or with a plastic implant.  That’s, it’s a generalized rounding of the lips.  There’s no detailing or curvature or creation of any structure it’s just stuffing it.  That’s what causes that trout pout as they call it (laughs.) 

Teri:  Trout pout.  Ok and last lets talk about how do you, I mean it is pretty darn painful to do your lips, what can you do?

Dr. Jacono:  Well, I think that doing, if you’re going to do a non surgical like treatment like lip injections.  The most important thing to do is to see a doctor who can do what’s called a block.  No matter how many topical creams you apply to the lips it is one of the most uncomfortable experience that any person will experience because the lips have so many nerve endings.  So what a nerve block is, it’s similar to going to the dentist.  You know, you go to the dentist; the dentist doesn’t drill on your teeth until he numbs things.  There’s a way to numb the nerve that goes to your lips, which is as one shot.  And with that one shot the entire lip goes numb.  And what’s great about that is, is that you do lip augmentation, you don’t just stick the needle in once.  If you do it correctly you probably stick the needle in 20 times, because you want to inject little sections of the lip here and there to help create curvature, balance and symmetry without just filling the lip with all the material.  Once it’s numb you don’t feel it, and because the lip is so sensitive if you give a shot in the cheek, the lip goes numb and then you don’t feel anything.  I’ve had so many patients that have had the lip augmentations done elsewhere for years and then they come to me and I give them this one little shot and then they literally don’t feel any of the pain or the anguish of getting the lip augmentation procedure.  So, ask your doctor to do a nerve block, he’ll know what …

Teri:  A nerve block instead of Tequila, because I swear, it hurts so bad…

Dr. Jacono:  Yeah it does, take Tequila and a rag, bite on this (laughs)

Teri:  Exactly!  A lime, Tequila and drying towel.  (laughs)  It’s the only way!  But, you know, I mean it’s so worth it because I want to have pretty lips, but it does hurt, so a nerve block is great advice.  And I think we’re running out of time now.  And Dr. Andrew Jacono from Manhattan, you are the lip expert.  So, I’m pretty sure you’re going to be getting a lot of calls of people wanting to fly there and have you do their lips.

Dr. Jacono:  That’d be fine.

Teri:  We’ll definitely have you back because I have more to ask you, we are running out of time.

Dr. Jacono:  Ok perfect.

Teri:  If you’d like a copy of today’s transcripts please go to personallifemedia.com and we’re gonna link up Dr. Jacono’s website with our website, personallifemedia.com. If you have any questions or ideas for a future show, please email me at [email protected]  Thanks for listening today.

 

End Music:  “You Had a Little Work Done” by Mark Winter