BOTOX® Cosmetic vs. Fillers

Blank label medical glass vial and plastic syringe for injectionWhen looking to reverse the effects of aging by rejuvenating the face, many patients often turn to BOTOX® Cosmetic or dermal fillers for their desired needs. Considering which product to choose can be difficult since they both offer effective results that treat unwanted wrinkles and other signs of aging.

While both non-surgical products offer endless possibilities to help improve your facial appearance, it is also important to understand BOTOX® Cosmetic and dermal fillers are each used to help safely treat separate conditions.  

Knowing the Difference

One of the primary differences between BOTOX® Cosmetic and dermal fillers is the manner in which they seek to restore a youthful appearance.

Geometric Venn Diagram

BOTOX® Cosmetic relaxes facial muscles to soften lines and wrinkles. Dermal fillers, on the other hand, help restore lost collagen in the skin, which helps to create a more full, healthy appearance. BOTOX® Cosmetic can also help erase both static and dynamic lines on the face, whereas dermal fillers use a gel-like substance to fill in the wrinkles.

How can BOTOX® Cosmetic benefit you?

BOTOX® Cosmetic has the advantage of targeting the dynamic lines that are often unphased by other surgical cosmetic procedures. BOTOX® Cosmetic can also quickly and efficiently reduce unwanted lines and wrinkles while also treating blepharospasms, strabismus, and muscle dystonias. Because this product does not require cosmetic surgery, patients who prefer to avoid any necessary recovery time usually turn to BOTOX® Cosmetic for their needs.

How does it work?

A small amount of BOTOX® Cosmetic will be injected into your skin by a board-certified cosmetic surgeon to ensure the treatment is performed correctly and safely. Once injected, the muscles around your face will begin to relax preventing any more wrinkles and fine lines from appearing. One week following the procedure you will start to notice your facial appearance improving. These effects typically last up to four months. If the effects of your BOTOX® Cosmetic begin to diminish, you are welcome to undergo another treatment.

How can dermal fillers benefit you?  

Dermal fillers, or facial fillers, are considered one of the most popular options for patients wishing to reduce the appearance of wrinkles and fine lines. From reducing signs of aging to facial contouring, dermal fillers can help enhance your face without the need for major surgery. There are many different fillers you can choose from, such as:  

  • Restylane®
  • Sculptra® Aesthetic

How does it work?

Patients can choose between a synthetic or natural filler for their treatment. When injected under the skin, the solution found in dermal fillers will fill the soft tissue and cause the skin to rise or puff up. Puffiness is temporary and will usually go away over time. The number of injections you wish to receive, as well as the depth of insertion, may depend based on the type of filler you choose. You can see the difference immediately, although final results are seen two weeks after the treatment.  

Any questions or concerns regarding BOTOX® Cosmetic or dermal fillers can be addressed at The Cosmetic Surgery Center. Please call us at 216-350-3175.

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Breast Augmentation Recovery Guide

Dr Matt Goldschmidt Gel Breast Implant patientDeciding to undergo breast augmentation is a serious but fulfilling choice for many women, and one of the most critical parts of the breast augmentation journey is the recovery period. Taking care of yourself after surgery not only makes the experience more pleasant, but it can also ensure that your results are the best they can be.

Eat Healthy, Light Meals

Eating a healthy, balanced diet is essential for overall wellness, so it should be even more of a priority when recovering from an operation. Light meals are easier to digest, so you are less likely to experience the abdominal discomfort that is often associated with anesthesia and pain medication. Additionally, nutrient-rich foods give your body the resources it needs to rebuild tissue.

Maintain Hydration

Staying hydrated is crucial for all bodily functions, but it is especially important after undergoing major surgery. Maintaining hydration can help prevent constipation, promote optimal healing, combat nausea, and minimize excessive swelling.

Get Plenty of Rest

Immediately following surgery, you are likely to feel fatigued due to being under general anesthesia. However, getting plenty of rest throughout your recovery ensures that you are comfortable during the process and that you heal properly. Overexerting yourself can lead to postoperative complications or even compromise your results.

Follow Up With Your Doctor

Some patients develop rashes, excessive bleeding, infection, or other concerning side effects after surgery. Your surgeon should schedule several follow-up appointments to check your progress and answer any postoperative questions you may have. Once your incisions have healed, your surgeon can advise you on how to reduce the appearance of scars to improve your results further.  

If you have more questions about breast augmentation and recovery, call The Cosmetic Surgery Center at 216-350-3175 to schedule your personal consultation.

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Do You Have to Replace Your Implants After 10 Years?

Silicone implants on hand and natural breast“Are my implants everlasting?” It’s a question many plastic surgeons are asked. Many women see breast augmentation surgery as a long-term investment, but the fact is that implants don’t last forever. Many manufacturers say that saline implants should last up to 10 years, after which time they may need to be replaced. However, this isn’t a hard and fast rule. As with all facets of the aesthetic industry, implant life varies between patients.

Where did the 10-year lifespan come from?

The belief in the 10-year lifespan of implants comes from many manufacturers’ implant warranties. For example, Natrelle® offers a 10-year warranty that covers capsular contracture (grade III or IV) and implant rupture or deflation. Mentor® provides similar warranties on their implants; however, the terms may vary. This 10-year lifespan is only indicative of how confident manufacturers are in the durability of their products; it does not represent the accurate lifespan of your implant.

So, how do I know if I need to replace my implants?

Dr. Matt Goldschmidt Breast Augmentation patient with ImplantsIt is good practice to go to routine follow-up appointments with your primary breast augmentation surgeon. You will see the surgeon several times in the first year, after which you will only need a check-in at 10 years. This meeting is designed to determine whether you’ll need an implant replacement, though it doesn’t necessarily mean you will. Some doctors recommend a yearly visit as well.

At your 10-year visit, specific breast or implant characteristics are evaluated, including:

  • Potential implant ruptures or leaks
  • Visible laxity that may have resulted in double-bubble deformity or bottoming out
  • Malposition of the breast implants
  • Your satisfaction with your implant type and placement

Structurally, my implants are fine, but I’m not happy with my breast appearance…

This is an issue that many women are having at their 10-year visit. In the past decade, there have been prominent advancements in implant technology, and patients can now achieve more natural and appealing augmentation results. The desire to switch implant types is especially popular among women who underwent their surgery between the ages of 18 and 21 because they could only choose saline implants at the time of their original surgery (silicone implants are only recommended for women 22 and older). Whatever the reason, selecting a better quality or newer implant type after 10 years can enhance your overall satisfaction with your breast appearance and ensure quality results for years to come.

If you have more questions about the breast augmentation process, call our office at 216-350-3175 to schedule a consultation with our board-certified cosmetic breast surgeon.

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Facelift Risks: Are You a Good Candidate?

Any type of surgery comes with certain risks, and facelift surgery is no different. However, techniques used in today’s facelift surgical procedures have been thoroughly tested, and, as a result, the associated risks are rare. Before having surgery, your doctor will discuss those potential risks with you; you will have plenty of opportunity to ask questions, so you can feel entirely confident in your procedure and your recovery.

Potential risks that could occur during or after facelift procedures include:

  • Accumulation of fluid under the skin (seroma)
  • Asymmetrical results
  • Bleeding
  • Hair loss at the incision site
  • Healing-related problems especially if you smoke
  • Infection
  • Lung- or heart-related problems 
  • Nerve-related complications, including numbness or loss of sensation or muscle tone
  • Scarring problems or scars that are very visible
  • Skin discoloration or other irregularities
  • Other risks associated with the use of anesthesia

Your surgeon should discuss all of these risks with you, prior to your surgery, and you’ll be asked to sign a detailed consent form to ensure you understand these issues.

During your consultation visit, your doctor will also discuss your medical history, including past surgeries you’ve had, any chronic medical issues you have, and any medications you’re taking. Some health issues or medications can increase your risk of developing a complication during or after surgery, which means surgery might not be the best choice for you.

Generally speaking, women and men who are in good general health, who don’t smoke, and who have healthy healing responses tend to be the best candidates for facelift surgery. And of course, it’s also important to have realistic expectations and a positive outlook with regard to your surgery, your recovery and what results you can achieve.

To learn more about facelift surgery and to find out if you’re a good candidate, call The Cosmetic Surgery Center at (216) 264-8100 to schedule your free consultation today.

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Facelift Benefits: More Than Skin-Deep

Everyone knows facelift surgery helps smooth out wrinkles and eliminate sagging, loose skin, but restoring a more youthful look is just one of the benefits of the surgery. Compared to noninvasive cosmetic treatments like BOTOX and cosmetic filler injections, facelift surgery offers a whole host of significant advantages well worth considering.

The results are long lasting.

 Unlike injectables that offer short-lived improvements (typically a few months for BOTOX and up to a year or two for fillers), facelift surgery helps you look younger for years after your procedure. In fact, one study found 70% of patients were still satisfied with their results more than 12 years after their surgery.

You’ll feel more confident—and happier (yes, happier).

 Researchers at the University of Basel found patients who had cosmetic surgery to improve their appearance were happier than those who had considered surgery but decided against it. What’s more, their heightened feelings of happiness, self-confidence and self-esteem persisted for more than a year following their procedure. And in another study from 2017, researchers from Johns Hopkins found that people perceived women who’d had facelift procedures as being more attractive, more youthful and even more successful.

The results look natural.

 Compared to facelift surgeries performed a decade or more ago, recent advances in surgical techniques yield results that are much more natural-looking and custom-tailored to an individual patient’s facial structure.

Surgical approaches are optimized to work with your underlying anatomy, so that a cosmetic surgeon can correct aging issues at their roots, for longer-lasting results and greater satisfaction—even years after surgery.

You can combine facelift surgery with other treatments and procedures.

 Having a facelift doesn’t limit other options. Many patients opt for eyelid lift surgery at the same time as their facelift procedure, to reduce puffy/tired looking eyes and restore the upper face for a completely refreshed appearance.

Others combine a facelift with a neck lift to get rid of folds and creases in the neck, some of the first—and most dramatic— signs of aging for many people. Another benefit: Combining procedures means less recovery time and usually lower cost as well (versus doing them separately).

Ready to learn more about facelift surgery and how it could benefit you? We would love to help! Call The Cosmetic Surgery Center at (216) 264-8100 to schedule your free consultation today.

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A Brief History of Facelifts: More Than a Century of Refinements

Facelifts may seem like a relatively recent “invention,” but actually, they’ve been around for decades. In fact, the first facelift-type surgery was performed back in 1901 in Germany, when surgeon Eugen Hollander performed a modified procedure on a Polish patient who wanted her cheeks and mouth “lifted.” A few years later, the first book on facial cosmetic surgery was published in Chicago in 1907, and there was a landmark paper on facelift surgery in 1919. This last publication explored the technique of lifting, repositioning and re-draping skin to tighten facial contours and remove wrinkling in the skin.

And the rest, as they say, is history.

Or at least, it was until the 1970s, when Swedish surgeon Tord Soog introduced what eventually became known as the “SMAS” technique, named for the Superficial Musculoaponeurotic System of tissues that surround and connect all of the facial muscles.

Soog’s groundbreaking technique focused on dissecting and repositioning the facial muscles, rather than simply detaching and then tightening the overlying skin to smooth out wrinkles and lines.

The SMAS technique paved the way for further refinement by well-renowned French plastic surgeon, Paul Tessier.

Tessier developed a “deep plane” technique of restoring the youthful contours of the face. In this technique, a physician elevates and lifts the facial plane by dissecting the deep layer of tissue that attaches the facial muscles to the underlying bones, For his technical breakthrough, Dr. Tessier is widely regarded as the “father” of contemporary craniofacial plastic surgery.

The beginning of the 1990s marked another shift, as cosmetic surgeons began focusing on restoring lost facial volume while minimizing appearance of scars associated with facelift surgery. This led to a highly customizable approach that can be tailored to suit the needs and goals of the individual patient, leading to greater satisfaction and long-lasting, natural-looking results.

At The Cosmetic Surgery Center, we work closely with each patient to help them achieve their goals so they look and feel their confident best. To learn more about facelift surgery, call The Cosmetic Surgery Center at (216) 264-8100 to schedule your free consultation today.

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Facelift Surgery in a Nutshell: What You Should Know

Are you considering facelift surgery? You’re in good company. The American Society of Plastic Surgeons reports that in 2016, more than 131,000 women and men had facelift surgery to banish wrinkles and tighten sagging skin. But what causes facial aging in the first place, and how do facelifts “work” to reverse these signs?


Facial aging is caused by a number of factors. For example, sun and other environmental exposures play an especially significant role by causing incremental damage to the internal structure of skin, weakening it and making it more susceptible to the signs of aging. There’s a natural decline in facial volume—especially in the cheeks and around the eyes—which means skin looks and feels less firm and plump. At the same time, there’s a gradual weakening of the facial muscles—especially the large platysma muscle—that results in a “downward drift” that contributes substantially to sagging and wrinkles in the lower face and jowl area.


And your overall health and life experience play a role: Chronic disease, stress and even genetics also play significant roles in facial aging.


Good skin care routines, including faithful use of sunscreen, can help alleviate some very minor signs of skin aging. But to address more significant signs, like saggy skin and wrinkles, you need a more aggressive and comprehensive approach. That’s where facelift surgery comes in.


Facelifts use advanced surgical techniques that focus on correcting age-related issues in the midface and lower facial regions, including sagging skin, droopy jowls, lines and wrinkles around the mouth and chin.


During the facelift procedure, your surgeon restores the natural contours associated with a more youthful face. He does this by gently lifting and repositioning weak facial muscles and removing excess skin to create a smoother, former appearance. Plus, facelifts can be combined with other procedures, like a neck lift to eliminate the dreaded “turkey neck” or a forehead lift to elevate your brow area.


If you’d like to learn more about facelift surgery and whether it might be a good option for helping you achieve your goals, call The Cosmetic Surgery Center at (216) 264-8100 to schedule your free consultation today.

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An Overview of Face Lift Surgery

Face lifts are among the most popular cosmetic procedures for both men and women in the country. There are many reasons why your face may show signs of aging as early as your thirties. Stress, UV rays from the sun, genetics, contaminants in your environment, alcohol, smoking, and gravity all play a role in the aging of your skin. These factors may cause the skin to loosen and begin to sag. Wrinkles also begin to develop around your mouth and eyes due to the constant muscle movement in those areas. Fat deposits start to move down towards your chin and neck. Over time, all of these effects create an aged look in your face. Facelift surgery can correct all these concerns by lifting and tightening the skin around the middle and lower half of your face.

There are many different types of face lifts that can be performed. A face lift surgery may vary from person to person because our faces don’t all age in the same way. Every facelift is customized for each patient. Some things that contribute to the customization of your surgery include your gender, the condition of your skin, the location of any fat deposits, your age, and/or a variety of other considerations. Your specific facelift procedure will also depend on what your concerns are regarding your appearance. Patients who are more concerned about the wrinkles around their nose and mouth will have a different facelift procedure than those who are concerned about loose skin around their jaw line.

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Recovery from Rhinoplasty (Aesthetic Nasal Surgery)

Here are some tips for your recovery period to make it much easier. Elevate your head at all times to keep swelling to a minimum. Apply ice bags to your eyes and cheeks as much as possible for the first 48 hours after the rhinoplasty. However, make sure not to get the nasal cast wet or put any pressure on it. It is recommended to stick to a liquid diet the day of the surgery. You will be able to resume a regular diet the next day. You will probably have some bloody nasal discharge for two to four days after your rhinoplasty surgery. Change the gauze pad under your nose as often as needed. Do not rub or blot your nose as this will lead to irritation. It is also normal to have a small amount of blood drip down the back of your throat. Should quick/brisk bleeding occur, lie down flat with your head slightly elevated. Apply fresh compresses to the nose. You may also be instructed to use Afrin nasal spray on a limited basis. Call the office if bleeding lasts for longer than 30 minutes. To prevent post-operative bleeding, do not sniff or blow your nose for the first two weeks after surgery. Try not to sneeze, but if you do, sneeze through your mouth. The day after surgery, begin to clean the edges of your nostrils to remove crusts. Use a Q-tip dipped in hydrogen peroxide. Strenuous activity should be restricted for at least two weeks after surgery. After two weeks, you should slowly increase your activities back to normal by the end of the third or fourth week. Avoid contact sports and any direct, physical contact to the nose for four to six weeks.


Some more general information for after your rhinoplasty surgery includes coming in around seven days after surgery at the office. At that time, the nose will appear better but still swollen. You will not see the final results right away. Much of the swelling will subside rapidly over the next few days to weeks. However, it usually takes about a year for the last 5 percent of swelling (usually in the tip of the nose) to disappear. The tip of the nose will feel numb and occasionally the front teeth will feel “funny”. These feelings will gradually disappear as well. The inside of the nose will also be swollen. This will result in difficulty breathing which will progressively improve with time. After the cast is removed, the nose can be washed gently with a mild soap and makeup can be applied.

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How Rhinoplasty Surgery Works and What to Expect

On the day of surgery, you will go to the surgery center where you are having the procedure done. There, you will be checked in by the nursing staff. This process consists of you filling out several forms asking for an emergency contact number, current information, and any new pertinent medical information. A member of the medical team will want to ensure you have a driver with you. You will also have to sign a form indicating that you understand and accept the risks of the procedure if you have not already signed this form prior to the surgery day. You will then be asked to change into a gown, go to the bathroom, remove any contact lenses, dentures, or other small items you may be wearing. You will meet with your surgeon before the surgery begins and they will go over the procedure with you again and explain the anesthesia that will be used.


After this process, you will have an IV inserted by the nursing staff and they will also administer antibiotics to you as part of readying you for your surgery. Once in the operating room, the staff will prepare you for surgery. . The anesthesia team will then administer medications to relax you and put you to sleep. As you drift off, the anesthesia doctor may ask how you are feeling to provide them with additional feedback on how the anesthesia is working. The surgical team will then cleanse your skin with antibacterial solutions and place sterile drapes and towels around your face to also help prevent infection.


A rhinoplasty is designed to reshape the nose and make it appear more aesthetic. It can make the nose larger or smaller; change the angle of the nose in relation to the upper lip; alter the tip of the nose; or correct bumps, indentations, or other defects in the nose. During the rhinoplasty surgery, incisions are made to access the bones and cartilage that support the nose. The incisions are made inside the nose so that they are almost invisible after the surgery. Depending on the desired result, some bone and cartilage may be removed, or tissue may be added (either from another body party or synthetic filler). After reshaping the bone and cartilage, the skin tissue is redraped over the structure of the nose. A splint is then placed outside the nose to support the new shape of the nose as it heals. Most patients prefer general anesthesia but some may elect to have a “twilight sedation” or intravenous sedation. Rhinoplasty surgeries can change the size, shape, and angle of your nose and bring it into better proportion with the rest of your face. Rhinoplasty can also correct structural problems with the nose that cause chronic congestion and breathing problems.

If you are interested in scheduling a rhinoplasty surgery, please call Dr. Goldschmidt at (216)-264-8100 or fill out the contact form at the top of the page.

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