What is Hyaluronic Acid? And Why Do You Want It?

Hyaluronic acid (HA) is a natural substance found in your own body as well as in topical serums and creams. Believe it or not, it is also the primary active ingredient in most injectable fillers used to replace lost volume in the face, for contouring purposes, or to fill in wrinkles and smooth the skin.


Hyaluronic acid is not an acid in the typical sense. It’s not a harsh chemical and it doesn’t strip your skin. In fact, it loves water. HA is a polysaccharide (complex sugar) that can absorb up to 1000 times its own weight in water. Application of HA-containing products leads to increased moisture in the skin which is especially great in dry climates.


In your body, HA is found in several places. It’s located in between skin cells, where it holds water keeping the skin plump and moist. It’s also found in the eyes and in joint spaces, providing lubrication and shock absorption. As we age, the amount of HA in our bodies is diminished. This leads to volume loss, dullness, and a more weathered appearance of the skin.


There are no skin conditions or skin types that cannot benefit from use of HA. In fact, most OTC beauty products that claim to be anti-aging will have at least a small amount of HA in them. Medical grade products, however, will contain higher levels and a higher quality grade of HA. HA serums and creams can be used under sunscreen and other products to humidify the skin and keep it plump and firm, reducing fine lines and wrinkles. Consistent, prolonged use leads to long-term support for the youthful appearance of the skin.


Shah Aesthetic Surgery recently launched Alchemy, our medical grade skin care product line containing HA. Our moisturizer for daytime use contains a high level of hyaluronic acid to increase water content in the skin, firming and plumping up the delicate tissues of the face where our skin needs the most support. Colorado’s semi-arid climate is very drying to the skin so it’s especially important to give it some extra support to keep it moisturized.


You can also find HA in pill form. Long term benefits of taking HA supplements are unknown. It may do you some good and there are no safety concerns, but using HA topically is a more sure fire way to benefit the skin.


As mentioned, HA is also found in injectable fillers such as RestylaneTM, BeloteroTM, JuvedermTM, and VolumaTM. These fillers have very consistent results in replacing lost volume in the face, contouring, filling in wrinkles, and smoothing the skin. HA fillers last between 6 and 24 months depending on which filler is used. At our office in Denver, Dr. Shah is an expert injector for these fillers and in using them is able to achieve significantly improved, natural looking results. Injectable fillers with HA are a very widely used non-surgical cosmetic treatment.


Another use of hyaluronic acid is in the treatment of osteoarthritis. Injections of HA into the joint can help improve shock absorption in joints affected by OA. Injections can also give temporary relief from joint pain, especially when combined with other treatments for OA.

With its many applications, use of hyaluronic acid is an important player in anti-aging both cosmetically and physically. If you are interested in use of HA in skin care or injectable fillers, contact us for more information.

Be careful about having your cosmetic surgery overseas!

So you have made the decision to have cosmetic surgery?  That is a great thing.  Now you have to figure out how to pay for it.  As you can imagine, the cost for cosmetic surgery typically isn’t cheap here in the U.S. Because of this, more Americans are contemplating going out of the country to have their procedures. Destination surgery is getting to be big business, and for the most part is fairly safe.

Here are some things that you must think about before you take the plunge:

1. While cheaper prices are attractive, it is important to factor in the cost of travel, hotel stays, care givers, “extras”, and return visits for check ups.  This can get quite pricey.  Video conferencing with sites like Skype can ease some of the postoperative burden.

2. Having a good support system to help you when you are recovering might be harder to find when you are far away from family and friends.  The cost of a plane ticket alone for a friend or family member could be enough to pay for another procedure.

3. Language barriers between you and your caregivers can leave you with a confusing picture of your surgical journey.

4. The training and credentials of the plastic surgeons in the foreign country may be difficult to reliably gauge and compare to the often superior training of surgeons in the U.S.

5. The state of surgical and perioperative facilities in these foreign countries may be less advanced than in the U.S., although international standards are being implemented in many countries as a way to level the playing field and ensure quality control.

6.  If you have a complication, it may be impossible to get back to the original surgeon to be evaluated and managed.  Patients with complications from surgery performed outside of the U.S. report finding it nearly impossible to get a U.S. surgeon to take up their continuing care.  If they do find such a surgeon, it tends to be very expensive.

With all the surgical talent here in the U.S. it is often hard to understand why a patient would want to go out of the country for their care.  If you are one of these patients, make sure you are armed with the necessary information to make the best decision you can prior to boarding that plane.  Cost should not be your sole motivating factor, no matter how much you think you are saving!

Summer Skin Care – The Basics of Looking Good!

Well here in Denver, Winter is about to be over!  Signs of Spring are all over the place.  I’ll be going up into the mountains for one last hurrah on the slopes with the family.  Summer is the next hurdle for patients of Shah Aesthetic Surgery.  Being a mile up in the air makes for some brutal skin aging.  The air is thinner, colder, and dryer.  The sun is definitely more intense.

People age much faster in my opinion in this alpine desert environment.  There are things you can do about it, so don’t fret!

Here is a list of simple options for great Summer Skin Care:

1. Water – drinking water keeps your skin cells plump and protected.  Summer in Denver means more outdoor activity.  This means more sweating, so keep your water intake high to protect your skin.

2. Sunblock – I am a big advocate for high SPF sunblock.  I personally use a 55 SPF sunblock with UVA/UVB blocking capabilities.  While sunblock in makeup is a good idea, it just really isn’t enough protection up here in Denver since we really get intense sun exposure more than 275 days per year.

3. Vitamin C – this vitamin is really the most important vitamin for making new collagen.  Since is it water soluble 1000-2000mg daily is a safe dose.

4. Exfoliant usage – I am a fan of topical exfoliant serum usage.  Retinols and Vit C/E serums top my list.  I personally prefer Vit C/E because it more gently treats my skin and is safer in sun exposed populations. That being said, Retinols are the superior serum.  Just remember to wear good sunblock and protect your face with a big hat.

5.  Chemical peels – Winter’s cold, dry air has done a number on your skin.  You can recapture some of the ground lost in the war on facial aging by getting a chemical peel.  A chemical peel uses different safe organic acids to gently loosen skin and have it peel off.  This is a more immediate result than the use of exfoliant serums alone.  Depending on the strength of the chemical peel, you can have one as often as on a monthly basis.  Skin looks brighter with a more even texture when you get a chemical peel.  Heck, I even gently peel my own face.  If you see me in person, you’ll realize why I am such a fan.  They are easy to do, easy to recover from, are low risk, and give results!

6.  Eat cleanly – this is a no brainer!  What you put in your body shows in your skin.  Here in Denver, there is no shortage of good food.  I eat both natural and organic as much as I can.  It is expensive, yes, but well worth it when done carefully.  But, even if you shop at a conventional grocery store, you can make healthy choices that will benefit your overall health.  And, everyone knows that Healthy is a lot sexier than Unhealthy!

Now get to it!

Celebrity Plastic Surgery Gone Wrong at the Oscars 2014

I’m sure that anyone who saw Kim Novak or Goldie Hawn at the recent Academy Awards telecast was able to tell that they were the victims of Celebrity Plastic Surgery Gone Wrong!  As a fan of the natural look after plastic surgery, it is obvious that these two beautiful ladies do not share my viewpoint.  I understand the need to maintain a look that made you famous, but the reality is that the human body changes too much to try and mask aging.  If you have the genetics to age well, then you probably will age well.  If you don’t, you are going to need a lot of help.

When much of the plastic surgery world agrees that less is more, Hollywood continues to buck the trend and go for more is more.  The result, more often than not, is bad plastic surgery.  I’m sure it is very difficult for an A-list plastic surgeon to say no to their famous clientele, but they should start saying NO!  The Hippocratic Oath’s first pledge is to “Do No Harm.”  I think that there is incredible harm done to the reputations of these actors and actresses when their unreasonable quest for youth makes them ask for harmful or unreasonable things.

What is most difficult is the request by the everyday patient to look like a celebrity.  With their extreme visibility, especially in the age of social media, celebrities wield incredible influence on the style choices of the regular joe.  I have to talk patients out of things all the time because expecting to look like a certain celebrity leads to having severely unrealistic expectations.

Even in laid back Denver, Colorado, patients will ask to have the lips of Megan Fox, the nose of Jennifer Aniston, and the rump of J. Lo!  It’s tough to watch their dejected faces when I have to bring them back to reality.

Sometimes I wonder why they just can’t leave well enough alone! Aging gracefully is an art form that sometimes does benefit from the eyes and hands of a talented plastic surgeon…

Cosmetic surgery performed in an in-office setting

Did you know that many cosmetic surgery procedures can be performed in an in-office setting?

Here in Denver, Colorado, Manish H. Shah, M.D., FACS has perfected the process of performing many cosmetic surgical procedures in an in-office setting.  There are many reasons one might choose to have their cosmetic surgery performed outside of the hospital or surgery center setting.  The following is a list of reasons many of Dr. Shah’s patients have elected to have their procedures performed in his office:

1. They are afraid or anxious about general anesthesia safety issues

2. They are healthy enough for non-monitored procedures (no continous monitoring of heart rate, blood pressure, or oxygen levels) – Level 1 anesthesia (Colorado Board of Medicine)

3.  They feel more comfortable with the idea of having their procedure using only Valium (or similar medication) for sedation/relaxation, and using local anesthesia (like at the dentist’s office.)

4.  They are interested in saving money!! (in-office procedures do not have anesthesiologist fees or facility/equipment fees associated with them)

There are many different procedures that Dr. Shah has performed using only sedation with Valium and local anesthesia here at his cosmetic surgery office in Denver/Englewood, Colorado:

1. Facelift (rhytidectomy)

2. Eyelift (blepharoplasty)

3. Ear pinning (otoplasty)

4. Nasal tip rhinoplasty – primary

5. Revision rhinoplasty

6. Non-surgical rhinoplasty

7. Mini tummy tuck (abdominoplasty)

8. Reverse tummy tuck (reverse abdominoplasty)

9. Small area liposuction

10. Breast lift (mastopexy)

11. Breast implant revision

12. Laser resurfacing of the face, neck, chest, and hands

13. Chin implants

14. Scar revisions of all types

In fact, over 90% of Dr. Shah’s patients will have procedures performed this way.  With a yearly caseload averaging around a 1000 facial and body/breast surgical procedures, this means that many patients have had their procedures this way.

If you are interested in finding out more about your options with regards to cosmetic surgery performed in an in-office setting, please contact Jenny Romano of Shah Aesthetic Surgery in Denver, Colorado at (303) 708-8234.

How is Botox anti-aging?

Here at Shah Aesthetic Surgery in Denver, Colorado, we are huge fans of Botox from Allergan.  Botox is made from a highly purified protein toxin.  When injected in small quantities into facials muscles that cause wrinkles, the muscles weaken temporarily.  In their weakened state, they can’t produce the same amount of wrinkling. Most patients will see results lasting around 3 months.  If a patient is consistent with their Botox usage, those same muscles can atrophy.  This reduces their strength over time and reduces their wrinkling capability.  This usually means that they can lengthen the time period between injections.

When muscles don’t move, the skin wrinkles less making you look younger.  Patients will still need good anti-aging skin care and sunblock to keep the collagen and elastin in the skin as healthy as possible. Regular Botox treatments and medical skin care at Shah Aesthetic Surgery will keep you looking younger!

Your options for Liposuction in Denver, Colorado

Now that the weather is starting to get colder one of our favorite things to do is eat!!  I don’t know what it is about this time of year, but it makes me hungry.  I have a sneaky suspicion that it makes you hungry too!!  For most of us, this means a little weight gain.  Denver, Colorado is a pretty healthy place, but there are lots of us who can’t seem to get rid of areas of stubborn fat, no matter how much time we spend in the gym.  What kinds of options do you have, you ask?  The most effective way to remove those stubborn fat deposits is by having liposuction.  There are multiple types of liposuction performed here in Denver by Shah Aesthetic Surgery.

1. Standard – Standard liposuction uses manual suction techniques to suck out fat from trouble areas using small incisions placed in the skin.  It is fairly old-school and it’s use is limited.

2. Power Assisted – Power assisted liposuction (PAL) uses a mechanical device that oscillates like a little battering ram under the skin to make removal of fat a little easier and more aggressive.  Areas of tougher tissue are also more effectively treated using this technology.

3. VASER Assisted – VASER assisted liposuction (UAL) uses ultrasound energy to vibrate water molecules around fat cells under the skin causing them to explode and liquify.  It makes fat removal even easier, with less bruising.  In addition, the ultrasound generates heat that some feel helps tighten the overlying skin as it contracts, giving even better shape.  It is my favorite way to perform liposuction for body areas.  I will often combine it with PAL for maximum results.

4. Laser Lipolysis – Laser lipolysis, or, Smartlipo MPX by Cynosure, is a liposuction technology that use a small fiberoptic laser placed under the skin that melts fat and also help tighten skin.  It is a little more risky because it can heat the skin quickly so careful attention needs to be paid to avoid burns.  It is also one of the only treatments that show efficacy with the treatment of cellulite.  It is one of my favorite methods for fat removal and skin tightening in the face.

Nothing replaces good diet and exercise, but most of us know that it is sometimes not enough.  Liposuction remains a mainstay method for body contouring.  A consultation with a plastic surgeon trained in liposuction will help you understand the benefits/limitations/risk/alternatives of the various methods of liposuction here in Denver, Colorado.