Eye Surgery
Colorado External Ptosis Repair by Dr. Burroughs from Springs Aesthetics in Colorado Springs

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Internal Droopy Eyelid (Ptosis) Repair by Dr. Burroughs from Springs Aesthetics in Colorado Springs

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Eye Procedures
Non-Surgical Filler Blepharoplasty (Eyelid Lift) By Dr. Burroughs in Colorado Springs

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BlephEx Eyelid Treatment For Dry Eyes Blepharitis by Dr. Burroughs in Colorado Springs

This is Dr. John Burroughs of Colorado Springs. I’m an oculofacial plastic surgeon. Here. In this video, I’m going to demonstrate the BlephEx treatment that is helpful for patients with blepharitis and dry eye. As you can see, this is a spinning rotary device with a very soft tip on it with a special soap that’s safe for the eye. And with the spinning tip, you thoroughly clean the eyelid margin, the eyelashes and the oil glands that open along the lid margin. It’s quite comfortable. As you can see, this patient is not flinching. This spinning device goes very quickly, but because it’s such a soft foam and with the soapy material that’s present, it doesn’t drag along the eyelid margin. This procedure takes approximately 6 to 10 minutes to perform total time for all four eyelids, and extremely helpful for patients that have blepharitis, particularly of the type that affects the oil glands posteriorly. This causes an evaporative tear problem to occur where the tears evaporate off the eye too quickly, causing them to be red and uncomfortable.
Blepharitis affects millions of Americans, as does dry eyes. Many patients can seek improvement with over the counter artificial tears, lubricating I gels and ointments, as well as use of over the counter flax seed and omega fish oil type supplements, as well as warm compresses. So how does it feel on that right side that we’ve already treated? It feels just lighter or something. Yeah, so feel better. Good blepharitis is often categorized as either anterior or posterior. And the advantage to the BlephEx over other more traditional treatments is that it treats both the anterior form, which is the skin and eyelashes, as well as the posterior form that affects the oil gland openings. It provides a fantastic mechanical debridement of the lid margin and eyelashes that simply cannot be obtained with other lid scrubs. Even prescription strength lid scrubs, warm compresses, tea tree oil, and baby shampoo soaks to the eyelids. It works very quickly. Typically, you need to do a treatment once and then it is good for approximately four to six months. This is a fantastic addition for patients that suffer dry eyes as well as, and furthermore, besides the bacteria biofilm buildup, people can get mites on their eyelashes that were very difficult to eradicate, and the BlephEx is very effective at its mechanical removal of these mites and bacterial biofilms so that the eyes can feel better. Thank you for watching.
Under Eye Filler Blepharoplasty For Tear Troughs, Bags, Hollows by Dr. Burroughs in Colorado Springs

Hi, I’m Dr. John Burroughs and welcome to my video on the filler blepharoplasty technique using a cannula. This is used for lower eyelid rejuvenation. You can see where the needle had just been pointing the nasal jugal deformities, also commonly known as the tear tract deformities. Most of the time, through a single needle injection, I can rejuvenate the entire lower eyelid with a hyaluronic acid filler. My two preferred fillers are either Belotero made by Merz or Restylane made by Galderma. Here you can see through the cannula the hyaluronic acid filler being injected into the depressed area of the lower eyelid. This can help mask this hollow area and also mask the fat herniation that some patients have above this area. This provides a smoother continuity between the lower eyelid and cheek junction, which is sought after by many patients as they get older. Some patients also have some depression on the lateral aspect of the lower eyelid cheek area, and additional filler can be placed in this area as well.
All of this is done through that single injection site and can be done very carefully. One of the cheap advantages of the cannula is that it has a blunt tip so that there is less chance of bruising, and more importantly, less risk of the filler being injected into a vessel which could cause severe complications to include blindness and skin necrosis. Here you can see we’re completing up the left side at the outer aspect. The patient has remained comfortable throughout the entire procedure. One advantage to this is that there’s usually no swelling or bruising, and you can go to activities immediately following the injections. Here, she’s going to be shown with the mirror, her immediate after results, and you can hear in her own words her response and see the pop in her eyes.
Wow, isn’t that nice? That’s going to be great. This is a great technique as it has no downtime and you get an immediate result as compared to surgery. But it can also be done as an adjunct to surgery. Here you can see her before on that right side and her immediate after, and you can see how much smoother the lower eyelid cheek junction has become. I thank you for watching this video and call us if you’re interested, and here is a final before and after patient who also had the filler blepharoplasty technique.
Lateral Tarsal Strip Ectropion Repair Colorado Springs

A Tarsal strip here, to tighten the corner. Hope the eye feels better.
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All right. That’s it. You did great.
Botox for Blepharospasm & Apraxia by Dr. Burroughs from Springs Aesthetics in Colorado Springs

So this patient has a blepharospasm as well as apraxia of eyelid opening, which causes her eyes once they clamp shut to not want to open, right? So she gets Botox injections every three to four months so that she can function with driving and reading and being able to keep her eyes open because when the spasms are occurring, it makes her feel uncomfortable to be driving down the road. She requires a fairly high dose. We have to do a little more than one syringe to get the effect that she needs. I’m going to tilt you back here to help you feel a little better and relax. One nice thing is for most of these injections, the patient can keep their eyes closed and the patients feel a little bit of a stick, but it’s not usually too uncomfortable. So these are going in to help with the part when they clamp shut so that she can keep ’em open instead of them staying shut. If you pinch the skin and shake it, it helps it not sting as much, which I know I would appreciate. If you don’t get these muscles here during the spasms, they can cause the eyebrows to pull down, which can interfere with the vision as well.
Upper Lower Blepharoplasty with Dr. Burroughs from Springs Aesthetics in Colorado Springs

Hey everyone. This is Dr. John Burroughs at Springs Aesthetics. I wanted to share with my viewers and upper and lower eyelid cosmetic eyelid surgery that is called a blepharoplasty, and it can be done lots of ways. So I wanted to share a couple of pointers and a before and after result. I’ve been fortunate to be part of the chapter publications for these outstanding oculoplastic textbooks. It’s been three of ’em now and have over a hundred chapters that I’ve been able to share with other colleagues. So an upper blepharoplasty is where you remove hanging skin to improve the appearance so that you look more refreshed and not so tired. This patient also had protruding steato ble on or fat bags underneath with dark deep hollows. So he had a wedding coming up of his daughter and had about six weeks to heal beforehand, and he wanted to proceed.
He’s also an engineer, and if anybody’s taking care of engineers, they’re very detail oriented. So you can see here his before and then his after on men. You don’t want to arch or lift the brows too much or it can look effeminate. So basically I took out some of that excess skin that was hanging very conservative amount, and then went ahead from underneath. And there’s this, what’s called the roof or retro orbicular oculi fat pad roof is easier and you release it and then suture it up a little bit higher on the orbital rim, and you can see that nicely lifted things up without giving him a surprised or effeminate look. You can also note that as lower eyelids are much smoother, there’s nice effacement of the nasal jule or tear tr deformities in a nice much smoother lower eyelid profile. Now here’s a picture without the flash, and you can just see how prominent those lower eyelid fat bags were, and you can see afterwards a nice result. So I just wanted to share this with everybody. My favorite surgery to do is upper and lower eyelid surgery because it helps people look better, feel better, and it can sometimes help ’em to have better peripheral vision out to the sides. Thanks for watching and I hope everybody’s safe and has a great day. If you have any questions, then please reach out to us at Springs Aesthetics at (719) 749-3606. Thank you again for viewing and more videos to come.
Blepharoplasty
Cosmetic Lower Eyelid External Blepharoplasty by Dr. Burroughs in Colorado Springs

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Cosmetic Lower Eyelid Blepharoplasty by Dr. Burroughs from Springs Aesthetics in Colorado Springs

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Body Procedures
Armpit Hyperhidrosis (Excess Sweating) Fractora Treatment By Dr John Burroughs in Colorado Springs

Hi, this is Dr. John Burroughs, and on this video we’re going to show a recorded demonstration of a patient who received Fractora treatment to the armpits. Many patients have excess of sweating of their armpit areas that also causes odor that can be unpleasant to them and others. Fractora delivers radiofrequency heat through tips. You first anesthetize the area with some local anesthetic, and then you can deliver the energy to destroy the sweat glands permanently. This can rid patients of excess sweating, as well as the body odor from this particular area. It’s advantageous over Botox as it provides a more permanent solution. On this slide, you can see the corn starch test, which shows areas of sweating. On the right is the area that had been treated on this patient. Again, on the right, you can see where there’s much less sweating as evidenced by the corn starch test. Thank you for watching.
Non-Surgical Fat Removal With BodyFX with Dr. Burroughs from Springs Aesthetics in Colorado Springs

Hi everyone. This is Dr. Burroughs at Springs Aesthetics. With Megan, we’re doing a BodyFX fat destruction treatment. This is a completely noninvasive way to address troublesome areas of fat that diet and exercise haven’t been able to get rid of. Megan’s using the handpiece right now to apply radio frequency heat, and there’s also some vacuum that’s involved to help pull the fat area up into it. It heats it to a temperature that kills the fat cells that will then be absorbed later on. The benefit to this over cool sculpting is that the BodyFX also heats the skin, so it tightens up around the area so that you don’t have lax skin after the fat is dissolved. Now, this does take six to eight treatments and you can only do limited areas at a time, but the thighs, the buttocks, the side fat and the abdominal fat are fantastic areas to treat, and there’s no downtime with this, and other than some warmth, it’s not generally uncomfortable.
Now, for some before and afters, this patient was an avid exerciser and was unhappy with their fat roll and loose saggy skin. This patient wanted to have more toned thighs and buttocks area. This patient also wanted more toned thighs and buttocks and improvement of her cellulite dimpling. Here you can see the side views the dramatic improvement that she achieved. Thanks for watching. If you have unwanted fat or cellulite, then give us a call.
Wrinkle Blocker
Brows and Frown line injections by Dr. Burroughs from Springs Aesthetics in Colorado Springs

Hey, this is Dr. John Burroughs at Springs Aesthetics. This is a patient who does not like her “elevens” or “mom lines” here, frown lines. And so what you can do is use a cannula like I’m using right now to push through the tissues. If you undermine the wrinkled areas with it, it’ll loosen those dermal adhesions such that when you then put in your filler, it doesn’t displace to the sides because you want it right underneath where they are now, because there’s some important vessels that run through here. My assistant is holding pressure over those vessels because we don’t want to get the filler into a blood vessel and through this one site, I can then go down here. I’ve already undermined it and go like this, and that helps him out a lot. And then I was going to show real quick here too, we don’t want to overfill and give her like a unicorn appearance there, but if you go in, you can laugh when you go in right by the brow. Here you can give a subtle brow elevation. It looks very natural. It looks very beautiful. If you look at young female classic brow, it’s got some fullness in this area. And by redeveloping some of that fullness that is deflated with age, you get a nice little elevation and then you can massage it a little bit.
Dermal Fillers
Advanced Filler Rhinoplasty With 22G Cannula by Dr. Burroughs in Colorado Springs

Hey everyone, this is Dr. John Burroughs in Colorado Springs. I’m an oculofacial plastic surgeon. Here I’m going to show a filler rhinoplasty using Restylane lift. This is an off-label use for fillers, but it’s something we commonly use. Now, in my opinion, the only safe way to do this is to use a 22 gauge cannula, which is not sharp. As smaller cannulas act just like needles and needles carry a high risk, especially in the nose of blocking a blood vessel because the needle can penetrate into the vein or artery, which can then occlude the vessel that could cause the skin in the area to die and scar. It can also, these needles in the smaller cannulas under very rare circumstances, embolize through the vessels to the eye and even cause blindness. Now, I’ve already used the needle that allows the entry of the cannula into the area need to inject, and right here we’re injecting the tip to help it project better as it was starting to protrude inferiorly and the patient did not want this appearance.
You always want to have plenty of hyaluronidase enzyme available so that in the event of an emergency where you start to get a vessel occlusion, you can inject the area and flood it with the enzyme. Here at Springs Aesthetics, we keep always between five and six full bottles of the hyaluronidase in the unlikely event that we would need that. So usually for a nose I only come from below and then one site above. But this patient had particular asymmetry concerns as well as a prominent dorsal ridge. So she required more sites of injection than typical.
I think any filler that’s injected acts like a implant and serious infections can occur. So we prep the skin with Hiba cleanse, which kills bacteria on the surface within seconds. That preparation of the skin was not shown in this video. Now we are using Restylane lift for this case. It has a good G prime or stiffness to it that lasts well in the nose. I’ve had most patients have at least nine months of improvement and some up to a year. I want to note on the cannula where that red colored cap is just below. The white portion of the syringe is an orientation for where the port on the cannula starts to inject. Now during the injections, you do sometimes need to massage and see how things are going by both appearance and palpation. Here’s an area on her lateral aspect of her left side of her nose that needed filling to improve the symmetry. You can also improve the appearance of a wide or sweeping nose by injecting and creating more of a dorsal ridge. Here’s a before and after showing that symmetry and a dorsal ridge improvement, particularly near her tip, it was improved. Here’s a smoothing of that dorsal ridge.
Here’s another case where this patient had a very broad nose that swept, which you’ll see in a moment and after her injection. You can see on the right smoother and less broad-appearing nose. Here on the oblique view, you can see the improvement of that sweeping she had of her nose, and then you can see it again on this sagittal view. She was very happy with this result. And then you can see on this young lady also improvement of her dorsal ridge and obtaining a more straight appearing nose. I hope this was helpful and again I recommend 22 gauge cannulas for the maximal safety call if you have any questions. Thank you.
Filler brow lifting and contouring with Dr. Burroughs from Springs Aesthetics in Colorado Springs

Hey everyone, it’s Dr. John Burrows at Springs Aesthetics. I wanted to show a brief portion of a talk I gave at a recent facial plastic surgery meeting. We’re going to specifically cover the brow lifting and contouring portion with dermal filler as we age, our fat pads throughout our face deflate or lose their volume and then descend. This can occur for our brow fat pads right here as well. And this is a drawing explaining some of that from a paper I published 14 years ago. So as part of rejuvenation of the face, either with surgery or nonsurgical means it’s important to address the brow fat pads to reinflate and raise them for a more youthful appearance right in this area here. So brow filler can work well for this in a nonsurgical setting. Again, I’ve taught this and talked about it in the past. You want to use a 22 gauge cannula in my opinion, because this whole area along the orbital rim has pretty sizable veins and arteries that are very easy to get into with a needle.
And you should be aware that if you get filler into a vessel anywhere in the face, that it can cause blindness or skin necrosis from blocking that blood vessel. So again, I use 22 gauge cannula for this, for the safety and because you can do it well. I start from the lateral aspect after prepping the skin with antiseptic solution like Hiba cleans and go along the orbital rim for the area I’m trying to reinflate and raise. And on this one, she didn’t need a lot of elevation to her brow, but she wanted a little bit of enhancement in the projection. That’s quite beautiful.
Now here’s another case I did from the frontal view. She had a filler injected in this area, and you can see how it nicely raised it. It also gave her a little bit more of an effeminate arch, which she greatly appreciated.
Here’s another case on a very nice lady that wished to have her brows lifted a little bit and she also had this deep sulcus and we call that an A-frame deformity. So I injected a filler into the upper lateral browse on each side, and that was one syringe. And you can see the nice improvement she got as well as that improvement of that sharp angle that she had beforehand, that a-frame deformity has been nicely improved. So that was just a brief video showing what can be done with filler in the eyebrows. It was only a small portion of the talk I gave, but I thought I would share it with everybody. And I appreciate everybody listening in. Hope everybody’s safe and doing well. Thank you.
Minimizing Filler Complications: Are Cannulas Always Safer? with Dr. Burroughs in Colorado Springs

Hey everyone, it’s Dr. John Burroughs. I wanted to briefly discuss something that can be very serious and oftentimes fortunately treated. We’re going to look at a case of a vascular occlusion of the right facial artery that resulted from hyaluronic acid being injected with a 27 gauge cannula in a poor fashion. I like to present one of my international meetings just coming up, had to be canceled due to the recent pandemic, but I wanted to share this anyway on my YouTube channel. So when it comes to the aging of our face, there’s 4 Ds I like to think about. There’s the descent from gravity, deflation from fat loss, degenerative skin changes and distorted bone changes. There’s several buttresses in the face as shown on the slide that if you can rebuild or reinforce with fillers can really help with those aging changes that we see. Now, fillers are great because fullness is a sign of youth and health.
These fillers can fix fine lines and fine folds as well as fix large areas of fat, deflation and even mask fat bags under the eyes and even sags in different parts of the face. There’s different types. The most commonly used are the hyaluronic acid fillers. I call these the sugar fillers because what they’re constituted by the calcium hydroxyl appetite filler, which there’s radius, there’s sculpture, which is a polylactic acid, and then there’s some permanent fillers. And fortunately or unfortunately, hyaluronic acids are the only ones that are reversible. It’d be great if we had other filler types that would be, so any injector needs to have a very good appreciation of the vessels in the face. I call this vessel awareness, kind of like fighter pilots who fly in formation have to have great situational awareness. So in this case, I’m going to quickly show you. You can see this is the facial artery running in here and a lot of injectors will be injecting along that area to reduce the nasal labial folds.
Now, when it comes to injecting, cannulas can be safer than needles, but not all cannulas are treated equally. It’s been found in a study that the 22 gauge cannula is definitely safer than most of the needles in a study. It could not be pushed or forced its way through into an artery, whereas the cannulas that were 25 gauge, 27 gauge or higher acted just like needles. So you might as well not even use cannulas of that size. Now another nice part about cannulas is that once they’re under the skin, they tend to move through the skin in a more comfortable manner for the patients. It can also give less bruising and swelling, and that’s a great benefit, and I think those that want to learn how to use ’em well are serving their patients very well.
So again, on the cannulas, there’s multiple companies that make these. I like to use the 22 gauge two inch in the face because a lot of times you can inject larger areas just with a single site of entry, which can reduce the infection risk and it also reduces the discomfort for the patient not having to go in so many sites. So here’s the case. This was a patient referred to me because of the situation that you can see in the slide here. She had had a filler placed in this area as well as down in here, but this was the area of the occlusion. A 27 gauge needle was used, sorry, 27 gauge cannula, but again, it acts just like a needle. And the person that was doing the injection did not realize this. Unfortunately, when that filler got into that vessel, it caused this whole area of blanching here to no longer get the blood flow it needed.
So just like when you’re having a heart attack, if the blood flow is not going to the right parts of the heart, this causes chest pain and discomfort. Well in the face. It can also cause discomfort. Another telltale sign is that the bruising is irregular and kind of splotchy with areas of significant palor. You can also get a small area crusting and necrosis, which you can see right here. So fortunately this patient was got to me within about an hour and a half, and I went ahead and flooded the area with hyaluronidase, which is that enzyme I had talked about earlier that can reverse hyaluronic acids. Now you unfortunately have to put quite a bit of this enzyme in to get the restoration of the blood flow and you can’t always. So that’s why it’s so important to try and avoid these to begin with.
Interestingly, as soon as this area had been flooded with the enzyme, her started getting colored back very quickly and her pain almost resolved within a few moments to a few minutes. So here’s another view. As she first came in, and this is immediately after the injection of the enzyme, you can see some color coming back and very important indication that the restoration of blood flow had occurred. Here she is a few days after that injection, you could see where she had a focal area of the skin necrosis and here she is a month later, looks good. However, she’s still going to have that area which will probably leave a small permanent scar. It is however excellent and fortunate for her that the restoration of blood flow is much quicker because I’ve seen photographs and patients presented at meetings where they have large areas where the skin sloughs off and it causes permanent scarring.
Now, another quick thing I wanted to mention about fillers is you want to get ’em done in a clean environment, make sure the skin is prepped. Well, alcohol is okay, but better is Betadine or chlorhexidine. Chlorhexidine is amazing because it kills bacteria within seconds, whereas Betadine, for its full effect, you need a few minutes. Alcohol’s good for wiping off makeup and kind of oils and things, but it doesn’t really disinfect the skin as well. Now Chlorhexidine is toxic for the eyes, but for the other areas of the face, it’s quite fine. This lady was a different patient referred to me and she had been on a cruise recently in the Caribbean and just thought it would be nice to get a filler placed in this area. So she did, and I wasn’t there, but I assumed the environment was not very clean. She probably didn’t have her skin and septically clean, probably just a little bit of alcohol.
And these injections of any of the fillers are like a implant and implants can get infected in any part of her body. And that’s why if you have a total hip or total knee joint replacement that they use antibiotics and an extremely sterile environment. So this lady had bounced around for several months as she didn’t even live in Colorado and kept getting these red painful nodules that would express purulence now and then. And so you can’t just throw antibiotics at this, it’s not going to completely take care of it. Here’s a syringe showing about a cc and a half of purulent material that expressed when I first met her. So I went ahead and put her on antibiotics that cover atypical bacteria, one of the high risks of these infections. And so Bactrim works well for that. And there’s others. I also flooded the area with hyaluronidase, so the antibiotic that she was taking could get into the area and this also helped dissolve the filler so it could be absorbed and cleared out of her system.
So another interesting thing about these enzymes, the hyaluronidase is they don’t always have to be used for emergencies. I’ve turned filler, sculpting for when you can take filler that was placed too much in one area or cause some swelling in one area, say it’s elevated like a mound, and then you can flatten it out a little bit but not lose the whole effect to where you still have that big fold that you’re trying to address. This works amazing for that. There’s certain protocols and things I could discuss on a later video, but you don’t use the full strength. You dilute it down and you have to place it very carefully. One interesting to point to be aware of is that the different hyaluronic acid fillers though they will dissolve from hyaluronidase. Some take more than others, some take a lot. Restylane made by Galderma is one of the ones that’s easiest to dissolve, takes the least amount.
And then there’s, and unfortunately the Juvederm family, which produces amazing results by Allergan, their newest ones like the Velure, Volbella and Voluma take a lot more to dissolve. So that can be an issue for patients when there’s a problem that occurs. So again, the enzyme’s good if you have an infection or nodules, which can occur with fillers on occasion. So some of the take home points are that you always want to have filler injected in a clean environment and make sure the person that’s injecting you cleans the skin. And even antiseptically cleans the skin. Alcohol is really not enough in my opinion. You want to be sure you’re injector is qualified and that if they’re not a physician, that they have a physician medical director that’s available for medical emergencies. And these occlusions, usually they’re going to occur right away. But sometimes the symptoms aren’t clear to the patient or the injector for an hour or more and they need to be addressed quickly.
Just like when you have a heart attack, you don’t sit on it for days. You need to get into the emergency room to get treatment. The enzyme amounts you need can be quite substantial. That one case I went over took six vials, which is a lot, but scarring that could be permanent and prolonged ischemia or lack of blood flow of the area, that’s a serious thing. So it’s worthwhile to have a lot of the enzyme always available. And if you’re getting injected in a new spa or physician’s office, you really want to ask, do you keep enzyme available? If they don’t, that’s a real warning sign. Even though filler complications are rare, they do occur. And if it was your skin, wouldn’t you want to be sure you have the injector, having the ability to inject it with enzyme as soon as possible. We already covered proper skin antisepsis and the large cannulas are the very safest, like the 22 gauge.
And there’s also a 23 gauge. But once you get to 25 gauge, 27 gauge or higher, there’s a false assumption because it’s a cannula and not sharp like the tip of a needle. It’s such a small caliber, smooth tip that it still acts like a needle and can get into the blood vessels. And then the last thing is if you’re being injected at an office or a spa, you need to be sure that if there’s contact that you can do after hours to be sure you can get the treatment you’re needed. If you go to the emergency room, these enzyme compounds are not always readily available, whereas the place you get injected, they should always have it on hand. If they don’t, I don’t think they should be injecting and I just don’t think it’s good care. So thanks for tuning in. I hope this was helpful and hope everybody is doing well and having a great day. Thank you.
Lip Filler By Melissa with Dr. John Burroughs at Springs Aesthetics in Colorado Springs

Hi everyone, I’m Melissa. I’m a nurse injector and the first thing I’m going to do with our model today, if you look, this side of the lip is bigger, more full than this side. We call that asymmetric and I’m going to go ahead and start off making her lips symmetrical, meaning to get them both the same on each side. So what I’m going to do is I’m going to take this blue pen and I’m going to outline it to make it where it matches the other side and that will give me a marker to know exactly how full I need to make it. Because once you start injecting, the lips start to swell and you can’t tell if you’ve actually accomplished your goal of making them symmetrical or not. So this will give us a little bit of help in that.
I’ve chosen for this model Restylane® Defyne, so I also want to let you know before you come in, maybe three to four days if you’re taking aspirin, fish oil, all those things can cause bruising and it doesn’t cause the bruise actually me doing the injection starts that process but your blood doesn’t clot up so it just continues to bleed when you’re using something like those are blood thinners, so it’s going to more likely cause a bruise and that also can make that bruise last longer too. She’s doing really well. So I’m going to start working on the bottom lower lips. So would you go ahead and slightly open your mouth? Thank you. What I’m doing right now is just going along where you would do like a liner, a lip liner I did up top just kind of outlining the lips. She has a great subtle lips, just needed a little tweaking. No one’s perfect, no one’s exactly the same on each side. Some people you can tell less than others. Yeah, it’s a little more painful on her bottom lip seems to be.
Do you like to typically start with vermilion border?
I do. Well, I actually start where the deficit is more and then work that out because you want to see how much product you’re going to have left and then you work with it from there. But right now her bottom lip was already pretty full. So I’m right now just going to kind of enhance it a little bit. You always want your bottom lip bigger than your top lips. Let’s just aesthetics 1 0 1 bottom lip always needs to be bigger than the top lip. And if you need a break, you let me know because I’m all about comfort here. You doing okay? All right, we’re almost done with this part.
So another important thing is not to over volumize the outside portions of the lip. In other words, where the commissures are.
You kind of want to stop at a certain point.
Kind of concentrate on the central two thirds the most.
And I think they would call that the joker look if you…
Enlarge it all the way across.
Yes, we don’t want to do that. So now this is the pillow part. I’m going to make a pillowy puff, kind of a pouty mouth is what they call it. Almost done here. Go ahead and put your lips together. Normally she’s got a little bit of blood. Let me just apply some pressure there. Wow, that’s looking great. Okay, so I’m going to go ahead and have the model look at her lips. I’m not done at this point. We’re just looking to see about the symmetry, see if she notices anything. I’m still noticing a little bit through here needing to be filled out, but I just wanted her to get a little bit of a glimpse of what we’re doing and then we’ll start. That was just like I said, a 10th of a cc and it’s already made a major difference. Wow. We’re going to continue on, enjoy being here and watching this because I hope to see you soon to help your lips achieve the best look they can. So open up a little slightly. Okay, I’m going to go right here. And that helped Go ahead and slightly close. Yeah, that’s looking good. So right here I’m going to give her a little bit in the middle.
Looks like she’s been real comfortable.
I always…
I haven’t felt anything hardly really.
Well some of the people out there you might not experience it, not hurting as much, but I will tell you we did use and I will always use unless you just don’t want me to use a lidocaine cream on the lips. So that will help with comfort. It’ll also help with maybe a little inflammation and mainly comfort though for our patients and Dr. Burrows likes to use that a lot too.
And we find the lidocaine tetracaine mixture ointment is really great for taking out any discomfort with this.
Did you see how that perked up? Look at this side. Now look at this side just one little bit. Smidge helps that right there. Look at that. This is really an art and I love doing what I do. You can tell most of my patients come in saying, I really feel comfortable with you. You really enjoy what you’re doing. And I do. Okay, I’m going to do this side to kind of even it out. Little pitch. Here we go. We’re going to make that just perk up. Those beautiful lips. She already had beautiful lips. She really just wants them to be more symmetrical and plump. A little blood, not much, just a little bit.
Okay, right in here.
This is really the most tender area and I like to kind of just shape it to where I want this product to be. I’ve watched on some of the nurses websites and even some YouTube videos that I’ve seen put out there where they’re putting three syringes in people’s lips and I just don’t even understand it. We are at 0.8 of a CC and I’ve already achieved this with this model. To put three of these syringes in her lips would be a duck lip and that’s non attractive to anyone. Go ahead and close your mouth. Okay, going in the wet dry border right here, that will turn that lip out a little bit or up.
This does not make your lips stiff. If you can see her lips are very soft. This is a great product to use in the lips. Okay, I am going to start working on the bottom and this right here along this realm I’m going to show you that’s a little bruise starting to form. You can get bruises on your lips. We treat bruises for free but not on the lips. You cannot do an IPL on your lips. So when you do come in, just know that it can cause bruising and that should go away probably depending on the bruise and how much you bruise within three to five days. Ice will help, but also lipstick if you need to hide it. Do you want to give her a second to, so one of the things that we also look at is this model doesn’t have it, but some people have that downward smile work. Yeah, right there. She demonstrated perfectly even at being relaxed looks like they’re frowning. This technique that I’m going to show you if you put it right here, like a little V in the corners of the mouth, a little there and a little here. It can turn that into a smile look instead of a frown.
But very natural looking.
Yeah, just very subtle.
You can already see that.
Look at this side to this side.
Just a very nice subtle. The other thing, comment on helping them get that look with botulinum.
About a centimeter out and a centimeter and a half down.
Okay, about a centimeter out and a centimeter and a half down right about here. And it relaxes that muscle. When it relaxes it you would think it would pull down but it doesn’t. It actually pulls that muscle up gently, very gently. Ugly. Open your mouth. Thank you. So you notice that this model is bleeding. I did ask her prior to the procedure if she’s taken anything like Ibuprofen, anything like that. And she has taken some Aleve in the last few days for a headache. And so that is the reason she’s bleeding more. And potentially as you can see, some of that darkening will probably be bruising.
It’ll be okay.
And lipstick covers it very well.
Lemme get this bleeding under control a little bit and we’ll move on to the next part.
And if the bleeding extends outside the red area, the lip, you can use the intense pulse light which will make it go away very quickly.
And that would be down in this area but not actually on the lips. And that can happen where the bruising extends out into the facial area around the lips and we can treat that as he said, but we cannot treat the actual lip itself. Can I go ahead and close slightly?
I would also add an experienced injector will be able to tell swelling from the filler product under most circumstances so that you don’t underfill or overfill one area compared to the other because they can feel a bit different. The filler versus some swelling. Go ahead and close your lips.
Wow, look at that. I’m going to give her a second to look.
Wow.
One thing I’ll also add, lips can take time and your injector should take time because it’s very notable area once it’s injected. So you want it right.
I’m done with the bottom.
Besides the topical anesthetic, injecting slowly helps and you can also do some distraction by tapping the skin near the area you’re injecting and that helps confuse the nerves and take out some of that discomfort. Injecting slowly is also safer and provides a more precise injection.
Another thing to also be aware of is when you get your lips enhanced, they’re more likely going to chat because now there’s volume in there. So use a really good lip. Chapstick. We have, SkinCeuticals has a really good lip balm. We also have elastin nectar or balm and that would really help too. So I’m going to go ahead right in here in the Vermilion column actually in the columns and I’m just going to show you right here, I’m just going to put a little product right there. This can be a little tender. So we have the model, take a deep breath in. So this is called elastin enhance. It’s post-injection serum and I’m placing that on the model’s lips. Got a little blood right there. Elastin carries really good products, especially post-procedural healing. And then they also have products that will continue the healing process after. You don’t need to use, like the nectar. Nectar is something that we use after someone’s had CO2 laser or any type of injury to the face.
Can also be used beforehand because it boosts the arnica levels in the skin.
Very true.
Up to 50 times.
Okay, go ahead and close your lips. Just want you guys to get that finished look of this model’s lips and we’ll do a before and after picture. Thank you guys. Stay safe and have a great day.
We just finished the model’s lips. One of the things that was important is when she called to make her appointment, she did tell us that she was prone to fever blisters and that was really good of her to tell that because doing lip filler can also aggravate or promote a fever blister if you are prone to those. And if you are prone to fever blisters and we’re going to be doing injections in your lips or round your lips or any type of procedure that like CO2 around your lips, we can call in a preventative medicine to start that before you get that done prior to the injection.
And then that will help not bring on that cold sore. One other product that I wanted to share, and we don’t sell this but I just picked this up at Walgreens, it is arnica cream and that is something post procedure. You can also use it before the procedure. There’s also arnica pills. So we have a line that we use at our practice more and it is the elastin line and it’s the nectar. So if you use that a few days, even a week before your injections and just apply it on your lips or any area that you’re going to have CO2 done or any type of injections, it has a arnica in it, so it’s going to help with bruising and help not bruise potentially at all. And if it did bruise, it’s going to make it a lot less than what it would without using it and just wanting to kind of see what you want to achieve the look that you want.
If it’s just you want ’em, symmetry being equal on each side. If you have a scar, we can actually work with people that have scars on their lips from maybe they had a dog bite when they were younger. Filler really helps to conceal that into even out that in the skin. We can do that with your cheeks also. A lot of people have the nasal labial area where it’s starting to droop. If we put filler in the cheeks, sometimes that’ll also help because everything as we get older starts to come down. So filler can be used in a lot of areas of the face. I love using it. It makes a big difference. I can’t do surgery. I’m not a doctor, I’m not a surgeon. Dr. Burrows can do surgery. A lot of people do need that, but it really just helps to enhance and to help with fine lines, wrinkles, and even deep lines. So we’ll see you at Springs Aesthetics.
Here you can see her before picture and notable asymmetry. And here’s her post picture with improved symmetry. Here’s the sagittal view and now the post-injection view with nice enhancement.
Cosmetic dermal fillers injections & high temperature procedures by Dr Burroughs in Colorado Springs

Hey everyone, it’s Dr. John Burroughs. I want to do a little experiment showing that the fillers, the hyaluronic fillers are very resistant to heat. So you can do laser after putting them in and even radio frequency. This is Restylane Lyft, and then this is the original Restylane with the lidocaine in it. So I’m going to use a low temperature cautery, and then I’ll use a high temperature cautery to show you here. You can see it’s working. See how bright that gets? So here’s the low temperature. It doesn’t really glow much, but if you go ahead and put it to there, see how it’s burning and leaving black. So it does certainly work. And then when you do your high temperature, that’s crazy. So you see that it’s definitely working. So this is Restylane Lyft. I’m put a pile there and am going to put a second dollop of it. And we’ll even do just kind of a linear thread, and then we’ll do the same thing with the Restylane.
All right, so here we go. We’ve already showed you this works just fine. So on the Restylane Lyft, you zoomed in there real good. I’m going in there and it’s not doing anything. I’ll show you. It’s still working. You see that little black mark? So it’s still working. All right. And then when we go to the regular Restylane, let me clean off my tip. All right, so here’s the regular Restylane, say nothing. Now, even when we go to the high temperature cautery, give you an example, then again it doesn’t do anything. So this is Restylane lip. See, it’s not melting, it’s not really’s only spreading around because I’m doing it trying to get it to melt off, and it’s not saying it’s still working. Then we’ll do it on the regular Restylane, same thing. So I wanted to show you that everybody, thanks for watching.
Dr. Burroughs shows why pull back method for cosmetic filler injections is dangerous, Colorado Springs

Hey everyone, it’s Dr. John Burroughs. I wanted to show everybody that the pullback method where you withdraw with the plunger is very dangerous because with a thick, viscous filler, it’s not going to be able to give a flashback. So in this syringe right now, you can see I’ve got just preserved saline here. I’ll get squared out, and when I put it into the food coloring and pull, you get an immediate flashback without any effort. Now, when you use a filler, any of the hyaluronic acid fillers that are thicker, you’re not going to be able to do that. I’ll show that here. And this is the provided needle that comes in the packages. This is Restylane with the lidocaine, and you can see when I squirt it, it’s in this needle now. Okay, so the needle’s primed, like when you’re regularly injecting because you don’t want air in it. And when I stick it all the way in and pull, look at that, I pull back about four tenths of a CC until I finally got that. And nobody’s going to pull that much back when they’re doing the experiment. And it didn’t happen until we got to the, yeah, it was about the 0.4 tenths of a CC mark. So I just wanted to point that out and just again suggest that cannulas are remarkably safer. Thanks for watching.
Mini Facelift
Mini Incision Facelift & dermal filler by Dr. Burroughs from Springs Aesthetics in Colorado Springs

This is Dr. John Burroughs in Colorado Springs. I’m an oculofacial plastic surgeon, and I’m going to be showing my video for the mini incision facelift. Here you can see her before and after photos. First, you want to start with prepping the skin, and oftentimes before I do a facelift or with the facelift, I like to do dermal fillers to fill in areas that have become deflated. You just saw placement in the nasal labial folds in the glabella. You start your facelift by making an incision in front of the ear, which masks it nicely, and on the mini incision facelift, it doesn’t wrap very far behind the ear. Next, you move onto the removal of the skin, which you know how much to remove based on how much lift you want to get along the jawline and the upper neck areas. Here you can see the tissue that’s being removed.
You then want to trim the tissue that’s overlying the SMAS, which is the submuscular at neurotic system, which is kind of the soft tissue structural support for the facial muscles and tissues. Once that’s been cleaned up along the SMAS, you have a nice gliding plane that you can lift the tissues and with careful deep suture placement, it takes the tension off of the skin and these incisions can heal very nicely. You can also tighten the SMAS through this incision. In those cases when that’s necessary, or even remove a small amount of SMAS, usually I don’t remove the SMAS, but it can be done. I like to stay above it because you stay on top and above the nerves to the face that control the movements of the facial muscle, so it’s a safer way to do it. Here we’re moving on to the chemical peel, which I like to finish with on many of my patients, and this helps tighten the fine lines, the skin, and help with pigment unevenness. For the eyelids, I like to use a cotton tip applicator as I find it more precise. And then as I move on to the rest of the face, I use a soft two by two.
And as you watch, you can see your skin start to get to a dusky white coloration. The great thing about the mini incision facelift is that it can be done in the office setting just with local anesthesia. Oftentimes, I’ll give a mild oral sedative and there’s not much downtime though we do leave the stitches in for seven to 10 days. This is a great procedure because of the very fast recovery, minimal bruising, and minimal downtime. It’s quite comfortably done, and you get a great result along the jowls and also the upper neck. Thank you for watching.
Mini FaceLift, "Short-Scar" FaceLift by Dr. Burroughs from Springs Aesthetics in Colorado Springs

Make sure it looks perfect.
Yeah, definitely, little pinch. Okay.
You are doing great. Great.
This filler lasts between a year to two years, so we consider that semi-permanent and then with the small amount we have left, we will put some between your eyebrows there with this special cannula, which is designed to help it not get into the blood vessels. Tilt chair back. Canula also doesn’t hurt as much as a needle would. It’s also penetrate a blood vessel which could cause it to get into the bloodstream and potentially cause a stroke in the eye or things like that. Other complications we don’t want. You can see how that area there already you plenty comfortable. Good. So the skin incision, we take all the way down to the SMAS, which is a scaffolding for the face that allows for a nice smooth closure and the important nerves that run through in front of the ear to move the face called the seventh nerve branches. They’re all deep in the mass as long as you don’t cut deep into it. See how that’s redefining the jaw on there? Then we want to keep a nice pretty air load. Your jaw junction so close that keeps it from getting a pixie here form, which would make it look like she’s had a face left, which we don’t want. Want to Just look nice. The chins pulled up, they’re hanging down.
How it looks, this looks a little tight at first. It loosens up, and these sutures are placed deep.
A few passes to mass. There’s no tension on the skin.
Doing okay?
Yeah, good.
The other nice thing about doing this, an office like this is a little bit of a mild Tylenol narcotic and it’s quite comfortable to do it and you don’t have as much nausea and those kinds of issues like you can get with deeper forms of sedation or anesthesia, want the incision placed right in front of the ear. That will be nice and smooth. Now for right behind it here, I’d like to do a few interrupted type sutures that will just dissolve. That way if there’s a little bit of fluid that needs to work its way out, it can. Turn your head just a little bit.
We will do a few more of those and the skin closure superficially will be with the suture will take out in a week to 10 days. Pretty easy to close as you’ll see a few moments on. Now this incision can be carried farther if you’re trying to lift more of the neck than the jaw. Most of her problem was the neck next as well. This is considered a scar, mini facelift. As you can see, it does a nice lift there, not other than the incision, get a lot of result for a small decision and safe dissection. All right, we are going to start your peel now. So this is a trichloroacetic acid. Just kind of keep your eyes closed for now. It’ll feel a little bit warm, but that fan will kind of suited, so go ahead and look up for a moment. You get all way on your eyelid there. You doing okay? Good. Hey, you can close now as the peel starts to work, it makes this white frost appearance feeling a little warm. Yeah, it’s coming. Is it tolerable? Good. We are on the home stretch here, so this will help even out some of the pigment crome where your skin color’s uneven and working the fine wrinkles and it takes about seven to 10 days to finish peeling. In about an hour or two, this white color will turn to a red and then four or five days, it’ll start looking kind of brown as the outer layers of skin peel off. We’re almost done here, huh? Try and get some lip wrinkles there. Real nice.
Almost done. There’s some areas where this peel doesn’t take up as even just because the skin’s not been as damaged, but that’s a pretty nice even frost there. That’s going to be a nice result. Going to feather it into the neck a little bit. Make it have a nice blend, transition zone. This is a steroid cream, which you start to help it soothe. We are doing good. Almost done. And then we put a little outer coating Vaseline as well. More comfortable. Okay. Your peel is done.
Forehead & Brow Lift
In Office Cosmetic Forehead & Brow Lift by Dr. Burroughs from Springs Aesthetics in Colorado Springs

Make your incision right with your hairline. Here we start to just dissect one subcutaneous plane right below the skin surface.
Sure. Are these the stitches that dissolved or do I need to come back and have them removed?
Yeah, these ones dissolved it. Your last layer will be the kind that we remove. Okay. Because they will heal nicer. Okay.
Is that about a week from now? Yeah.
Tricky guard suturing around the hair. If the hair is some friend and your healing the incision, it takes a few extra moments. Thank you.
Okay.
That looks great. Okay. We’ll clean you up and I’m put a little dressing on it. Just keep your swelling down.
Okay. We’re all done. Thank you.
Facial Cosmetic Procedures
Liquid Facelift By Dr John Burroughs at Springs Aesthetics in Colorado Springs

Tell us what you’re looking forward to today with the wrinkle blockers and wrinkle fillers.
Oh, I’m looking forward to getting rid of wrinkles.
Okay. And then just kind of point on your skin, the areas that are bothering you right now.
Mostly here. Here.
Yeah.
These.
The bags underneath? Yeah. And then besides the prominent parentheses and the marionette lines and her frown lines, go ahead and frown for us real tight. Now relax. And the bags are in the eyes. She’s got some areas of deflation right here. And then on that area, which is a fairly typical aging thing that we see.
Really grateful for the work that’s been done, especially on my mouth because of post-op complications that had kind of collapsed and Dr. Burroughs was able to lift it back up and puff it out a little bit and it looks more like me. I’m also very grateful to get rid of this enormous trench that I have in my forehead from just gripping my face together, and that’s very much more smoothed out. So I’m really happy.
She had a fantastic result. You can see the improvement of her lower eyelid bags, improvement of her lips, as well as some lifting of her lower face. Here you can see those under eye bags, how improved they are, as well as the elevens and frown lines. And here’s a final picture. Thanks for watching.
Wrinkle Blocker "Botox" Injections By Dr. Burroughs from Springs Aesthetics in Colorado Springs

Hey everyone, this is Dr. John Burroughs. We’re going to be doing wrinkle blocker today. We’re going to address, can you bring your head up, raise your forehead. Good. Now show me your frown lines. Okay, so we’re going to address these areas to make her forehead smoother, which is a big desire she has. We’re going to work on the early crows feet that she’s developed now. Also work when we work on her frown lines to help bring her brow up just a bit and to counterbalance treating up here because if we overtreat up here and not address her brow depressors, her eyes are going to get more hooded, which is a mistake that you can see that we’re going to avoid on her. We’re also going to work on the muscles here. This will give a little gentle upturn to the corner of her lip to give a kind of pleasing appearance. So, alright, you can lay on back. So these don’t have to hurt if you kind of pinch and shake the skin a little bit. It just basically helps relax the area there.
For the DAO muscles, you go out a centimeter down about a centimeter to a centimeter and a half, and then within a few days we’ll start seeing the results of two weeks will be the maximum effect. So we’re going to give a few over here. These little fluid blebs go down over about a half hour. She’s doing great. All right, now squeeze your brows again. Okay, relax. You never really want to go lateral to the pupil. If you do, you can get more of the spock or mephisto eyebrow. So you want to stay medial to that area. Squeeze one more time. Okay. Relax through. There’s no restrictions after you get wrinkle blocker. She can go to the gym and work out if she would like. That’s no problem. Some speculate that if you move the muscles for the first few hours afterwards that it might help it work a little better. I also work on the depressor supercilious muscle, which runs right down in that area. I find if you first get the corrugators it is got a little bit of numbing effect in it, which will help those others not hurt as much. So by doing that, and then you can slide down here to get that depressor, which kind of runs in line with the orbital rim. If you see a little bit of oozing, that’s okay. Just kind of hold pressure immediately and that’ll get it to stop so that they don’t get a bruise.
The corrugators are pretty good sized muscles, so sometimes they’ll lose just a little. Now raise your forehead again. She kind of has a short forehead so you don’t want to overtreat or it can cause it to fall more so if you stay up high like I’m doing here, that’ll help avoid the brows coming down, giving her a more masculine look that we’re trying to avoid. So you don’t want to do any touchups on this until it’s been a few weeks. That’s where the maximum effect will be. Otherwise, you might be chasing your tail. If patients do get that Spock eyebrow, that’s just really easy to put a couple units here and there, and that’ll easily take care of that. She really wants a smooth forehead, so I gave her quite a bit. And I’m going to do the last little bit right here. And that’s it. She’s done awesome here. You can see her before and after forehead lines have been improved. Here you can see her frown lines are dramatically improved. She looks more relaxed. Here you can see the gentle upturn to the corner of her lips. And here you can see the great improvement of her crow’s feet area. Thanks for watching. Have a great day.
Wrinkle Blocker "botox" Facial Injections with Dr. Burroughs from Springs Aesthetics

Hey, this is Dr. John Burroughs at Springs Aesthetics. We’re going to be treating this mid thirties beautiful lady for the lines in her forehead. Can you raise your eyebrows up? Okay. She doesn’t like that. Now give me your frown. Okay. She wants to look more relaxed. She has been told by some, she kind of has that resting angry face. Now give me a big smile. Okay. And then scrunch your nose. There you go. We’re going to try and relax her bunny lines there so that she doesn’t get the deep lines from her nasal muscle. And then we’re also going to do a little bit in her depressor over here and here to give a gentle upturn to the corner of her lips, which she’ll give her a more pleasing, approachable appearance as well. So go ahead and lay back and we’ll start down here with her depressor. Angularis. Pull your lip down like you did earlier. No, just your muscle. There you go. You see how she does that? Go over a bit centimeter about down a centimeter and a half and just a couple units. Sometimes I’ll do four depending on how deep they are. Good.
All right. You relax that and then smile for me. Good. Relax. You’re doing great. If you tap ’em while you’re injecting and pinch and squeeze, it’ll help ’em not be as uncomfortable with the injections. When you really want to lift the lateral brow. If you get a little bit up higher here, you can get a little more arching like that. I don’t give too much. I don’t want to give her a spot eyebrow or something. She won’t like doing great. It’s got a big vein there. I can see. I don’t know if it’s showing up in the video, but it tracks like that. So I’m carefully avoiding that. So having good lighting is important. So we’re done with her crow’s feet. If she’d had deeper crow’s feet, sometimes you’d do a concentric row of four spots and then a few more out here. All right. Now give me the frown with your eyebrows. Okay. Don’t go lateral to her pupil, because that’ll make the brow arch, which we don’t want too much arching. You’re doing great. So I’m giving her about four units at each of these spots here.
People that don’t frown too much here or have small muscles, they can sometimes get by with just 16 to 20 units. And then people like myself get close to 40 there. It takes a lot to relax mine. And then I’m going to give her a couple here. You’re doing great here. And then when you want to get the depressor superciliaris switch runs along the orbital rim here, medially. I go in a spot I’ve already done and kind of march down to it. Give a little bit and then a little bit more here. You don’t want to go deep to the orbital rim or you might affect the superior ble muscle. And then her nasal, which causes those bunny lines are right here. Just takes a couple units.
And I really like these syringes because they have a little plunger sheet. You’re not leaving any behind. Now on her forehead, she has a relatively short forehead, and she’s starting to get those horizontal forehead rids. So we want to stay up high. If we go mid forehead or below, we’re going to make her eyes hood, and then she won’t be as happy with me as I’d like her to be. So raise your forehead again. Remember the front, you can relax. The frontal splits like a V, but it can be very asymmetric from patient to patient. Sometimes on one side it’ll be closer to the midline and then have a bigger gap on the other. So you can really kind of tell by the way their lines form Doing great.
Giving her a few units of each of these spots here for patients that you’re worried will get the arching of their eyebrow, you can counter that by doing just a couple units here. But we want to give her a little bit of an arch on men. They don’t want that arch because it looks effeminate. So I’m getting just a little bit low here, but not much. So she’ll still be able to pull upward, and that takes care of her. Thanks for watching. Here you can see a nice improvement to the forehead lines while still maintaining nice brow positions. Here you can see the improvement when she frowns and how relaxed she looks. Here’s an improvement to her nasal or bunny lines by her nose. And here’s a nice subtle improvement to the upturn at the corner of the lips. It’s quite popular in our practice. Thanks for watching.
Botulinum Toxin For TMJ & Facial Slimming w/ Dr.Burroughs from Springs Aesthetics, Colorado Springs

Hey, this is Dr. John Burroughs at Springs Aesthetics. This beautiful lady here would like a slimming effect along her jawline, and she also gets TMJ symptoms at night because she clinches too much. So go ahead and clench for me so you can now relax, help with both those issues by giving a small amount of wrinkle blocker right into those areas there.
And then you want to balance it out on the other side, clench again.
So this really does help their symptoms. They’re little kind of sometimes like a little tiny mosquito bite as it goes in, but it’s not too bad. And that will start to help her within two to three days and then last for several months. It’s a pretty big muscle, so you got to give a fair amount in there, but the improvement you get is well worth it. So thanks for watching.
Other Procedures
External Cantholysis Tarsal Strip by Dr. Burroughs from Springs Aesthetics in Colorado Springs

This is Dr. John Burroughs, and I’m showing the External Cantholysis so that I can create a Tarsal Strip. This patient had a transcutaneous lower eyelid blepharoplasty, and so support at the lateral cantholysis is needed to avoid atropin or retraction. Releasing the cantholysis also makes it easier to get the lower eyelid fat in patients who need fat removed, sculpted or repositioned. This is showing the closure with five oh Vicryl suture to reform the lateral canthal angle. Thank you for watching.
Transblepharoplasty Arcus Release by Dr. Burroughs from Springs Aesthetics in Colorado Springs

I am showing here a trans blepharoplasty approach to the acus release for lower eyelid cosmetic surgery.
Transconjunctival Internal Cantholysis by Dr. Burroughs from Springs Aesthetics in Colorado Springs

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Temporary Suture Tarsorrhaphy by Dr. Burroughs from Springs Aesthetics in Colorado Springs

This is Dr. John Burroughs of Colorado Springs, and I’m going to show my temporary suture tarsorrhaphy technique that myself and some co-authors published in archives of Ophthalmology about 10 years ago. You can use a 4-0 silk in a single arm fashion. I typically suture the central centimeter of the upper lid to the lower lid, passing your suture needle through the meibomian gland openings. This provides strength and integrity to your temporary closure, and I often will place four square knots to try and keep it from coming apart. With repeated application of medications to the ocular surface. Several square knots is being shown, and then you can leave about an inch of suture to make it easier to remove in a couple of weeks. It can be repeated, and I like this technique because you don’t need to use bolsters. It’s very helpful for patients that are having corneal ulcers or non-healing exposure keratitis due to decreased sensation of the ocular surface. Thank you for watching.
Ear Gauge Repair Before & After with Dr. Burroughs from Springs Aesthetics in Colorado Springs

Hey everybody, it’s Dr. John Burroughs. I wanted to share a pretty interesting case. There’s a lot of people that have had gauge earrings placed in the past, and then they regret having them because it leaves this large defect. And this gentleman wanted to have it repaired because as he’s gotten into his thirties, he wanted an expanding option for job opportunities, and he felt during interviews that this was not optimal to have. So he hadn’t even been wearing his gauge earrings for quite some time. But again, you could see the sagging of the lobe and then the hole right here. So this is a nice thing to repair for patients. Basically, we have to cut a new area within it. If it’s a smaller hole, one that’s this large, we had to make an incision across here, remove that part of the skin, and then up this way, and then bring things around. So his was a little more complicated, but nonetheless, he’s thrilled with his result. This is only three weeks out and left a couple of sutures here that I didn’t get out before the picture, so I regret that. But he’s happy, he can’t believe this, and he’s got other friends with gage defects and he’s already sending them because it can make such a big difference. Thank you for tuning in. I hope everybody has a great day.