Inner and Outer Harmony

The most common reason people come to my office in Scottsdale for facial rejuvenation is because they want to look as good as they feel. For example, a very bright professional woman saw me because she felt that she looked ten years greater than her actual age and felt twenty years younger than she appeared. She is one of the best in her field, is in great physical condition and wanted to look good for her age. She had reached a point where she could not accomplish the outward expression of how good she felt inside with makeup and exercise alone. She underwent a facelift and eyelid surgery with me and could not be happier that her outward appearance reflects how she feels inside.

Of course, changes that come with age are a reality. This doesn't mean, though, that we have no choice... It is reasonable to correct the damage that occurs. I have been asked, "Why do we age?" and "Why do some people seem to age so much faster than others?" Those are the questions of the century, really, but we know that many factors will affect our external appearance of age. In Arizona, we are all too aware of the effects of the Sun and ultraviolet rays. But probably equally important are heredity, smoking history, history of taking steroids or certain strong medications, history of serious illness, and yes...stress. So, to control the aging process, we can protect our skin from the sun, not smoke, stay well and live a low-stress life, right? To some degree this is true, but we often don't have much choice about our genetics or stress levels, and many of us lived in a time when sunscreen did not exist, so significant solar damage may have already occurred.

In those circumstances, the best treatments are both surgical and non-surgical and should be done in a way to maintain a natural appearance while minimizing the amount of "down-time." I offer a facelift operation for women and men that accomplishes the most natural, long-lasting results while minimizing "down-time." The operation is essentially painless and the recovery is relatively easy.

If you are interested in looking as young as you feel, call my office at (602) 457-5700 for a consultation or send me a request online.

Holiday Cosmetic Surgery

A favorite patient of mine was chatting with me about her upcoming cosmetic surgery procedure and asked me when was the "best time" to have cosmetic surgery.  It's an interesting topic, so anytime a patient brings up something interesting, I like to add it to my blog.

Much like having children or going on a diet, the old addage "there is never a perfect time" still applies.  It is true that the busier times for cosmetic surgery in Scottsdale are the Holidays (November through February) and the Spring.  Even though there is no perfect time, we all can relate to timing things so that they impact our "regular" lives the least.

I have to smile when I see ads that promote "new face for the new year" or "give yourself the gift of beauty for the Holidays."  The true motivation for most people is that the Holidays fit better with their personal schedules in order to get things done.  Many times, my patients have waited for months to have their procedure over the holidays purely for convenience.

The question behind the question of "when is the best time to have plastic surgery" is really about recovery time and your schedule.  Each procedure has a different recovery period - including what activities you can perform during recovery, healing times and visible signs of surgery (like dressings, bruising, sutures).

As a general rule, most recovery periods are from 5-10 days depending on what was done and the range of activity is from "normal" to "light activity at home."  The less involved the surgery or procedure is, the faster and easier the recovery will be.  For example, the lightest laser resurfacing procedures can have just a 2-3 day period of pink skin, while the deepest treatment can have two full weeks of recovery, the first week spent essentially indoors.  You would be correct if you guessed that the most dramatic results are achieved with a more involved laser peel.

Celebrity Plastic Surgery

Every time I take a passing glance at a tabloid magazine, it seems there is some photo and blurb about some famous person's latest cosmetic surgery - especially if it is "plastic surgery gone wrong!"  This type of sensational gossip is not new, but it does give the wrong impression of the field of facial cosmetic surgery.  Morbid curiosity with what possible distortions and imperfections might await behind the cover is what publishers hope will sell more issues of their magazine.

Of course, those stories wouldn't even exist if there was not some element of truth in them.  Let's face it, I don't have to name names (and I won't) to make you think of more than a few female and male celebrities who underwent some type of cosmetic procedure that has left them with an unusual appearance.  Every time they appear on TV or the big screen (if they can still get work), I can almost hear a crowd of people across the nation saying "I would never do that to my face," or "WHY did they do THAT?"  The worst part of it all is that, often, these celebrities asked for this to be done to them, and they convinced a surgeon somewhere to do it, in spite of knowing that it would not look right.

I am not the first facial cosmetic surgeon in Scottsdale (or across this great nation) to have a celebrity sit in my office and ask that I perform a procedure that I feel would not look good.  It is my oath and obligation to decline such requests and offer alternatives that will look natural.  No matter how exciting it may seem to have a celebrity asking me to operate on them, it is easy for me to say "no" because I believe in being consistent and true to form.  If what I am doing is not art, I am not interested in doing it.

But, when you are out with friends and they start to talk about a celebrity's bad nose job, weird eyelids or terrible face lift, don't assume that this represents all or even a significant percentage of cosmetic facial surgery.  In reality, the vast majority of facial plastic surgeons (especially those who are board certified and fellowship trained) are ethical and work to achieve harmonious results that do not look "operated."  There are far more actors in Hollywood and other household names who have had very natural-appearing facial cosmetic surgery than those who look bad.  These individuals were able to work with their surgeon, respect their opinion and take "no" for an answer when it was necessary.

Like many of my colleagues, I have had the "honor" of operating on famous people.  Although they do carry some additional precautions because of paparazzi and the curiosity of the general public, they are mostly normal, reasonable people.  They get good results because they develop a common goal and work toward it.  This is the same for any patient - whether a teacher, household engineer, police officer or even a physician.  It is truly the greatest honor to treat the members of my community who don't desire fame and glory.

Remember that for every "celebrity plastic surgery gone wrong" there is at least ten times the number of "super secret celebrity cosmetic surgery gone right" and countless more non-celebrity surgery gone right.  The real pathway to getting the right results it to find a surgeon with whom you are comfortable who will go over your goals and expectations and work to develop a cooperative plan to achieve success.  If you are looking to get that process started or just want another opinion, contact me through this site or call my office for a consultation.

Digital Imaging or Imagining?

Advances in technology have certainly improved our lives and generated all kinds of new ways to deliver information.  Many of us now read our news, get directions, listen to music and even learn about Scottsdale cosmetic surgery over the internet.  Image technology has generated surreal movies or photos where virtually an entire new world or effect can be created.

In the realm of cosmetic surgery, technology has also made its way into many surgeon offices.  Computers have greatly improved laser technology, have streamlined our medical records and allow a surgeon to create images to represent the results a patient might expect - digital imaging.

I was speaking to a new patient recently and she said she was told that computer imaging is “fake” and isn’t realistic.  If you have spent any time reviewing this site, then you know that I use computer imaging for almost all of my cosmetic surgery consultations.  But, my very intelligently skeptical patient brings up a good point:  Since computer photo image manipulation is being used, isn’t it by definition fake?

That depends on how the images are created and used.  Firstly, imaging must be done making only the maneuvers that the surgeon can reasonably expect to execute.  This means that imaging should be performed or at least reviewed by the surgeon before it is presented to a patient.  Only a surgeon’s honest representation of what is reasonable should be shown to patients.  Secondly, the true purpose of imaging should be to demonstrate to the patient that the surgeon has an understanding of their desired improvements as well as the limitations of surgery. 

Just like anything else, computer imaging software is a tool that can be used properly or can be abused.  Anyone who has worked with these types of programs knows that a patient’s anatomy can be changed in ways that are not only unrealistic, but impossible.  Unfortunately, if imaging is done in this way to sell surgery, the surgeon will end up with a lot of dissatisfied patients and will get a reputation for this behavior.

Probably the most valuable aspect of cosmetic surgery imaging is that it can stimulate discussion about the desires of a patient with the surgeon such that both sides can understand and agree on the approach and the expectations for a result.  Though the images that spark the discussion may be alterations of a photograph, the benefits of having a common goal and mutual understanding before surgery are definitely not “fake” and make a huge impact in reaching those very realistic goals.

Injecting Beauty

All of us who seek to maintain or improve our image know that everything we do carries with it certain limitations and risks.  This bit of reality has pushed science and medicine toward the "Holy Grail" of cosmetic treatment: Something that can give noticeable improvement right away, looks natural, doesn't cost too much and has minimal or no down time.  Alas, we are not there yet! Rest assured, though, that great minds continue to pursue this lofty goal.

In the meantime, we have many solutions that are the closest answer to this question - Injectable cosmetic treatments.  The major types of products and services available are:

• Muscle relaxing injections like Botox (Abobotulinum Toxin A) and Dysport (Onabotulinum Toxin A)
• Dermal hyaluronic acid fillers like Restylane, Juvederm and Perlane
• Dermal Calcium hydroxyapatite (Radiesse)
• Deep injection of poly-methyl methacrylate (ArteFill)
• Injection of collagen building therapy from Poly-L Lactic Acid (Sculptra)
• Fat transfer - injection of fat taken from elsewhere in the body to add facial volume

 So...just choose from these products and services and get great results, right?

In short, NO.  These products have to be handled properly and placed in very precise locations in order to give the best results.  The knowledge of anatomy, physiology and the practiced dexterity possessed by a facial cosmetic surgeon is far beyond any "nurse injector" or aesthetician, regardless of their individual experience.  The truth is, these products and techniques are not harmless and when a bad outcome occurs, it can leave a patient with quite a serious problem that can take a long time to resolve.

I have taken care of many patients injected by unlicensed, non-physician "injectors" who have had to undergo removal of product or had to tough out three months of a drooping eyelid or eyebrow.  Of course, there are also those patients who just don't quite get the improvement they had hoped, so they seek a more trained hand.  When it comes to cosmetic facial injection by a non-physician "injector" to save money, the old addage that you get what you pay for holds true.

I have very strict standards on the quality of work my patients receive.  I treat each patient as they were my own family member.  I would only recommend to my wife, brother, sister or mother that they receive these injections from a fully trained, licensed physician.  For this reason, I personally inject all of my patients, every time, without exception.

Everybody has their own favorite tricks of the trade.  I have adaptations I have developed to give something special to patients that they are not likely to find elsewhere.  My approach to lip augmentation injection is very refined and provides a natural, balanced, beautiful look.  I have a technique for elevation of the down-turned corners of the mouth that can give instant results.  Botox and Dysport patients of mine know that I can improve the frown lines while simultaneously giving an attractive brow lift.

In those patients who just can't afford the downtime or the expense of surgery, I offer an all injection facelift technique which adds volume and elevation to the midface while softening the lines of the lower face.

Fat transfer is one of the true miracles of facial rejuvenation, and not every plastic surgeon in Scottsdale performs this procedure properly.  The very selective removal of fat from another body location without leaving evidence at the donor site and then transfer of this living tissue to the face in a careful and balanced way restores volume that is your living tissue, and is therefore permanent.

If you have had cosmetic facial injections in the past or you are just considering it for the first time, make an appointment to meet with me.  I will give you a complete analysis and will tailor a treatment that best suits your goals and anatomy.  I often have special promotions for my established patients to save on the cost and new patients always receive a sizeable savings.