Check out the recently published September issue of Town & Country magazine, “Speaking Volume”, which highlights the role of dermal fillers in facial rejuvenation.

New approaches for rejuvenating the face without incisions have caught the attention of mainstream media!  This is a very exciting article reviewing the dramatic shift in how physicians soften signs of facial aging.  I’ve been a huge fan of dermal fillers and fat transfer for more than a decade. . . .and spent  considerable time cultivating my own unique 3D approach.  Volume enhancement is the ideal anti-aging solution, particularly for individuals of darker skin tones who have a risk of keloid scarring.  I’ve known for a while that the traditional “around the ear” facelift incision was not a good choice for women of African descent.  Injectable facial enhancement with dermal fillers or natural fat is definitely the way to go!  Fillers Vs Facelift – The NEEDLE WINS. . . .I must Agree.

I had the wonderful privilege of having a patient of Kenyan descent travel all the way from Norway for rhinoplasty. She searched the globe for a surgeon with a sensitivity for ethnic beauty . . . and made the journey to see me!

Question:
Do all doctors use computer imaging for nose jobs and what is the purpose of this?

Answer:
Computer imaging is a wonderful tool to help patients gain an appreciation for expected outcomes. The majority of physicians have traditional photography using two-dimensional photography to create images of the patient and to use this two-dimensional image to facilitate conversations related to aesthetic outcomes.

In our office, we have innovative three-dimensional imaging technology to show patients in a more authentic way what they would look like following rhinoplasty surgery. This technology is the most advanced method available to simulate surgery using the patient's own image.

Question:
What is the risk of heavy scarring from a facelift? I am a 53-year-old female and have heard horror stories about facelifts gone wrong.

Answer:
One of the most significant complications of facelift surgery involves scarring. The risk of scarring increases with tension placed on the incision line. It is known that increased tension promotes widened scars and keloid scarring in patients of darker skin tone. It has been my position to avoid the traditional facelift incision because of the significant risk of scarring with this procedure in certain populations of patients.

We adopt an alternative approach to the facelift which involves injectable facial enhancements using a combination of synthetic and natural fillers. This approach avoids any significant risk of scarring.

Question:
I broke my nose several years ago and it looks like it is sort of twists to the side ever since. I thought of getting a nose job right afterward to fix it but never did. Is this something that can still be fixed and how would it be done?

Answer:
Improvement of a crooked nose is one of the most challenging rhinoplasty operations but it is never too late to seek a more balanced and harmonious correction. There are a variety of different techniques that I am able to utilize to straighten a crooked nose using your own cartilage or, in some instances, synthetic injections with hyaluronic acids such as Restylane or Juvederm and sometimes Radiesse. With the variety of techniques available, both surgical and non-surgical, we are able to significantly improve the appearance of a crooked nose many years after the injury.

Question:
With all the different injectable fillers out there, I would really appreciate it if you could detail some of the more effective ones and what they are best at treating.

Answer:
One of the most significant advances in cosmetic facial plastic surgery over the past decade has been the introduction of facial fillers as a tool for restoring youthful facial contours. The most common fillers that I use in my practice are hyaluronic gels such as Restylane or Juvederm, the calcium hydroxylapatite filler Radiesse, and your natural filler, fat.

Dependent upon the goal, we frequently use a combination of synthetic and sometimes your own natural fat to improve youthful contours of the face. We often use three-dimensional facial imaging as a method to determine ideal amounts of filler necessary to reverse the signs of aging.

Question:
I have really horrible jowls that I would like to have improved. There are so many different facelift techniques out there. Is one best for treating jowls?

Answer:
Patients frequently present to my office with complaints of jowling or laxity along the jaw line. There are many different ways to address skin laxity in this area. The traditional facelift involves an incision around the ear. My practice focuses on patients who are seeking alternative approaches to a facelift without the risk of scarring. We frequently address the jowls by injectable facial enhancement coupled with facial liposuction. These alternative techniques avoid the risk of scarring which are associated with the traditional facelift.

Question:
I keep seeing something called osteotomies in rhinoplasty. What is this? Is it always part of a rhinoplasty procedure?

Answer:
Osteotomy is the medical term for breaking the bones. Osteotomies are a common component of rhinoplasty surgery, particularly when patients complain of a wide bridge.

There are many different types of osteotomies to improve the overall contour of the nasal bridge. Dependent upon the patient's aesthetic goals in reference to narrowing, an osteotomy may be a part of the procedure.

Question:
I had a rhinoplasty surgery about three months ago that involved tip work. The cartilage in the tip now feels very hard and I just wanted to know if this is how it should be or if there is possibly something wrong. Will it eventually get softer?

Answer:
It is not uncommon to have thickening in the tip area immediately following rhinoplasty surgery. It is a natural part of the healing process. Over time, as the swelling resolves, the tip will feel much softer and the contour will be significantly improved. This typically improves over the course of the first year following rhinoplasty surgery.