Overdone is bad news for a prime steak but for a face it’s down right disaster.
What separates the good, the bad, and the botched, is the talent of the surgeon.
(F) What’s your specialty?
(W) I am a Board Certified plastic surgeon. But you can’t be in this business without doing the injectables. Not every patient is ready for surgery. Some people come in expecting surgery and don’t need it. See Part 1: The Injectables
(F) Do you screen for unrealistic expectations?
(W) Yes, and it has gotten easier for me. I was naive about people’s expectations at the beginning of my practice. Now I spend a lot more time consulting with the patient before doing surgery.
A red flag goes up when a patient has multiple complaints about multiple areas and has already seen 3 or 4 surgeons.
Some patients can’t be satisfied. There’s a fine line between people being overly obsess, and people with body dysmorphic disorder (BDD), who dislike every aspect of their body. To operate on someone like that is a mistake.
(F) What’s new about new faces?
(W) As far as surgery goes, there’s been a big push for minimally invasive procedures using small incisions. We use cameras for precision in things like brow lifting. There is a mid-face lift where you lift just the cheeks.
There’s a superficial muscularaponeurotic system (SMAS) facelift. The SMAS is the muscular system of the face. It contains fat pads that tend to drop as we age and cause jowling and deep labial folds. We lift the skin to get at SMAS, and the work is done on the deepest (third) layer of skin.
(F) What is the most popular procedure for women in their 50s and 60s?
(W) I see a lot of women who want their upper and lower eyelids done. This includes removal of some skin around the eyes and a brow lift. I also do a combination lower eyelid lift and a cheek or mid-face lift. Neck lifts are very popular, and I do a lot of injectables.