Facial plastic surgery is a broad medical practice that someone who delivers great results from facelift may not always be able to do the same with eyelid surgery procedure, as suggested by renowned plastic surgeon Dr. Karan Dhir.
The most crucial step to achieve good results from eyelid surgery procedure is to find a “qualified” surgeon who must meet the stringent requirements stated below:
- Appropriate board certification
Before-and-After Photos of a Patient Who Have Had an Eyelid Surgery Procedure
Surgeons with board certification in general plastic surgery, facial plastic surgery, and/or ophthalmology can deliver predictable results, assuming that they routinely perform it for several years.
- Specific training and experience
The “right” surgeon must be performing the sought procedure on a regular basis, with hundreds, if not thousands, of surgeries under his belt. His portfolio of before-and-after images of previous works will serve as a proof of his level of expertise and experience.
- High patient satisfaction
A prudent person should ask for patient references and her doctor’s complication and revision rates. In addition, it makes sense that she considers her surgeon’s reputation.
Aside from previous patient references, other good sources include referrals from friends, family, and/or general physician. Nevertheless, it remains important to conduct one’s own background check and due diligence.
It is important to note that high patient satisfaction and low complication rates are only possible if the surgeon makes all the effort to conduct proper patient selection and promotes honest communications and good rapport.
Traps to Avoid:
Some patients choose their doctors based on price alone, others rely heavily on catchy ads or “brand names” of a surgical technique without realizing that these could prevent them to perform their due diligence.
While paying a premium price does not automatically ensure better results, a doctor whose fees are way lower than the average (eyelid surgery involving both the upper and lower lid typically costs $4,000-$6,000) could mean that patient safety has been compromised to preserve his profit margin.
Aside from heavily discounted plastic surgeries, a prudent patient should also avoid doctors who pressure them to have more procedures than they want. It is important to note that surgeons must adhere to high ethical standards that are anchored in patient safety and high satisfaction.
Qualified and reputable surgeons remain busy that they will not rely on discount plastic surgeries to attract more patients despite economic downturn. Some experts even say that lowering the fees too drastically could be a sign of desperation of non-specialists/unqualified doctors, as opposed to just a marketing strategy.
There are several neck lift options due to varying anatomies and underlying cause/s of the problem. For instance, some patients are concerned about the appearance of neck bands in which excess fat may be culprit, while others have “turkey wattle” that is typically caused by weak or splayed platysma muscle.
A comprehensive physical is always necessary to determine the best course of action. And during consultation, the patient must also share her motives and cosmetic problems, allowing the surgeon to explain and offer methods that can improve her appearance.
Before-and-After Photos of a Patient Who Have Had Neck Lift Surgery
Dr. Karan Dhir, one of the leading Beverly Hills plastic surgeons, explains the three most popular neck lift options, which are occasionally performed simultaneously to achieve the best result possible:
1. Double chin and neck band appearance. If these are caused by excess fat beneath the skin, minimal liposuction can create a smoother, more rejuvenated neck contour.
A small round incision, about 1 cm in diameter, is positioned beneath the chin where a microcannula or hollowed tube is used to suction out the fat. However, it is crucial to preserve some fatty cells to maintain the natural contours of the lower face and anticipate soft tissue shrinkage that tends to progress with advancing age.
Over-aggressive liposuction must be avoided at all cost because the platysma muscle in the neck will become prominently visible beneath the skin—immediately after surgery or years afterwards—further contributing to the aged appearance.
2. Loose skin in the neck and jowling. A direct skin excision is needed to contour the lower portion of the face; this is generally accomplished by placing incisions around the ear’s contour that may sometimes reach the nape to achieve more rejuvenating effects.
Oftentimes, this excision-based neck lift is combined with standard facelift in which the incision starts from the temple behind the hairline that curves down and behind the ear, or even the nape if the neck requires contouring as well.
Proper wound closure is imperative to prevent scar migration and poor healing.
3. Weak platysma muscle. Sometimes, the vertical muscle in the neck that has become splayed causes the sagging appearance. To address this problem, a small incision beneath the chin is used to reshape or sometimes even remove a tiny portion of the muscle.
Patients with thin skin and very little fat may choose a non-surgical alternative in the form of Botox, which can be done in 15 minutes.
Male endoscopic brow lift is particularly suitable for patients with receding hairline or hair loss problem. With this technique, 2-6 small incisions about 1 cm in length are positioned behind the hairline so the scars remain hidden.
For patients with hair loss problem and large forehead, the standard technique in which a long continuous incision at the ear’s level is used can be problematic—it can lead to more visible scar and add more height to the forehead.
Meanwhile, the aforementioned problems can be avoided by endoscopic brow lift techniques, which use an endoscope or fiber-optic camera attached to a screen. Doctors also use other tiny articulating instruments to tighten and reshape the deeper structures of the forehead.
Even with the use of shorter incisions, endoscopic techniques can still elevate the entire forehead and brow, which is often achieved by using some form of internal sutures or anchors. If needed, the surgeon will also weaken the muscles responsible for the “frowning” appearance.
Contrary to popular belief, male endoscopic brow lift is not just about raising the sagging brow. An equally important goal is to reshape it in a way that it is gender appropriate. The consensus is that male brows must appear heavier and more horizontally oriented compared with female brows.
Also, male brows must ideally lie at or even slightly below the bony part of the upper eye socket, while female brows must be positioned about 0.5.-1 cm above this margin to achieve gender appropriate results. Simply put, over-aggressive lifting of the forehead area is particularly detrimental to male patients due to its feminization effect.
Nevertheless, over-aggressive surgical maneuvers can still spell disaster for women who may end up with a perennially surprised or quizzical look, warns Dr. Karan Dhir, one of the leading Beverly Hills plastic surgeons.
Men generally require a more conservative surgical approach than women due to the gender-based definition of beauty. For this reason, minimally invasive brow lifts in which shorter scars are used are often suitable for male patients.
Some doctors feel that most men seeking brow lift will only need the tail end of their brow to be lifted since the medial or inner portion rarely descends to a significant degree.
By lifting the tail end of the brow, which is achieved by placing short bilateral incision in the temple area behind the hairline, some patients may notice that the fullness in their upper eyelids is reduced as well, further contributing to their more youthful appearance.
Nose surgery bump removal is a highly customized procedure since each patient has unique underlying features and personal tastes. To further deliver satisfying results, it must also take into account the person’s gender, ethnicity, age, and even height.
While it is possible to limit the surgery to the bump on the nasal bridge, most patients will need all or at least most of the components of their nose—i.e., tip, supratip, nostrils, columella, etc.—to be reshaped as well to achieve a more balanced, smoother appearance.
Contrary to popular belief, nose surgery bump removal is not just about eliminating the irregularity in the bridge. For instance, some patients want to maintain “subtle” bridge fullness to preserve their ethnic or distinct family feature, while others desire for a straighter profile or something that appears more concave.
Nose surgery is often described as a surgery of millimeters, thus a good patient-doctor communication is of utmost importance. As a result, a growing number of practitioners are offering 3D computer imaging technology that allows their patients to preview the likely postop results.
The upper third of the nose is composed of bone, while the remaining lower two-thirds is made of cartilage, which is a flexible connective tissue. Most people’s humps are caused by irregularities both in the bone and cartilage, although sometimes the hump is limited to the bony or cartilaginous part only.
In many cases removing or trimming the excess bone and/or cartilage is enough to eliminate the bump. However, some patients have a condition called pseudo-hump deformity, which requires a different approach.
A pseudo-hump deformity is caused by an underdeveloped or somewhat hollowed bony part in the upper portion of the bridge (radix), thus creating an “illusion” of excess fullness below its area. To address this problem, doctors use a technique called radix grafting to create a smooth profile.
Grafting is the use of tissue taken from the donor sites, such as the septum or wall separating the two nostrils, bowl of the ear, rib, etc., to improve the structure, shape, and even function of the nose, as explained by leading Beverly Hills plastic surgery expert Dr. Karan Dhir.
Even without the pseudo-hump deformity, some patients will still need grafts especially if their surgery involves large hump and/or bridge reduction. The idea is to preserve the structural integrity of the nose, leading to normal breathing functions and long-lasting results.
The surgeon’s collection of male facelift photos of his previous patients will reveal a lot about his level of expertise and artistic eye. Take note that a good result should look natural, with no surgical stigmata such as [visible] scars, overly tight appearance, flat cheeks, and distorted smile.
Dr. Karan Dhir, one of the leading Beverly Hills plastic surgeons, explains the key variables that you should look into when assessing your doctor’s male facelift photos.
Before-and-After Photos of a Male Facelift Patient.
The ear should not look distorted, i.e., the detached part of the earlobe should remain that way after surgery. For this reason, you should compare the ears between the “before” and “after” photos.
Too much tension or incorrect direction of pull can distort the ear, leading to the pixie ear deformity. While a revision can mostly reverse this appearance, it always makes sense to avoid it from the very beginning through appropriate surgical techniques.
The “after” photos should reveal facial hair position that is the same as the “before” image. To preserve the natural hair growth, skilled surgeons maintain a small area of non hair-bearing skin at the base of the earlobe and avoid excessive pulling of the soft tissue.
One of the most visible signs of surgery is the presence of hair-bearing skin that is too close to the earlobe, prompting the patient to shave too close to the ears.
The hairline and sideburns should remain unchanged after surgery; however, they could move into unnatural positions or have their shape altered after an aggressive technique (i.e., excessive or incorrect direction of pull).
Oftentimes these problems can be repaired by a hair transplant surgery whose results must reflect the natural direction and angle of growth and “grouping” of hair follicles to completely hide the bad effects of an aggressive facelift.
Too much lift in an attempt to raise the saggy mid face can lead to flat cheeks, while leaving the lateral side of the face unnaturally tight.
The cheeks in the “after” photos should have natural plumpness, as opposed to looking gaunt, flat, or overly tight. For this reason, some patients may need “volumizers” usually in the form of dermal fillers and fat graft, which are both injected into the skin.
As aging progresses, the jaw line and neck skin have the tendency to sag, making the lower face looks “heavy” and undefined. For this reason, most facelifts also address the area to achieve a smoother, more balanced appearance.