Posted on: June 1st, 2015 | Posted in Facelift, Stem Cell Face Lift
More than a decade ago, a few of the most notable face lift plastic surgeons in the country participated in a meeting where they performed a live face lift on a group of twins. Each plastic surgeons used his own published technique and a year later the results were evaluated by a group of plastic surgeon. The purpose of this famous “twins study” was to establish if one technique would stand alone as the “gold standard” to achieve the best result. Unfortunately there was no winner. No one technique was singled out as “the best technique”. No result stood out clearly as the best! The conclusion was that no matter what technique anyone used, it was the skills of the surgeon that mattered, and all the results were similar because they were all good surgeons! A bit disappointing, wasn’t it?
In retrospect, there is some truth in the conclusion: it is undeniable that the ability, judgment and skills of the plastic surgeon do play an essential role in a successful outcome in a face lift. Experience helps preventing complications, a sense of beauty dictates what is needed and the skills of the plastic surgeon make it happen.
What about techniques?
Every plastic surgeon uses some form of basic technique which he modifies accordingly, depending on situations determined by patient’s anatomy, age, risks factors etc.
How does the patient (the consumer) make sense of all of the different techniques?
The plastic surgeons use their own terminology to identify in one technique or the other and this is passed on to the patient with the implication that it would be easily understood. But most of the time, it is not. So let’s try to shed some light upon this subject.
Face lift surgery is subjective, like anything else, to trends. And, like any trend, techniques come and go. We all get excited about a new technique and for a while everyone will incorporate it in their armamentarium only to find out that it does not deliver the results we were expecting. At that point, the search is on for something else to fill the gap.
Let’s review the most popular techniques and try to establish benefits and downsides of each of them.
Probably the most popular of the face lift techniques (and the most used) is the so called SMAS face lift. The SMAS ( Superficial Muscolo-Aponeurotic System) is a thin layer of tissue which overlies the muscles of facial expression. It was discovered in the 70’s and since then haa become probably the workhorse of facial plastic surgery. Before that, face lift was basically a skin- only procedure where only the skin was elevated through the classic incisions around the ears, pulled and stitched together.
The SMAS facelift consists of isolating and elevating this thin tissue over the facial muscles and transpose it upward. By doing that it transmits the pull to the skin which is elevated at the same time. The benefit of this technique is that the tension of the pull is transmitted to the SMAS layer so the skin can be pulled with less tension. The downside is that the direction of pull of the SMAS is horizontal or at best oblique in the High SMAS (a recent modification of the technique) giving the face a un-natural pull.
There have been a lot of spin-offs on the SMAS techniques like the one I mentioned before, the High SMAS and several others , like the SMASECTOMY where the SMAS instead of been repositioned is partially excised. In my opinion, it does not make any sense of excising any structure of the face but the skin because by removing something the face loses volume when in fact we want to add volume to an aging face that is deflated. The other variations of the SMAS Face lift consist of folding, cutting or moving the SMAS a few millimeters up, down, left or right and it is hard to believe that by doing that the final result would change substantially.
The subperiosteal face lift was in vogue a few years ago. It consists of moving the facial tissues upward by relying on the periosteum which is thin layer of tissue right above the facial bones. The benefit of the subperiosteal face lift is that you move the deeper structures of the face as a unit therefore being able to reposition all the layers at once. The subperiosteal technique has been plagued by severe swelling and a longer post-operative recuperation so it is now used only in select cases where a mid-face elevation is warrant.
Another popular facelift technique is the so called “Deep Plane rhitidectomy” or Deep Plane face lift and the Composite Face lift which is an evolution of the deep plane face lift. The concept is to mobilized the facial structures from underneath the facial muscles and incorporate the area of the lower eyelid and cheek as a unit. The benefits of this technique are, like in the subperiosteal face lift, the facial structures are moved as a unit avoiding the pitfalls of the SMAS face lift. The problem is that the dissection is done in the plane where the facial nerves interconnect with the facial muscles and therefore are at risk of being injured. Also, the post -operative course is longer due to excessive swelling and bruising. And still, in my opinion, the vector of pull is not vertical but horizontal so it creates a “done” look.
There also being a surge facial rejuvention techniques that incorporate fat grafting in face lift techniques. In my opinion, most of them are not done properly because they are forced to place the grafts in areas of the face where the skin has not been mobilized for survivability issues and for this reason does not help in delivering a natural result.
Lastly there is been a push for less invasive techniques like the lifestyle face lift and the short scar face lift. The first one is a modified version of a very conservative face lift and the only claim to fame is that it is done under local anesthesia. I do offer most of the facial procedures under local anesthesia so there is no point of getting a lifestyle lift when a more sophisticated version is available at the same conditions.
The short scar face lift claims less visible scars but it is a gimmick. The scars are still present in the front of the ears where they are most visible and are shorter in the back. It is a recycling of the old style mini-lift.
The short comings and the downsides of all the techniques I have described have pushed me in the last 20 years to develop my own techniques. First, with the vertical face lift, I completely changed the vector of pull of the facial tissues, switching from the traditional horizontal vector to a much more natural vertical vector and in doing so avoiding the” pulled” look. Then with the regenerative face lift I combined the use of stem cells in the vertical lift by placing the cell-enhanced grafts under the facial musculature avoiding the known pitfalls of fat grafting like irregularity and poor take. The stem cell regenerative face lift is the last generation of my face lifts and it is in my opinion, hands down, the most advanced face lift in the world. The most comprehensive photo gallery available with one of the best face lift before and after photos and pictures are a testament of the validity of the technique.
Posted on: March 12th, 2015 | Posted in Facelift, Plastic Surgery
The “No Visible Scar Facelift”
The appearance of wrinkles and sagging skin on your face can sometimes give away your age when you’d rather not. To eliminate signs of aging in the face, many individuals undergo facelift surgery. While this procedure often produces satisfying results, it does require incisions to be made and weeks of recovery time.
Traditional facelift techniques have long provided effective results, but the scarring inevitably left behind is less than desirable. Although improvements have been made in the methods and technology used, most facelift procedures still leave scars. However, Dr. Renato Calabria offers the “No Visible Scar Facelift,” and he was one of the first surgeons to perform this procedure. His goal is to provide all the benefits of a regular facelift procedure without any visible scarring.
The Difference Between a Traditional Facelift and the “No Scar Facelift”
A traditional facelift procedure involves making incisions at the hairline of the scalp that run down around the ears to give access to the underlying facial tissues. Although these scars are not easily noticed, they are more apparent when the ears are left uncovered or the hair is pulled back.
For the “No Visible Scar Facelift,” Dr. Calabria creates tiny incisions within the mouth and scalp that result in no visible scarring once they heal. He uses a device with a light attached to the end called an endoscope, which allows him to adjust the underlying tissues through the tiny incisions.
To schedule a consultation with our board-certified plastic surgeon, Dr. Calabria, we welcome you to call (310) 777-0069 or fill out our online contact form today. We look forward to hearing from you soon!
Posted on: March 11th, 2015 | Posted in Breast Augmentation, Breast Implants, Plastic Surgery
Breast augmentation is one of the most common plastic surgery procedures in Beverly Hills and Los Angeles and there are a lot of detailed information on the internet about all you need to know, from the type of breast implants to the different breast augmentation procedures available, from recovery time to cost.
But I bet, despite all you diligent research, you did not know about these 10 important facts about breast augmentation, breast revision and breast lift.
Number 10: You will require more than one operation, guaranteed!
Many plastic surgeons will depict a perfect scenario where they fail to mention the fact that it is guaranteed that you will have to replace your implants at least once in your life time if not more. Implants don’t last a life time like some plastic surgeons may imply. 90 per cent of breast implants are leaking after 10 years and therefore they need to be replaced periodically.
Number 9: Large breast implants have a higher incidence of problems!
Large breasts seems to be popular in today’s world. A lot of women seek to reach very large dimensions on their breasts and plastic surgeons are trying to accommodate their wishes placing breast implants that are definitely too big for them. It is not only a matter of proportions but large implants cause more complications like rippling but more importantly the excessive weight will cause the breast skin to stretch much more. This will eventually become so evident that the breast will look deformed. Anything more than a C cup breast will require, with time, a breast lift. The bigger the breast implants, the shorter will be the time by which the patient will need a breast lift. Breast lift scars are much more visible than the breast augmentation scar therefore the more you can postpone or avoid the breast lift, the better it is.
Number 8: Scar tissue around the implants can occur up to 80 per cent of the breast augmentation cases.
Scar tissue around the breast implants occurs in most of the cases. In many cases, this scar tissue will cause a capsular contracture or a capsular contracture which means that the breast will get firmer to the point it may even hurt to touch. The pain may also be present constantly. The incidence of capsular contracture may vary from 5 to 65 per cent. The treatment consist of removal of the scar tissue with a procedure called capsulectomy. Even after removal, there is no guarantee that it will never happen again. In fact it is just the opposite. It can re-occur many times.
Number 7: You will be required to monitor the breast every often and the only way to tell if the implants are leaking is an MRI
The patient needs to know that after breast augmentation surgery, she will be required to monitor her breasts often and if she does not have any insurance this may be costly because the only reliable test to make 100 per cent sure that the implants are not ruptured is an MRI.
Number 6: The breast implants may be masking a potential breast cancer.
Even if we are getting very sophisticated with radiological imaging, there is no question that the breast implants may cover partially some of the breast tissue therefore not visible to the test. If the breast implant is over the pectoralis muscles, it is worst. If it is under the muscles it could be up to 10-15 per cent of the breast tissue covered by the implants. It is true, though, that women that have breast implants have a lower incidence of of breast cancer for the simple reason that they are monitored more often.
Number 5: Breast feedings may be impaired.
Despite many women that have breast implants went ahead and breast feed regularly, there is a slight decrease of probabilities of being able to breast feeding.
Number 4: Belly bottom breast augmentation may not be the best approach
For a while, belly bottom breast augmentation was very fashionable, not anymore. The reasons are that it was much more difficult to perform and it was done in a blunt technique so the results were not as good, but also because with the change to silicone implants it became impossible to fit them in the small scar. Furthermore the manufacture’s companies will not provide insurance for breast implants introduces by the belly bottom because too much pressure would be applied to the implants in the effort to fit them through the incision.
Number 3: Breast augmentation with fat is more natural and there are less complications.
Breast augmentation with fat is very fashionable lately. It is true that could be a valid alternative to the classic breast augmentation with implants but there are some facts that you have to keep in mind. The fat placed in the breast may not survive therefore you may require multiple surgeries. Also, and more importantly, the fat can die and cause calcifications in the breast. This may be difficult to assess (even though we are getting better at it) and to distinguish from cancer. Also keep in mind that the breast augmentation with implants will give you a perkier and more youthful look versus the one with fat alone which it is more subtle. Also keep in mind that you can only go up one cup size or two. When you inject a lot of fat the incidence of fat necrosis is higher. Breast augmentation with fat or stem cells is a good alternative for a patient that had multiple incidences of capsular contractures and the implants are no longer the best option.
Number 2: Multiple surgeries on your breast may cause issues with internal scarring so you have to be more careful when you have a revision surgery.
The more we operate on the breasts, the more scarring we cause. This mean that the blood supply can be impaired. This means that repetitive surgeries require more attention ,from the surgeon’s stand point, ( and therefore an experience surgeon is required) to the blood supply because the risks of poor healing is greater.
Number 1: Tear drops implants can displace
Tear drops implants are a good idea conceptually but in practicality they are much more difficult to position and if they move, like often happens, they cause a significant deformity which will require revision surgery. Round implants are much easier to manage and if they rotate nothing will happens.
Women need to know the pro and cons about breast augmentation; too many times the surgeon is too cavalier about of possible risks. The truth is that a patient who is well informed, she is a better patient and she can deal with problems much better than an un-informed one. The prove is that despite all these negative factors, breast augmentation as a favorable response in more than 90 percent of patients.
Dr Calabria is a very experienced breast surgeon in Beverly Hills and Los Angeles and not only will provide with excellent techniques options but, more importantly, will guide you in choosing which is the best option for you not only short terms but in the long run and he will give you advices to make sure you will not regret having made this difficult decision.
Posted on: November 11th, 2014 | Posted in Plastic Surgery
Lower lid rejuvenation is one of the most requested but challenging procedures in plastic surgery today. The classical approach to treating sagging skin in the lower eyelid is to cut it out with a lower blepharoplasty procedure. However, this approach has changed in the last few years. We have realized that an aggressive skin and fat excision will, over time, create a skeletonized, hollow look under the eye.
The focus has shifted toward identifying all the elements of the aging lower lid and treating them each in a different way. To date, though, the lower eyelid remains one of the most difficult and unforgiving areas to treat.
This is true for multiple reasons. First, the skin of the lower lid is very, very thin and cannot withstand even the most minimal error. Second, the position of the lower lid with respect to the eye is crucial to the patient’s appearance and even a millimeter too high or low can dramatically change a patient’s look. Too high, and the patient appears to have smaller eyes. Too low, and the sclera will show – which is very difficult to correct. Three, two separate issues have to be addressed – a volume shift of the existing fat due to gravity and a volume loss due to atrophy of the fat that is secondary to aging. Four, there is a texture problem with the skin under the eye that it is often perceived by the patient as loose skin when in fact it is not. Fifth, the look of the lower eyelid area can change dramatically when the patient is in repose versus animation. Particularly when the patient is in animation because the motion of orbicularis and zigomaticus muscles, (the facial muscles involving in closing the eye and smiling) can give a false impression of excess skin when there isn’t any. This can fool even the most experienced plastic surgeon so it is crucial to be able recognize that. Just as crucial, is to be able to recognize that Botox has a role in minimizing and preventing crow’s feet and lines and often works in conjunction with surgery.
I have introduced new surgical approaches to lower eyelid rejuvenation. Among the most innovating, is the pinch blepharoplasty where just a ”pinch” of skin is removed without violating the orbicularis muscle (which is one of the most common causes of morbidity). This procedure also allows for a very short downtime. Sometimes this approach is combined with a lateral cantopexy to assure that the lower lid does not drop and change position. Often, a transconjunctival blepharoplasty is used to address an excess of fat which is not removed but repositioned.
The volume deficit can be addressed with a very conservative fat grafting procedure, but again, great caution must be used. This type of fat grafting must be done with meticulous technique and great accuracy. The fat must be placed almost under the muscle in small “pearls” (drops) to avoid irregular contouring – a complication that is very difficult, if not impossible, to treat.
One procedure which has attracted a lot of attention is stem cell lower eyelid rejuvenation. The idea behind this procedure is to rejuvenate and regenerate the lower lid skin which is usually more wrinkled due to the intense action of the eyelid muscles. Also, the lower lid skin often has poor texture due to sun exposure, environmental, genetic and hormonal factors – all which can be addressed with the stem cell procedure. Injections of stem cells derived by the PRP (platelet rich plasma) can be potentially very effective in this area and virtually complications free!
Posted on: October 6th, 2014 | Posted in Facelift, Home, Plastic Surgery
I often blog about making the decision to have a facelift and, once you have done so, how to choose the right plastic surgeon.
The term face lift includes a myriad of options that are very different from each other. It is not like buying a car, where you know which model you like and you have to shop for the lower price or the best deal.
The issue is a lot more complex even though the financial component plays a significant role.
In this prospective, I will divide the potential patients in three groups so you can see which group you fit into.
The first group, which is probably the smallest of the three, is made up of people to whom “money is no object”. They want the best and don’t care how much it costs. The biggest mistakes that this group makes are:
- Picking the most expensive surgeon on earth, mistakenly thinking that price equals talent and ability.
- Picking the most famous surgeon with the most media exposure. You can’t believe everything that is in the media. Often these surgeons spend big money to get themselves on these shows or in magazines and no amount of money can buy training, talent or experience. I believe that sometimes the less qualified surgeon will take the “media” route because he doesn’t have the skill or talent to make it without this kind of exposure.
Picking a surgeon in the above two ways is the “easy” route. It’s much harder and more time consuming (time is a commodity to many wealthy people) to do your homework and actually research each surgeon. Also, they are often used to exclusivity so they want to pick a one of kind plastic surgeon and they use price as a selection criteria. Of course, the most experienced plastic surgeons command higher fees: in fact there is little difference in fees among the top surgeons. But when you find a plastic surgeon whose fees are 3-4 times what the most reputable ones are charging, that by itself it is a red flag. Think about it: his results should be 4 times better than the most experienced plastic surgeons. In the 25 years I have been practicing (and the thousands of facelifts I have seen), I have never seen a surgeon deliver results that were that much superior.
Assuming that the plastic surgeon on the reality TV show or in the media was selected based on his/her surgical skills it is also a common mistake: there are so many other factors involved in casting these shows such as: affability, personality and looks.
Don’t fall for it: do your homework.
The second group of patients consists of people who can afford to have a face lift done by a reputable plastic surgeon who specializes in facelift and they are willing to do some homework. Here the decision is harder. Since money is not playing a big role, the decision should be made on real facts.
Most of the plastic surgeons considered for the job are well trained, they have excellent credentials and, once you meet them they have good bed side manners.
In this case the decision should be results driven. You need to become an expert in analyzing before and after pictures and compare the actual results of the 2-3 possible candidates. Base your decision on the best. Also try to understand what the differences are in technique between plastic surgeons you are considering and compare them. Usually, different techniques deliver different results. If somebody tells you that with a tiny incision they can correct all the signs of an aging face, don’t believe it. Also if they tell you that the surgery is going to take only one hour and the next day you will look good, beware. Of course, it is possible to deliver natural, long lasting results with less down time. But when it sounds too good to be true, it usually is.
The third group consists of people who may not be able to afford to have a facelift. This group often bases their decision on price not results. They are willing to settle for an “improvement” rather getting the very best result. This is the “something is better than nothing “attitude. The problem with this is that it can be very dangerous or at the very least very disappointing. The top plastic surgeons are expensive and there is no way around it, period. If you bargain hunt for a plastic surgeon then you may get what you pay for, unfortunately.
My best advice for this group is to wait, save enough money to go to an experienced plastic surgeon who specializes in facelift.
A Harvard professor said something that I think is really fitting (I’m paraphrasing here) : “nobody really needs to listen to Beethoven, but you do it because it makes you feel better.”
Well, nobody really needs a face lift, so when you decide to do it, do your homework! Remember; it’s surgery not a facial! Don’t base your decision solely on the financial aspect.
Posted on: July 11th, 2014 | Posted in Facelift, Fat Grafting, Plastic Surgery, Stem Cell Face Lift, Stem Cell Plastic Surgery
Update and latest news on stem cell face lift, stem cell plastic surgery and fat grafting in Beverly Hills and Los Angeles.
The use of stem cell and fat grafting is definitely the latest and hottest trend in plastic surgery today. Like any trend, it will reach the highest point and then it will plateaued to a level dictated by the actual, tangible clinical results. There is a lot of confusion about the use of stem cell in plastic surgery and many doctors have jumped on the stem cells band wagon making claims there are not based on any scientific bases.
I like to set the record straight.
I have been interested in the application of stem cells in plastic surgery for many years and because I practice not only in Beverly Hills and Palm Spring but also in Europe (Milan and Rome) where there are less restrictions in this field, I have been fortunate to accumulate a sizable experience. I have presented my techniques involving the application of stem cells in Plastic surgery to various international meetings, and in one of them I have actually performed a live face lift using adult stem cells in front of an audience constituted by more than 200 plastic surgeons from all over the world. I’m also an author of a chapter in a book entirely dedicated at stem cell application in plastic surgery entitled “the cell-enhanced Regenerative face lift.
Regenerative Medicine is a new branch of medicine that involves the use of stem cell for new medical and surgical therapies. I and many other plastic surgeons have embraced the field of regenerative medicine with the goal of developing new applications and procedures both in reconstructive and cosmetic surgery.
First I like to define in very simple terms the different stem types, and specifically differentiate embryonic from adult stem cell. Embryonic stem cell are more controversial, they were first isolated in 1998 and the most important characteristic is that they are pluripotent meaning they can differentiate into to the 3 germ layers that make up the human body. This meant that now we had the means to potentially generate custom-made tissue to replace defective tissue. The problem with embryonic stem cell is the controversy related to embryonic harvesting.
Therefore the attention of the researchers have shifted to adult stem cell which does not require potential embryonic issues. Adult stem cells can be reprogrammed to become pluripotent which means they transform in other cell type. In fact for this discover a Nobel Prize in Medicine was awarded.
Another important discovery was that researchers found an abundance of these Adult stem cell in fat and considering how easy it is to extract fat trough liposuction, these cells became easy available. Where it gets tricky is how to extract these adult stem cells from the fat. In fact, most plastic surgeons are simply centrifuging the fat and claiming that they are injecting stem cells but what they are doing is fat grafting, which is nothing really new. The best technique to extract adult stem cells from the fat is enzymatic digestion with collagenase and the most sophisticated system available to do that, in my opinion, is the Celution System by Cytori. In the US the system is not FDA approved but in Europe is available.
How does it work?
The plastic surgeon extract the fat trough liposuction, the fat is inserted in the Celution device and the system generates a much smaller amount of very concentrated adult stem cells. Then the fat is supplemented with these stem cells and re-injected in different areas of the body. This process is generally considered a process of minimal manipulation. This fat grating enriched by stem cells exhibited in a study published in Lancet a survival rate of 81 per cent 4 months after transplantation compared to 16 per cent in fat grafting alone. There are many potential application of stem cells enriched fat grafting. Face lift is one of them. There are two potential beneficial effects in using stem cells enriched fat grafting in face lift: one is the mechanical effect of restoring the volume of the aging face to a more youthful look and the second, which is still not proved, is to improved and rejuvenate the skin itself by bringing cells that a potential of creating new blood vessels and therefore bring more blood flow to the skin itself. Other areas of the body, like hands, neck etc. have the potential to be rejuvenate in this fashion. A new existing area is the breast: stem cell enriched fat can be used not only in case of breast reconstruction after cancer but also for breast enhancement and augmentation or in case of complications due to breast implants like capsular contracture, rippling hardening of the breast due to the implants etc. A word of caution is due: definitely the future is bright for potential clinical application of stem cells in plastic surgery but more studies are needed to corroborate these potential clinical application and to demonstrate the safety of these techniques before we can make certain claims.
Regenerative plastic surgery will continue to grow as new clinical opportunities will be evaluated and I’m glad I have the opportunity to be on the fore front of this exciting new field of stem cell plastic surgery.
Posted on: June 18th, 2014 | Posted in Facelift, Plastic Surgery
All you need to know about face lift techniques to make an educated choice in Beverly Hills and Los Angeles area.
There are more face lift done in Beverly Hills and Manhattan than anywhere else in the world but surprisingly enough the face lift patient does not make choices based on hard facts, instead she/he is more incline to pick a plastic surgeon from the gossips columns of a magazine.
Sometimes I think that you need to be a plastic surgeon to understand the differences in some of the techniques used in face lift surgery, so let’s try to make it simpler.
Most of the traditional face lifts are based on a similar technique: the skin is freed from the muscles underneath and then a layer of thin fibrous tissue overlying the muscles called the SMAS, is pulled in a horizontal direction and stitched in a higher position. The skin is re-draped on top, pulled, the excess removed and stitched in place around the ears. There are minor variations in the theme which are mostly inconsequential despite what different plastic surgeons may like you to think.
In general, considering the similarities of the current techniques what may be the difference is in the execution by different surgeons, especially the attention to details in stitching etc.
That is true but, in my opinion, there is a technique that is very different and stands out from the rest: it is called the vertical face lift. The technique differs in a substantial matter, both philosophically and factually.
Philosophically the major vector of pull is not horizontal but vertical.
Factually, it is a much more sophisticated operation. The skin is freed in a much wider fashion for two important reasons: one is that the wider dissection allows to re-drape the skin better and more efficiently, so more excess skin will be removed. Second, it allows access to the facial muscles so they can be reposition in a vertical direction, re-creating the more youthful framework of a younger face and by doing so, it avoids the reproduction of the pulled, unnatural classic face lift look.
Many surgeons claim that they are performing the vertical face lift but in actuality it is not very easy to perform. It takes knowledge of the facial anatomy and special skills.
For a lot of plastic surgeons in Beverly Hills and in Los Angeles it is easier to perform a simpler, less time-consuming version of the vertical face lift.
Don’t settle for less, become a more sophisticated patient. Any face lift, no matter who does it, (INCLUDING THE LIFE STYLE LIFT) will improve somewhat the aging face.
Learn to judge the final result based not only on an improvement of some kind but on the correction of all the signs of the aging face.
Develop a sense of beauty and artistry, train your eyes on details and truly appreciate a natural result, then and only then you will be able to decide what is the right face lift technique for you and you will be able to pick the best plastic surgeons in Beverly Hills to execute it.
Posted on: June 3rd, 2014 | Posted in Facelift, Plastic Surgery, Uncategorized
If you are contemplating a facial rejuvenation procedure or /and a face lift in the next future you can’t afford not to go to a face lift expert.
Now the question is: what makes a plastic surgeon a face lift expert?
The first step seems obvious: to make sure your “board certified surgeon” is a real plastic surgeon. Easy? Not really.
A lot of surgeons called themself plastic surgeons but more than half of practicing cosmetic surgeons are not certified by the American Board of Plastic Surgery, the gold standard, the only board who is recognized by the American Board of Medical Specialties. Also they need to be a Member of the American Society of Plastic Surgery, a Society with one of the highest ethical and professional principles.
Now the trick is that the surgeon can be “board certified” but from a different board, like the ENT board or dermatology board which does not represent the gold standard for plastic surgery. Furthermore they can be also certified by the American Board of Facial Plastic Surgery or the American Board of Cosmetic surgery which are boards that are not recognized by the American Board of Medical Specialties therefore their requirements are not as stringent as the American Board of Plastic Surgery. All of these doctors can say that are “Board Certified” and you will be tricked. Another pearl is to make sure that they have privileges in the hospital for the same procedure that they are planning to do to you.
Now this is pretty basic, but I’m surprised to hear many times that the patient thinks his or her doctors is well credentialed when instead he/she is not board certified in Plastic Surgery.
The next important step is to figure out what defines a facelift expert.
One of the most important characteristic of a facelift expert is that his/her practice should be predominately devoted to perform face lifts. Most plastic surgeons at the top of their carriers have developed a predilection for one particular cosmetic procedure: make sure you choose the one who does mostly face lifts.
A second very important feature is the type of practice he or she has. Facelift surgery is a very sophisticated type of surgery which requires attention to details. A practice which favors volume over high quality would not be a good fit. As the surgeon is pressed for time, he may overlook some important aspects of the surgery like impeccable suturing therefore compromising the final result. An example of a volume practice would be the life style face lift type of practice where a large number of consecutive cases are performed daily. This model, in my opinion does not privilege high quality and excellence in results. A more “boutique” approach is preferred where the plastic surgeon performs only one face lift a day and he is personally involved from the consultation day, through the pre-operative period, from the first stitch to the last one and more importantly, he is there for you after surgery.
The third factor is understanding what kind of face lift is offered. There are a lot of techniques on the market. Every technique is different, it has a different downtime and delivers different results. Also the capacity of the plastic surgeon to tailor the technique to your face is essential. A cocky-cutter approach, like the life style lift, will not be ideal for every patient and the ability to forge an approach for each individual needs is indispensable.
The forth and probably the most important feature that characterizes a real facelift expert is concrete, outstanding results. A lot of plastic surgeons, especially in Beverly Hills are well trained, have experience, had media exposure, have performed surgery on celebrities. So, what boils down is results!
The only practical parameter to compare results among doctors is the before and after pictures gallery.
You want to look for consistency in natural results. Of course, you have to keep in mind of the make- up, the different in lighting, etc., but it is still the best way to evaluate ability and experience.
Don’t settle for a few before and after pictures but demand to see at least 10 to 20 patients and then you can formulate an opinion of the plastic surgeon.
A fifth element that is of paramount importance is the ability to develop a clear communication channel with you plastic surgeon: he has to be available, easy accessible and understanding of your needs.
A surgeon on a pedestal will not be able to fulfil your expectations.
A face lift expert is all of these. If you do your homework well you will be able to achieve your goals.
Remember, the plastic surgeon is not going to deliver a perfect result and realistic expectations are a key to be happy after your face lift, no matter the expertise of your plastic surgeon.
Posted on: February 13th, 2014 | Posted in Uncategorized
Amid the fast-paced world that we live in, there is always pressure to maintain a youthful appearance. In an effort to look our best, many individuals regularly undergo plastic surgery to achieve the best results. However, some potential patients wonder if there is a certain timeframe that a specific procedure must be performed. The truth is, individuals in their 20s all the way up to their 40s and beyond are suitable for the same procedures as long as they are in good health and fit a few basic candidacy requirements.
While all people experience unique signs of aging that are unique to them, the aging process is relatively similar for most people in each general age group.
Although most people in their 20s do not experience many extensive developments in aging, the desire for self-improvement and preventative skin care lead this age group to undergo cosmetic treatment.
To achieve a more attractive physical appearance and contour the body, individuals often choose to have procedures done, such as breast augmentation and rhinoplasty. In addition, chemical peels, laser resurfacing, and microdermabrasion are often performed to preserve the condition of the skin and eliminate minor facial imperfections.
The signs of aging tend to become more apparent for individuals in their 30s. Women in this age group are also typically left with the negative consequences of pregnancy and weight gain.
BOTOX® Cosmetic and filler injections can restore youth and volume to the face, while breast enhancements and body contouring procedures, such as tummy tuck surgery, can give women a slimmer, more attractive physique.
People in their 40s usually notice the skin on their face and body beginning to sag and hang. As a result of a slower metabolism, the body also accumulates more excess fat deposits that are harder to get rid of through diet and exercise.
To restore a smoother and tighter facial appearance, surgical procedures such as facelifts, eyelid lifts, and forehead lifts are desired. In addition, full body contouring procedures, like liposuction and body lifts, are also performed to remove excess fat deposits and tone up the body.
No matter how old you are, cosmetic surgery can be beneficial. If you would like to learn more about the procedures we offer at our Beverly Hills practice, feel free to call (310) 777-0069 or fill out our online contact form today. Our board-certified plastic surgeon, Dr. Renato Calabria, looks forward to helping attain a youthful appearance so you can look as good as you feel.
Posted on: January 30th, 2014 | Posted in Uncategorized
A facelift is one of the most desired procedures in all of plastic surgery because it provides a noticeably more attractive and youthful facial appearance. Even though the procedure typically works wonders by addressing sagging skin and wrinkles on the midface, the aspect of scarring has discouraged some people from undergoing facelift surgery.
In the past, scarring and plastic surgery went hand-in-hand. In other words, if a person wanted to undergo a surgical procedure, he or she would most likely end up with some degree of scarring. However, as surgeons improved their knowledge and devised more efficient techniques, scarring became less obvious. This led to the development of the no visible scar facelift (scarless facelift), which Dr. Calabria was on the forefront of perfecting. By utilizing instruments specifically designed for minimally invasive procedures, Dr. Calabria is able to provide patients with results similar to that of a traditional facelift without the scarring that accompanies it.
Traditional vs. Scarless Facelift Techniques
A traditional facelift procedure involves making incisions at the hairline of the scalp that run down around the ear area. Although these scars are not easily noticed, they are more apparent when the ears are left uncovered or the hair is pulled back.
With the assistance of an endoscope, the no visible scar facelift allows tiny incisions to be made on the inside of the mouth and in the scalp to make scarring almost completely unnoticeable in any situation.
Since the scarless facelift is less invasive than the conventional method it also provides patients with the added benefit of a shorter recovery time. With a traditional facelift, patients can usually expect over a week or more of downtime before resuming their normal lifestyle. Comparatively, when the scarless facelift technique is performed, patients are able to return to work and their normal routine much sooner because there is less swelling and bruising.
We encourage you to contact our Beverly Hills practice for all of your facial rejuvenation needs. Dr. Renato Calabria is certified by The American Board of Plastic Surgery and offers an array of facial rejuvenation techniques that can effectively help you attain a youthful appearance. Call (310) 777-0069 or fill out an online contact form today. Dr. Calabria looks forward to meeting you during your initial consultation and helping get the look you want.