Nip This Tuck That

It’s nice to share patient testimonials.  Here’s one we received recently from one of our Rhinoplasty patients.  Whether you’re a celebrity, captain of industry, one of the social elite or just an average guy or girl…we want you to have the very best when it comes to your Beverly Hills Facelift, Rhinoplasty, Blepharoplasty, Forehead Lift, Breast Augmentation, Tummy Tuck, Liposuction, Otoplasty, Celebrity Face Lift, Neck Lift, Hair Transplants, Hair Restoration, Lip Augmentation, Cheek Implants, Chin Implant, Botox, Radiesse, Restylane, Juvederm, Chemical Peel, IPL or whatever plastic and cosmetic surgery or procedure you want to look naturally refreshed and more attractive. 

Dr. Francis R Palmer, III

I recently had Dr. Palmer do some work on my nose and I couldn’t have been happier about the result. I have never really been happy with my nose. There were several things that bothered me when I would see pictures of myself or as an actor on film. But I was too embarrassed with the idea of doing something about it and also didn’t want to drastically change my appearance.  My girlfriend who is the only person I told about it said look it’s your face if you do this you should find the best. We live in Los Angeles I am sure in Beverly hills are some of the best Plastic Surgeons in the world, you should find one. Its your face and you should get the best even if it costs a little more. After doing research I came across Dr. Palmer. I liked what he said about doing less and making smaller changes…and sculpting to your face. I met with him and he said he wouldn’t shave the bone and rather just would tighten and raise the tip. It would make my nose a little straighter and have a less round and hooked tip. And also would be a less intensive procedure than the other doctor recommended. He said it would do what I wanted but would be subtle and he bet me that no one but me would notice. he said that people would just notice that I looked better. I was nervous but he was so right. In my case I had no scars a small bandage which i got off four days later. No one has noticed but like he said I have gotten many compliments about how good I look. Most importantly I have noticed and am so happy with the result. I still look like me but just better. The things that have always bothered me were lessened. I really couldn’t recommend Dr. Palmer more. I looked for the best and feel like I found him. And beyond just the result, the process couldn’t have been better. Robyn and Andi in the office have been awesome from scheduling and being available and answering all my annoying questions before and after. I am greatly and truly thankful to Dr. Palmer and his staff for their work and the results. I feel better about myself. The work which is so natural and subtle that no one but my girlfriend and I even know that I did this…which is just what I wanted.  Thank you. 

T.

Beverly Hills, more so that Jio De Jeneiro or any other location in the world, has maintained the title of “Plastic Surgery Capital” and is the pinancle of aesthetic medicine.  Aesthetic medicine I define as the business of making people more attractive and business is booming in this multi-billion dollar industry.  In the US alone, last year, over 30 million aesthetic procedures (including plastic surgery, cosmetic surgery and non-invasive procedures) were performed by plastic surgeons, cosmetic surgeons, aesthetic dermatologists and opthalmologists across the United States.  In all cases, Beverly Hills, in my humle opinion leads the way because we are also the celebrity and entertainment capital of the world.  Our celebrities and stars look gorgeous and it’s no secret that more than a few have had some plastic surgery, cosmetic surgery or aesthetic medical procedures to enhance their appearance. 

 But the secret is now out to the rest of the world and coupled with the weak dollar against other world currencies, we are seeing a massive influx of plastic surgery, cosmetic surgery and aesthetic medical procedures from out of country as part of increased tourism.  Our practice has always been international with my practice in London for over 7 years while here in Beverly Hills but in the past 2 years the number of out of country clients from Japan, Singapore, China, France, Italy, Spain, Portugal, Taiwan, Saudi Arabia, Kuwait, UAE, Russia are all on the upswing as they take advantage of the expertise of Beverly Hills Plastic and Cosmetic Surgery and the exchange rate with the dollar.  In my opinion, Beverly Hills Plastic and Cosmetic Surgeons are the best trained plastic surgeons in the world, bar none…so if you can come to beverly Hills for the best plastic and cosmetic surgery and you can get it for less because of a weak dollar…it’s a no brainer.  Eyelifts, facelifts, Neck lifts, Rhinoplasty, Breast Augmentation, Cheek Augmentation with Implants, Chin Augmentation with Implants, Lip Augmentation, Hair Transplants, Otoplasty, Liposuction, Tummy Tucks, Browlift, Botox, Restylane, Juvederm, Perlane, Radiesse, Chemical Pells, Skin Care and IPL treatments…there’ll all here and the international community is taking advantage of this opportunity to get Beverly Hills quality.  If the best is here, why would anyone go anywhere else?

 Dr. Francis R Palmer, III

Rhinoplasty Beverly Hills style.  I don’t believe that it’s coincidence that celebrities seek Beverly Hills Plastic and Cosmetic Surgeons.  As a plastic and cosmetic surgeon here in Beverly Hills for almost 20 years and someone who has performed Rhinoplasty, Revision Rhinoplasty for over 20 years (including some 100 cases before I finished my surgical residency) I’d like to think that there is a certain style and elegance to the way that I approach the aesthetic shaping of the nose.  In other words, a Nose Job or what we call Rhinoplasty.  That sense of style can be summed up in the follow points, which anyone interested in Rhinoplasty or Revision Rhinoplasty should understand.

 1. The nose is not the aesthetic center of the face even though it can draw a great deal of attention to itself.  This means that trying to acheive a perfect nose through multiple Rhinoplasy surgeries is pointless.  All you need is a sleek natural appearing nose without major flaws.

2. You stare at your face and nose way more than any observer, so the things you see may not be evident to everyone else.  This is why you need an expert aesthetic analysis of your face and nose by an aesthetically gifted plastic and cosmetic surgeon before you have a Rhinoplasty or Revision Rhinoplasty.  During this consultation, it’s the plastic surgeon’s job to use his/her aesthetic skills and knowledge of Rhinoplasty to ascertain if your are or are not a suitable Rhinoplasty candidate. 

A suitable Rhinoplasty candidate is someone who’s appearance will be improved by the Rhinoplasty and someone who has a good chance of getting an improved nasal shape with little chance of complications.  Every surgery, plastic surgery including Rhinoplasty has risks but an experienced Rhinoplasty surgeon can tell when the odds are in your favor or are against you.  This is not a little point but a big deal and a lack of this understanding, in my opinion, is the one of the main reasons people have to have Revision Rhinoplasty….some over and over again as the patient and plastic surgeon chase the unattainable.

 3. Realistic expectations are key.  Forget the computer images of your nose until the day we can get computers, not plastic surgeons to do your Rhinoplasty.  Manipulating pixels are one thing but have no basis in reality when it comes to Rhinoplasty or revision Rhinoplasty that is the surgical manipulation of cartilage and bone.  Before and after pictures of similar noses are much more important for you to see what is and isn’t realistic to expect after your Rhinoplasty. 

Revision Rhinoplasty is even more complicated and the expectations must be adjusted to making the nose look more natutral and normal which is often the goal of these procedures.

4. Not all plastic and cosmetic surgeons who do Rhinoplasty or Revision Rhinoplasty are created equal.  We all have different training and experience.  We all have different sense of aesthetics..of what is important and not. 

5. Do your research.  Pay for consultation so you can get information and not hard-sell tactics to convince you to have surgery.  Never use price as your deternming factor.  Second best is never a bargain at any price.

 Read more about Beverly Hills Rhinoplasty here:  http://www.drfpalmer.com/Rhinoplasty.html

Dr. Francis R Palmer, III

Well actually, a miniturized incisiosn Face Lift and neck Lift is our new generation of Beverly Hills Face Lift that we like to call our “Celebrity Lift”.  It’s called a Celebrity Face Lift, because a celebrity challeneged us to come up with a minimally invasive Face Lift that had smaller incisions, recovery time yet still very effective.  The “Clebrity Lift” is all of the above.  This next generation Face Lift was featured on “The View” see the video clip here:  http://drfpalmer.com/movie/index.html    Read more about the “Celebrity Face Lift” here:

 http://www.drfpalmer.com/PalmerCelebrityLift.html

The benefits of this minimally invasive yet highly effective Face Lift procedure developed right here in Beverly Hills are the following:

1. Much smaller incisions than the typical Face Lifts and Neck Lifts.  The incisions do not go into the hair and as such help maintain present hair thickness. 

2. Smaller areas of tissue dissection which means less bruising and swelling after the Face Lift.

3. Combined with Radiesse or Perlane injections to shape the cheeks for enhanced youth and beauty.

4. Can be performed without anesthesia.

5. Takes 90 minutes or less.

 Dr. Francis R Palmer, III

 Rhinoplasty or the re-shaping of the nose is the top or one of the top plastic and cosmetic surgery procedures perfomed here in Beverly Hills, across California and around the world.  I have written numerous articles on Rhinoplasty and what this procedure can and can’t do but I feel that people are not getting the message when it comes to ways to shape the tip cartilages and increase the height of the nasal bridge.

Lately, I’ve seen a wave of patients that underwent closed Rhinoplasty with placement of a silicone L-shaped graft to the nasal bridge to increase the nasal height.  The problem isn’t the dorsal segment of the graft but rather the vertical segment of the L-shape.  This short vertical segment is designed to go between the two sides of the tip cartilages and by doing so will logically increase…not decrease the size of the nasal tip.  The junction of the vertical and horizontal portions of the graft sits just above the nasal tip cartilages and can cause skin erosion and damage to the nasal skin.  Bottom line, patients have this L-shaped graft elsewhere and then come here to have it removed because they don’t like the aesthetics of what it did to their nose.

The graft can be trimmed leaving just the dorsal segment but typically the nasal tip cartilages must be repaired and the strengthened by using a conchal cartilage ear graft to the nasal tip all performed through an open Revision Rhinoplasty.  So if you are looking to increase the height of your nose and want your nasal tip smaller….you may not want the L-shaped nasal graft which, in my opinion, may require you to have another Rhinoplasty to deal with the issues this type of nasal graft can create.

  Francis R Palmer, III MD

 Rhinoplasty remains one of the most commonly performed plastic and cosmetic surgery procedure with hundreds of thousands performed each year in the US alone.  Such a common plastic surgery procedure, so why are there soo many unanswered questions about Rhinoplasty before and after the surgery?  Truth is, I’m not sure.  I’ve been performing Rhinoplasty and Revision Rhinoplasty for over 20 years now from the time of my residency at LA County USC Medical Center and into some 18 years of private practice in Plastic and Cosmetic Surgery in Beverly Hills and London (from 1994-2000).

I think several key points about Rhinoplasty and how potential consumers get their information about aesthetic medicine which includes treatments and surgery designed to improve the appearance, has something to do with the issue: (these are my opinions)

1. Rhinoplasty is the most technically difficult plastic and cosmetic surgery procedure performed in Aesthetic Medicine.

2. Aesthetic judgment of the plastic surgeon about what will and will not make the nose more attractive is key to success of any Rhinoplasty.

3. In the best scenario (highly skilled Rhinoplasty Surgeon, proper aesthetic judgment, great outcome) the nose will go up 2 points on a 10 point scale with 10 being perfect.  Yes, you heard me correctly.  A nose that ranks a 7 out of 10 could go to a 9 but won’t be a 10.  You get the point.  This is an important point…you do not need a perfect nose.  You should have a nose that appears sleek and unobserved.

4. Post Rhinoplasty healing can be prolonged and complicated and is negatively impacted by: thick skin, previous Rhinoplasty surgery or trauma.

5. Repeated Rhinoplasties to seek perfection are fraught with danger as the nose looses some of it’s ability to heal after each subsequent Rhinoplasty.

6. You must be realistic about expectations after a Rhinoplasty.  make your nose appear sleek and unobserved and then look at your Cheek, Eyes/Eyebrows and Lips as the defining facial characteristics that make a face look beautiful or handsome.

7. TV shows that talk about Rhinoplasty are able to just give you sound bites about the complexities of the procedure and all that’s involved.  Magazine articles typically give even less information and often are quite superficial in nature. 

 Some additional tips:

1. Never use price as a determing factor for a Rhinoplasty.  Experienced, well-qualified Rhinoplasty Surgeons don’t offer specials…trust me on that.

2. Find a Rhinoplasty surgeon that exhibits the type of facial aesthetics that make sense to you.

3. Experience is key….there is no substitute and Rhinoplasty experience takes 5-7 years minimum as a practicing plastic and cosmetic surgeon.

4. In some states dentists and other groups are now allowed to perform Rhinoplasty.  You may want to inquire about training and decide if this sounds right to you.

At the end of the day, your nose should fit your face and look natural.  If you follow this advice you are helping to make that a reality.  If not you could wind up looking worse as some of the celebrities that have recently made the news.

By Dr. francis R Palmer, III Beverly Hills Plastic and Cosmetic Surgeon

Beverly Hills Face Lift:

There are many different forms of Face Lifts available so how are you to know which one is best for you?  Let’s take a look at some basics regarding the different types of facelifts.

Traditional Face Lifts:  Here incisions are placed along the contours of each ear beginning in the temporal hairline, continuing around the front curves of the ear, behind the ear within the crease and then extending into the posterior scalp.  The incision is about  12 inches in length.  The skin is then elevated and the underlying SMAS muscle layer is lifted and the excess skin is trimmed and the incisions closed.  There are variations of the Face Lift incisions that go in front of the ears or the hairline but these are typically more noticed and therefore not desirable.  There are also variation of these traditinal facelifts that include only skin or that apply sutrures that fold or lift the SMAS layers.  In my opinion, the best method is to trim excess SMAS and then suture the SMAS into a higher position.

NeckLifts:  To remove excess skin and muscle pleats (”turkey neck”) a formal neck lift may be required.  This is often incorporated into the Traditional Face Lift and uses the popsterior ear crease and posterior scalp portion of the incision to access the neck.  The neck muscle (Platysma) is then tightened, the entire neck skin dissected, the neck muscles then pulled upwards and excess scalp trimmed within the posterior scalp.

Read more here: http://www.drfpalmer.com/FaceLift.html

Both of the above procedures are extensive plastic surgery procedures taking between 3-6 hours with recovery times of weeks to months.  In this fast paced society, the number of people interested in this amount of surgery or recovery time has drastically diminished in the past 5-10 years when they were the norm.  Today people are far more interested in versions of Face Lifts and Neck Lifts that are less invasive, with less surgery time, smaller incisions and of course rapid recovery.

“Celebrity Face and Neck Lift”:  I like to think of our “Celebrity Lift” (read more here: http://drfpalmer.com/PalmerCelebrityLift.html ) as a mini incision Face and Neck Lift.  It tightens the underlying Smas and removes excess skin of the face and neck with small incisions and limited skin dissection which means a very quick recovery….often the next day.  Combine this with Cheek Augmentation using Cheek Implants or Radiesse Injections and you have a powerful toool to make the face look 10 years younger in 90 minutes of surgery time, or less.  Now you know the secrets some of the celebrities have known for years.

 Francis R Palmer, III

 Ok, like this just is being noticed for the first time that some of the celebrities actually look worse after their plastic and cosmetic surgery or treatments.  The latest was a story about Priscilla Presley and industrial grade silicone injected into her face.  This isn’t something new and I’ve written about the danders of silicone injections for some time now.  People, including celebrities, are victims to the unrealistic scams that promise no surgery facial rejuvenation. 

   Read more here:

Posted Mar 24th 2008 11:15PM by TMZ Staff

TMZ has learned Priscilla Presley is the victim of a botched cosmetic procedure. What’s worse — it was at the hands of a gigolo who was sent to prison for perpetrating an injectable scam on Hollywood’s elite.

 If you are not fully educated on your options regarding facial and body rejuvenation…find out more before you become victim to just such a scam.  Siliocne can’t be removed or reveresed.  Better to have reliable fillers like Restylane, Radiesse or Juvederm….or proven procedures like Facelifts, Breast Augmentation, Blepharoplasty, Rhinoplasty, Botox, Cheek Implants, Chin Implants or lip augmentation using Alloderm.  These things work….no hocus pocus, just proven, highly effective plastic and cosmetic surgery procedures and treatments.  Don’t get taken in by scams….be an educated, informed consumer.

Dr. Francis R Palmer, III

I’ve been doing lots of Rhinoplasty lately which always includes open Rhinoplasty with cartilage ear grafts to re-shape the nasal tip and even some silicone straight grafts to build up the nasal bridge.  The later is very popular in non-caucasian Rhinoplasty as a way of increasing the height of the nasal bridge.

Read more about Rhinoplasty here: http://www.drfpalmer.com/Rhinoplasty.html

 Cheek Augmentation has always been one of my specialties and it seems that in the Celebrity, Hollywood and plastic surgery corners, I’m known as the “Cheek Guy”…that’s cool….  I use both Cheek Implants and/or Radiesse or even Perlane to shape cheeks.  Both Cheek Implants and the injected molded paste of Radiesse and Perlane give great looking cheeks.  Which one is right for you will depend on how much time you have for healing and what shape your cheeks are at the moment….and of course whether you want a permanent change or one that lasts about 12 months.  Implants are permanent but Radiesse and Perlane can be customized to each Cheek, something that isn’t possible with a Cheek Implant.

Read more about Cheek Implants here: http://www.drfpalmer.com/CheekImplants.html

Read more about Radiesse Injections here: http://www.drfpalmer.com/radiesse-injections.html

Botox still is one of the most popular aesthetic treatments and I have done Botox Injections to soften unwanted lines and wrinkles for almost 20 years.  Whether you want the lines around the lips soften or you want to get rid of the Crow’s Feet or forehead lines, it’s tough to beat the fast, effective results that you get with Botox.  Obviously, you need to find a plastic and cosmetic surgeon well experienced in Botox Injections and be sure they use real Botox from Allergan and not a knock off brand that may be harmful.

Read more about Botox Injections here: http://www.drfpalmer.com/botox-injections.html

The “Celebrity Lift” which is a minimal incision Face Lift and Neck Lift, featured on ABC’s talk show “The View” http://drfpalmer.com/movie/index.html has continued to be a huge favorite in people seeking facial rejuvenation and why not…if you can look 10 years younger in 90 minutes or less with very small incisions, no general anesthesia and no sutures to be removed all with recovery that’s measured in hours, wouldn’t you be excited.  We have patients from all over the world having the “Celebrity Lift”… many fly home after 3 or 4 days.  With the full facelifts and necklifts it would be 10-14 days before they could fly and almost a full month recovery time.

 Read more about the “Celebrity Lift” here: http://www.drfpalmer.com/PalmerCelebrityLift.html

Spring’s just around the corner which means before you know it, you’ll be wearing a bikini and hitting the pool or beach.  This time of year many women turn to Breast Augmentation using either Saline or Siliocne Breast Implants.  Silicone Breast Implants are more available than they were in the past as the FDA has eased the regulations allowing women 25 or older to have this as an option for Breast Enlargement and Enhancement.

Read more about Breast Augmentation with Implants here: http://www.drfpalmer.com/BreastAugmentation.html

Dr. Francis R Palmer, III