Nip This Tuck That

Cheek Augmentation with Cheek Implants what you should know.

Cheeks are the single most aesthetically important facial feature as outlined in my What’s Your Number the palmer code system and book. What’s Your Number..the palmer code says that your face can score a perfect 100 points, a whopping 75 of those points are possible if your cheeks are ideally shaped. This means that the cheeks alone have the power to make your face look young, old, femine, masculine attractive or less so.

The good news is that I have outlined for you what the perfect female and male cheeks look like and yes, you can have these using cheek implants…or fillers like Radiesse or Perlane but that’s a subject for another day.

The bad news is that implants or fillers that create the wrong aesthetic cheek shape can be devastating bad for your appearance. You can look like a masculine woman, a feminine man or just plain gruesome (like a puppet).

Cheek should be augmented following a set aesthetic standard that allows the female cheeks to be full, soft, round and naturally femine….while in men, the cheeks are angular and masculinely chiseled.

There are many, many variations of sizes, shapes, thickness and materials for cheek implants…the vast majority of which I feel do not create the proper aesthetic cheek shape in my over 20 years experience performing cheek augmentation with cheek implants. I do not believe it’s a good idea for the implant to become incorporated into the bone or facial tissues and have seen patients (done elsewhere) that sadly agree. Some of these patients I am unable to help because I can’t get the implants they had placed elsewhere out. Just remember, permanent means permanent, so I like silastic implants that are easilly removed if you decide to do so for any reason.

It should be stated that, in my opinion again, using facial implants like cheek or chin implants requires a quantum level of aesthetic sophistication on the part of the plastic and cosmetic surgeon who’s placing the implants. The implant size, shape, thickness, material and mode of placement (through the mouth, through the eye, under the skin in front of the ear or through an incision in the scalp all are possible but do not yield in my opinion the same results.) In fact, I’d go so far as to say that some points of insertion should not be considered which brings me to the next point.

As you search, you should consult with experienced top or the best plastic and cosmetic surgeons who perform cheek or chin augmentation with mplants frequently. This is not an easy surgery to learn or master and you do not want to look worse that you did before the surgery.

I’d like to leave with a final thought. The internet is a terrific source of great information as long as that information is genuine. Be careful to get your information on cheek implants, rhinoplasty, breast augmentation, eyelid surgery, botox, juvederm, radiesse or any plastic and cosmetic surgery treatment or procedure directly from the plastic and cosmetic surgeons who perform these procedures…not from the numerous generic directories (websites) that have material written by lay writers or people in sales as a way to get you onto their sites.

These sites charge fees to the listing doctors just so they can suggest, link or refer you to one of the thousands of doctors and surgeons for you to consult with and have these procedures. Problem is, they haven’t written the information, so how do you know the surgeon is experienced. Anyone can write about a surgical procedure but only an experienced surgeon can tell you how it’s done and what you can expect because they’ve actually done that procedure many times.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
What’s Your Number…the palmer code book
Media Accolades
Patient Testimonials

Think looks don’t matter…they do, of course. This is why I wrote the book on the subject: What’s Your Number..the palmer code available here

Latest article, on the subject, in Forbes Magazine

Plastic and cosmetic surgery treatments and procedures like Facelifts, Rhinoplasty, Eyelid Surgery, Browlifts,
Breast Implants, Cheek Implants, Chin Implants, Lip fillers, Botox, Tummy Tucks, Liposuction, Hair Transplants, Restylane, Juvederm, Radiesse, Sculptra and IPL…all improve your Number and your appearance.

We all, deep down inside know that our appearance does matter even though it’s not fair…but who ever said life was fair? That’s why you need to learn how to best improve Your Number.
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Dr Francis Palmer
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Voted “one of the world’s best” plastic and cosmetic surgeons

Facelift Facts from Beverly Hills

Continuing with our Face Lift series, let’s talk about the general classes, or types of Facelift techniques and procedures. Remember that even within the same category of facelift types, each plastic and cosmetic surgeon can perform the surgery very differently…so much so that they are not similar surgeries.

General types of Facelifts:

1. Skin only Facelifts:

These older techniques, have a skin incision, the skin of the face and neck is elevated pulled up and back. The excess skin is then removed. They have the disadvantage, in my opinion, of not tightening the underlying muscle layer (SMAS).

2. Skin and SMAS Facelifts:

Here the skin is elevated as well as the underlying SMAS layer which can be sutured, folded or elevated..trimmed and re-approximated into a more youthful position (I believe actual elevation of the SMAS, trimming it and ten suturing the SMAS back together is the best method as folding the SMAS or suture elevation of the SMAS alone can loosen allowing the SMAS to sag)…excess skin is then trimmed and removed.

3. Long Skin Flap with SMAS Facelift:

As above the skin and SMAS are elevated, except here the skin can be elevated all the way to the nasolabial folds. This increased skin dissection can place the skin, of the face, at increased risk of vascular injury and for that reason as well as the prolonged recovery time required from the extensive tissue dissection…these types of Facelifts have fallen out of favor.

4. Extended SMAS Facelift:

In this technique, also called a “deep plane” facelift, the skin is elevated and then the dissection is continued at the SMAS level for an extended amount over the face. Although this decreases, the vascular injury to the skin, the recovery time is quite long for these types of Facelifts and it can be many months before all the lumps and bumps subside….once again, these issues have caused these facelifts to be much less popular.

5. Midface or sub-periosteal facelifts:
Remember pictures of celebrity faces after plastic surgery where their eyebrows are overly raised and the corners of the mouth are arched un-naturally into a “joker” position? These are the results of this type of lift, in my opinion. Unlike the previous facelifts, these lifts are touted as not requiring an incision (this also means that no skin can be removed from the face, so always keep that in mind). Incisions are placed inside the mouth and within the temporal hairline. The tissues of the face are then lifted off the bones. When the facial tissues are moved upward and back, the corners of the mouth and eyebrows are also pulled into that un-natural (again my opinion) appearance. Sadly, once in such a position it’s very difficult to bring these back down. I do not like, have never liked (I recall seeing consults with this odd, operated upon look in London in the mid-late 90′s and first learned of this type of facelift) and do not recommend this facelift technique…but others do and perform these routinely. You decide if you could tolerate the look this faclift can give.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
What’s Your Number…the palmer code book
Accolades from the media
Patient Testimonials

Shaping the face during a facelift can be done and when the proper facial aesthetics are followed, the incisions, the tissue dissection can be limited which in turn means there will be smaller scars, less bruising and swelling and a shorter recovery time. This is the idea behind the creation of our “Celebrity Lift” ™ that can make you look 10 years younger in less than 90 minutes with a recovery time that’s measured in hours, not weeks.

The key is addressing the central portion of the face, the cheeks. The nasolabial folds are reduced and the cheeks are properly shaped using cheek implants or fillers like Radiesse or Perlane. About 50 % of our patients, including the international clientele, elect to have our Celebrity Lift under local without general or twilight anesthesia.

Celebrities, socialites and those in business rarely have months to be away from the public, so they will benefit from the rapid recovery offered with our Celebrity Lift. Because there is less trissue dissection, smokers and those with a long history of smoking may still be a candidate for this powerful, yet minimal incision facelift and necklift.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
Creator of the “What’s Your Number…the palmer code” system and book.
Accolades from the media & Press
Patient Testimonials

Facelift Facts from Beverly Hills continued. Today we’ll cover in more depth how you can have beautiful soft feminine cheeks as a woman or angular, ruggedly handsome cheeks if you’re a man. Learn what the clebrities know when they have plastic surgery that looks fabulous.

Cheek Implants remain the only permanent solution, in my opinion, as permanent fillers placed within the fatty tissues of the face tend to sag over time and do not stay put like cheek implants. Cheek implants are placed, let’s say that they should be placed, directly on top of the cheek bone itself. The body then forms a thin capsule around the implant which keeps it in place. In my 20 plus years experience performing cheek implants/augmentation, I have found that this happens in about 1 month. I have all my cheek implant patients use a U-shaped pillow for 1 month after the surgery.

There are numerous shapes, sizes and materials that cheek implants are made from however, I prefer the silastic (solid soft silicone) as it can easilly be removed and does not become intergrated with the cheek bone or soft tissues…which can create significant problems should you ever want your implants removed. the silastic implants are very well tolerated and I have removed ones that are over 20 years old, when I was replacing them (placed by another plastic and cosmetic surgeon) with implants more aesthetically shaped…and the old implants looked completely intact.

Cheek implants can be placed through incisions inside the mouth on the reflected portion of the upper lip near the canine tooth and this is my preferred route. Some plastic and cosmetic surgeons use an incision inside or below the lower eyelid but in my opinion this is a small incision to get the implant through and may require cutting the lateral canthus. All of these issues can and may lead to a malposition or frank ectropion (droopy lower eyelid) and for that reason, I choose not to use this incision. The implants can be placed through an incision inside the temporal scalp but placement and proper seating of the implant is very akward and for that reason, I do not use that approach. When a full facelift is being performed at the same time, rare these days since I tend to use the “Celebrity Lift” which is a minimun incision Facelift, the implants can be placed from underneath the elevated and dissected skin over the face by creating an additional incision in the proper area of the lateral malar bone and dissecting the tissues off the bone in both front and back directions.

For those individuals who are not candidates for cheek implants, soft tissue fillers remain a viable, albeit temporary solution. The good news is that you can have beautiful cheeks in less than 10 minutes with these fillers..the bad news is that the results will last 8 -12 months at which time the fillers must be repeated in order to once again acheive the desired effects. The results, in my opinion, tend to remain at the corrected level for 6-8 months after which they decrease slowly until your cheeks are back to their baseline, pre-filler shape.

I like using Perlane when someone doesn’t have anytime for post injection swelling and these patients have gone out the night of the cheek augmentation using Perlane. To me, Perlane’s effects seem to last about 9 months in most people. Radiesse is another great filler to shape the cheeks, seems to last about 12 months and we have used radiesse on many, many patients both during their “Celebrity Lift” facelift procedure or as an office cheek augmentation filler treatment. The treatment takes about 15 minutes and there is some post filler swelling, but this subsides in the next day or so. Not my choice if you have an engagement that night or the next but still we use lots of Radiesse to shape cheeks and I love the product. For me, you can’t go wrong with either Perlane or Radiesse, but I have to state what may seem obvious. There is no magic in these fillers themselves and even though they are terrific products, you can look odd or even deformed if they are placed in the wrong place or in the wrong amount. I have turned away patients requesting me to inject more radiesse or perlane in their cheeks after they have had too much of either placed in the wrong places (injected elsewhere by other doctors, nurses or surgeons) making the cheeks appear deformed. So be sure that you know the proper shape your cheeks should be and be sure so does the plastic and cosmetic surgeon that’s doing the cheek shaping using these fillers. To be the best or one of the top plastic and cosmetic surgeons, in my opinion, you have to know this information. Don’t know the proper shape? More here and here.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
What’s Your Number…the palmer code book
Media Accolades
Patient Testimonials

Facelift facts from Beverly Hills. As we continue discussing facelifts, let me place emphasis on shaping or creating the proper cheek shape as one of the primary goals with this procedure. As important as removing and tightening excess skin is during a facelift, it will all be for naught unless the cheeks have the proper aesthetic shape. This often overlooked fact, is the difference between the facel looking youthful and atrractive versus overly-pulled and windswept. The way to avoid that unwanted “done” look is to make sure that your plastic and cosmetic surgeon knows the proper shape for a male and female cheek and the ways to create them during the facelift surgery. Really, this requires additional steps to be taken but they can certainly be done at the same time. The best, the very top plastic and cosmetic surgeons, as well as the celebrities that look stunning after their facelifts all know this simple fact. Learn the proper cheek shape in my new book: “What’s your Number…the palmer code.”
Ok, now you know the proper cheek shape, so how do you get it?

#1, permanent solution are cheek implants…there are probably over 100 shapes and sizes made of different materials but over the past 20 years of performing cheek augmentation, I prefer and use just a few sizes…one shape and all of the implants are made of silastic. Why? Because these are the most successful in creating the desired cheek shape.

#2, temporary shaping of the cheeks using Radiesse or Perlane. Permanent fillers should be avoided, in my opinion as these must be placed within the fatty tissues of the cheeks and this layer does shift with age into the nasolabial fold. If injected, these permanent fillers will shift along with the cheek fat and create even deeper more prominent nasolabial folds. Not a good thing.

Which option is best for you will depend on the bone structure of your cheeks and your decision to opt for a temporary or permanent solution.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
What’s Your Number…the palmer code book
Accolades from the press

The recent death of a former miss Argentina of what sounds like a fat emolism as a result of fat transfer to the buttocks often referred to as the “Brazilian Lift”….underscores the inherent risks of plastic and cosmetic surgery. One of the best ways to control these risks is to select the top, best qualified surgeon you can find. Learn how to select your plastic and cosmetic surgeon using a simple 4-step guide.
Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
What’s Your Number…the palmer code book

Face Lift Facts from Beverly Hills.

We will take a look at the most pertinent facts that you should consider when seeking a Facelift or facelift procedure. Today, we will concentrate on the basics of what a facelift can and can not do when it comes to rejuvenating the face.

Facelifts have been around for over 4,ooo years and the purpose reamins the same today….to rejuvenate the face. In simple terms, the facelift should tighten the underlying muscle layer (SMAS) of the face and remove excess skin and fatty tissue. Please keep that in mind when reading some of the more outlandish claims that are all over the internet.

The problem is the many variations on facelifts that have emerged over the past 20 years, including some that are not capable of accomplishing the basic goals previously outlined. Some do not allow SMAS tightening or skin removal, making them less effective in rejuvenating the face.

In the next segment on Facelifts, we’ll take a closer look at some of the more common types of Facelifts but today let’s end with palcing the apprpriate amount of emphasis on the aesthetic importance of facelifts and what they should accomplish. I have been performing Face Lifts for over 20 years and while the techniques have changed, my focus has not. The primary goal of my Facelift, as all my plastic and cosmetic surgery procedures is to create/restore the most attractive facial aesthetics. As simple as this sounds, this aesthetic vision is not taught in medical school or surgical training. It is however, the most important factor to consider when you are trying to improve your appearance. Isn’t that the purpose of having plastic and cosmetic surgery afterall?

The face has various facial features that carry different aesthetic importance. Some will transform the face into one that is youthful and attractive while others have much less impact. These aesthetic principles, The Palmer Code is outlined in my new book “What’s Your Number…the palmer code.” I strongly suggest you read and learn what makes the face and body attractive before you have any type of plastic surgery treatment or procedure. For now, I’ll leave you with this thought..if the cheeks are not ideally shaped, during any type of facelift procedure, the face will not be perceived as youthful and attractive and may actually appear overly pulled, tight and mishapen. The very best, top rated plastic and cosmetic surgeons understand this and when you see inspired Facelift results (gorgeous celebrities) this aesthetic vision has been followed (the Celebrity Lift). Some media comments and testimonials.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
What’s Your Number…the palmer code book

Updates on facelift series, cheek implants and Rhinoplasty were lost with the switch over to our new servers. I will get these back up as soon as possible.

Dr Francis Palmer