Nip This Tuck That

WOW!+�-� I have to make major decisions on several key entertainment items that, I believe, will have significant impact on my career.+�-� It’s so strange that it’s not enough to be a highly trained, skilled, experienced Plastic & Cosmetic Surgeon…you have to be media savvy and camera ready as well.

I actually have taken the role as a teacher and beauty advisor to the general public.+�-� I do it for all of my patients so why not for everyone.+�-� That’s the basis for my appearances on TV, my articles in Magazines and the TV show projects that really interest me the most.+�-� I want you, to see quality…experienced…balanced images of+�-�a Plastic & Cosmetic Surgeon.+�-� I want you, as consumers to be well informed about the wonderous things that are available and have a good idea of what types of things will make you more attractive…that’s why I came up with my “Palmer Beauty Principles”.+�-� But there is so much more to my career and life.

+�-�I want you to try and imagine a typical day in my life.+�-� I have breakfast with my family, like many people do everyday and I come to the office.+�-� In consultation I see people with one thing on their mind…”how can they become more attractive.”+�-� Whether it’s their first surgery or a revision, that’s the gist of our conversation.+�-� People, as you can imagine run the entire gambit from very sweet to downright belligerent..from reasonable to completely unreasonable (in their expectations) and from easy to improve to next to impossible.+�-� I need to compassionately deal with all of them in the best way that I know how.+�-� How do I do that?+�-� Very early in my career, as I grappled with those questions, I decided that the best way for me to handle every patient was to simply “tell them the truth as if they were one of my family.”+�-� So that’s what I have always done and it has served me well over the past 16 years that I have been in practice.+�-� I further decided to teach every patient, during consultation about their own unique beauty and exactly how…and why…I would improve their appearance.+�-� What comes out of all this exchange is a customized list of possible ways to make them more attractive based on their unique situation.+�-� That’s the easy part…the psychological part and the teaching…the difficult part, as you can imagine, is doing the surgery.

+�-�When I was a resident surgeon training at LA County USC Medical Center, one of the World’s largest ( and busiest) teaching institutions I used to comment that “surgery is stressful.”+�-� I’m sure that comes as no surprise to anyone but the level of stress can’t be imagined unless you have ever done surgery.+�-� Imagine walking into a room with several other people all waiting for you to begin.+�-� The patient is asleep, draped and prepped and the Scrub Tech hands you a scalpel.+�-� You take the scalpel and cut into the skin of the face or body and it starts to bleed.+�-� In between, stopping the bleeding with an electrical cautery device, you continue to lift and separate the tissues with scissors.+�-� Most of the time, important things like nerves and large vessels are where they are supposed to be…but not always…so your concentration can’t wane…not even for a second.+�-� You’re hesitant to even blink but yet you must continue….you are the moving force of this event and without priogress, on your part, the surgery won’t get done.+�-� You press on…dealing with micro changes in the tissues at a continuous rate, adjusting what you do based on the sensory feedback received through+�-�touch, sight and sound.+�-� You try not to think about this patients’ wishes, hopes or her/his family as this takes away from the the level of concentration needed to press forward.+�-� You remain alert and incredibly focused.+�-�

+�-�This goes on for as long as it needs to continue for you to complete the surgery to your satisfaction…you then breath easilly…you are finished.+�-� It’s been said that all great surgeons perform each and every operation a minimum of 3 times.+�-� Once in their head before the surgery starts, during the actual surgery and once again after the surgery is completed in their head to see if there was anything…anything that could have been done better.+�-� I find truth to that saying, but I have always done that ..plus prayed for my patients before…during and after the surgery.+�-�

+�-�How do you deal with all this pressure…I can’t speak for all Plastic & Cosmetic Surgeons but I get strength from having a clear aesthetic plan, for each patient, before I ever pick up that scalpel, from the confidence that I know what I am doing…and what I have to do to accomplish my aesthetic goals for this patient, in the experience that I have gained from 18 years of doing similar operations on others and the strength from saying a prayer to God to guide my hands during the operation.+�-� With all of these things, I find the confidence and strength to pick up the scalpel, make that cut and move through the surgery to completion…while I chat with the OR personnel or relax listening to music making it look effortless and easy.+�-� Pressure…what Pressure?

This is what goes on behind the scenes when you have a Rhinoplasty, Face Lift, Brow Lift, Blepharoplasty, Breast Augmentation, Lip Augmentation, Cheek or Chin Implants or a Tummy Tuck.+�-� Each of these Plastic and Cosmetic Surgery Procedures has its own skill set, you have to get into the correct frame of mind whether you’re working on the average Joan, a captain of industry or a major celebrity.

Dr. Francis R Palmer, III

You can look 10 years younger with a Minilift, Radiesse Injections to sculpt the Cheeks and fill in the Nasolabial folds under local infiltration with Lidocaine in less than 90 minutes. The very next day you can put your hair down in front of your ears and go out….go back to work, really!!

I use my Palmer Beauty Principles to make the cheek area more youthful and the Minilift…a mini version of a facelift to tighten the facial muscles and trim excess skin. I combine skin excision of excess neck skin through a small incision hidden under the chin. The results are nothing short of amazing. You can augment the lips with either Restylane (lasts several months) or Alloderm (lasts about 7 years) for an even softer, more youthful appearance.+�-� When patients do all three procedures…we call it our “Beauty Trifecta.”

This is the trend right now…more frequent, smaller procedures with less anesthesia (if any), less surgery and less recovery. Why wait until the aging process has you looking tired and old when you can keep your youthful good looks with a minimally invasive local procedure? Seems that the “baby boomers” are changing the way people view plastic and cosmetic surgery procedures and when they choose to have them done.+�-� Learn what the celebrities have know for years….quick easy fixes can keep you looking young and attractive.

Francis R Palmer, III MD

+�-�Tag this one under ” Buyer Beware”…+�-� Had lunch with the Beverly Hills area Restylane sales rep at a very trendy sushi restaurant and during our conversation he mentioned that bootleg Restylane was found in the US.+�-� Now for those of you unfamiliar with Restylane, it’s a great soft tissue filler that’s injected into facial folds and wrinkles.+�-� It can also be used to plump up the lips.+�-� It’s been approved for use, here in the US, for about 1 year and we do a large volume of Restylane Injections in our office.+�-� I personally think it’s a great product.+�-�+�-�

+�-�Bootleg Restylane apparently is being sold to doctors in the US from sources other than the company that has the distribution rights.+�-� I know our office frequently receives faxes offering Restylane, Botox and other injectable products for amazingly low prices.+�-� We have never felt comfortable buying these products from any company other than the company reps.+�-�

+�-�You may recall a similar incidence with Botox in Florida where Botox was obtained from a source other than Allergan, the company that distributes Botox in the US.+�-� Several people became ill and after an investigation, the Botox used was not up to snuff.+�-� How does this happen and how can you protect yourself from it happening to you or someone you love?+�-� The best way, is never use price as a deciding factor when getting soft tissue fillers or any plastic & cosmetic procedure.+�-� By doing so, you may be falling prey to doctors that will buy these materials from other sources in order to cut costs.+�-� Remember, if it sounds too good to be true…it probably is!+�-� So what was in the bootleg Restylane that the company discovered.+�-� Well my sources tell me that it was in an identical box to the real Restylane but contained liquid silicone.+�-� Yikes!+�-� Be sure to ask+�-�your doctor where he/she obtained the Botox or Restylane and be sure to go to well kown reputable physicians for your Botox, Restylane, Radieese or Collagen injections.+�-� Pay the going rate for these services and you should be OK.+�-� It doesn’t matter if you’re interested in Botox, Breast Augmentation, Rhinoplasty, Blepharoplasty, Forehead Lift, Face Lift, Cheek Augmentation, Chin Augmentation, Lip Augmentation, Rdiesse Injections+�-�or a Tummy Tuck…do not choose your Plastic and Cosmetic Surgeon based on price.+�-� Experience, aesthetic vision and expertise are the proper means by which to judge and select your plastic and cosmetic surgeon

Dr. Francis R Palmer, III

+�-� March 8, 2006:+�-� I have been doing Botox Injections to soften lines around the mouth for over 10 years.+�-� It really+�-�works on those nasty vertical lip lines…you know the ones that seem to get worse every year and defy ever treatment know to mankind.+�-� You’ve tried Lasers, chemical peels and a whole host of srcubs, creams and lotions and nadda…the lines are still there!+�-� Botox is a modern day miracle and when used properly, can soften these stubborn lip lines without making you face look like it’s enetering the next ice age.+�-� Can this be true?+�-� Trust me it is!+�-�

The right amount of Botox at the right dilution….shhh..I have my own secret dilution that+�-�I have used for years and the lines soften right before your eyes.+�-� If that’s not magic then I don’t know what is.+�-� We have patients that have to fly here from across the country because we are one of the very few that can treat their lip lines.+�-� Yes, it smarts for a second…I mean it is an injection albeit with a very small needle but the discomfort is well worth it to rid yourself of these unsightly lip lines.+�-� So if you have+�-�lip lines..don’t get a Laser or Chemical Peel but consider Botox as an option.+�-� The effects last about 4-6 months…not bad for a 2 minute treatment and no downtime!+�-� PS there is a limit to the amount of Botox that we can use around the mouth and sometimes we need to treat additional lines after 1 month for a better aesthetic result.

Botox+�-�can also used to soften lines around the nose before or after a Rhinoplasty!

After your Botox Treatment use a skin care regimen that builds collagen in your skin for a further improvement in the texture and appearance of your skin including the area around the mouth.+�-� My new Cosmeceutical Skin Care company Francis R Beverly Hills+�-�offers numerous products that I developed to smooth, soften and rejuvenate your skin.+�-� Why not have skin as beautiful as celebrities?

+�-�Francis R. Palmer, III MD

March 7, 2006: I saw the lady that had+�-�the Tummy Tuck+�-�yesterday…see that post…for her first post-op visit.+�-� She has 2 bulb drains+�-�under the skin over the abdomen to remove any excess blood and serous fluid. These typically remain in for 3-4 days after the surgery.+�-� She’s also wearing an abdominal binder. It’s like a girdle that goes across the abdomen and gives some compression to the surgical area.+�-� She’s slightly bent over…we pulled and removed excess skin and patients usually can stand upright at about 1 week after the surgery.+�-� The muscles are a bit sore…we tighten them along the entire abdomen…that’s what gives the nice tight flat appearance to the abdomen after the surgery.+�-� But all in all she looks fantastic and she’s going to be thrilled.+�-�

+�-�Saw some consults+�-�for Tummy Tucks, Breast Augmentation, Face Lifts, Revision Rhinoplasty, Lip Augmentation, Blepharoplasty, Cheek Implants, Chin Implants, Brow Lift, Botox Restylane, Juvederm+�-�and Radiesse injections to scuplt the face without implants.+�-� They want what the celebrities get…natural beauty.+�-� You can read all about all of these procedures on my surgery website (sorry I’m still new at the HTML code for hyperlinks)

http://www.drfpalmer.com

I’ll share+�-�all of these prcedures, with you,+�-�over the coming days and weeks.+�-� But for now, feel free to read all the material that+�-�I have written on the subject and take a look at some of the before and after photos.

Thursday 3/2/06: Yikes!! A busy day today.+�-� The British film crew is coming this afternoon+�G��-�time to get my TV face on.+�-� Remember, I promised myself always to have fun doing these shows.+�-� I am curious what the aspiring actress will look like and what she+�G��G��s going to ask me to do for her to improve her appearance?+�-� I+�G��G��ll fill you in on Friday.

Saw a consult yesterday afternoon after a full day in the OR.+�-� She was almost 50 and says she dates men that are 35.+�-� She asked for my advice in ways that she could look younger.+�-� A reasonable request.+�-� After taking a look at her, I recommended removing the excess skin of the lower eyelids, a minilift and some Botox to soften the vertical lines around her mouth.+�-� It always amazes me that people feel that the eyes make them look more or less attractive.+�-� My Palmer Beauty Principles show that they eyes make you look tired, when aged, and not tired when there are no excesses of skin or fat around the eyes+�G��-�but they don+�G��G��t have the aesthetic power to make you more attractive per se.+�-� She+�G��G��ll look almost 10 years younger after those procedures with about 1 day recovery.+�-� Until that pill+�G��-�you know the beauty pill that we take once a year to make us look 25+�G��-�.until that pill is developed+�G��-�these simple procedures are the best way to take years off of your face.+�-� When combined with Radiesse to re-shape the cheeks into a more youthful position+�G��-�.you can get real beauty enhancement.

Saw a woman this morning that has loose skin of the face and neck+�G��-�allot of loose skin, but she absolutely doesn+�G��G��t want a Facelift+�G��-�I+�G��G��ll come up with some custom version of a minilift with direct excision of the neck skin from an incision under her chin with some Radiesse+�-� to build up her cheeks+�G��-�add some micro-lipo of the nasolabial fold fat and whoala +�G��-�.she+�G��G��ll look almost 10 years younger.+�-� Making people more attractive is a joy!+�-� Over the past 16 years, I have accumulated a large number of plastic and cosmetic surgery procedures at my disposal+�G��-�but I tend to view these procedures as tools+�G��-�.tools that I can modify, mold and evolve to do the aesthetic things that I want to do rather than take the inherent limitations of what the procedures would give me.+�-� I think it+�G��G��s a frame of mind really.+�-� I see a patient.+�-� I am presented mentally with that image of the patient aesthetically.+�-� My mind then uses the Palmer Beauty Principles within seconds to see where the features could be made to look more ideal, as this is the key to true beauty!+�-� My mind then scrolls through the menu of possible procedures picking the right one for the job.+�-� Sometimes when I am presented with a tough case+�G��-�.I just let it stay in my subconscious and the solution comes to me when I+�G��G��m driving home or reading the paper.+�-� How cool is that.+�-� That+�G��G��s why I blog+�G��-�..I have this vast amount of knowledge and experience that I want to share with you+�G��-�why?+�-� So all of you are armed with knowledge on how you can make yourself more attractive if you, or a loved one, ever has the desire to do so.+�-� That+�G��G��s why I write articles, books, and try to teach something useful to consumers each time I appear on a TV show+�G��-�no matter the subject.
+�-�

Tuesday 2/28/06:+�-� Debugging both websites+�G��-�aargh, what a pain.+�-� Skin care website+�-�+�-� http://www.FRBH.Com has an old version on the servers and the plastic surgery site http://www.drfpalmer.com has broken contact links+�G��-�.who said this was the golden age of communication?+�-� It+�G��G��s not enough to be a well trained plastic & cosmetic surgeon, I have to be a techy as well+�G��-�.I don+�G��G��t think so.+�-� No offense to the techies+�G��-�.they+�G��G��re seriously way smarter than I am when it comes to the internet, computers and html code.

Spoke with my agent.+�-� The one sheet for the new show looks good.+�-� Hope it works out+�G��-�that will be exciting!+�-� Shooting for another show +�G��+�Pop Culture+�G��-� is scheduled this Thursday with the British film crew.+�-� The show is slated to begin airing this June.+�-� I guess it+�G��G��s just part of the biz anymore.+�-� I have to be camera ready.+�-� Truth is, I+�G��G��m a bit of a ham and really enjoy all of it.+�-� Man, I can remember, the first time I had a TV camera stuck in my face+�G��-�talk about freaky.+�-� It+�G��G��s amazing how you just get used to it and calm down with experience.+�-� I try to always have fun with whatever show or film crew is here+�G��-�.the biggest thing for me to remember is to just relax.+�-� The last thing I want is to be a stuffy Beverly Hills Plastic Surgeon because that+�G��G��s just not me.+�-� I+�G��G��m the guy next door+�G��-�just with 10 years training and an emotionally charged high pressure job that I totally love.

Testing prototypes for the hand held device+�G��-�+�G��-�+�G��-�sshh, this one+�G��G��s a secret.+�-� More later.+�-� PS, it+�G��G��s amazing!+�-� No, this has nothing to do with the think tank project mentioned in Monday+�G��G��s post.+�-� It+�G��G��s a different project.

Saw the patient we did a Browlift, nasolabial fold micro-liposuction and used Radiesse to fill out her cheeks using my +�G��+�Palmer Beauty Principles+�G��-�+�G��-�she looks almost 10 years younger.+�-� I am so happy for her+�G��-�she+�G��G��s thrilled and so am I.+�-� This is so cool!+�-� After 16 years, I still get excited to see my patients more beautiful and attractive.+�-� Thank you Lord for giving me the privilege to make people happy!

Monday 2/27/06: Well here we are. The inaugural launch of a glimpse into my life+�G��-�.wow, no pressure. I have so much that I want to share with you, that I don’t know where to start.+�-�+�-�Hopefully, I can give you some insight into what it+�G��G��s like to be me. Christian, family man, father of 2 teens (please pray for me), artist, writer, aspiring TV Star (that+�G��G��s an entire story in itself) and the gatekeeper to my patients beauty+�G��-�their identity+�G��-�an awesome responsibility that I take very seriously. I believe that a truly gifted Plastic & Cosmetic Surgeon must have: The Eyes of an Artist, The Hands of an Angel and The Heart of a Lion. The artist must know how to make you more attractive. The Angel treats your tissue gently and with respect. The Lions Heart gives me the strength to hold someone+�G��G��s identity in the palm of my hands and allows me to cope with this awesome responsibility. Welcome to my world! I am wrestling with my son one moment and the next, I am laying open the face of a 45 year old lovely woman who wants nothing more than for me to make her look more attractive. She has a loving family that cares deeply for her and wants only the best for her+�G��-�and the pressure mounts!

I was contacted by another talk show wanting to do a makeover. The woman, for the makeover, had lost a great deal of weight, had a ton of surgery elsewhere for sagging skin +�G��+�everywhere+�G��-� and still wants to look better. This breaks my heart, but she+�G��G��s never going to look good and I+�G��G��m not sure that another tummy tuck, thigh lift or arm lift will make a significant difference. The tough part is breaking the bad news to the patient, who desperately wants to look normal, and to the TV Show Producer, who wants to put together a dramatic show. I feel badly, but I think I+�G��G��ll have to pass on this one.

Robyn, had me look at numerous photos from potential patients, from all over the world, asking for plastic and cosmetic surgery via e-mail. I am still amazed at how many hundreds of e-mails we get each day. It floors me every time I think about the number of these initial contacts that wind up having surgery with us. I never imagined this would happen. Not in my wildest dreams. I wrote the original material for the website over 8-9 years ago just as a way for people to get a sense of who and what I was. Maybe, that+�G��G��s why it works? It+�G��G��s like speaking with me+�G��-�only from the comfort of your house computer.

Saw a very hip woman, doctors wife, in her late 50+�G��G��s who hasn+�G��G��t done any plastic surgery to this point in her life+�G��-�she+�G��G��s looking for a little +�G��+�spruce up+�G��-� and wanted to speak with me about Contour Threads

Thread Lift This is always an interesting conversation. Patients don+�G��G��t want any incisions but are amazed when I go through the logic of that means +�G��-�no skin is removed as well+�G��-�. She finally realized that one of my custom Minilifts Face Lift with lower Bleph Blepharoplasty was the ticket. She+�G��G��s going to look amazing+�G��-�..7 years younger+�G��-�what a cool job I have.

Assisted on a Rhinoplasty this afternoon. The patient wanted the bridge of her nose built up, so we used a dorsal solid silastic (silicone) implant. I personally would have asked the patient to consider using Radiesse. Radiesse would have been done as an office treatment with a simple skin injection. No surgery, no anesthesia, no recovery and the material lasts up to 2 years. Not my decision however. That+�G��G��s what makes Plastic Surgery an art and not cookbook+�G��-�the way each surgeon looks at each individual patient and decides what to do or not do. No 2 decisions will ever be completely alike.

Drove down to Irvine to review the prototype device for the think tank group. If this thing works, the way we think it will…we are going to make a whole lot of people very happy. I am hired by an East Coast think tank that brings emerging new technologies to physicians and the public in the field of Plastic Surgery and beauty. The latest project is nothing short of remarkable+�G��-�.sorry, can+�G��G��t share anymore at this time+�G��-�.confidentiality agreements+�G��-�stay tuned!

Dr. Francis R Palmer, III