Nip This Tuck That

The best Face Lift in the US and the World must, in my opinion, not only lift and tighten tissues while removing excess fat and skin but must also shape the cheeks in order to achieve a more aesthetically, attractive face. Our Palmer Celebrity Facelift is designed to all of the above. Shaping the Cheeks can be done in minutes using either Radiesse, Perlane or Juvederm Ultra Plus.

Before the Palmer Celebrity Face Lift begins, the cheek area is marked outlining where the filler will be injected. Once the patient is asleep and the Palmer Celebrity Lift has removed the excess fatty tissue, trimmed the SMAS muscle layer, lifted and trimmed the excess skin…the fillers are injected and massaged into the proper shape.

Based on the filler that’s used, the results last between 8 and 12 months at which time the filler can be repeated as an office visit. You can think of this as a yearly maintenance in order for you to maintain a soft, natural and attractive look. Men, the filler can be used in the Cheeks, Chin and Jawline to create angularity and a more ruggedly handsome look.
Of course, Cheek Implants can be used as a permanent method of enhancing the shape of the cheeks.

Botox to decrease unwanted wrinkles, Restylane or Juvederm to enhance the lips or additional plastic and cosmetic surgery procedures like Breast Augmentation with Implants, Eyelid Surgery, Rhinoplasty, Chin Implants, Lip Implants, Tummy Tucks, Thigh Lifts and Buttock Lifts can be performed at the same time.

The take home message when it comes to Face Lifts is to be sure that the Facelift addresses the SMAS layer through elevation, trimming and suturing and not merely folding upon itself or suspension with sutures as these may come apart. The Face Lift should also have the ability to create a soft and naturally feminine face for a woman or a ruggedly handsome face in a man. The Face Lift should NOT create an overly pulled, distorted, stretched mouth or eyebrow distortion as these are not aesthetically pleasing facial characteristics. The best Facelift surgeons may not be in your area and you may need to travel to reach the top Facelift surgeons but the trip will be less expensive than the cost of a revision Face Lift. Read what the print media what the media says about Dr Francis Palmer and his face Lifts. Watch Dr Palmer on TV presenting his face Lift procedures.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

An american doctor who had his license revoked in 2003 was posing as a top American Plastic Surgeon in Dubai. This bogus physician was operating on people on his kitchen table.

What was the lure for these innocent victims to have a completely inexperienced person cut them open? The oldest one around…A CHEAP PRICE. This is a tragedy as these people will no doubt spend countless thousands of dollars to correct the damage that was done and in some cases it may never be fixed or look right.

How many times must this type of disaster occur before the public wakes up and realizes that price has no business as the driving factor in who performs your plastic and cosmetic surgery procedure: whether it be a Face Lift, Rhinoplasty, Eyelid Surgery, Cheek Implants, Chin Implant, Breast Augmentation, Tummy Tuck, Arm Lift, Buttock Lift, Botox, Radiesse or Perlane. There is no substitute for experience and talent in a plastic and cosmetic surgeon and you will pay top dollar for the best US plastic and Cosmetic Surgeon…however, “you get what you pay for”..as this article sadly illustrates.

About once a year I am contacted by a Hospital, Plastic and Cosmetic Surgery Clinic or businessman wishing to have me consult and perform plastic and cosmetic surgeries in Saudi Arabia, Oman, Kuwait and the UAE including Dubai. In fact coincidentally, I received just such a communication by e-mail yesterday. For almost a decade, I traveled to London and performed consultations and plastic and cosmetic surgery procedures as an overseas consultant, so I am well versed with the theory of importing the top, the best US (American) plastic and cosmetic surgeons to go to the middle east. The trouble is, the time required to go such distances and the time it takes away from my practice here in the US (Beverly Hills).

Instead, I believe that the patient is much better off making the journey to the top, the best US plastic and cosmetic surgeons. I remember telling quite a few international patients that if given the choice of one of us being tired after the journey, “who do you think it should be, the patient or the plastic and cosmetic surgeon.” Everyone of these patients said ” The patient because I want my plastic surgeon fresh and alert.” Right answer!

We have patients that travel from all over the world to have plastic and cosmetic surgery here with us in Beverly Hills. If you want the top, the very best that the US (America) has to offer, you will have to travel. Whatever the cost, it will surely be less than what these poor people will spend for corrective surgery after trying to save money with this bogus physician and there’s no way to place a price tag on their pain and suffering.

Having said all that, I’m not saying that when I am sent a private 747 by a super wealthy patient who’s flying me to their location with adequate compensation and a fully staffed and equipped hospital or clinic that I would decline to go. I have made many such special arrangements for royalty, business tycoons, socialites and celebrities and will continue to do so. We frequently have 3-5 international patients at our Beverly Hills clinic at any given week and we are used to making their journey here easy and as effortless as possible and have for many years.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”
TV Appearances

I have been performing Face Lifts for almost 25 years and I have seen the evolution from the Face Lifts in the mid 80′s that just pulled the face back until it looked like an alien creature more than a youthful version of a human being. Then came the 90′s with the more is better mentality in life and plastic surgery…so, the faces were pulled even tighter at ever increasingly deeper tissue levels causing many months of swelling and healing, yet something very basic was still missing…in my opinion.

Having trained with some of the world’s best plastic and cosmetic surgeons, here in Beverly Hills, I finished in 1990 and eagerly began practicing what I had been taught in the preceding 10 rigorous years. After just a few short months, it was obvious to me that the Face Lift techniques were aesthetically inadequate. In other words, these Face Lifts pulled the face and neck, tightened tissues and removed excess skin but the faces didn’t appear soft, natural and more attractive in many cases. To say the least, I was greatly disappointed and wondered what on earth I was going to do now.

Being a true Virgo, in nature, I made up my mind to learn what I needed to do what it was I wanted to do…make people more attractive in a highly consistent and reliable manner. I studied beautiful female and male faces until I identified a pattern. Inconspicuous at first, I adopted these patterns to my face Lifts and got astonishing results. Encouraged, I repeated this over and over again until they became part of my thinking, patient evaluation and surgical techniques.

And that’s the take home message here. The best, the very top plastic and cosmetic surgeons are just like the best in any field. They are the innovators, the ones that ask “why” or “why not” when confronted with perplexing and complicated issues. I don’t perform any one surgical technique accepting the aesthetic limitations it provides…instead, I modify the available surgical procedures to accomplish the desired aesthetic effect for each and every patient I touch. It’s my responsibility. It’s my calling. It’s what I do for a living. I make people more attractive in a highly predictable manner whether it’s Breast Augmentation, Rhinoplasty, Eyelid Surgery, Cheek Implants, Botox, Radiesse, Perlane or our “Palmer Celebrity Face Lift.” If Celebrities can look amazing…so can you.

Francis R Palmer III MD
Creator & Author: “What’s Your Number…the palmer code”
TV Appearances
Print Articles

If you are like most people, you want to look your very best which, in simple terms means, a naturally, beautiful face…one that appears more youthful and attractive. When Plastic and Cosmetic Surgery accomplishes this goal, the results are truly inspired. In my opinion, this should be the primary goal of all aesthetic plastic and cosmetic surgery treatments and procedures. If it doesn’t make you look better, than why do it?

Trick is to find the least invasive plastic and cosmetic surgery treatment and or procedure to accomplish this goal. For unwanted lines and wrinkles, clearly Botox and now Dysport, as well, both deliver fast and highly effective results with almost no downtime or recovery. Follow this line of reasoning, our “Palmer Celebrity Face LIft”, uses a much smaller incision, with limited tissue dissection all resulting in a naturally, youthful and beautiful face with a recovery that’s measured in hours instead of weeks and months like traditional Face Lifts.

Rhinoplasty can be modified to meet similar goals by using a retrograde tip technique that’s minimally disruptive to the tissues over the nasal tip resulting in a more rapid recovery time. Other plastic and cosmetic surgery procedures can be modified with an eye towards a quicker recovery including Eyelid Surgery, Browlift, Cheek Implants, Chin Implants, Lip Enhancement using Alloderm Implants, Breast Implants for augmentation and enhancement,Radiesse Injections, Tummy Tucks and Buttock Lifts. As you do your research on any plastic and cosmetic surgery procedure you’ll find that the very best, most talented and experienced plastic and cosmetic surgeons are always improving on how they do things…their surgical techniques evolve to accomplish the primary goal: Achieve a more youthful, naturally beautiful appearance with as little bruising, swelling and down-time as possible.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

Nothing like a knock down drag out challenge that benefits consumers looking to soften those unwanted lines and wrinkles. Medicis launched Dysport, their version of a type A botulinum toxin, some months back, hoping to make a dent in Alergan’s Botox market. Not a small task since Botox has been one of the most effective aesthetic medical products, of all time in my opinion, being used for over 2 decades to soften lines and wrinkles when injected into the target muscle.

Dysport has decided to up the ante and has offered the following challenge to anyone seeking a botox-like treatment to decrease unwanted lines and wrinkles. The offer is valid through the end of April, so don’t hesitate if you want to take advantage of this limit time deal.

Here’s the deal. Dysport will give you a $75 rebate for your first Dysport treatment and then you have 14 days to decide whether you “love it” (in which case you’ll get another $75 towards your second Dysport treatment scheduled at least 3 months after your first one) or you “leave it” (in that case you’ll get a $75 rebate the next time you use Botox or another type A botulinum toxin product). Either way, you’ll save $150, which seems like a great deal. In our Beverly Hills practice an area of Botox or Dysport is $300, so the $75 rebate is effectively a 25% discount from that price in which case you’re only paying $225 per area.

I have no financial interest in Dysport or Botox and use both in my Beverly Hills office to soften lines and wrinkles. I also think you need to read the offer for yourself before having any treatments.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

Medicis has a type A botulinum toxin ( same type as that found in Allergan’s Botox) in a topical application. Similar results are rumored, with Revance topical application and Botox injections but I remain a skeptic. Seems to me that it’s much more difficult getting the same concentration of botulinum type A toxin to the desired area. The desired area is the muscle(s) causing unwanted lines and wrinkles.

With Botox injections, the needle penetrates the skin and tissues to the level of the muscle causing the unwanted line or wrinkle. The toxin is then administered through the needle and syringe directly to the targeted muscle. The toxin relaxes the muscle and the line and wrinkle is diminished. Simple and easy to understand.

Now, when a cream or lotion is placed on the surface of the skin things get far more complicated.

1. How much of the toxin and how rapidly is it absorbed by the skin

2. How deeply is the toxin absorbed by the tissues…remember the toxin needs to get to the muscle in order to make it and the resulting line or wrinkle relax. If the toxin is stuck in the dermis of the skin or in the deeper fatty tissue above the muscle, how can it affect and relax the muscle?

3. If the toxin does reach the fatty tissues or the muscle (getting through the tough exterior tissue of the muscle called the fascia) will it be taken away by the various blood vessels within the fat and or the muscle. For the botulinum toxin to be effective it must come into contact with the neuromuscular junctions within the muscle in some amount for some period of time.

I am unsure that all these criteria are being met but I await the opportunity to try Revance for myself as I have been using Botox injections in my Beverly Hills plastic and cosmetic surgery practice for 20 years. I love the idea of rubbing a cream and making the lines and wrinkles go away but I as of yet remain a skeptic. I will keep you informed as I learn more.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

Face Lifts have evolved. The Palmer Celebrity Face Lift is an evolved Face Lift with smaller incisions, less tissue dissection and disruption…which means there is less bruising and swelling. This minimum incision Face Lift allows patients to fly home in as little as 3 days after the procedure.

Below is a picture of how aging effects the face. Arrows are used to show the direction of facial tissue sag.

Aging face and Neck

The Palmer Celebrity Face Lift uses much smaller incisions, than traditional Face Lifts, that are contoured around the front and inside of the ear. Unlike traditional Face Lifts or Mid Face Lifts, no incisions are placed inside the hairline, in front or in back of the head, thereby eliminating the risk of hair loss or unsightly scars inside the hair.

The Palmer Celebrity Face Lift does elevate, trim and lift the SMAS muscle layer along with trimming excess skin which may not be done with a thread lift or suture lift procedure. The Palmer Celebrity Lift goes a step farther still by shaping the cheek area into a more naturally, youthful appearance by adjusting facial fat and using fillers like Perlane and Radiesse. Cheek Implants can also be used when a permanent augmentation is desired.

In the picture below, arrows on the face represent the direction of lift.

Arrows show direction of tightening

The result is a naturally more youthful and attractive face….the antithesis of the old “wind swept”, “over pulled” faces where the tissues are just pulled and distorted. The Palmer Celebrity Face Lift is evolved and in my opinion represents the Face Lift of the future…right now, today. I’m sure that the top Celebrities know the best plastic surgeons are the ones who’s techniques evolve and continue to provide the very best with the least amount of scarring, swelling, bruising and recovery time. Watch Dr Francis Palmer present his ground breaking Palmer Celebrity Lift on ABC’s hit TV show “The View”.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

Plastic & Cosmetic Surgery “Tip of the Day” from Beverly Hills Plastic and Cosmetic Surgeon, Dr Francis Palmer.

The Wall Street Journal had a story about Plastic and Cosmetic Surgery today….Breast Augmentation with Breast Implants is now the most popular plastic surgery procedure or at least it was in 2009. This is from data collected by one of the three organizations of surgeons who perform plastic and/or cosmetic surgery procedures like Breast Enhancement/Augmentation , Face Lifts and the like.

Liposuction was dethroned as the most popular, most commonly performed, plastic surgery procedure and was actually down about 17% from the previous year. The article also noted, which we have discussed here numerous times in the past, the increasing trend towards less invasive procedures. This was my motivation behind creating our minimum incision Face Lift the “Palmer Celebrity Face Lift” which was featured on ABC’s hit TV show “The View”. Botox and fillers like Restylane, Radiesse and Perlane remained popular.

Rhinoplasty was mentioned only in passing but according to my calculations, of published data from all three surgical groups who perform plastic and cosmetic surgery, remains the top or one of the top plastic surgery procedures performed year after year.

It is true that Breast Augmentation is popular and Silicone Breast Implants have gained popularity since the FDA lifted their restrictions some time back. I have seen two sets of patients that are interested in Breast Augmentation with Breast Implants. The first group are young women who have small breasts and would like the size and or shape improved. Silicone Breast Implants are available for women 22 years of age or older. Younger women would need to use Saline Breast Implants.

The second group of women interested in Breast Augmentation are those who have had children, or are older and wish to regain a more aesthetic breast size and shape using Breast Implants. These women may also need some form of Breast Lift along with the Breast Implants. I believe that all Breast Implants should be placed below the muscle which offers an additional layer of tissue above the Breast Implant.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

Here’s Today’s Plastic and Cosmetic Surgery Tip:

The day after the Academy Awards with all the gorgeous and handsome celebrities on the red carpet it’s natural for our thoughts to turn towards our own self improvement through plastic and cosmetic surgery treatments and surgical procedures.

If you are looking to make yourself more attractive, be sure that you understand what facial features are the most important from an aesthetic point of view. According to my new book that defines and identifies beauty, there are three top facial features in a beautiful or handsome face. The Cheeks, Eye Area and the Lips.

Of these three features, the Cheeks are the most aesthetically important and should be considered in all cases of facial rejuvenation, where the goal is to look naturally youthful, as well as younger faces where the goal is a more beautiful face. This should be the main focus of any plastic and cosmetic surgery procedures, treatments or surgery. From Botox, Restylane, Perlane, Radiesse, Cheek Implants, Face Lifts, Eyelid Surgery or Lip Enhancement/Augmentation.

Face Lift techniques that overlook shaping the cheeks to a naturally, youthful shape miss the mark, in my opinion, as they leave the face over-pulled, windswept or otherwise unnatural in appearance. I have found in over 20 years of performing Face Lifts, that tightening and removing just the right amount from the face combined with shaping of the cheeks either with fillers like Perlane and Radiesse or with Cheek Implants gives the face a youthful, natural beauty that is otherwise not achievable. This was my inspiration for creating our “Palmer Celebrity Face Lift”.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

The Palmer “Celebrity Lift” is a minimum incision Face Lift that’s combined with aesthetic shaping of the face. This 90 minute, minimum invasive, procedure has the SMAS lifting of the much more invasive, older types of Face Lifts but can be performed with or without anesthesia. The recovery time is measured in hours…not days, weeks or months because the procedure is less invasive. In fact, most patients travel back home to Asia, Europe or across the US in as little as 3 days following the Face Lift procedure.

The Celebrity Face Lift is often combined with a reduction of the fatty tissue within the nasolabial fold (NLF) the accumulation of which occurs with facial aging. Further facial refinements are accomplished by improving the cheek’s volume and shape. Male cheeks are made to be more angular, while women’s cheeks are converted to a softer, more rounded shape in the front of the face. The shape of the chin and jawline may also be addressed. Facial shaping can be accomplished using Fillers like Radiesse or Perlane and/or with Cheek and/or Chin Implants. The Lips can be made fuller using Restylane, Juvederm or my favorite lip implant (Alloderm Sheets). Botox can be used to soften lines of the forehead, Crow’s Feet or around the mouth for the finishing touches.

The result is a face that appears youthful, more attractive and the opposite of the dreaded over pulled, wind swept appearance.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”