Q: I often read that it takes 10 days to recover from a face lift but I don’t know if that includes upper and lower blephs plus browlift, which people often have at the same time. I’d like to know how long to budget in a general way even as you need to add the disclaimer that everyone is different, we all heal at different rates. If it helps I am a 45 woman basically in good health, some asthma and allergies, of Caucaision and African-American descent.   A: I have performed Face Lifts for over 20 years and don’t perform Brow Lifts along with Full Face Lifts because of the area of tissue dissection that required: across the entire forehead, face and neck.  This leaves very little area for blood supply to heal the skin flaps along the lower section of the Face Lift.  I typically will perform the full Face Lift, Neck Lift with or without the Bleharoplasty (eyelid Surgery) and save the Browlift for another time at 6-12 months later.  This is safer than having a problem with healing after the Face Lift where a portion of the skin could die creating an unsightly large scar. Full Face Lift with Neck Lifts require patients stay in the Beverly Hills/Los Angeles area for a minimum of 10 days and the tissues will take 4-6 months for the swelling, lumps and bumps to resolve.  Depending on your particular case…how much tissue dissection, skin removal etc. is performed, the longer your recovery time.  Most patients are able to put on makeup and look at 1 month post-op.   Q:When is the pre operative surgical markings done for a face lift and blepharoplasty. It is before the surgery while you are awake and sitting up or after you are sedated and lying down? A: I have been performing Face Lifts for over 20 years and have taught Face Lift techniques to resident surgeons for quite a few years. The markings associated with a Face Lift could be done either way…with the patient sitting up which is the way I saw plastic and Cosmetic Surgeons do when I was training over 20 some years ago. I have always allowed my Face Lift patients to lay down on the O R table before I do the facial marking as I feel it allows them to relax more. IMO, if the results of a Face Lift are not what you desired, I really doubt the way in which things were marked had any real impact. It’s more important that the true aesthetics of the face are accentuated during any Face Lift technique. The aesthetics of beauty is the topic of my new book “What’s Your Number…the palmer code”. Q: Opinions on Stem Cell Facelift? Is the “stem cell facelift” hype or something worth looking into? I have seen wonderful before and after photos, but I have learned not to always trust them. Thank you for your input. A: Sadly, complete hype. Stem Cell Face Lifts are nothing more exotic than your own fat treated to isolate the naturally occurring stem cells within your fat which is then injected into your face like traditional fat transfer.  Stem Cell Face Lifts may plump up the face but there’s no evidence to support claims that these stem cells will magically rejuvenate your face. Stem Cell Face Lifts can’t:

• tighten the underlying SMAS muscle layer
• tighten or remove excess skin

Q: Would a Surgeon Refuse Me a Temple Lift for Being Too Young?

I am a 20 year old female. I realize that face lifts are intended for much older people, but I think a temple lift could help improve the overall look of my face by giving the outer corners of my eyes a subtle lift and slightly lifting my lower cheeks. I’ve used my fingers to gently elevate the skin in that area and I quite like the way it looks. I don’t think my age should be a big factor in determining whether or not I am a good candidate for this surgery.

A:

At 20 years old it’s unlikely that your eyebrows are low enough in position to warrant any type of Forehead Lift.  I would always reserve the right to change my opinion based on seeing you but in my 20 + years of performing Face and Forehead Lifts, I have not performed a Forehead Lift on anyone under 27 and any type of Face Lift on anyone under 32 years of age.

Q: Face Lift at 40 years old

If I’m in my 40’s, would it be alright to have a Face Lift instead of a filler like Perlane or Restylane? A: Your age is much less of a deciding factor than the signs of aging and the shape of your facial features.  If you have nasolabial folds, jowls and excess loose skin, fillers would be helpful in shaping the face but won’t and can’t remove excess skin or tighten the underlying SMAS muscle.  For that, you would need a Minimum Incision Face Lift or a larger, more invasive traditional Face Lift. Think of fillers like Radiesse, Perlane, Juvederm, Restylane and Sculptra as the least invasive and effective method of reversing facial aging.  Combined Minimum Incision Face Lift along with fillers as the next step and finally fillers with a more involved type Face Lift as the most extreme way to rejuvenate the face and neck.

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Blepharoplasty or Brow Lift how can I tell what’s right for me

Fullness of the upper eyelids come from two places.
• One is the position of the eyebrows. If the eyebrows are low, in position, this adds fullness to the upper eyelids.
• The other factor is true excess upper eyelid fat and skin which honestly, is a bit rare at 31 years old. Now here’s why I believe you can’t get your anser from these photods.

In women, the proper aesthetic shape of the eyebrows and eyes must be determined in person by the plastic and cosmetic surgeon in order to determine which of the above mentioned two factors is causing the upper eyelid fullness in your particular case. I mention this in my new book on the aesthetics of beauty , “What’s Your Number..the palmer code.”.
The surgeon must, IMO, place your eyebrows in the proper aesthetic position and then with you opening and closing your eyes, assess the amount of upper eyelid fullness remaining. There are three possible outcomes all quite revealing:

• When the eyebrows are elevated to the proper position, all the upper eyelid fullness is gone. This means the fullness is due to low eyebrows and the solution is a Brow Lift, not an upper Blepharoplasty which if performed, in this scenario, would actually cause your eyebrows to become lower after the procedure. More on this later.

• When the eyebrows are elevated, some of the upper eyelid fullness remains. This indicates that a Browlift would remove some, but not all of the fullness, the remainer of which could be removed with an upper Blepharoplasty as a combined procedure.

• The eyebrow is already in the proper position and all of the fullness remains, indicating that an upper Blepharoplastyy alone would remove this excess. This is the only scenario, of the three possible, where an upper Blepharoplasty alone is indicated.

Until this simple, but crucial maneuver is performed on you in person, the appropriate procedure can’t be determined. If an upper Blepharoplasty is done when the correct procedure should have been a Brow Lift, to raise the eyebrows, the Blepharoplasty can cause the position of the eyebrows to go even lower after the procedure. Once this happens, the Brow Lift often can’t be performed because there’s simply not enough skin on the upper eyelid to allow the eyes to close properly after the eyebrows have been elevated. This can result in corneal exposure and complications.

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

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Plastic and Cosmetic Surgery is the art of aesthetically enhancing the physical form. When properly performed, it can dramatically improve one’s appearance, restoring natural and youthful beauty.

A skilled plastic surgeon can help you achieve the look you’ve always desired through a combination of sound aesthetic judgment and surgical expertise that takes years to cull. Quality plastic surgery is “invisible”-it helps you look younger and more attractive, without appearing obvious or artificial. However, aesthetic vision and surgical skill vary among surgeons-so be sure that you are in the hands of a surgeon that is aesthetically gifted, highly competent and extremely well experienced.

Follow these four simple-common sense steps when selecting your plastic and cosmetic surgeon.

#1. First and foremost, listen to the aesthetic judgment of the surgeon. Does it sound like something that would enhance your appearance? Proper beauty aesthetics are easy to comprehend when properly explained. If it sounds reasonable to you, then proceed to step two. If it doesn’t sound right to you…..get another opinion. There is simply no substitute for sound aesthetic judgment! You may wish to read my new book on this subject “What’s Your Number…the palmer code.” **Available at Amazon.com

#2. Ask yourself if the surgeon has the experience to do what he/she is suggesting. Don’t be afraid to ask the surgeon-”how many times have you performed this procedure?” Most important of all-be sure to see real before and after photographs of patients who have undergone the same procedure. Do not settle for computer simulations! The computer will not be altering your looks—-the surgeon will! This is extremely important because, there is no substitute for experience! If you are satisfied, then proceed to step three-if you are not sure, then get another opinion!

#3. Once the first two steps have been met, you can factor in the price. Prior to this you’re not certain which procedure is right for you-therefore the price should be irrelevant. Step three is a point where you can be fairly comfortable with the level of surgical competence and overall satisfaction, so you may want to compare costs. Minor differences in costs may reflect such things as, how much of the finishing stitches does the surgeon do-or does the assistant complete this portion of the procedure. How well are the incisions hidden and how often will you have follow-up visits with the surgeon. There are reasons for price differences-be sure that you understand exactly what you are/are not getting! You may opt to pay the higher price for more personalized care! You can continue on to the fourth and final step.

#4. This is more of an intuitive step than the previous three. Here you may want to factor in variables like the board certification of the surgeon. Does he/she carry an impressive reputation in the community or carry a university teaching affiliation? How do you feel about the surgeon and the office staff? Follow your gut instincts—–they will serve you well!

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
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The Palmer Celebrity Face Lift, featured on ABC’s “The View” can make you look more naturally attractive, take off up to 15 years all in 90 minutes or less with or without general anesthesia. The secret lies with it’s creator, Dr Francis Palmer that Tatler Magazine named “one of the World’s Best” Plastic and Cosmetic Surgeons for his pioneering work in Face Lift techniques that shape the face in an attractive manner…avoiding the pulled, wind swept or upturned mouth joker look.

The Palmer Celebrity Lift is the next generation Face Lift that offers the following:

1. Much smaller, well camouflaged incisions that are 1/4 the length of more traditional Face Lift incisions.
2. Incisions do not go into scalp so hair loss is not experienced from incisions within the hair as may occur with
traditional Face Lifts, including some S-lifts, Mid Face Lifts and others.
3. Less invasive… The Palmer Celebrity Lift is a highly focused yet smaller area of tissue
dissection resulting in less area within which bruising and swelling can occur compared to traditional Face Lifts.
This results in less bruising, swelling and recovery time that can be measured in hours and days instead of weeks
and months as is the case with more invasive traditional Face Lifts.
4. Patients can fly home to Europe, Asia, the Middle East and across the US in as little as 3 days following
The Palmer Celebrity Face Lift versus 7-10 days with traditional Face Lifts.
5. The Palmer Celebrity Face Lift undermines, lifts, elevates and sutures the underlying SMAS
layer instead of merely lifting or folding the SMAS with sutures or barbed threads that must rely on keeping their
two-point fixation intact for the SMAS tyo stay lifted….should the threads or sutures come loose…the SMAS will
simply unfold and go back to its sagged position. This is why Dr Palmer does not use or recommend any type of
suture/thread suspension face Lift procedure. The Face Lift must, in Dr Palmer’s opinion, dissection, trim, lift
and re-suture the SMAS (muscle) layer for the effects of the Face Lift to last.
6. The Palmer Celebrity Face Lift combines SMAS tightening with excess skin and fat removal
combined with shaping of the cheeks, chin and jaw using either Cheek Implants, Chin Implants or fillers like Perlane, Radiesse, Sculptra, Restylane, Juvederm, Botox or Dysport. Just how the cheeks, chin, jaw and the Lips are shaped are based on Dr Palmer’s new book on the aesthetics of what makes us beautiful “What’s Your Number…the palmer code” available at Amazon.com Of course other plastic and cosmetic surgery procedures like Breast Augmentation with Breast Implants, Rhinoplasty, Eyelid Surgery, Brow Lifts and even Tummy Tucks can be done at the same time.
7. Because The Palmer Celebrity Face Lift is designed to do all the above….it can be performed under local, IV sedation or a general anesthesia in 90 minutes or less.

If you’re looking to be more naturally beautiful, as a woman or more ruggedly handsome as a man…The Palmer Celebrity Face Lift might just be the answer. You may have to travel to see Dr Francis Palmer in Beverly Hills but the journey is a small price to pay for the expertise, quality and impeccable aesthetic judgment that you will receive. All Plastic and Cosmetic Surgeons are NOT created equal… How To Choose Your Plastic and Cosmetic Surgeon.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”
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When trends become mainstream, they can and often are taken too far. Remember Twiggy and the thin craze? How about the Waffe-look that plagued Hollywood leading ladies to the point even the star-crazed media cried “foul”? All of these are examples of a trend gone wrong. The quest for ever simplier, less invasive ways to make yourself look more youthful and attractive is no different. As the article points out, patients not interested in the large, more invasive traditional Facelifts kept seeking less and less invasive procedures until the results became un-aesthetic. Dermatologists were preaching “who needs surgery, you can just plump up the face with all sorts of fillers that are placed in all sorts of areas of the face”… While a little, or should we say the correct amount of Botox, Radiesse, Perlane, Restylane, Juvederm or Sculptra can create a wonderful aesthetic improvement in the face….more doesn’t equate with more aesthetic results and some people’s faces looked like “puffer fish” all swollen, round and puffy.

The message here is clear. Use fillers in a reasonable manner to create shape to the cheeks, chin and or jawline as well as filling the nasolabial folds, jowls and marrionette lines. Use a minimally invasive face lift procedure like our “Palmer Celebrity Lift” to tighten a loose muscle (SMAS or Platysma) layer and remove excess subcutaneous fat and skin. Combining the two techniques, or using Cheek Implants/Chin Implants is the appropriate way for your face to maintain a soft, naturally beautiful shape and appearance.

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

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Just stepped out of the OR where I removed a small, button-style chin implant from a tall rugged-looking man. He came to me seeking a more augmented and defined chin then what he had obtained from the button chin implant that had been placed by another surgeon elsewhere.

This story illustrates my two basic principles of aesthetic plastic and cosmetic surgery, including Chin Implants.

Rule # 1: The Aesthetics of Beauty must be followed. In this case, the small button-style chin implant was not consistent with the aesthetics of beauty and was incapable of making his chin more rugged and masculine. In a word, the procedure, in my opinion, was doomed to failure, from a purely aesthetical sense, once that size and shape of chin implant was selected. At that point it didn’t matter how technically gifted the surgeon was or how much experience the sugeon had with chin implants….the patient’s appearance was not going to be improved, nor was this chin implant capable of increasing his “Number”.

Rule # 2: You, as the consumer have the responsibility of selecting the best, even the World’s best plastic and cosmetic surgeon that you can find…making certain that the surgeon follows the aesthetics of beauty in a way that will improve “Your Number”. Here are four simple steps. on how to choose your plastic and cosmetic surgeon, that will help you in your search.

Never, never and oh, did I mention never use price as your determining factor for sekecting a plastic and cosmetic surgeon to perform your plastic and cosmetic surgery procedure whether it’s a Chin Implant, Rhinoplasty, Face Lift, Breast Augmentation with Breast Implants, Lip Enhancement, Eyelid Surgery, Browlift, Cheek Implants, Tummy Tuck, Botox, Dysport, Radiesse, Restylane, Juvederm or Sculptra. Select your plastic and cosmetic surgeon as if you were a celebrity and you had to have the world’s very best.

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

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I prefer using an incision hidden under the chin versus one on the inside of the mouth. The surgery typically takes about 20 minutes and I have not found it necessary to use sutures or screws to hold the chin implant in place. Patients are allowed to fly back home to Europe, Asia or the Middle East 1 week after the procedure.

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

I believe, that more than any other plastic and cosmetic surgery procedure…Cheek Implants must be just the right size and shape to create the proper aesthetic contour. If the Implants are to small, large, wide, thick or the wrong shape….the facial aesthetics will be off and the face looks odd and sometimes downright deformed. Hardly the naturally beautiful or handsome look you wanted to achieve.

When I see patients who have had, what I believe are, an incorrect size and or shape) Cheek Implants there always seems to be a lack of aesthetic understanding on the part of the plastic surgeon and the patient. In many cases, the Cheek Implants were placed in an ill-advised attempt to plump up and fill sagging facial tissues resulting in massively over-sized implants and a deformed face.

Here are my important take away points for anyone seeking Cheek Implants as a way to shape and improve facial appearance.

1. Cheek Implants must be subtle in shape and size….they should enhance not overwhelm the face.

2. Not everyone is a good candidate for Cheek Implants and this is based on the actual shape of your existing cheek bones.
The entire cheek bone should have an ideal aesthetic shape, as outlined in my new book “What’s Your Number…the palmer code. However, it’s quite common for one or both cheek bones to have sections that are ideally shaped and parts that are not. When the majority of the cheek bone is properly shaped, adding a Cheek Implant is likely to make the cheeks and face appear to broad or large and this is something that obviously should be avoided. In that case, fillers like Perlane, Radieese or Juvederm Ultra Plus can be injected to fill and enhance just the deficient segment of the cheek. This is a temporary solution but one that is highly effective and avoids disfiguring the face.

3. When using Cheek Implants, a little augmentation goes a long way.

When augmenting the cheeks with Cheek Implants, using a subtle implant makes the cheek and the entire face attractive…but once the implant is even slightly to large, small or thick…the cheek and the face appear deformed. “A little is good, more is terrible.”

4. Not every Plastic and Cosmetic Surgeon is comfortable using Cheek Implants.

Just this week we had a person contact us via e-mail to say she visited a well known plastic and cosmetic surgeon about possible cheek implants to which the surgeon gave a less than supportive opinion about the merits and benefits of using Cheek Implants to improve the facial appearance. This position, with which I completely disagree should make that patient realize she must seek another plastic and cosmetic surgeon who believes in Cheek Augmentation with Cheek Implants.

Cheek Implants can, will and do alter the facial skeletal shape and as such may be daunting to some plastic and cosmetic surgeons…it’s OK, not everyone has to perform every type of plastic and cosmetic surgery procedure. You do need to find a plastic and cosmetic surgeon that does many Cheek Augmentations with Cheek Implants and who gets a consistently great aesthetic result with Cheek Implants. Why would you go anywhere else?

5. You always, always, get what you pay for.

The best, the top Cheek Implant surgeons will charge accordingly. Beware of discount prices as these may indicate a surgeon with little or no experience.

6. Do be open to adjunct procedures along with your Cheek Implants.

If the tissues of the face and or neck are loose and have sagged, Cheek Implants should never (in my opinion) be used to lift these tissues as this requires an implant that is very large, thick and aesthetically incorrect. When used in this scenario, the Cheek Implant is inconsistent with a naturally youthful and beautiful face. Instead you may wish to tighten, lift and remove excess fat and skin for a face that is shapely and more attractive using our “Palmer Celebrity Facelift.” Think of this as re-draping the tissues over the improved cheek structure once the Cheek Implants have been placed.

Of course Rhinoplasty, Eyelid Surgery, Breast Augmentation with Breast Implants, Botox, Browlifts, Tummy Tucks, Chin Implants and Lip Enhancements can also be done at the same time as Cheek Augmentation.

7. Celebrities are no stranger to Cheek Implants.

I’ve seen numerous pictures of celebrities before and after their alleged plastic and cosmetic surgery and they may have had Cheek Implants to fill and shape their cheeks.

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

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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.”

Photo Credit: Steve Granitz Wireimage

Grammy’s 2010 Taylor Swift: Taylor looks beautiful in this blue dress but what if we had a magic wand and could change her appearance to make it a perfect face, what would we consider doing?
1. The eyebrows are low, so perhaps some Botox to the eyebrows or a Brow Lift.

2. The left cheek is a bit more flat than the right so a little soft tissue filler to shape and contour the cheek using either Radiesse

3. The upper lip is thin compared to the lower lip, so perhaps either a soft tissue filler to the lip borders using Restylane or Juvederm or a semi-permanent lip implant like Alloderm that seems to last about 7 years.

4. The nose is a little thick and a Rhinoplasty (nose job) could thin and refine both the nasal bridge and tip.

This is, of course fantasy, and a make believe exercise but still fun and exciting to imagine. So what’s her “Face Number” now: 86 Fantasy Makeover Face Number: 99 with 100 being perfect.

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

***Disclaimer: This information is provided for entertainment and educational purposes only and is not intended to imply the above mentioned person has had, or will ever have any type of plastic surgery treatment or procedure or any affiliation with Dr Francis Palmer.