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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ThePalmerCode.com

Today’s news carries a story of Cindy who’s had a record 52 plastic and cosmetic surgeries. I recall media about Cindy, over the years both here and the UK (primarily), where she’s advocated this extreme amount of plastic surgery. Cindy received a stern talking to by Barbara Walters some years back about too much plastic surgery, during one of her US TV appearances and that must be at a point when she had fewer surgeries than the 52 being reported today. Is she a Celebrity because she’s had plastic surgery? It would appear so.

The question isn’t whether it’s right or wrong for her to have this exaggerated number of plastic and cosmetic surgeries ranging from Face Lifts, to Breast Implants, Cheek Implants, Chin Implant, Rhinoplasty and Eyelid Surgery….but rather should this be something that others should emulate? To this, I say a resounding NO! 52 surgeries seems ridiculous, outrageous and highlights some other need that is being met with constantly going under the knife. I’m not convinced that she looks good or better, so I’m not sure what the point of 52 surgeries would have been. From a video on today’s media, she has her hair hiding the front of both ears…what do the scars there look like after multiple Face Lifts and her right side of her mouth seems not to move as well as the left which could indicate nerve damage from one or more of these surgeries.

If we were to use The Palmer Code to calculate her Face Number, would that Number be higher in her before or after photos? ‘m guessing the before pictures would score higher, but you do the calculations yourself and formulate your own opinion. More is not always better and with plastic and cosmetic surgery at the World’s Best level, there is no substitution for sound aesthetic judgment and this would not dictate 52 surgeries, not ever IMHO. The media does consumers a disservice running these pieces with a disclaimer “please don’t try this yourself”.

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

Question: If I’m in my 40’s, would it be alright to have a Face Lift instead of a filler like Perlane or Restylane?

Answer: Your age is 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 nor can anything injected into the face (fillers or your own fat stem cells as recently hyped elsewhere) tighten the skin and 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 of Full Face Lift as the most invasive/effective way to rejuvenate the face and neck. At the end of the day, you’ll have to decide along with the plastic and cosmetic surgeon you choose to do your facial rejuvenation, which of these three options works best in your particular case.

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

media quotes about Dr Francis Palmer and his plastic and cosmetic surgery techniques
magazine articles about Dr Francis Palmer and his plastic and cosmetic surgery techniques
Dr Francis Palmer’s tv appearances
Dr Francis Palmer’s Patient’s reviews and comments from Thank You cards, letters, E-mails and Patient reviews from the best possible source…our own patients.

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
Media quotes about Dr Francis Palmer
Magazine articles about Dr Francis Palmer and his Plastic and Cosmetic Surgery Techniques
Dr Francis Palmer’s TV appearances
Thank You cards, letters, E-mails and Patient reviews from the best possible source…our own patients.

Whether you’re looking to treat the wrinkles of your forehead, eyes, lips; want to shape your cheeks, chin, jaw line and nose: or you’re looking for lip augmentation or enhancement, these soft tissue fillers can be a quick, easy way to improve your appearance.

Model, not actual patient for educational use only.

Whether you’re right here in Beverly Hills, Los Angeles, Orange Country or out of state or visiting from China, The Middle East, The UK or elsewhere in Europe, these soft tissue fillers and wrinkle treatments can be done as an office visit in 10-15 minutes and you’ll be on your way with a fresh, new look. Radiesse will last about 12 months, Perlane 8-9 months, Sculptra up to 24 months, Juvederm and Restyalne 6-9 months. These treatments are very well tolerated and our patients fly back home all over the world the same or following day whichever they prefer. Be sure to have these soft tissue fillers and wrinkle treatments with an aesthetically qualified and well trained plastic and cosmetic surgeon that understands the aesthetics (beauty) of the face as outlined in my new book on the subject “What’s Your Number…the palmer code” available at Amazon.com Fillers, if placed in the wrong amounts or in the wrong place can make the face appear odd and unattractive. Wrinkle treatments like Botox and Dysport can cause weakness and drooping of the eyebrows, eyelids and lips if placed in the wrong areas. Be sure that you’re getting approved fillers and wrinkle treatment injections and not some low-cost imported product from outside the US as these are not regulated and may not be what they claim.

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

Our Own Patient Reviews and Testimonials from Thank You Cards, E-mails and Letters

What the Media says about Dr Francis Palmer

Magazine and Newspapers Featuring Dr Francis Palmer

TV Show appearances by Dr Francis Palmer

How to Choose Your Plastic and Cosmetic Surgeon

Let’s continue with our series on Rhinoplasty with some specific areas where the nose can be improved. The major anatomical areas of the nose are:

The Nasal Tip:

When people speak about the nose being long or short, in length, they are really describing the angle of rotation of the nasal tip as it meets the upper lip. In long noses, the tip is under rotated from the ideal 105-115 degrees with the later more appropriate for women rather than men. When the tip angle of rotation is 90 degrees or less, the tip is seen as hanging…almost like you could touch it with your tongue. The opposite is also true when the tip is over rotated with and angle greater than 115 degrees giving the nose a short, “pig nose” look.

Rhinoplasty can change the angle of rotation closer to the ideal utilizing various surgical techniques from onlay cartilage tip grafts to trimming the anterior septal angle. If there is an excess of tip cartilage, this cartilage can be re-shaped or reduced to achieve a more streamlined appearance. Tip cartilage shape, symmetry and rotation are the major issues that need to be assessed before a specific and effective Rhinoplasty plan can be formulated.

The upper lateral Cartilages:

The area immediately adjacent and above the nasal tip is referred to as the Supratip and consists of the upper lateral cartilages that combine in the mid line with the superior (upper aspect) of the nasal septum to form the nasal dorsum or bridge. This area can be indented (concave), flat or Convex (stick out) and there can be quite a bit of asymmetry between the two sides of the nose in this area. In addition, the nasal bridge can have a bump, depression or be crooked to one or both sides resulting in an overall C or S nasal shape. The cartilage in this area can be shaped and trimmed for added symmetry and shape. During Rhinoplasty, the nasal bridge can be thinned horizontally and the vertical height can be either reduced or increased to address the specific flaw.

The nasal bones:

The next area of the nose is made up or the right and left nasal bones that join the bony portion, of the nasal septum, in the mid line to create the uppermost area of the nose and nasal bridge. As the cartilage area below it, the nasal bones can be wide, asymmetric, high or low to the face. The bones can be rasped using a nasal rasp to reduce and shape the bone or the bones can be surgically broken and fractured to move their alignment (called osteotomies). There are numerous types and ways to create nasal fractures but I prefer the lateral method where the nasal bones are fractured where they attach to the face. The nasal bones should be splinted for 1 week with a nasal cast and our patients are advised to avoid physical contact that may shift the nasal bones for 1 month post Rhinoplasty. We do not use nasal packing for Rhinoplasty even when the nasal bones are fractured except in cases where deviations in the nasal septum have been removed….in which case a small piece of telfa is placed in each nostril overnight and removed the next day during the first post op Rhinoplasty visit.

The nasal septum (inside the nose and separates right from left nasal cavity):

The nasal septum has little effect on the outside shape of the nose except in extreme cases of septal deviation leading to loss of structural support to the overlying tip, upper lateral cartilages and nasal bones. The most common septal manipulation, in my practice, is the resection of the anterior septal angle to allow rotation of the nasal tip. Next most common manipulation is to remove deviated portions of the septum to improve air flow in the nose. It is normal to have cycling and reduced airflow through one side of the nose alternating to the other side every 90 minutes or so…but becomes a problem when one side of the nasal airway is always reduced or blocked. In these instances a septoplasty to remove the hard cartilage or bone obstruction can increase the airway space. Septoplasty can be carried out alone or as part of a Rhinoplasty.

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

Thank You cards, letters, E-mails and Patient reviews from the best possible source…our own patients.

Dr Francis Palmer on TV
Dr Francis Palmer in the Media
How To Choose Your Plastic and Cosmetic Surgeon

If you have a weak chin using a Chin Implant for augmentation, of your chin, can balance the entire lower face. Here’s an excerpt from my new book “What’s Your Number…the palmer code, that defines beauty, describing how you can evaluate your chin and profile. “I’m sure it comes as no surprise that broad, squared chins are an ideal shape for men. Women however, appear more attractive with smaller, rounded chins. Regardless of gender, clefts and dimples add to attractiveness.” excerpt from “What’s Your Number…the palmer code.

What's Your Number...the palmer code book

Here’s how you can measure your chin. On profile view, draw an imaginary vertical line downward from your lower lip. A woman’s chin should be 1/4 of an inch behind that line while a man’s chin should approach or slightly exceed the line. If your chin is behind these measurements, you chin is relatively weak for your lower face and you may benefit from Chin Augmentation with a Chin Implant.

The ideal male and female chin shape and size.

**These are photos of models, not patients, and are included for educational purposes only.

The Chin Implants that In have used for almost years years are made of soft silastic and are very well tolerated by the body. I do not like Chin Implants that become part of the bone or the overlying soft tissue as these are difficult or impossible to remove should you ever desire to do so. The Chin Implants come in different sizes from 1 to 4 with 4 being the largest. Typically sizes and 1 and 2 are used. I prefer and believe that Chin Implants should only be placed through a small incision under the chin. This incision placement allows for dissection under and not through the mentalis muscle’s attachment to the chin (this happens with an incision on the inside of the mouth) preventing upward migration, of the Chin Implant, into the mouth as well as ptosis or drooping of the Chin Muscle years after the procedure which is often referred to as “witches chin.” These complications can all be avoided by placing the Chin Implant through an incision under the chin versus an incision on the inside of the mouth.

Chin Implant surgery takes less than 30 minutes and is typically performed under general anesthesia. Swelling is minimal and quickly resolves. Patients can drive home in a couple of days and fly in 1 week following their Chin Augmentation. Either dis-solvable or removable stitches are placed depending on the travel plans of each patient. We do require that all Chin Implant patients sleep on a U-shaped airline style pillow for 1 month following their Chin Implant or feel and touch the implant force-ably with their fingers to avoid any shifting of the implant. Chin Implants, like Cheek Implants are placed under the covering of the bone and are quite stable at 1 month after placement. Normal and even strenuous activity can be resumed after 1 month. Celebrities can use Chin Implants to balance their faces and improve their appearance…so can you.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”
Thank You Cards and Testimonials from our Patients **The best reviews are from actual patients!
Dr Francis Palmer in the media
Dr Francis Palmer on TV

When you think that you may be interested in nasal refinement through Rhinoplasty be sure to do the following:

1. Learn the basic beauty aesthetics of the nose and how it relates to the face as outlined in my new book “What’s Your Number….the palmer code

2. Be realistic in the type of result that a Rhinoplasty can achieve. This will often need to be determined during consultation with a well trained, highly experienced Rhinoplasty Surgeon. “How to Choose Your Plastic Surgeon.”

3. Have Consultations with 2 or 3 top, best Rhinoplasty Surgeons based on experience and pay for the consults. Free consults are typically offered by less experienced Surgeons offices and they may concentrate more on selling surgery than educating you about what would look good on your nose and face.

4. Do not look for bargain priced Rhinoplasty. The Best, Top Rhinoplasty Surgeons do not do cut-rate priced Rhinoplasties. Expect to pay in the upper range of Rhinoplasty costs to get the best. There are no secret deals, bargains or special offers…ever. Some of the most difficult Revision Rhinoplasties that I have had to perform where just such instances. The patient got a too good to be true deal…and had to pay me top dollar for their Revision Rhinoplasty.

I understand that you may not have one of the World’s Best Rhinoplasty Surgeons in your city, state or even country and yes, I am advocating that you make the effort to travel and have your Rhinoplasty in such instances in the city the top Rhinoplasty Surgeon operates whether it be in Beverly Hills or elsewhere. I further realize that in today’s society where instant gratification and convenience is everywhere that traveling to Beverly Hills seems an extreme inconvenience but “it is what it is.” If the best Rhinoplasty Surgeon is there then you should go there for your Rhinoplasty. Rhinoplasty is the most technically challenging of all the plastic and cosmetic surgery procedures, IMHO and takes thousands of Rhinoplasties performed and a minimum of 7-10 years experience before a plastic and cosmetic surgeon is truly proficient at performing Rhinoplasty. In Revision Rhinoplasty, the difficulty is a quantum level higher and requires even more experience to achieve the desired aesthetic result. Celebrities, at least some of them get the best, top plastic and cosmetic surgeons to do their plastic and cosmetic surgery procedures including Rhinoplasty, so why can’t you?

Next time Part Two: Fundamental Parts of the Nose.

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

Dr Francis Palmer’s tv appearances
Patient reviews and testimonials from letters, thank you cards and e-mails that our own patients sent to us.

1. Deflated and or sagging breasts: Breast Augmentation and Enhancement using either saline or silicone Breast Implants that can be combined with a Breast Lift if the Breasts are ptotic (sagging).

Breast Augmentation is a very popular Plastic & Cosmetic Surgery Procedure whether you’re from Los Angeles, Beverly Hills, San Diego, Orange County, New York, Miami, London, Milan, Hong Kong, Singapore, Abu Dhabi, Dubai or elsewhere in the world. At his fully accredited outpatient Plastic and Cosmetic Surgery Clinic …located in Beverly Hills on the west side of Los Angeles near the California Coast, Dr. Francis Palmer, voted “one of the world’s best” plastic and cosmetic surgeons performs Breast Augmentation, Breast Enhancement and Breast Enlargement Procedures in his Beverly Hills Int’l Center for Aesthetic Surgery. If you are considering Breast Augmentation/Enhancement/Enlargement with either saline or silicone Breast Implants, it’s important to be knowledgeable about all your choices and options.

Before having Breast Augmentation (Breast Enhancement & Breast Enlargement) Procedures there are several things for you to consider. What size Breasts are you looking to achieve with the surgery? Would you like Saline or Silicone Breast Implants? Which incision placement is the best option for you? Do your breasts need some form of breast lift and finally, should the breast implants be placed above or below the Muscle (Pectoralis Muscle)?

Deciding Cup Size before Breast Augmentation: The diameter of your breasts give some indication of the breast cleavage as well as the outer shape (roundness) of the breasts. Generally speaking, a Breast Diameter of 11 cm’s is an A cup, 12 a B, 13 a C, 14 a D and so on. As a general rule, you can draw an imaginary vertical line from the outer hips and the Breasts should touch that line. This gives a balanced overall shape to the body.

Breast Cup Size on Profile

Breast Augmentation incisions have an effect on the visibility of the scar and whether the areolar complex can be lifted at the same time. Incisions in the breast include: around a portion of the areola (nipple complex), within the crease below the breast or remote locations within the armpit (axilla) or the belly button (umbilicus). remote incisions are used for saline implants only that are folded and placed in a deflated state. Silicone Breast Implants come pre-filled are are too large to be placed through incisions in the axilla or umbilicus which could cause damage to the implant. It is also more difficult to manipulate the breast allowing accommodation of the breast implant or to control bleeding within the breast pocket than when using incision around the nipple or those within the breast crease.

Experience…Impeccable Aesthetic Judgment…in fact, Dr. Francis Palmer wrote the book on understanding the Aesthetics of beauty as a guide to having the right Plastic Surgery Procedure to improve your appearance.

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

Written by world-renowned Beverly Hills Plastic and Cosmetic surgeon, Dr Francis Palmer who was voted “one of the world’s best” plastic and cosmetic surgeons by tattler magazine, this is the very first book to define and quantify beauty and our outward appearance….while defining the most important features of the face and body, their relative impact on how beautiful we are perceived and how they can be improved in a consistent and predictable manner.

Book Cover

What’s Your Number is a completely new and revolutionary self-improvement system that shows you how to measure, analyze and improve all aspects of your life, both inside and out.
Here’s the secret! Dr Francis Palmer discovered that everyone has a number. This single, all-encompassing number represents the culmination of everything that makes you who and what you are. This number…your number is the way you present yourself to the world. More importantly, by using the What’s Your Number System, you can control and improve every facet of your life…from your outward appearance to your personal relationships… and so much more!

The knowledge and resources are all here for you to realize your life’s full potential.
So, the only question remaining is….What’s Your Number?

Dr Francis Palmer uses The Palmer Code Number approach to facial shaping using soft tissue fillers like Radiesse, Perlane and Sculptra…the only difference being his ability to see and create the most aesthetically attractive feature based on his “What’s Your Number” system. The results can be nothing short of amazing where Perlane can be injected to soften the cheeks making the face appear more youthful and attractive in just a few minutes. “We have patients that shape their cheeks and hit the red carpet that very night looking fabulous. Of course, Botox can be added to soften unwanted lines and wrinkles as well as Restylane or Juvederm to plump the lips.”

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