Nip This Tuck That

Information on Plastic and Cosmetic Surgery topics brought to you by Dr Francis Palmer , world renowned Beverly Hills Plastic and Cosmetic Surgeon voted one of the “world’s best” plastic and cosmetic surgeons.

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.”

The are so many sources today all claiming to give you information about plastic and cosmetic surgeon including a list of the top, best plastic and cosmetic surgeons that it’s easy to become overwhelmed in your search. How are you supposed to know which source you can trust? Here’s a brief article that I wrote on How to Choose your Plastic and Cosmetic Surgeon that would apply for someone seeking any type of plastic and cosmetic surgery or procedure including Botox, Dysport, Eyelid Surgery, Rhinoplasty, Forehead Lift, Face Lifts, Cheek Implants, Chin Implant, Breast Implants for Augmentation and Enhancement, Lip Augmentation, Perlane, Radiesse, Restylane, Juvederm or Sculptra.

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.

World’s best soft tissue fillers like Radiesse, Perlane, Sculptra, Juvederm, Restylane, Botox and Dysport injections to enhance the lips, treat wrinkles and shape the face.

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

Chin Implant for Chin Augmentation: Beverly Hills Style

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

Based on my new book “What’s Your Number…the palmer code” available at Amazon.com

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

Perlane, Radiesse, Juvederm Ultra Plus and Sculptra are all great soft tissue fillers if used in the proper amounts in the right places. In Beverly Hills, we use these fillers to:

1. Soften Nasolabial folds and Marrionette Lines

2. Form and shape the Cheeks

3. Form and shape the chin

4. Create flare to the Jawline

5. Shape and soften the nose

Lip Augmentation and Enhancement is best done with fillers with smaller molecule size placed along the vermillion border of the lips. Perlane, Radiesse, and Sculptra should be placed into a fatty tissue layer and the lips do not have such a layer.

When using these fillers to create shape the the Cheeks, Chin, Nose and Jawline the proper facial aesthetics must be considered. You can learn these in my new book “What’s Your Number…the palmer code”.
Fillers take 10-15 minutes as an office visit and you should consider fillers as a form of beauty maintenance that you’ll most likely do once a year, or so, not different from Botox or Dysport treatments to soften unwanted lines and wrinkles except these are done about every 6 months, or twice a year in comparison.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”
Patient Reviews, comments and testimonials
Dr Francis Palmer on TV

World Renowned Beverly Hills Plastic and Cosmetic Surgeon, Dr Francis Palmer, voted one of the “World’s Best” plastic and cosmetic surgeons describes his Palmer Celebrity Face Lift that offers smaller incisions, less bruising/swelling and associated downtime than traditional Face Lifts.

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.”
Dr Palmer in the media
Dr Palmer Media Continued
Patient Testimonials

Face Lifts like our “Palmer Celebrity Lift” (featured on ABC’s hit TV show “The View”), Breast Augmentation with Silicone or Saline Breast Implants, Rhinoplasty (Nasal Surgery), Blepharoplasty (Eyelid Surgery), Cheek Implants, Chin Implant, Lip Augmentation with Alloderm or silicone implants, Tummy Tuck and various types of body lifts…are all great ways for you to improve on the way you look. However, these plastic and cosmetic surgeries have downtime and if you’re looking for a way to look great right now, today you simply can’t beat fillers and wrinkle softening injections. It’s what many Celebrities do before Oscar, Emmy’s, Grammy, People’s Choice Awards or anytime they want to look star quality beautiful….and these quick, easy fixes are not just for women anymore as more and more men are discovering fillers and wrinkle softening injections as a means to make them appear more angular, handsome and youthful.

If you’re considering fillers and wrinkle softening treatments here are a few suggestions for you to consider:

Botox, Dysport, Radiesse, Perlane, Sculptra and Juvederm are the same no matter what plastic and cosmetic surgeon or dermatologist you choose to administer the treatment. There is no inherent magic in the fillers or neourotoxins (Botox, Dysport) themselves…these materials don’t possess smart technology to ensure that they are placed in the right just the right amount to give you the very best aesthetic results. If yu think about this logically, it makes sense. Using Botox, Dysport, Perlane, Radiesse, Juvederm or Sculptra is an art in and of itself. It requires a level of skill, training and experience, so do not use price as your determining factor of where and by whom you receive these treatments. If you want the best, top results you’ll have to pay a reasonable fee. Period. It’s a great idea for you to learn the basic aesthetic principles that will make you more attractive which I have done for you in my new book “What’s Your Number..the palmer code.”“>”What’s Your Number…the palmer code” available at Amazon.com.

Here are some uses, we have for the neurotoxins and various fillers: These procedures are done as an office visit in 10-15 minutes with minimal discomfort or downtime. Patients fly here from all over the world for these treatments and are allowed to fly home the same day.

1. Reduce unwanted wrinkles of the forehead, glabella (between the brows), Crow’s Feet and around the lips or mouth using either Botox or Dysport. I like to have my patients receive a full treatment as a booster 1 month from the initial treatment for added effect. Once that’s done, the Botox or Dysport treatments can be done every 4-6 months to maintain the results.

2. Elevate the corners of the mouth or eyebrows. Botox or Dysport can be used to elevate the corners of the mouth or the tail of the eyebrows.

3. Botox and Dysport can be used to reduce unwanted areas of enlarged facial muscles around the mouth or nose (“nasal srunching”).

4. Shape the Cheeks, Chin or Jawline using fillers like Perlane or Radiesse. Allows your face to look more youthful, feminine and naturally beautiful as a woman or more angular and ruggedly handsome if you’re a man. All in 10-15 minutes with the results lasting about 6 -12 months depending on which filler is used. We do use Cheek and Chin Implants to permanently enhance the Cheeks and Chin for men and women but I have been hesitant over the past 20+ years as a Beverly Hills Plastic and Cosmetic Surgeon to use Mandible (Jaw) implants because of he risks and possible complication associated with those implants, so the fillers offer a safe and viable alternative for people who require jaw enhancement IMHO. Because Radiesse is a thicker molecule there’s a bit more swelling and lumpiness with this than after Perlane IMO so we prefer to use Perlane the first time our patients have fillers to shape the face and in all cases where our patients have an important event, like a red carpet, appearance that night or the following day.

5. Plump up the lips, using the proper aesthetic proportion outlined in my book, using Juvederm.

6. Fill out the Nasolabial (NLF) folds or Marionette Lines using a variety of fillers. Juvederm for superficial (folds not too deep), Perlane and Sculptra for deeper folds. Radiesse can show as a stiff line within the fatty tissues in some patients and should be sued only when the folds are very deep IMO.

7. Sculptra is excellent to fill out hollows or depressions in the face, temples or hands. Sculptra is a staged type of treatment where the patient receives an initial treatment and then is treated again in approximately 8 weeks for a full correction. Some times a third treatment is required. The good news is that Sculptra, unlike the other fillers, causes your body to make its own collagen and the results last up to 2 years. I do not use Sculptra to create shape in the cheeks, chin and jawline as I feel the larger molecules of Perlane and Radiesse are better adapted for that purpose.

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

Dr Palmer on TV

Dr Palmer in the Media

Patient Testimonials

Today’s Wall Street Journal has an article that talks about the growing trend in Plastic and Cosmetic Surgery of people becoming more interested in minimally invasive surgical procedures as well as fillers and Botox/Dysport. If you’ve been reading this blog for the past 8 years, or so, you’ll see that we talked about this trend beginning almost 10 years ago. We happened to be honored in the late 1990′s by Tatler magazine naming us as one of the “world’s best” plastic and cosmetic surgeons in general and one of the “world’s best” Face Lift surgeons in particular…one of only two plastic and cosmetic surgeons receiving the coveted distinction in the entire world. I bring this up to highlight the point that I am very familiar with facelifts and the various Face Lift procedures having performed Facelifts for over 20 years both here in my Beverly Hills Surgery Center and in numerous Hospitals in the UK (London) for about 8 years. During that time, I have seen the increasing trend of the public move away from the 55-60 year olds who came in for a Browlift, Upper and lower eyelid lift and full face and neck lift, which was very common in the 1990′s to the 35 year olds who just wanted to start doing smaller, less invasive procedures so they could stop the effects of aging, on their face at a much earlier age. This became the montra of patients in the 2000′s and in 2010 the trend is increasing as the pace, of our lives more ever faster. Who has time for weeks, or months of swelling, bruising or non-activity? Who wants 6-8 hours of a general anesthetic and large or long incisions that are obvious to everyone? Who wants to age until they’re 60, only to have the “full monty” and look completely different after a complete face makeover? Answer: not many which was the jest of the wall street journal article.

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.”

Dr Palmer in the media
Dr Palmer in media
Dr Palmer tv appearances
patient testimonials

Soft tissue fillers can be used to augment the Cheeks, Chin and Jawline in about 10 minutes as an office treatment using Radiesse, Perlane or Juvederm Ultra Plus. What’s important, for you as to remember is that these fillers hold no aesthetic qualities but are merely a tool to create and reflect the artistic aesthetic ability of the plastic and cosmetic surgeon, dermatologist, MD or RN injecting the material. If the injector places the Radiesse, Perlane or Juvederm Ultra Plus in the wrong amount or in the wrong area, the desired aesthetic result will not be acheived. So, it becomes important for you to know the proper aesthetic shape of your face including the Cheeks, Chin and Jawline….which is the topic of my new book “What’s Your Number…the plamer code.

Before Radiesse

Before Radiesse

After Radiesse

After Radiesse

Here’s an example of using Radiesse to Augment the Cheeks and create a masculine flare to the jawline.

Aesthetic Improvement After Radiesse Treatment: Cheeks are more prominent…Jawline more defined and flared giving the face a more rugged and handsome appearance.

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