As with any service industry, there are convenience stop businesses and destination businesses. You see that with restaurants (think of McDonald’s or Chili’s versus French Laundry, one of the best restaurants in the United States) and you see this concept applicable to the plastic surgery business. I stress the term business and not medical field for a reason in this essay. I can safely say that most people that pursue higher education in any country do so to seek a better life, better pay and have more opportunities come their way. Of course, most scrupulous doctors experience immense satisfaction from treating their patients as well and, cynically speaking, are not simply in it for the financial award.
Like all professionals, doctors do seek out (and deserve) a certain financial reward for all the years of dedication, study, stress and life sacrifice they undergo in order to carry out their profession and deliver the best care they can to their patients. However, in this day and age of increasing competition and commoditization in all aspects of health care including plastic surgery, surgeons are forced to perform more surgeries at lower costs and possibly increased medical risk to patients. This alarming trend can especially be seen in plastic surgery where the end results of a hastily performed surgery are not hidden within a body cavity but are plainly visible on the face. Some of my colleagues brag about the speed at which they perform a surgery citing the many corners that they “cut” during an operation as unnecessary steps (no pun intended). I suppose they feel more akin to a Usain Bolt than that of a gifted watchmaker.
This brings me to the title of this blog post-The Lifestyle Lift. To the unsuspecting public this facelift is heavily marketed as a viable, simpler, safer, faster quality facelift at a fraction of the price. In fact, this facelift is an overly simplified distillation of pre-existing ideas wrapped in a new packaging as something brand-new and revolutionary. The one aspect that is revolutionary about this facelift is that it is one of the first surgeries that has been rebranded and marketed directly to the “consumer”. The company then refers the “consumer’ to one of their participating surgeons in the network to become a patient. Unfortunately, as a Beverly Hills plastic surgeon board-certified by the American Board of plastic surgery, I have seen many results of this “Lifestyle Lift” that reek “cookie-cutter surgery” in which performance is measured in terms of speed and not quality.
I have seen many unacceptable, hideously widened scars most probably stemming from the fact that the surgeon did not perform a wide enough dissection to allow a tension-free closure (which is tantamount to a good scar). I have also consulted with many patients who were dismayed by how the “Lifestyle Lift” failed to meet their expected goals with incomplete treatment of their jowls, neck and midface.
While it is true that all surgeons have their small subset of unhappy patients either because of unrealistic expectations, sub-optimal results or unexpected complications, the large percentage of unhappy patients complaining of their “Lifestyle Lift” is too hard to ignore. For a good article on the subject that appeared in Plastic Surgery Practice.
Dr Haworth, a specialist in Liposuction in Beverly Hills, describes a new technique of Liposuction that improves upon traditional techniques. He calls this 360 liposculpture and delivers unprecedented results in terms of achieving the ideal human body shape. He has performed this procedure on hundreds of patients ranging from Hollywood celebrities to showgirls and housewives
My staff and I are frequently asked why it takes me longer to perform my body contouring procedures compared to other plastic surgeons. This is because most surgeons intensely dislike performing Liposuction (or suction assisted lipectomy [SAL] as it is known in plastic surgical parlance) and use it simply as a tool to “debulk” or reduce the size of a body part. Little attention is paid to actually contouring the body itself by creating provocative curves and beautiful blends from one anatomical section into the other. This is true body reinvention at its best.
How is 360° liposculpture performed?
With unwavering concentration, with meticulous careful attention to detail, with minute cannulae (the small tubes through which the fat is aspirated), with a intimate familiarity of techniques ranging from conventional tumescent liposuction to laser-assisted and syringe. Syringe, you may ask? Yes- this low tech technique provides the most control for the surgeon. allowing him to sculpt the most minute of body contour irregularities- liken the detail provided by actual hand stitching in clothes to machine stitched. Even though the average person may not notice the difference (especially if he or she considers the procedure a commodity), a true connoisseur will appreciate the exceptional result afforded by 360 liposculpture. This technique is not for the surgeon with a faint of heart- it is extremely exhausting, time-consuming and demanding of one’s most exceptional skills. Of course, a keen eye and appreciation of human form and beauty is a must.
What are some of the benefits of this 360° liposculpture?
A sublime result maximally customized for each individual patient. Some of the added benefits of 360 liposculpture are obtained by creating a youthful midline abdominal groove, enhancing the waist, reducing unsightly “bra strap” fat bulging, reshaping the ankles and calves fabulously from all angles, contouring beautifully elegant knees and sculpting feminine shoulder and arm definition down to and past the elbow, etc, etc..The list goes on.
However, this technique will not improve stretch marks or cellulite (Nor will any other Lipo suction technique for that matter). A high degree of skin contraction will result. A few examples will follow:
Note the back rolls, ill defined waist and thick shapeless midsection
After 360 Liposculpture of the abdomen, back and waist
Note how the three-quarter view shows how the hip roll and back are compressed together in an acute angle. With 360 liposculpture, Dr. HAWORTH is able to elegantly “open up” that acute angle, thereby rendering a far more elegant look to the body. The patient consequently looks taller as well.
With 360 liposculpture, Dr. HAWORTH is able to elegantly “open up” that acute angle, thereby rendering a far more elegant look to the body. The patient consequently looks taller as well.
This patient would not wear certain dresses because she was embarrassed by the shape of her lower legs. She felt that they were bulky and lacked shape. They did not ascribe to her ifeminine ideal. Diet and/or exercise would not give her the results she was looking for.
Dr RANDAL HAWORTH performed 360 liposculpture of the calves, knees and ankles to create an elegant look in her lower legs which she thought otherwise impossible up to now. Diet or exercise cannot obtain this type of result
For further information, go to drhaworth.com or call 310-273-3000 to arrange an appointment with Dr. Randal Haworth, a Beverly Hills plastic surgeon certified by the American Board of Plastic Surgery.
Fat transfer is a brilliant way in order to fill up the lower eyelid circles which gradually appear with age as the mid facial fat sags southwards. Though one can inject any number of temporary and permanent fillers into the area with magnification (such as Juvederm®, Restylane®, Artefill®, Belotero®, etc.), one must remember that fat is an excellent solution. By filling out this dark circle/hollow, a smooth beautiful interface is created between the lower eyelid and the upper portion of the cheek. The harsh defining ledge of the lower bony orbit is smoothed out.
Here is a classic example of a strategic fat transfer to the lower lid. The results are permanent and natural appearing.
Note the harsh shadowing around the lower eyelid interface with her upper portion of her cheek. This is called the “tear trough” and worsens with age.Note the smooth result that was obtained by softening the shadowing and ledge that defined her lower eyelid hollow. Fat transfer was performed in order to obtain this result.
Obviously, as we continue to age, the cheeks descends further thereby widening the “tear trough” or lower eyelid Hollow/dark circle. The fat that worked perfectly to bridge the gap is now inadequate since the gap has widened. The results of fat transfer should be permanent, however, as long as the surgeon adheres to proper fat harvest and transfer techniques.
For further information into how Dr. Randal Haworth of Beverly Hills(Certified by the American Board of Plastic Surgery), Call 310-273-3000
Needling treatment also known as CIT (which stands for collagen induction therapy) has actually been around for quite a long while now. It is truly a low-tech device but it has found a new place in my bag of aesthetic tricks.
Why? Simply because it works. It seems to be the most effective procedure in this day and age to reduce stretch marks (striae distensiae), firm and elevate tissue(knees, elbows, buttocks etc.), reduce scars (including acne ones), reduce hyperpigmentation-all in all it seems to result in a healthy, more youthful appearing skin.
How does it work?
The patient starts applying fat-soluble vitamins A and C antioxidant oils to the skin two weeks prior to the planned procedure date. The fat solubility of these vitamin oils allow them to penetrate human epidermis and dermis far more effectively that many of the other available competing products. These in turn stimulate the skin to produce more collagen and rejuvenate their elastin component. The device (which is basically a roller with approximately 200 needles attached to it perpendicularly) is then utilized to produce tens of thousands of small needle marks penetrating into the dermis. This in turn, induces a cascade of collagen production, the effect of which is amplified by the combined use of the antioxidant vitamins. In a way, the roller is not only producing a controlled injury to the skin but also acting as a very efficient drug delivery system.
I generally recommend a number of treatments to get the most optimal results. Here’s just one example of the fairly dramatic effect one could achieve by this methodology. The woman had undergone myriad laser treatments to reduce her stretch marks, but to no avail. After just two Roller treatments, she achieved the following result.
This woman had a previous abdominoplasty in order to help reduce her stretch marks. She was dissatisfied with the result and had many laser treatments to reduce her stretch marks. They are still very obvious in width and depth.
She underwent two rounds of Needling/CIT. Note the dramatic reduction in stretch marks both in terms of width and depth.
For further information about CIT, needling therapy, call the office of Dr. Randal Haworth (310 273 3000) located in the Haworth Institute.
As one of the leading rhinoplasty specialists in the United States, Dr. Randal Haworth continues to challenge himself to be the best he can be. By constantly questioning his results and asking himself how he can do things better, he feels he is subjecting himself to the highest quality assurance and delivering the best possible outcomes in plastic surgery .
Performing rhinoplasties are one of my favorite specialty since the nose place such a central role in the total harmony of the face. Consider it like one of the leading instruments in the orchestra. Though most plastic surgeons and patients alike obsess on nasal humps, wide bones as well as drooping, boxy, pinched and ill-defined tips and, of course, the width of the nostrils, little attention is paid to the actual shape of the nostrils. In other words, a surgeon should not only assess whether the nostrils are wide at their base, but also whether they are arched, pointy, thick or sigmoid in shape.
One of the most common and unflattering nostril shape is that of the “samurai nostril”. Look at the following two photographs and you will see what I mean.
Another example of these flared nostrils that may look appropriate as a menacing sign but not a flattering one for beautiful womanA samurai mask manifesting the flared, aggressive shaped nostrils that are unappealing in a woman
There are a few ways to correct this but probably the most reliable is to harvest a “composite” graft from the hidden portion of one’s ear. This detailed surgery involves insinuating this graft between an incision made on the inside of the nose, corresponding to the actual width of the retracted portion of the nostril. This graft is then sutured into place with the skin side facing the actual inside of the nostril to maintain the continuity of it’s lining. One can lower the nostril about 3 to 4 mm with this technique. Of course, some resorption of the graft occurs so it is best to over-correct this.
Other techniques involve strategic V-Y plasties, which are essentially internal tissue rearrangements of the inner aspect of the nostril in order to lower its rim, cartilage grafts in the actual substance of the nostril to help correct pinched tips while lowering the rim and, finally, filler. These latter techniques, though successful to some degree, are not as effective as an ear “composite” graft.
Note the following two cases in which “composite” grafts were taken from the ear and placed within the nostril to lower them. Of note, simultaneous upper lip lifts to further enhance a feminine appearance were performed.
Transgender patient was retracted nostrils, long upper lip and droopy corners of the lip
Dr. HAWORTH performed a modified rhinoplasty by lowering the nasal arched “samurai” rims (nostrils) as well as an upper lip lift and DAO release to lift up the droopy corners of the mouth
Patient with a long upper lip and retracted “Samurai”nostrils after a previous rhinoplasty by another surgeon
Dr. Haworth performed an upper lip lift along with nostril rim lowering via a composite graft from the ear. Fat transfer was also performed into the upper and lower lips. Notice the more feminine harmony
The Challenging Question in Modern Plastic Surgery
“I am fearful about plastic surgery. “Whenever I am in , Beverly Hills, LA or New York, I see people with bad work looking so fake. Their lips are and breasts are so out of proportion!”
I , as a Board Certified plastic surgeon in Beverly Hills, hear this time and time again in conversation at dinner or in my clinic. “I don’t want to look like Michael Jackson!” is another common proclamation of patients during nasal surgery consultations. Instead of getting frustrated with these opinions, I agree with them. It is because I understand their source. It is simple; “good” plastic surgery is invisible, while so called “bad” plastic surgery is not.
Bad plastic surgery (whether it be a rhinoplasty, facelift or breast augmentation) can result from any of the following three scenarios. The first is poor performance of a procedure. Fortunately, this is a rare occurrence when a properly trained surgeon certified by the American Board of Plastic Surgery performs the surgery. The second is poor healing by the patient, perhaps complicated by infection. Again, this is infrequent especially in healthy, well-selected patients. Finally, the third issue is the question of aesthetic taste. No amount of plastic surgical training will guarantee appreciation of balanced facial form and pulchritude. By way of analogy, not all self-professed artists who attend the same art school will emerge as equally talented artists.
What makes for good plastic surgery then? It is the fruit of a surgeon who’s not only technically proficient, but also possessive of a keen eye and aesthetic sense. A beautiful and youthful face reflects visual harmony between facial structures. With age, harmony turns into visual dissonance as youth cues disappear. As a surgeon, it’s my job to serve as a conductor to bring these diverging aging elements together again. Youth cues are lost as wrinkles, folds and sagging facial features arise. Most plastic surgical training emphasizes the re-establishment of major youth cues while overlooking the minor ones. In order to re create the major youth cues, I eradicate jowls; I soften the nasolabial folds, (the fatty accumulation that runs from the bottom corner of the nostril to the corner of the mouth,) contouring a strong jaw line and a firm neck and rejuvenating the eyelids through a combination of endoscopic brow lifting and blepharoplasty (eyelid tucks.)
In order to paint a convincing portrait of somebody in their youth, the surgeon should not only recreate the major youth cues, but also the minor ones. To do so, the surgeon must address the hollows underneath the eyes, the drooping corners of the mouth, the elongated upper lip (hiding the upper teeth), the sagging lower lip (exposing the lower teeth) and the elongated ear lobes. True visual choreography is required.
I’m excited by the array of minor youth cue procedures now developed. Most are relatively minimal in scope. Among these are the Endotine ST and B mid-face lift, the first vertical and reliable mid-face lift that not only addresses the hollows under the eyes, but also softens the nasolabial folds. All in all, it provides a more natural and subtle rejuvenation, avoiding that “pulled back” look. The procedure takes forty minutes when combined with a blepharoplasty (“eyelift” ). This technique is made possible by the development of a new absorbable device placed via the eyelid to elevate the cheek fat pad back to it’s position of youth.
There are other minor youth cues and I address them as well – by performing upper lip lifts with a hidden incision inside and around the nose, as well as corner lip lifts and earlobe reductions as necessary. The upper lip lift shortens the distance between the nose and the lip, allowing the upper teeth to be seen. One only has to peruse the fashion magazines to see how this look is indicative of a fresh and youthful lip region.
The before and after photos included below, are good examples of the above principals put to use. This 28-year-old girl has premature signs of aging from massive weight loss. Both major and minor youth cues need to be established to achieve harmonious balance. Consequently, I performed an endoscopic brow lift, lower blepharoplasties with fat transfer, an Endotine mid face-lift, liposuction of the neck, upper lip lift and fat transfer.
There are artists who have become doctors and doctors who have become artists. Since I have started painting as a little child and have graduated to exhibit my later work in respected galleries, I consider myself as one of the former. I am fortunate that my background has imbued me with an artist’s eye, which translates into my work. Regardless of Beverly Hills, New York or other urban center, Plastic surgeons should always strive to deliver to their patients not only the best technological advances in plastic surgery, but also in a way that reflects passion and inspiration with an aesthetic sensibility.
How and where we store fat is genetically determined at birth as is the “body type” that we are destined to have throughout life. La Jolla, CA, plastic surgeon Lori Saltz, MD, says, “Some women are ‘apple shaped’ and carry weight in their hips and abdomen while others are ‘pear shaped’ and carry their weight in the butt and thighs. The distribution of fat remains fairly constant as our weight goes up and down. Areas that are problem areas will always be problem areas, regardless of how much weight is gained and lost.” Besides the butt, thighs and stomach, other common problem areas can include the knees and ankles, which tend to be more resistant to weight loss via diet and exercise because they are congenitally predetermined. “The only way to correct fat in these areas is with surgery,” says Beverly Hills, CA, plastic surgeon Randall Haworth, MD.
“I lost weight and now I’m left with all the excess skin that just hangs. Why does that happen and what can I do about it?”
When weight is lost and skin elasticity is poor, the skin can become saggy.”With age, the skin loses elasticity. When the skin is not elastic and able to ‘stretch’ and ‘contract,’ it won’t bounce back post-weight loss, leaving you with too much skin for your new body,” says Dr. Haworth. Pregnancy can also be to blame. “The skin expands during pregnancy, just like with weight gain, losing elasticity. Most times, the skin does not return to its former degree of tightness,” says Dr. Saltz. Minimally loose skin can be treated noninvasively to create new collagen. “When there’s significantly loose skin, it needs to be surgically tightened, removing the excess. Surgery doesn’t improve the physical quality of the skin we simply get rid of anything that’s extra that may not be ‘fitting‘ the body properly,” says Orlando, FL, plastic surgeon Armando Soto, MD.
The Benefit of Fat
It may seem strange to add fat to your body but in the case of volume toss or contour irregularities some doctors feel fat is the best way to correct the problem. “It sounds counterintuitive that fat can make the body look better but in many cases, adding fat to depressed areas can give smoother—looking skin,” says Dr. Soto. “Fat transfer is a good way to add volume–it works well and is permanent. But how the fat is treated [low pressure removal is best] determines how it will survive,” says Dr. Haworth.
The Lowdown on Lipo
Before noninvasive treatments and fat-melting devices made their mark on the body-contouring front, Liposuction was the method of choice. While it’s still viewed as the ultimate way to eliminate fat and contour the body, the removed fat can now be used to better the shape of your body by removing it from one area and transferring it to another.
How it Works
Once fat has been suctioned out from the stomach, hips or thighs, your plastic surgeon will strain and wash it with saline, before drying and cleaning it [Dr Saltz says there are more sophisticated methods that include spinning the aspirated fat in a centrifuge or running it through a filtration system]. “If the fat is not rid of any fibers and blood products then more unwanted inflammation will be induced, which will result in more fat resorption,” notes Dr Haworth . From there, the fat is injected into volume-deficient areas. Body fat can also be used to plump up aging areas of the face, too.
Streamline Your Arms
Liposuction is probably the best way to get rid of unwanted fat on the arms. But in order to ensure successful results, the quality of the skin needs to be in good standing. “The more elastic the skin, the better the liposuction results,” says Dr. Haworth. “If there’s too much loose skin in relation to the amount of fat lost, the skin will be left flabby.”
Experts weigh in on 2012’s makeup trends and offer injectible directions for achieving red carpet glow.
Upper Lip:
“The upper lip should allow for tooth show, whereas the lower lip should veil the bottom teeth – when you see an upper lip that’s much fuller than the lower lip, you instantly think it’s fake,” says Beverly Hills plastic surgeon Dr. Randal Haworth. “Patients often equate youth with volume, and this is where things go cosmetically awry.” Haworth recommends lip surgery in the form of upper-lip lifts, corner lip lifts and simple V-Y plasties (which involves internal tissue rearrangement) instead of multiple fillers.
Celebrity blogs lit up with speculation that Taylor Swift had undergone plastic surgery after the singer stepped out looking a lot bustier on April 23.
“It appears she’s gone from an A-cup to a C-cup,” Beverly Hills plastic surgeon Dr. Randal Haworth tells Life & Style, “But it could be a push-up bra; they’re so well-made these days that it’s almost impossible to tell if a woman is wearing one.”
Taylor (whose rep had no comment) did buy some new push-up bras on April 24, when she spent $600 at Victoria’s Secret in L.A. “Her breasts didn’t look fake to me,” says an eyewitness. “She looked natural and gorgeous.”
Reality star Lo Bosworth is known for her petite frame but has recently been spotted with some new curves!
Life & Style reveals in its new issue — on newsstands now — that the former MTV star went under the knife late last year. “She had a breast enhancement several months ago,” an insider close to the 25-year-old reveals to Life & Style. “It always bothered her that she was so flat, so she got herself a present.”
Beverly Hills plastic surgeon Dr. Randal Haworth, who does not treat Lo, estimates that she went up about two cup sizes. “She is clearly fuller,” says Dr. Haworth. “Probably a C-cup.”
Her pal adds, “Lo is very happy with the results.”
