Newsletter

Natural Results

So what determines natural results? There are a few causes for unnatural results. The first involves older techniques. My favorite statistic is that the half life (the time it takes for 50% of something to die or dissipate) of medical knowledge is 3 years. This astounding fact means that in 3 years 50% of what we now know in medicine to be true will be proven to be completely false. There is too much scientific information out there at the moment. So much so that the FDA and other organizations do not have enough time to investigate the information to be efficacious and safe. As techniques in plastic surgery have evolved, a more conservative approach has actually developed in some procedures. For instance, it was customary to remove all the excess skin and fat from the upper and lower eyelids. Some of the patients who underwent eyelid surgery five to 20 years ago are now returning with sunken-in dark upper and lower eyelids. Such sunken deep and dark upper or lower eyelids with no excess skin or fat are difficult to reverse. One possible solution is fat injection back into the upper or lower eyelids to fill-in the deep sulcus which gives the eyelid its dark shadowing. I typically remove a minimal amount of fat if absolutely necessary, being certain to leave some of the fat behind to give the eyelid its soft appearance. At the lower eyelids, the philosophy of fat removal is changing. Whereas in the past it was felt that the bulging bags at the lower lids were due to excess fat, currently I along with many other surgeons believe the fat at the lower eyelids is actually necessary and not in excess. The bag or bulge at the lower lid is actually due to a weakness in the membrane or “septum” which holds the fat in the eye socket. To correct the bags, it is more appropriate to strengthen the membrane and thereby push the bulging fat back into the socket rather than cutting the fat out. The perfect analogy is an inguinal or groin hernia. In repairing these hernias, we do not cut the bulging intestine out. We simply strengthen the structures holding the intestines in the abdomen thereby correcting the painful bulge.

The second cause for unnatural results in plastic surgery is the lack of comprehension for or adherence to rules of aesthetics. There are certain unwritten but ever present rules in every society and ethnic group which determine who is beautiful. A plastic surgeon must understand these ethical and societal rules and must discuss them with you prior to any cosmetic or even reconstructive surgery. It’s too easy to make an Asian eyelid appear Caucasian, or African American noses appear white. But to do so would change the character of your face. In some cases, perfect eyelid shapes have also been changes to appear Asian as they are pulled too tight. So in addition to understanding these rules of beauty, a conservative approach to plastic surgery is absolutely required to achieve natural results.

The last cause for unnatural results is excessive plastic surgery. It’s important for the surgeon to tell his / her patient that no surgery is necessary. At many instances I find that I spend much time explaining how beautiful my patients really are and how minimal their particular area of concern is. The adage of “less is more” is absolutely correct in such cases. It is better to do a small procedure to improve a particular concern than to perform a larger surgery which may be excessive and yield fake or unnatural results. If the risks of any cosmetic surgery is so great that it outweighs or even comes close to the benefits, that procedure should NOT be performed. Cosmetic surgery is for meant to safely make you more beautiful while exposing you to the absolute minimum of risks. The appreciation of this fact would prevent many of the poor or unexpected results we see in plastic surgery.

We encourage you to come in for a consultation so we can discuss your particular concerns and achieve your natural results.

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