The esteemed San Diego Face and Neck Specialist, John M. Hilinski, M.D., reveals everything you need to know about face lift makeovers and cosmetic surgery in San Diego.
Q: Who should consider plastic surgery in San Diego?
A: The best candidates for plastic surgery are individuals who already have a positive self-image but are looking to improve upon one or more aspects of their appearance. One of the most common motivators I see for plastic surgery is a prematurely aged or tired look that can detract significantly from one's overall sense of well-being.
In other instances, the motivating factor is an imbalance between anatomic areas that draws unwanted attention. As long as there are realistic goals in terms of type and degree of change anticipated, plastic surgery can be recommended as a rewarding option for many such individuals.
Q: Who should consider facelift makeovers?
A: A face lift makeover can be a very gratifying choice for males and females alike who demonstrate the unflattering signs of the aging process. People who have a history of excess sun exposure and/or those who smoke cigarettes demonstrate more advanced signs of aging at an earlier age.
Most individuals inquiring about possible facelifts are bothered by the fact they appear older than their stated age. Others state they look excessively tired and even sad. As I inform all of my patients, the aging process is actually quite complex and involves multiple factors, not the least of which is your individual genetic makeup. Starting as early as the forties, this aging process can result in unwanted facial folds, flattening of the cheek, jowling of jawline, and sagging skin along the neck.
To counter these effects, contemporary facelift surgery techniques have been developed that are much different than those used even ten years ago. Long gone are the days of the 'windblown' or 'done' look that resulted from pulling too tight on the face. Today, a contemporary facelift in San Diego focuses more on a complementary approach that will hopefully keep your friends guessing how you achieved the results. This involves lifting and repositioning the important deeper tissues while also attempting to add volume to certain parts of the face. Together, this balanced approach helps to provide a natural, three-dimensional enhancement of the face and neck.
Q: Is there a "gateway" plastic surgery trend? Is there potential for addiction in plastic surgery?
A: One of the most popular "gateway" procedures in my office is the San Diego facelift surgery. Most patients who consult with me are requesting to look more rested and youthful but are not necessarily sure how they can accomplish this goal. Because the term 'facelift' is so widely used, many patients are under the impression that a facelift procedure is all they need to achieve their goal. Unfortunately, a facelift, in the strict sense of the term, is actually intended to improve only the lower face and upper neck. Many patients, however, also have significant concerns regarding other regions of the face that will not be adequately addressed by just facelift surgery.
Many patients also have concerns about the eye area, describing excess heaviness and shadowing that further contribute to a prematurely aged look. In this case, I may recommend additional procedures beyond the facelift. These include browlift (or forehead lift), eyelid lift, midface lift, and fat transfer, which can be added individually or in combination. Fortunately, as a group, we do a great job of screening prospective plastic surgery patients who demonstrate psychological risk factors for such addictive behavior.
Q: How can a series of procedures be the ultimate makeover?
A: I specialize in facial plastic and reconstructive surgery. It is not uncommon in my practice to see patients who opt to undergo the 'ultimate makeover' rather than choosing just one or two areas for facial rejuvenation. This type of makeover typically involves the following combination of procedures: browlift (or forehead lift), upper and lower eyelid lift (or blepharoplasty), midface lift (or cheek lift), facelift, neck lift, and fat transfer. A browlift is done to reshape the eyebrows and lift them to a more rested position. An upper blepharoplasty helps to redefine the upper eyelid crease while decreasing unwanted heaviness.
A lower blepharoplasty diminishes excess puffiness and dark shadowing involving the lower eyelid. A midface lift targets the area in between the lower eyelid and the corner of the mouth to help fill out unwanted hollowing and restore an esthetically pleasing cheek contour. The face and upper neck lift, as described earlier, is intended to improve unwanted jowling and sagging skin. Fat transfer can be considered 'icing on the cake' as it helps to augment the results of these procedures by providing volume enhancement. Overall, such an ultimate makeover can produce a dramatic transformation while preserving key features of the face that help to maintain a non-surgical, natural look.
Q: What are the most common procedures people combine at once or undergo over a short period of time? Why these combinations?
A: The reality is not all patients are quite ready or need to undergo a surgical procedure to achieve a more youthful and rested look. Fortunately for this group of people, there is great non-surgical alternative to a facelift. This widely popular choice involves combining several different office-based procedures that target certain layers of the face.
This includes BOTOX® treatment, soft tissue fillers (or dermal fillers), and skin resurfacing. BOTOX® cosmetic is used to stop movement of certain facial muscles below the skin that create unwanted expression lines, or hyperdynamic lines. These include the frown lines in between the eyebrows and crow's feet around the corner of the eye.
Dermal fillers are a group of biologically compatible materials placed just below the skin surface. They are used to 'fill in' or 'plump out' deep skin creases that would, otherwise, contribute to a tired, aged appearance. These fillers, which include Restylane, Perlane, Juvederm, Radiesse, and now Artefill, are a vital component to any non-surgical approach for facial rejuvenation. When done in concert with one another, these procedures can take years off in just one office visit, making it one of the most popular combinations of procedures we offer.
Q: How much cosmetic surgery is too much cosmetic surgery?
A: Cosmetic surgery is considered excessive whenever the risks of a certain procedure begin to outweigh the benefits. In some cases, this distills down to the actual medical or surgical risks associated with the surgery. For instance, if there is a high likelihood of damaging a certain nerve or blood vessel during a procedure, this would be considered unacceptable and excessively risky given the elective nature of cosmetic surgery.
This principle also holds true for any patient with a serious medical condition that may be aggravated by the surgical procedure and/or the anesthesia. In other cases, it comes down to a low likelihood of achieving a beneficial outcome for the patient. For example, if a potential candidate has unrealistic expectations, it is unlikely the benefits will ever outweigh the risks associated with the procedure. In such cases, it would be considered excessive and imprudent to proceed any further.
Q: Plastic surgery is not solely a superficial procedure. Please share an example of how plastic surgery, or specifically a facelift makeover, alleviated a tragic situation.
A: Although a majority of my practice focuses on cosmetic facial enhancement, I also perform reconstructive facial surgery. In fact, success in terms of reconstructive facial surgery relies heavily on plastic surgery principles used in everyday cosmetic procedures. One of my most memorable reconstructive cases involved a very unfortunate young lady who sustained extensive facial trauma from an explosion.
Tragically she lost both of her eyes and was left with severe deformities and scarring involving her forehead, cheek, lip, and chin.
Working together, an oculoplastic surgery colleague and myself volunteered our time to help reshape her face and restore a relatively normal contour. Since then, she has made great strides emotionally in moving further and further away from this tragedy. I truly feel fortunate to have been involved with her case in San Diego. Plastic surgery is not solely a superficial procedure; her case is a great example of how facial plastic and reconstructive surgery can figuratively and literally goes beyond appearances to help transform lives.
Q: What should patients consider when choosing a San Diego cosmetic surgeon?
A: I think level of expertise is one of the most critical considerations when choosing a plastic surgeon. In today's day and age, there is an overabundance of San Diego cosmetic surgeons who claim to be trained in 'cosmetic' enhancement. Unfortunately, many of these physicians have very limited formal training in actual plastic surgery. In fact, a good number are obstetrician/gynecologists and emergency room physicians who have opened medical spas simply as a side business. In my opinion, your appearance deserves more than this.
At the very least, you should choose a physician that is board certified in plastic surgery, which qualifies that individual as having met very stringent requirements within this challenging specialty. If you are looking to have a facelift and rhinoplasty performed, it just makes sense you would choose a physician with expert training and board certification in facial plastic surgery.
In the modern beauty-obsessed world, it’s hard not to be fixated on the many treatments done to Hollywood stars. From rhinoplasty to facelifts and breast augmentation, as long as you do your research and find the best local Cosmetic Surgeon in San Diego, you too can have the red carpet worthy look you want.
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