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2023 Message:

In this practice, our goal is to be as straight forward as possible, keeping things as simple as possible, with any procedures or advice being directed towards a single goal or strategy: Helping you achieve better facial structure or health without unnecessary risk or collateral problems.  Largely these problems can be avoided by only using tools or concepts that are restorative or in harmony with nature.  But the tradeoff of this is that not every wish can be achieved, and some things have to be accepted as impossible or not worth pursuing.  But with the things that are worth pursuing, we should tread carefully, and do our best to predict outcomes as close to accurately as possible and anticipate problems, then communicate these issues as best as possible to families, clients and patients.

If you are interested in rhinoplasty, the best candidates for successful structural improvement have either very deviated, asymmetric, very curved noses, overly long (too close to lip), or overly projected (sticking out from face).  So, a nose with a twisted or over-sized appearance can be made smaller, and straighter.  But for thick appearing noses, or those with subtle deformities, surgery is not a great option as the risk can outweigh the benefits.  With structural improvement, when substantial, improvement in nasal breathing can be achieved as well if necessary.

For facial aging, most importantly brow position can be obtained usually using Botox (tm).  Juvederm Ultra Plus XC can be used to achieve higher cheek bones, restore the vermillion border of the lip or to camouflage the marionette lines of the jowl.  Surgery can be used to reposition tissue in conjunction with this.  Finally, sleep must be optimized to achieve any aesthetic or structural improvement, otherwise maneuvers can be temporary or limited.  Mouthbreathing and sleep apnea can result in multiple aesthetic and functional problems and usually must be addressed in the absence of excellent tone.

Above all, communication between the surgeon and client or patient is paramount to achieving improvement, both for expectations and in the partnership of meeting objectives.  There should never be a rush to treatment, but instead a goal to build trust through long-term communication of goals and possibilities.  The greatest tool, then is thoughtfulness, more than any instrument.