Face procedures articles

Dr. Ricardo L. Rodriguez discusses plastic surgery for the face and related topics.

  • DAO release – Lifting the corner of the mouth

    A photo of a patient's face, showing her lips before a lip lift.

    “DAO” (Depressor anguli oris) release to lift the corner of the mouth. I have always been a fan of the lip lift procedure. There are many reasons why it’s preferable to fillers, but the most important one is that it looks so good and natural. The effect is best in the central part of the…

  • Facelift: What other people see first

    An image showing the a path created by tracking the eye position when looking at a photo.

    Most patients seeking facelifts say that coworkers or family members tell them “they look tired” all the time. They then proceed to pull upward on their neck or lower cheeks mimicking the effect they want from surgery. To make a point, I sometimes cover my face and ask what color my eyes are. They always get it right (my eyes are brown). I then ask whether I have bands in my neck (I have one). Invariably they say they didn’t notice. So, what’s the point I’m trying to make? People make judgments about how old your face looks from your eyes, not your neck or jowls. There is a famous study where the picture of a woman was put on a screen. A subject looks at the picture. Behind the screen there is a camera that tracks the eye movements of the subject looking at the picture of the woman…

  • The Liquid facelift (Liquid lift)

    A woman's forehead and eyes.

    The Liquid facelift. I first heard about it from Heidi Rebuck, a Juvederm and Botox rep from Allergan. “The Liquid facelift” is basically what I did with my male patient, using a filler with Botox, but I think these pictures of “The Liquid facelift” are worth a thousand words. Basically, the patient in the photo (courtesy of Allergan) had Botox to forehead and “crow’s feet” wrinkles around the eyes, with tissue fillers to the lips, nasolabial folds (folds that go from side of nostrils towards the corners of the mouth), and possibly under the eyes. The change is dramatic and substantial.

  • Upper eye lift or Brow lift?

    A photo of a patient's left eye, showing the area above the eye that needs to be corrected.

    Many young women come to my office when they start noticing a little bit of ‘extra skin’ on their eyelids, or sagging upper eyelids. They have heard about Eye lifts (blepharoplasty), and how easily it can be performed- under local anesthesia. Naturally, they are very interested because the procedure is performed in the office and takes only 1-2 hours. However, the Upper eye lift is not an ideal procedure. I don’t think the results are as good as a brow lift. Furthermore, if too much skin is taken off, the eye lids will have a had time closing and the patient can suffer with dry eye syndrome. In fact, I usually prefer to perform a Brow Lift instead of an Eyelift in order to achieve a better result. The Brow Lift will elevate the brow to it’s youthful position, and in the process it will lift the upper eyelids. The result is a refreshed natural appearance.

  • Very comforting! (Lip implants and Sculptra)

    A photo of a patient's face, showing the areas that have been corrected.

    I went to see Dr. Rodriguez on Sept 25th for Lip Advanta Implants and Sculptra. I was greeted by the nicest staff and made to feel very comfortable. I was more than briefed on every option that I asked about to ensure a confident choice in procedure. After my procedure, I was a bit terrified by the immediate effects of surgery (swelling), but the entire staff assured me that the swelling was completely normal.

  • Restylane, Sculptra, Botox: Advantages of a short term approach

    A collage of photos of a patient's forehead, showing the patient before and after a botox treatment.

    For forehead wrinkles, a cosmetic dermatologist will tend to recommend “therapy”, or facial fillers such as Restylane, or BOTOX. All of these injectables have to be repeated over time, with the full knowledge that if therapy is stopped, the wrinkles will come back. The plastic surgeon, on the other hand, will think of a more permanent solution, such as lifting the muscles that cause those wrinkles in the first place. Thus he may recommend an endoscopic forehead lift.

  • How long do Fat grafts last?

    An illustration of a calender.

    Several people have asked me if fat grafts are permanent. They keep reading from other sources that fat grafts are not permanent or that they may need another procedure. In my experience, when done correctly, fat grafts are permanent, and I have yet to do a second procedure to add more fat in any of my patients. This is because of the way fat is harvested and the choice of sites for harvesting fat are crucial to the success of the Brazilian butt lift or any other fat injection procedure. In this blog entry I will detail how I harvest fat, process it, inject it, and care for the graft after surgery. In a subsequent entry I will describe how choice of harvest site matters.

  • What type of Facelift should I get? Mini-lift, S-lift, Thread lift, XYZ-lift?

    A drawing of a woman's shoulders, neck and head.

    Patients are asking for specific procedures because they have been reached by the marketing efforts of Plastic Surgeons. Since surgeons are trained to do procedures, they market procedures as their product. In order to differentiate themselves in the marketplace, they come up with these catchy names to create a “unique” presence for themselves in the marketplace. Alternately, if there is a particular buzzword or catchphrase that is getting media attention, the surgeon will use it in his marketing pitch, to benefit from the attention generated by that particular “product-lift”.

  • The Lip lift: More youthful lips without the use of fillers

    A collage of photos of a patient's mouth, showing her lips before and after a lip lift procedure.

    Yesterday I did a Lip lift. My patient was a young woman, which is unusual for this procedure. Most women that need a Lip lift are older, and they have noticed the upper lip getting “thinner” as they age. Since the “red” part of the lip is getting thinner, they assume this is the part that needs to be augmented. So when a woman comes to me for lip enhancement, most of the time she is thinking…

  • Is Botox addictive?

    Botox logo.

    A British study was quoted in the news with the following teaser, “Is Botox addictive”? Here’s the short answer: no, breathe easy, it’s OK. The actual data quoted is that “up to 40% of patients feel a compulsion to have additional treatments”. Well, of course!! What else can, at such a low relative price point, for such little inconvenience, wipe years off your face? So you have it once. Hmm, that was easy! You become used to your new face because in three days, those wrinkles are g-o-n-e. Life is great, nobody is telling you you look tired, and when you look in the mirror, that’s what you’re supposed to look like!

  • Sculptra: A new Tissue filler

    Sculptra logo.

    Collagen, fascian, Restylane, etc., are wonderful options for tissue fillers, but their effect seems to be measured in months. If a patient repeats the procedure enough, the costs soon approach those of surgery. I found myself suggesting to more and more patients that they should just have surgery and make the result more permanent. Fat injections in the facial area do provide a longer lasting result than most fillers. However, fat injections are more of a surgical procedure rather than a quick injection. With fat injections, I use the patient’s own fat as a filler. The results can be dramatic and long lasting. Fat injections can be used in areas besides the face. I use a special type of fat injection is to fill out areas we never thought could benefit from large volume injections, such as the butt. I love doing fat injections, but there are a certain amount of pre and post op issues associated with it. So I look upon fat injections as a surgical procedure with a recovery time.

  • What does it mean to look younger?

    A drawing of a woman's shoulders, neck and head.

    Most patients who come to my office don’t come in asking for a full facelift. Most come asking for a specific face procedure to “make them look younger”.   If they are relatively young, they focus on the nasolabial folds the lines that go from the side of the nose to the corners of the lips). Or they may mention the lips, how they are getting thinner. If they are somewhat older, they will focus on the jawline and neck. I listen to them, because that is what they are concerned about, but then I have to ask: Do you want to look better to yourself or to others?

  • Old classmates try Botox and Restylane

    A collage of photos of a patient's forehead, showing the patient before and after a botox treatment.

    Last weekend (10 days ago) I went to my medical school 25th year class reunion at the University of Wisconsin Medical School in Madison, Wisconsin. I had been so driven in my surgical residency, then marriage, then being on the faculty at Yale, that wonderful memories had been buried deep. This was the first time I set foot in Madison in over 25 years!