Beyond Beauty by BBeyond Books

Beyond Beauty

running head

Photograher: Gabriel Hundiashvili Make-up and hair: Maira Ortiz

Beyond Beauty

contents First published in Great Britain in 2009 by Beyond Black London UK ÂŠ Beyond Black 2009 All rights reserved. No part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording or

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Foreword by Robert Goldwyn Introduction A Brief Introduction to Facelift Procedures

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Professor Daniel Marchac Dr. Darina Krastinova Dr. Sam Hamra Dr. Steven Fagien Dr. David Shafer

Top Surgeonsâ&#x20AC;&#x2122; Definitions of Beauty

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The Best of Beverly Hills... Dr. Raj Kanodia Dr. Garth Fisher Dr. Arthur Glosman Dr. Kevin B. Sands Dr. K. Alexander Dastgheib Anastasia

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Professor Laurence Kirwan Dr. Jan Linhart Dr. Henry Mentz Dr. Eric Auclair

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otherwise) without the prior written permission of both the copyright owner and the publisher of this book. ISBN 978-1-905904-19-8 Designed by Bradbury and Williams, London Printed and bound in China

Dr. Alan Matarasso Dr. Renato Calabria Professor Dan Reinstein Dr. James Stuzin Dr. Rod J. Rohrich Dr. Tomaz Nassif Dr. Marco Antonio Guedes Dra. Dayana Garcia Alves Dr. Ortiz Oscoy Dr. Goin Dr. de Benito Barry M. Jones Dr. Grant Stevens Dr. Jean-Louis Sebagh Three Prominent Trichologists Answer Nine Hair Care Questions Jigami Clinique La Prairie Lion in the Sun Vision International

CONTENTS

foreword

introduction

some of your participants have advocated and vary the treatment according to what the patient

The purpose of the present edition is to highlight the new and different procedures, treatments, products, etc. that are continually developed in the pursuit of refining, perfecting and enhancing beauty, as well as keeping the ageing process at bay.

needs. Even if one can understand the technique, the problem is that the patient really will never

We, as consumers, are constantly pushing the boundaries of physical enhancement beyond mere

understand the options and will have to go to the plastic surgeon about whom he or she has heard

attractiveness and into the realms of perfection – sometimes with disastrous results, either out of

does a good job.

ignorance or through narcissistic obsession.

The essential problem [of finding the best plastic surgeon] is a philosophical one: when a patient goes to a plastic surgeon, he or she will get what that plastic surgeon usually does. There are very few plastic surgeons who would use a technique that

There are very, very few plastic surgeons who individualize the treatment according to what the patient needs. More often the plastic surgeon does what he or she thinks he or she does best.

There exists a massive and ever-evolving industry that caters to our obsession with everlasting youth and beauty. Can these be attained? You may find the answer in the pages that follow and through the presentations of different

Robert Goldwyn Retired plastic surgeon and former editor of Official Medical Journal of the American Society of Plastic Surgeons.

medical practitioners. We have, as in previous editions, endeavoured to interview and feature many of the world’s top elective treatment physicians. Some of them have achieved iconic status, others are less well known to the general public, yet consistently credited with outstanding results. We have asked most to comment on Dr Goldwyn’s foreword, so that the reader would be able to ascertain what each plastic surgeon’s ‘comfort zone’ is. Our Beverly Hills chapter profiles some of the best surgeons in the most glamorous place on earth – an enclave famous for its talent, as well as its excesses, and sheer everlasting inspiration in the beauty stakes. We hope you enjoy perusing the book and find it useful if and when you decide to improve your appearance. For better or worse, our society perceives – and treats – old age as an affliction or a disease, so chances are, the vast majority of people living in the developed world would have resorted to some form of enhancement in the course of their lives, whether surgical or not, more or less invasive. Lastly, surgeons that we have previously profiled, are featured in the present edition with selected quotes and contact details. Many are at the top of their profession; others are on the way to becoming living legends in the history of elective surgery.

running head FOREWORD/INTRODUCTION

Photograher: Gabriel Hundiashvili Make-up and hair: Maira Ortiz

a brief introduction to facelift procedures

continuation of the strap flat muscle in the neck known as the Platysma. Tord Skoog in Sweden in 1974 was the first surgeon to identify the significance of tightening this layer in addition to a classical “skin only” facelift. This heralded the onset of the current techniques of facelifting. Dan Baker in New York City has popularised and simplified the SMAS technique by simply excising a strip of the SMAS and re-stitching and tightening it, calling the procedure a ‘SMAS-ectomy’. The SMAS facelift or rhytidectomy involves removal of excess skin, tightening the underlying SMAS, re-suspending the wide flat muscle in the neck known as the Platysma and then re-draping the skin in an upward and backwards direction. Excess skin is also removed during the procedure,

Most people contemplating elective plastic surgery wouldn’t have heard the name of Paul Tessier. Dr. Tessier, who died in July 2008 at the age of 91, was a French surgeon widely considered as the father of modern cranio-facial surgery. He pioneered a method of sculpting the malformed face

allowing for a tightening of the jaw line. The result is smoothing and some lifting of the cheeks as well as the angles of the mouth. There are many variations of the technique, all aiming to improve the sagging of the skin by stretching it laterally and tightening it.

using a revolutionary approach. He peeled back the skin and muscles from the bones of the face

There are a number of variations to the SMAS lift, namely suspensions, plications and a

to allow re-positioning and re-cutting of the bones: The surgical ‘plane’ was sub-periosteal (sub-

number of minimally invasive procedures, many of which are explained by surgeons who have

periosteal refers to the layer beneath the periosteum, the latter being the dense fibrous membrane

contributed to this book.

covering the surface of bones). He would combine his re-positioning of the bones with bone grafts to act as spacers rather like putting a jigsaw back together again. Many of his procedures also involved

Dr Sam Hamra has developed the Composite Facelift which he explains in a brief interview in the book.

surgery inside the skull, retracting the brain to gain access, so he enlisted the help of a neurosurgeon

As a rule, the less invasive the procedure, the less downtime a patient would experience, but

whose famous words when asked if he wanted to embark in this completely new and untested

the results may be proportionately shorter lived. However, good SMAS facelifts last ten years and

approach was ‘Why not?’ or ‘Pourquoi pas?’ His techniques allowed surgeons to correct monstrous

even then the patient looks ten years younger.

facial and skull deformities which hitherto had been unmanageable. He was able to enlarge orbits

The confusion and controversy continue as to whether deeper is better. It is doubtful that any

that were too shallow to hold eyeballs and narrow skulls that were too wide. His surgical technique

amount of surgery, text or discussion will resolve the issue and it will remain the personal preference

was utilised in children from as young as one year of age. What began in a cadaver lab became a new

of the surgeon and the patient as to which technique to seek.

specialty with surgeons practising his techniques around the world. The closest parallel would be “open-heart surgery” which became possible with the advent of the first heart-lung machines. The procedure was adapted to aesthetic surgery by Paul Tessier’s close disciple, Darina

Anophthalmic Orbitopathy Disease of the eye orbit and its contents.

subperiosteal lift to transform the underlying structures of the ageing face as well as sculpting

Periosteum The membrane that lines the outer surface of all bones except at the joints of long

the facial skeleton, thus not only rejuvenating it, but also embellishing it by “harmonization of the

bones.

skeletal volume”.

Subperiosteal Situated under the periosteum.

widely practised SMAS lift. Dr Tessier’s methods have had a major impact on reconstructive and aesthetic plastic

Subperiosteal operation Removal of bone effected without taking away the periosteum. Canthopexy A surgical procedure designed to tighten the lower eyelid by shortening supporting structures.

surgery. There are few surgeons who practice the deep plane facelift today, due to its complexity,

Canthus The angle of the eye.

longer recuperative time and risk of nerve damage. However like all techniques, in the right hands, it

Malar Of or pertaining to the region of the cheekbone.

offers good results and there are many ways to achieve the same goal.

Naso-labial The naso-labial folds are the two skin folds that run from each side of the nose to the

In addition to Darina Krastinova, Bernard Cornette de St Cyr in France and Oscar Ramirez in

corners of the mouth.

the U.S.A. are among those who perform this procedure with their own modifications However, the

Facia Of or pertaining to the face.

most widely practised facelift today is still the SMAS lift.

Subcutaneous Under the skin.

SMAS is an acronym for Superficial Musculo-Aponeurotic System and refers to the enclosing layer of fascia in the face which envelopes the facial muscle on its superficial aspect and is a direct

SMAS SMAS is an acronym for Superficial Muscular Aponeurotic System. It refers to an area of musculature of the face. This muscular system is manipulated during facial cosmetic surgery.

A BRIEF INTRODUCTION TO FACELIFT PROCEDURES

Krastinova, who is best known for her “mask lift” – a technique that uses the principle of the

This is sometimes referred to as the deep plane facelift because it goes deeper than the

Terminology

Photographer: Marko Tardito Photographer: Marko Tardito

Professor Daniel Marchac

required for special facial shapes, severe sagging or to address previous aggressive surgery.’ Daniel Marchac is of the opinion that the risks associated with a sub-periosteal facelift far outweigh the benefits and the results do not warrant the long recovery period. He tells me that the trend is for less aggressive forms of surgery and that in fact, a younger generation of plastic surgeons even consider the traditional SMAS too invasive, preferring the plications method and the suspension facelift procedure instead, both of which have a shorter recovery period (the drawback,

<< The result every patient should aim for is a sophisticated, younger, yet natural look. >>

Daniel Marchac is an internationally acclaimed surgeon whose work in the area

of course, is a more rapid recurrence of sagging). ‘A good SMAS should last 8-12 years and give natural looking results, whereas the deep plane pro-

of craniofacial and plastic surgery has earned him many distinctions and a ster-

cedure results in dramatic changes, often enhanced by bone grafting.’ Professor Marchac has written a number of medical papers illustrating his Vertical U incision technique which does away with the transversal scar behind the ear – the classic giveaway of a facelift – and

ling reputation among his peers. He founded The European Society of Craniofacial

hides it instead in the hairline starting at the nape.

Surgery (ESCFS) in 1984 and inspired the 1989 foundation of EURAPS (European As-

can be displaced higher up in the hairline. The Vertical U incision developed by Marchac is in front of the

This technique is also very effective when used on patients with multiple facelifts as the old scar ear and curves in the temporal area, continuing behind the ear and vertically into the scalp. The under-

sociation of Plastic Surgeons), dedicated to “promoting the excellence of plastic

mined area is under the scalp and the skin behind the ear. Dr Marchac has further developed this procedure by pulling the temporal flap downward in order to avoid the elevation of the hairline at the temples, another classic giveaway of a facelift.

surgery in Europe”. He is both founding member and past President of EURAPS.

In fact, having any scars in any visible area of the face is best avoided, says Dr Marchac, as scars are unpredictable in how their appearance changes over time. With hairlines receding in the temples area, preserving it scar-free becomes crucial for the ageing face.

A third generation surgeon of Russian descent, Dr Daniel Marchac’s professional stature has given him licence to often question some surgical procedures and openly challenge others, thus pushing the bar of excellence in plastic surgery.

Scar-avoidance is at the crux of a paper Dr Marchac has authored “against the short scar facelift” procedure pioneered by another world-famous surgeon, Daniel Baker, in the USA. The Baker lift alters the direction of the pull on the cheek, making it vertical in order to avoid

At the outset of our conversation, he tells me that he tailors his approach to the patient, tries to select the best approach and procedures among many by examining the patient and evaluating their demands and expectations, but has sometimes to make the ultimate decision of what is appropriate on the operating table itself, being only able then to appreciate the behaviour of the facial tissues. An editorial in this book looks at the pros and cons of more and less invasive techniques, in particular the deep plane and SMAS facelifts.

leaving a tell-tale sign behind the ear. This, however, automatically creates skin excess in the temples area, usually necessitating an incision that may be visible in front of the temporal hair. For patients who show signs of limited sagging or requiring secondary facelift (as well as for heavy smokers), Dr Marchac favours the suspension facelift which is a superior procedure to the simple plication of the deep tissues method, has a relatively short recovery time and minimal visible scarring. The suspension lift procedure was initially performed and described by Stocchero in 2002. It con-

Professor Marchac takes the point swiftly and tells me that to limit the comparison between the two procedures is to ignore the continual evolvement of facial rejuvenation techniques. ‘I used to do deep plane facelifts, but rarely do so now,’ he tells me. ‘This type of procedure is only

sists of using a single long surgical thread in the shape of a loop around the ear, lifting, repositioning and anchoring the sagging tissues of the neck, cheek and chin. Any of the procedures described above can be accompanied by fat injection, with fat taken from the patient by liposuction, to restore a more youthful face contour. Fat grafts are well integrated, especially in the malar area, and the results can last forever. On the other hand, Dr Marchac has become the most outspoken opponent of non-resolvable fillers, which may leave, over a long period of time, visible and painful lesions and granulomas that are often impossible to excise. There are many factors that affect the surgeon’s decision at the time of carrying out the surgery: how will the deep layer “behave”; the elasticity of the skin; the age and lifestyle of the patient….

Which brings us neatly to Dr Marchac’s philosophy The aim of plastic surgery is to slow down the ageing process and rejuvenate, yet avoid dramatic changes and he would not operate on patients who have unrealistic expectations. He advocates the reasonable

Professor Daniel Marchac

approach, giving natural rather than overdone results, with patients looking consistently a decade or so

Contact

younger.

Professor Daniel Marchac

‘There is no sense in a woman having a 30 year old face when her body and hands tell a different tale, nor does this do anything for her social life. The result every patient should aim for is a sophisticated,

France

younger, yet natural look. No one can remain young forever. Harmonious ageing requires harmonious,

Phone: 33 (0)147274431

rather than excessive rejuvenation.’

Fax:

33 (0)147276515

Email:

danielmarchac@hotmail.com

Website: www.cranio-facial.org

The suspension lift procedure was initially performed and described by Stocchero in 2002. It consists of using a single long surgical thread in the shape of a loop around the ear, lifting, repositioning and anchoring the sagging tissues of the neck, cheek and chin.

<< No one can remain young forever. Harmonious ageing requires harmonious, rather than excessive rejuvenation.>>

Professor Daniel Marchac

130 Rue de la Pompe 75116 Paris

Dr. Darina Krastinova

claimed that she’d get no patients unless she was in Central Paris The“wild Bulgarian”, a sobriquet she acquired when she argued with Tessier over techniques, proved him wrong and has a thriving practice. She has done a great deal of research into cranioorbito-palpebral surgery and corrective eye surgery, including rejuvenating techniques that involve fat and bone grafting.

Dr. Krastinova is, for reasons explained in this profile, best known as a maverick

People who were friends one day would cross the road to avoid them the next. So I wrote to them saying ‘I love you, I am your daughter

surgeon among the plastic surgery profession rather than the general public.

and one day you will be proud of me as I am of you.’ Krastinova was married at the time to a well known

Her trail-blazing career began when, as a young Bulgarian doctor, she read

Those who remain are passionate about her philosophy and skills as a surgeon. Even though she is more of a surgeons’ surgeon, Darina Krastinova does see prospective private patients at her clinic in Versailles. If you do decide to consult her, be prepared for an in-depth analysis of what you expect from plastic surgery.

surgery, not least because she is not afraid to push boundaries, not concerned with public perception, but rather, addressing her

Publications:

professional peers with her research.

Blépharoplasties esthétiques, complications et traitement, D.

She is not known as a celebrity surgeon, far from it – she

Krastinova, M. Jasinski, Annales de Chirurgie Plastique Esthétique

Bulgarian artist, Dimitri Lolov, who made an equally life-changing

hasn’t courted attention or publicity and her website is a relatively

49 (2004) 569-585)

decision to put his own artistic career on hold, look after their son

recent addition, boasting just one before and after set of images.

Le lifting facial sous-périosté, D. Krastinova-Lolov, Annales de

and allow his wife to pursue her career. Krastinova’s path was charted from the moment she joined

about Paul Tessier and determined to train with him.

She remains a controversial figure in the world of plastic

trainee surgeons.

Tessier’s team. Not only did she become his most famous and closest pupil,

Is she grooming anyone to take on the mantle of the world’s

Chirurgie Plastique et Esthétique, 1989, 34, n° 3, 199-211).

next proponent and expert in subperiosteal facelift surgery? The tragic and untimely death of one of her best pupils, Dr. Martin Kelly has left a big gap in her close circle of disciples and

she developed with him what has become the most controversial Given that Bulgaria was a communist

and boundary-pushing technique since the Skoog SMAS facelift: the

country at the time and travel outside

mask facelift.

of the Eastern bloc was fraught with

The mask lift is so named because it involves lifting the

difficulties, if not downright impossible,

entire facial mask, from the bone – that is, all soft tissues, muscles

this decision would have required

and cartilages, and repositioning them to re-create the original

extraordinary planning to execute.

youthful profile of the patient.

She says: ‘I never planned to leave

It is widely accepted that while Tessier was a brilliant,

my country, but I found my inspiration

innovative and forward thinking surgeon, today he wouldn’t be able

in the person of Paul Tessier in France in

to experiment to the extent that he did in his heyday.

1965. I saw him operate on a malformed

The technique, also known by its medical term of

child and knew he was the one. I was a

subperiosteal facelift, is so complex that few surgeons in the world

young Bulgarian living in a communist

have attempted it, never mind practice it on a regular basis.

country. I managed to find 300 francs and a friend helped me with the passport in

The majority of surgeons today prefer the relatively easier and risk-free SMAS.

1972. I boarded the train, leaving my son and husband in Sofia. At Foch hospital I quickly found

Aged 50, some time after the mask lift carried out by Dr. Tessier.

Dr Krastinova does not proselytise – she merely explains her results spanning a career of 3 years in Bulgaria and 36 years in

employment doing night shifts and my family was able to join me a few months later. France, at the time, was a wealthy and trouble-free country.

She has contributed to and written a number of medical papers, both in French and English, and lectured on the technique

Paul Tessier operated on many patients and was surrounded

Dr. Darina Krastinova

Clinique du Château de la Maye 49 rue du Parc de Clagny 78000 Versailles Phone: +33(0) 1 39 43 17 09 Fax:

+33(0) 1 39 23 33 17

Email:

darina.krastinova@9business.fr

enabled her to make a comfortable life for her family in France),

by young French and foreign doctors. It was 1972 and his work had

but also for reconstructive surgery which constitutes 60% of her

just been presented at a congress he had organized on his own at

practice.

40 rue Worth 92151 Suresnes Phone: +33(0) 1 46 25 22 97 Fax:

+33(0) 1 4625 26 64

Email:

d.krastinova@hopital-foch.org

Website: www.darina-krastinova.net

Back in Sofia I had an apartment, a job, my family and my friends.

She doesn’t operate on patients she doesn’t like and has an artistic approach embraced by her pupils – an international group of young surgeons who train under her, rather as she did under

In France, I had a bed sitting room at the hospital. I worked at night to feed my family. Little money, no friends… I was badly dressed, me who loved beautiful things!.. I had one pair of shoes for winter and another for summer … but it was great. We were young and discovering a free world …in the end we were just discovering the world and I — the world of big surgery. We were happy, life was open for us. I worked day and night.

Tessier. When I press the point, she explains that she looks at a patient’s life and aspirations and gives them the look their lifestyle warrants. ‘No point in giving a home maker a glamour face that doesn’t fit in with her way of life’. Her own face was “done” by Tessier many years ago. I scrutinise it as we talk and get a sense of its longevity that doesn’t

My husband helped a lot, looking after our son and taking care of everything else. Yes, it was hard, but we have lovely

translate itself into words. There is a solid and lasting suspension of the lower face

memories of that time. The French often invited us and we had a

that looks gravity-immune – the kind of face that has undergone

comfortable life.

what other surgeons describe as “the commando facelift”.

When I remained in France in 1972, the Bulgarian authorities were very harsh with my parents. People were afraid to visit them.

The Royal Society of Medicine — Honorary Fellow on July 18, 2000, in London.

Krastinova continues to practice plastic surgery in Versailles where she established a clinic, much to the horror of Tessier who

With my granddaughter, Ada.

DR. DARINA KRASTINOVA

Hôpital Foch

She remains, today, one of the most respected surgeons in the world, not just for cosmetic plastic surgery (which she says

Foch hospital.

Contact

Dr. Krastinova, aged 30.

all over the world.

At Foch hospital, order reigned everywhere and perfection was expected. The patient was placed at the centre of all care.

With Martin Kelly. I like all of my students but Martin was exceptional. A future superstar, as I called him. I miss him very much.

France.

Dr. Darina Krastinova in her own words BIRTH OF A SURGICAL PROCEDURE : THE MASK LIFT STORY

indications, publish it! ‘ This I did in 1989 (Le lifting facial sous-périosté, D. Krastinova-Lolov, Annales de Chirurgie Plastique et Esthétique, 1989, 34, n° 3, 199-211). In the same journal Paul Tessier published his considerations on the mask lift and other facelift procedures. In the years that followed a whole series of techniques were published. Everyone wanted to leave a legacy… yet, as Barry Jones observed aptly, ‘The mask lift is not an idea fallen from the sky to put itself forward and shine!’

pathology, but also found themselves rejuvenated and embellished. In 1984 a young woman aged 45 came to see me for her sad, drooping, cocker spaniel eyes. She wore violet eye lenses. I felt she had an adventurous nature and proposed a coronal lift, as I called it at the time, intending a subperiosteal dissection of the face, bone remodelling and tight lateral canthopexy. Dr. Tessier no longer worked at Foch Hospital, but I often visited him at his private practice at the Belvedere clinic. One day I

difficult and complex. Moreover I wanted my technique to give a long-lasting result. I understand a woman’s vanity and what women want. I think that sooner or later a means of skin retraction will be found and the classical subcutaneous facelift will disappear. With

bone structure cannot understand and use this technique. Until the mask lift, a facelift consisted of pulling the skin or at its best, doing the SMAS dissection and muscular sutures.

avoiding the formation of deep naso-labial folds.

we can rebuild forms. But how will we deal with the forehead,

shape of the eye (in a globular eye) is not a problem. The same

prominent superior orbital margins, big eyes, drooping eyes, flat

thing in a small eye would result in enophthalmous (make it even

malar prominences on a long face?

smaller).

My patron, Paul Tessier, found my results very good, and

How do we fight against the tendency of the face to close

the face is in the three dimensions. For example, enlarging the orbit in order to change the

Rapidly failures appeared and thus, the conclusion “it is a

in on itself with age; eyebrows and eyes that medialize (draw

bad procedure”. The mask lift has been abandoned by the classic

the presentation very brave, and proposed that we publish a paper

together), nose that lengthens, and the malar drooping (cheeks

cosmetic surgeon and is now carried out by some of Dr. Tessier’s

together.

sagging) onto the nasolabial fold (smile lines) that deepens?

pupils and by mine.

I continued developing my ideas. The technique enabled me to obtain results in cases where other procedures failed: in young, deformed and unsightly faces by remodelling the bone but also embellishing and rejuvenating the eyes by lateral canthopexy. Progressively, I extended the procedure to the “sunken” or

The mask lift offers a solution and a long-lasting improvement. At age 50 or over a cheek and neck lift are required.

always observed and believed in the phenomenal capabilities of the skin to retract itself and have made use of this.

the problem (globular eyes) but also prevented the appearance of

more hematomas. I don’t pull on the skin I just replace it vertically

At the beginning of the 80’s I began my series of operations on

round eyes and senile ectropion in later years on fragile and over-

and excise very little.

certain orphan pathologies: anophthalmic orbital facial palsy,

exposed eyes.

I have observed that pulling the skin results in thinning it, breaking it and causing premature ageing. I reposition the skin with a very light tension and the same

after time). It is excellent for younger faces with a tired look

with the coronal incision. I remove scalp tissue only in cases of

because it is discreet but very enhancing.

low foreheads in order to enlarge them. In the rest of the cases

my results without waiting for him. ‘You have constructed and developed the technique and its

I remove 3mm or less as I don’t feel that pulling will improve my result. Besides I love hair! Tight, lifted faces with enormous foreheads like the Tour

Schema 4: Forehead — re-section of muscle so as to decrease wrinkles.

DR. DARINA KRASTINOVA

The shock

One day Dr. Tessier called me and suggested that I publish

Schema 3: External canthopexy.

My subcutaneous dissections have always been large and

dissection with blunt dissectors, so now I don’t cut anything. No

of youth without the scarring (the scalp incision becomes invisible

Results are outstanding and long-lasting. A mask lift is for life.

As the mask lift raises the entire facial mask, the lower face

often counter-productive and the results of facelifts uncertain.

In harmonious faces this technique brings the plenitude

Indications are very precise. When all the rules are respected it is an “haute couture” facelift.

becomes a matter of bony structure and skin + / - SMAS. I have

“globular” eye, where classical blepharoplasty procedures were Thanks to the coronal lift or mask lift (Paul Tessier’s

Schema 2: Face Bone remodelling by grinding.

In the mask lift work is done on the bone and remodelling of

on facial wrinkles. Lipofilling is a marvellous procedure with which

hematomas and now I utilize the Brazilian technique of soft

my patients were not only happy with the amelioration of their

Many have failed. A surgeon who has no acquaintance with

careful and regular dosage, the use of Botox gives good results

mask and tighten distended eyelids. This way I not only corrected

were the techniques I was developing. Very rapidly I realized that

Curitiba where I did live surgery.

cheekbones, because they support the soft tissue of the face, thus

deep. Progressively I started to preserve safety pillars against

external canthopexies, orbital remodelling and bone grafts…these

I was invited all over the world. My favourite trip was to Brazil,

To obtain a youthful, beautiful and natural face is both

was large and beautiful yet not exophthalmic, but also lift the facial

surgery, such as the subperiosteal approach to the facial skeleton,

Everybody has wanted to do their own mask lift. Many colleagues have come to watch me carry out the procedure and

definition), I was able to not only enlarge the orbit so that the eye

Key procedures were based on Paul Tessier’s cranio-facial

The article finally appeared in 1995 after 4 years of writing

dimensions and at all the levels: skin, muscles and bone.

with tight skin… but it pays”.

also malformed and unsightly faces.

“think about the readers”. He was adorable and offered his help.

reconstruction in the three dimensions, as one ages in the three

of the surgery, he concluded “ugly she was, ugly she remains even

Basedow orbitopathy, orbital traumas, orbital malformations and

My old pupil and friend, Patricia Cecchi in Rome, translated. After 3 years and 9 versions, Bob Goldwyn wrote again saying

I obtained it: the star eyes, because they age slower, the high “slav”

decried it as a scandal.

cosmetic surgeon in Paris during a facelift operation. At the end

The mask lift is not only a procedure. It is a facial

Schema 1: Mask lift and face bottom lifting according to Mac Indoe Coronal approach.

- another battle and in English moreover.

and Reconstructive Surgery, January 1995, vol. 95, n°1, 21-36).

There were those who applauded the novelty and those who

On one hot August day in 1973, I was assisting an old

me to publish my technique in the PRS Journal. So I started to write

Facial Aesthetic Sculpturing, Darina Krastinova/Lolov M.D., Plastic

This presentation created a big sensation at the meeting.

beautiful.

invited everywhere and one day Bob Goldwyn wrote to me, asking

softer and more harmonious way.

I wanted the triangular face with star eyes of my youth and

In my early Parisian period (the 70’s), facelifts did not

After my presentation in 1986, I became a curiosity. I was

to be on the other side of the surgical knife. I observed myself like a

become quadrangular.

interest me very much. I didn’t find the surgery or the results

are flattened and the patient is no longer confident.

and re-writing. Even now it is only nearly perfect (Mask lift and

in my 40’s. The malar prominences had flattened and the face had

under Paul Tessier.

Dr. Tessier applied it in cranio-facial surgery. He searched

that has been pulled too much. There is no skin left, the structures

looked for ways of pulling and fixing the lateral angle of the eye in a

eyes that assumed a rounder shape in my 20’s and more so later

Years later, as a young doctor, I travelled to Paris to train

One of the keys of the technique is lateral canthopexy (lid suspension).

It is difficult to embellish a deformed, ugly, badly aged face, but it is practically impossible to operate on and normalize a face

fascia. In aesthetic mask lifts this did not give natural results, so I

Mine was a triangular face at the age of 10, with elongated

ugly people.

carried out by my pupils.

flattens and one often observes obvious oblique tractions.

had total confidence in him; secondly, I wanted to know how it felt

presentation with Dr. Tessier’s work on my face, as homage to him.

to make people beautiful: whether malformed children, or old and

My ambition was to ensure it lived on and that it could be

the level of the nose and it ends up level with the mouth. The chin

same procedure on me. Firstly, I found this technique fantastic and

A year later, I presented my first papers on the results of

When I was a little girl, I wanted to practise surgery in order

In Dr. Tessier’s hands, this was a strong and difficult procedure.

With age, the earlobe also disappears or elongates towards the chin. The chin-ear distance shortens. Normally the earlobe is at

for the “presumed” lateral canthus and fixed it to the temporal

the coronal lift at the French Society of Plastic Surgery, ending the

My father was a cardiac surgeon in Bulgaria.

subperiosteal dissection, lateral canthopexy and bone remodelling.

The poor patients who try to conceal these scars with the few hairs that are left or with wigs!...

told him about my observations and then asked him to carry out the

butterfly on the wall. It was 1985.

Taken in the well known Salle 8 in the Foch Hospital with Mr Tessier in 1975.

Working with Dr. Tessier for over 12 years (1972-1984) I assisted and then carried out hundreds of coronal operations with

Eiffel, absent sideburns, visible scars behind the ears are awful.

(and a few men’s) problems today. Do people invest unrealistic

or maybe more logical than face surgery, particularly following

the list of questions to ask.

hopes in a new face?

children, as all of the exercise in the world cannot do what tweaking than faces after many years. Patients always think in

higher socio-economic groups consider facelifts just part of the

terms of “redoing” the kitchen after aging. Why not apply the

process, less sophisticated groups are more likely for possible

same logic to the aeging body and face. In 1900 the average

disappointment if dreams are not met. A great result may be the

person lived 48 years. Now it is 78 years.

seem to be OK. Famous surgeons (known in the lay press through

verified. It is buyer, beware. One must see their friends after one

PR) do the most basic conventional techniques. These are fast

year, not after 3 months, since facelifts always look OK after a few

and easy, and the recovery is easy. Many celebrities have the

months, while the deformities do not show up perhaps until a year

“facelifted” look and all go to well known surgeons, who promote

goes by. The patient who was delighted and sent their friends to

terms like “designer face”.

her surgeon will be embarrassed if she becomes disappointed in time to tell her friends she made a mistake. In a sense, facelifts are the ultimate scam. A carotid artery bypass operation must be working immediately if successful. Not so with facelifts.

after working on it for 5 years. It simply moved the face tissues

Q How is it that people who have the resources to research

in a lateral direction. The big advance for me was creating the

and pay for a great facelift often end up looking grotesque?

Composite Facelift, simply adding eyelid-cheek surgery to the

A Fashion magazines are partly responsible, as a PR bit well

deep plane facelift that creates “peri-orbital rejuvenation” by

placed means more in gossip columns that the science retrievable

moving the upper face towards the eye area. Many surgeons

on the internet. Also is the desire of the rich and famous to “stay

adopted the deep plane facelift. It was easy to adopt since the

in the groove”. They usually use the same hairdressers, interior

cheek fat was included to the standard SMAS lift. The composite

designers, and divorce lawyers. Getting out of the pipeline they

facelift, far superior, is more demanding of surgeons so fewer

are in would be considered unusual.

surgeons venture into it. One must move the eyelid muscle up and bring the eyelid fat down over the orbital rim. Since the

Q Is there such a thing as a society plastic surgeon who is a

public doesn’t understand the difference, there is no incentive

well kept secret of the rich and famous? If so, who is he? Are

for most surgeons to go through the steep learning curve. It is all

you one?

about public education, but facelift education falls far below back

A There are a few quiet surgeons doing usually conservative

problems, breast cancer, cataracts, etc. in importance.

work with little fanfare. These minimal procedures don’t always

Q What are its limitations? Can a woman look perpetually 35

last a long time, and the results are also minimal, but there is no way to track this. The answer is in the question, well kept secret.

years old, or 20 years younger than her age, whichever is more

They are surgeons perhaps who have never written a scientific

applicable?

article or made a contribution, all of which is OK. There are, or

A There are no limitations, and in my opinion, any person aged

50 or older is a candidate, since it rejuvenates every part of the face, and every human has harmonious aging by that age and

were, a few well-born individuals who are already in the country club set. Every big city has this type.

therefore needs harmonious rejuvenation. Judging age is very

Q You train other surgeons to perform the composite facelift.

subjective depending on skin type and other factors. The same

Is there anyone outside of the U.S.A. who is competent enough

patient with Italian or Indian oily skin may look much younger

to perform it?

that her counterpart with more dry and wrinkly Scotch-Irish skin

A I have had surgeons here from many countries including the

following any type of facelift.

U.K. From that point on, I am not sure who is doing it. Since they

Q Doesn’t a youthful face look at odds with an ageing body

Phone: +1 (866) 773-9181

and is there a fix for that – where is the limit? How does one

Fax:

determine a limit, considering how addictive tweaking your face and body becomes?

A The face is open, the body is usually covered. Keeping

will not publish or present their results for a while, or until they modify it a bit, I would never know, but I hear good things about them.

DR. SAM HAMRA

Dallas, Tx. USA 75231-0805

weight normal is important to look compatible. I do frequent

A It is impossible since PR and advertising sell items every day.

Doing real research is possible, and still, many claims cannot be

A I named and published the Deep Plane Facelift in 1990,

Website: www.drhamra.com

Q How does a prospective patient cut through the hype and PR and establish which surgeon is good for them?

that by today’s more advanced standards are sub-optimal, yet

that so few surgeons offer or even mention it?

A In the near future it will involve surgery. Perhaps with science,

surgery can do. Body surgery actually lasts longer, needing less

who have had it, and doing their homework. While those in

Q Is the composite facelift a deep plane facelift and why is it

+1 (214) 754-9080

young much longer and surgery will go the way of buggy whips.

if that surgeon is the right one. I have written a book, now in the hands of the publisher, which expands on the topic, giving patients

Q Is there such a thing as a “designer face”? A No. 90 % of facelifts are conventional, traditional techniques

9301 North Central Expressway #551

genetic engineering, and who knows what else, we will look and feel

surgeon and if she knows what end point is desired, she can decide body surgery on facelift patients. Body contouring is as logical

best thing that could happen to most patients.

Contact

knowledge, a patient can ask the right questions to a potential

A I never recommend surgeons to patients. Armed with

Q Plastic surgery has become the easy fix solution to women’s A It is always a question of the patient’s exposure to others

Dr. Sam Hamra

Q Can you foresee a day when we will all look perpetually young, surgically enhanced?

Photographer: Lara Jade Title: ‘Bernadette’ Model: Bernadette MUA & Styling: Lara Jade Retouching: Lara Jade

Dr. Sam Hamra

Q Who would you recommend to a patient who is unable or unwilling to travel to the U.S.A.?

Dr. Steven Fagien

assume in error that everything falls as we age hence the solution

appearance, but do not rely on fat contouring alone to improve the

to this is a “lift”. In actuality, the most comprehensive approach

lower eyelid contours (bags and dark circles).

addresses the radial expansion by tightening the skin, muscle and

Dr. Fagien is one of very few physicians in the world entirely dedicated to cosmetic eye surgery. Like James Stuzin, with whom he often operates, he has no website. His patients, he says, are sophisticated, well-informed and go to him based on medical research or because of hearing his name over and over again from referring colleagues and happy former patients.

Conservative contouring of the fat, combined with precise

tendon with less emphasis on the “lift” or over-excision of soft

and separate skin and muscle tightening is what is necessary to

tissue.

improve patients’ appearance long-term, without the operated look.

Procedures

ligament), by a procedure called lateral retinacular suspension that

I perform a lateral canthopexy (tightening of the outer I developed, on almost all of my patients - this stabilizes the shape

Upper eyelid The procedure I have developed for the upper eyelid

of the lower eyelid and outer corner and prevents changes in eyelid

is actually so simple and less invasive than most other upper eyelid

posture that would otherwise be a tell-tale sign of surgery.

procedures, that at first many surgeons had difficulty under-

the result in a careful and artistic way. Surgeons who don’t have

in his approach which is at once precise, methodical and artistic.

and Marilyn Monroe. Both, however, had true upper eyelid ptosis

improving the appearance of volume. An incision is made in the

intricacies, but patients on the other hand are more interested in

(drooping and stretched muscles) of the upper eyelids which left big

skin, which is then tightened over the preserved (rather than

the result. The surgery per se, in fact, is not difficult, it is judgement

areas for make-up - great when you are young because your skin is

excised) muscle, so that the muscle folds upon itself and creates a

(knowing what works best at any particular stage that is most

so radiant and elastic. When the skin looks great, other issues seem

volumetric re-flationary effect in the process, as if you had injected

suited to the problem) that’s difficult. The devil, as they say, is in the

far less relevant or important.

a filling agent, regaining the youthful volume.

detail.

Our conversation goes back and forth between the technical and the philosophical. ‘There are,’ he says, ‘many different techniques that

Interestingly, lid ptosis, much like facial asymmetries,

The procedure is akin to tightening an old hammock while

A prominent Texas plastic surgeon was so impressed with

the patience may not be interested in this approach due to the

While I don’t personally want to refer to myself as an artist

can work for a variety of patients, but oftentimes, a particular

doesn’t matter (as much) in youth but gets accentuated,

this novel approach after viewing one of my early presentations at

(as others might), I have developed a vision based on experience

procedure or approach is more appropriate for the optimal result

unattractive, and undesired with age. If you look carefully at

a national meeting of plastic surgery colleagues, that he remarked

and having performed thousands of eyelid operations. My patients

for each face. Sometimes a particular technique may seem like a

today’s young and famous, what is most notable is the obvious

in the open forum that he had “been doing upper eyelid surgery

are usually sophisticated people who demand and expect a lot. My

great idea, but may not be what the patient needs or wants, and

volume as well as the absence of a deep hollowing to the upper

wrong for over 30 years!!”

motivation is that I want to see my patients happy – I love what I do.

may not accomplish a result that corrects or improves the ageing

eyelid, with far less visibility of the upper eyelid platform (where eye

problems that the patient dislikes.

shadow is usually placed).’

and good judgement and overall be a good doctor. Good surgeons know how to match problem with procedure.

‘When I look at textbooks from the eighties, I am aghast. Taking aging eyelids, hollowing them out so that they look better?

Most great surgeons also have an anatomic approach to

When I first started advocating that the youthful eyelid

plastic surgery, a higher level of understanding of what causes

was a fuller eyelid and that this could be improved by altering

facial ageing, a solution for correction or improvement and a vision

the traditional surgical approach, I was, to begin with, reasonably

Cross-section showing skin closure

of the result before it happens.

criticised by the plastic surgery establishment. Volumising is now

with intact orbicularis and the effect

The ageing process is very complex and there is no simple

widely accepted as a rejuvenating procedure. I don’t, however,

answer to correcting it. There are a lot of shortcuts in rejuvenation

believe in routinely volumising the eye area through fat injections

surgery, but the 20 minute procedure equals a 20 minute result.

or dermal fillers as this can be best accomplished in most cases via

What the patient cares about and desires is longevity, not just a result that lasts as long as the post-operative swelling. Laser treatment is a good case in point as is trans-

a thoughtful surgical approach with far more lasting and aesthetic results.’ Fat, philosophically, makes some sense as a component

The lower eyelid transconjunctival incusion.

Subdermal dissection (a skin flap) is performed.

The extent of dissection depends on many factors to achieve the desired result.

Lower eyelid Most patients complain about bags or dark circles

Conclusion Good surgeons at the very least need to be technically

under their eyes. The simplest way to address this, as has been

superb and produce consistent results. They continually amend and better their procedures in microscopic ways.

conjunctival fat removal. At the beginning, it seemed like a good

given that ageing means fat volume loss, but this is only part of

routinely done in the past, is to take the fat out. However, this does

idea to be able to affect the skin appearance with a laser application

the equation. Much of the problem of fat is its unpredictability and

not take care of the complex causes and may even result in other

and remove fat by an invisible incision inside of the lower eyelid.

today’s patients demand consistent and predictable results.

unanticipated issues.

The problem with injecting fat is that it has to survive

The amount of orbicularis muscle to be incised (horizontally) is determined.

The older method was to remove fat, skin and muscle much

usually quite compulsive about their work.

(to work), yet one has no control over which fat takes and which

like (conceptually) the antiquated approach to the upper eyelid.

much more to eyelid and facial ageing that includes changes in the

doesn’t, hence skin surface contour irregularities commonly

This method, whereby the incision was made through the skin and

a surgeon’s procedure that is well suited for one patient, may not

muscles and ligaments that must also be addressed in order to give

seen after fat injections even when performed by experienced

under the muscle, more often than not changed the shape of the

be as suited to the next. Great surgeons can often modify their

the best and long-lasting results that defy detection.

surgeons. Only if a patient is not a candidate for surgery would I

eyes and made them look rounder. It also gave the appearance of

technique to deliver an individualized approach that addresses the

having had surgery without really fixing the problem.

need. Different sides of the same face also may require different

Traditionally, plastic surgery was based on lifting and

use a filler and then I would recommend hyaluronic acid because the dissolution is more homogenous and the skin far less likely to

removal of apparent “excess” tissue. Eyelid surgery was historically

exhibit irregularities.

based on removing skin, muscle and fat and a surgeon would often

Patients also don’t want to look as if they’ve had a

My technique has evolved over many years. It is partly

Just as faces are all different, so they age differently and

variations of procedures. A great surgeon also knows how to

based on the premise that the muscle must be preserved and

adjust the procedure for one side versus the other in order to add

tightened and that this can be addressed by an incision just beneath

harmony.

procedure or surgery. By selecting the most appropriate procedure

the skin, which in turn also improves the skin appearance much

660 Glades Road

notwithstanding, this was far from the best that could be done. The

with precision, planning and execution, you can accomplish this.’

better than when the incision is made beneath the muscle. The skin

result, at times, is not due to a failure in technique but rather to

Suite 210

surgeon would be so impressed with the immediate results that he

retracts (shrinks) slightly when it heals; I use this to my advantage

this misinterpretation. I will often ask patients to bring in old

Boca Raton, FL 33431

wouldn’t think of the long-term implications such as visible scarring

Eyelids If you look at the cross section of an eyelid you will see

to improve the skin appearance rather than resorting to lasers or

photographs to review - not because I believe that surgery will bring

Phone: 561-393-9898

and the subsequent hollow look.

that it consists of many layers including skin, muscle and fat.

peels. I also use a skin flap rather than going under the muscle so I

them back to this point, but more to assess where they have been

The problems associated with ageing are the deterioration of

can manipulate the muscle, and appropriately and precisely tighten

(which is many times predictable without photo review), understand

induce changes that achieved the popular look of the day. Many

skin (quality), attenuation of the muscle, ligaments, and other

it to restore the contours by improving the laxity here.

their wishes, and discuss what surgery can really do for them. The

of the young and famous (especially in “Hollywood”) at the time

supporting structures and the shifting/atrophy of fat. Facial ageing

heralded looks such as very deep upper eyelids with vast areas

represents more of a radial expansion outward, not downward.

touch the orbital septum. I very conservatively contour the fat from

to apply make-up on. Patients followed suit and the surgeons

Thus, the word “lift” in plastic surgery is actually a misnomer. We

a trans-conjunctival approach (inside the lid) if it is overabundant in

In most cases, I don’t perform any muscle excision nor do I

Many surgeons misinterpret facial ageing. An erroneous

truth is, plastic surgery can more often make a patient look better but not necessarily younger.

Results of ten year-old lower eyelid surgery and recent upper eyelid surgery

dr. steven fagien

perform this procedure. The drastic difference in appearance

In the past, upper eyelid surgery for instance, attempted to

supratarsal volume.

The difference between an average and a great surgeon is

complexity of ageing and the changing that occurs. There is so

tightening and oftentimes, certainly with respect to the eyes,

of orbicularis ‘bulking’ to improve

the difference in judgement, not in technique. Great surgeons are

Contact

Email: sfeyeplastix1@aol.com

Results of Dr Fagien’s upper and lower eyelid blepharoplasty

And technicality aside, you obviously must have experience

This approach, however, does not correct or take into account the

I like to address every little issue so that I can surgically maximize

epiphany for them. attempted to replicate. Two examples of this were Marlene Dietrich

He has published extensively on eye surgery and even

Steven Fagien MD

standing it. More often, once they did understand it, it was like an A compulsive perfectionist, he has been compared to a watchmaker

designed the cover of his latest book.

<< Patients don’t want to look as if they’ve had a procedure or surgery. By selecting the most appropriate procedure with precision, planning and execution, you can accomplish this. >>

My procedure takes about two hours to perform because

Dr. David Shafer

of this world-renowned medical center introduced Dr. Shafer to patients from the Middle East to South America to Asia. During this time, Dr. Shafer travelled to Hanoi, Vietnam to participate in the Global Health Organization’s project to repair cleft lips and palates.

Dr. David Shafer is trained in all aspects of plastic and reconstructive surgery. However, he specializes in aesthetic surgery. He established

Dr. Shafer’s office features many photographs of children he treated in Vietnam with their delighted parents. After The Mayo Clinic, Dr. Shafer was selected as an Aesthetic Surgery Fellow at the Manhattan Ear, Eye & Throat Hospital in New York City. This fellowship is recognized as one

Shafer Plastic Surgery in Manhattan with one specific goal – to

of the most prestigious fellowships in plastic surgery worldwide (most plastic surgeons do not pursue specialized fellowship

break down the traditional doctor-patient barrier and create an environment where patients feel comfortable and relaxed. Dr. Shafer

training). However, Dr. Shafer continued honing his surgical skills and knowledge rather than going directly into practice in order to achieve the best, most advanced training possible for cosmetic surgery. His traditional surgical training at The Mayo Clinic complements the energy and innovation only found in New York

treats every patient as if they are family. In fact, many patients comment

City.

that talking in his consultation room is like sitting around the kitchen

to Manhattan Eye, Ear & Throat Hospital has given Dr. Shafer a solid

The road from the Arizona Burn Center to The Mayo Clinic foundation in plastic surgery. In addition to teaching plastic surgery residents from New York University, Columbia University, Cornell

table with good friends.

and Lenox Hill Hospital, Dr. Shafer remains academically active. In recent years, Dr. Shafer has written peer-reviewed articles and chapters on facelift techniques, Botox Cosmetic, Dysport™, and anesthesia for plastic surgery. Additionally, he has produced DVDs David Shafer’s surgical training began at the Arizona Burn Center

on Botox Cosmetic injections to teach other surgeons fundamental

in Phoenix, Arizona. His research in wound healing and surgical

skills and new developments.

techniques earned international attention and contributed to

Dr. Shafer has quickly made an impact in New York City

the scientific literature. Working with burn patients with complex

and internationally. In 2009, he was featured in W Magazine as a

wounds, Dr. Shafer focused on more than just survival. He

“Beauty Talent” in plastic surgery and as one of the “experts soon

concentrated on improving the patient’s wellbeing both internally

to be on your speed dial”. Dr. Shafer’s web presence is marked

and externally. Improving a patient’s appearance gives an enormous

by his development of the world’s first plastic surgery themed

psychological boost. Many high-tech reconstructive developments

iPhone application. The App features over 1000 interactive FAQs

in burn surgery, such as tissue engineering and tissue grafting,

about plastic surgery – from invasive surgeries to non-invasive

translate in a positive way to modern aesthetic surgery. As a

procedures. Dr. Shafer has described today’s plastic surgery

graduating Chief Resident, Dr. Shafer was honored with all three

patient as “sophisticated, inquisitive and information seeking”, and

possible awards including “Intern of the Year”, “Rick Weimar

created this resource with them in mind. Dr. Shafer is a modern

Ambassador of Medial Ethics”, and the “Harry W. Hale Jr. Surgery

generation surgeon and an innovator. He stays on the cutting edge

Award for Outstanding Surgeon”.

of technological and surgical developments to offer his patients the

With a focus on plastic surgery, Dr. Shafer continued his training at The Mayo Clinic, which is consistently ranked as best in class for hospitals and surgical training. The international draw

best possible treatment and advice. Dr Shafer’s practice is approximately 50% international patients. His Fly-In-Program hosts and cares for patients from

David Shafer, MD Contact David Shafer, MD Shafer Plastic Surgery 10 East 53rd Street, 25th Floor New York, New York 10022 Phone: 1-212-888-7770 Email:

ShaferPlasticSurgery@gmail.com

Website: www.ShaferPlasticSurgery.com

Dr. Shafer performs procedures in On the cutting edge of technology, Dr. Shafer created and launched the first Plastic Surgery iPhone App worldwide in late 2009.

his Midtown office with stunning city views. This patient describes the skyline as “equally breathtaking and relaxing”.

Central Park, New York City.

an evolving field, with new developments and technological

Q Do you believe that science will be able to address

advancements every day. I pride myself in staying on the top of

internal ageing - the disparity between looks and biological

the field and continually developing my skills. For example, facelift

age?

techniques have traditionally involved cutting and pulling of the skin

A People are living longer and healthier lives. It is not a misnomer

and tissues. We have all seen the outcome of an over-aggressive

when people state that 50s are the new 30s. People are more

pull. In my approach, my goal is to restore the face to its youthful

active and taking better care of their bodies. The physical and

position. This still involves surgery. However I also incorporate

psychological aspects of health go hand-in-hand. If you look better,

new technologies in purified fat cells for volume enhancement

you feel better. Staying fit, eating properly and exercising your mind

and laser skin tightening for a well-defined neckline. These same

all contribute to your overall sense of beauty, health and wellness. I

concepts can be translated to breast rejuvenation and shaping of

am a true believer in preventive medicine – and this includes plastic

the waistline".

surgery. Many procedures have a positive psychological benefit as

Q What specialties have past patients recommended to you

on your skin If you start early with Botox to decrease the daily

most? What procedures do they endorse most highly?

stress on your skin, you prevent the formation of the wrinkles.

A For women, my most common referrals include face and neck

Midtown between Madison and 5th Avenues, looks over NYC landmark St. Patrick’s Cathedral.

such as brow lift, in the future to smooth the wrinkles. Additionally,

liposuction is one of my more common procedures. Necks and

I believe one must approach the skin from a mechanical, nutritional

bellies seem to be a niche favorite for both genders. A well-defined

and structural approach. That is why in most patients we

neckline for both women and men can help one appear ageless,

recommend a botulinum product (Botox Cosmetic® or Dysport™) to

particularly as the jaw line droop is one of the first telltale areas

relieve tissue stress, nutritional supplementations to maximize skin

through the ageing process. Bellies are a pleasure to rejuvenate,

health, and structural enhancement through retinoid treatments.

to hide around her middle is just stunning. And men are equally

Q What do you see as the short-term future of Plastic

aware that a strong and masculine appearance is best without any

Surgery?

excess fat in their chest or lower abdomen. I continue to develop

A In the short-term, less invasive and preventive procedures are

new techniques for Botox. After publication of my chapter, my Botox

going to continue to become more popular. However, in the long

treatments increased over 1000%. While, I am a surgeon at heart, I

run, I think the pendulum will shift back to many of the traditional

incorporate minimally invasive procedures and treatments to help

procedures which have time-tested and long-lasting results.

optimize my patients’ outcomes.

the world.” Patients find it convenient to extend a business or leisure trip for a surgical procedure or treatment. Patients fly in

really just need a little nip here or tuck there, particularly as we

culture. My focus is on the individual patient and helping them

for a long weekend for a Smartlipo session or extend their stay for

are seeing younger patients taking more preventive measures.

achieve their desired goals.

a total body makeover. Patients enjoy keeping in touch through

Minimally invasive surgery is great for these people. I do remind

virtual online consultations directly with Dr. Shafer using video

patients however that there is no magic wand that can produce

conferencing over the internet.

dramatic results without downtime and incisions. There are some

Q What is your definition of beauty? A The idea of beauty has always been there, though the definition

amazing advances in filler and laser technologies which I use

of “beautiful” has radically changed over the centuries. The Romans

regularly on the right patients, but these are not equivalent to

had a very different ideal than, let’s say, Americans in the 1980’s. I

ensure he is very hands-on, and has one to one relationships with

results one can achieve with "real” surgery if needed. It is really

look to enhance features that the person already has, rather than

his patients from the earliest consult to post-operative recovery

a matter of balancing the best procedural plan with a patient's

to recreate a transient aesthetic. Youth, for example, is considered

and follow-up. His Upper East Side patients brag about his post-

desired outcomes and expectations.

beautiful, so I try to replace what my patient has lost over the

operative house calls and several have turned into surrogate offices where nurses do the bulk of the pre- and post-operative

Q Does SmartLipo work? A It does for the right candidate. I was originally a sceptic of

interactions. Dr. Shafer’s approach is a key part of why his practice

Smartlipo and other laser liposuction technology. First of all, it is

thrives on referrals. Despite his great talent, he has modesty and

a misnomer. The Smartlipo portion of the procedure is really the

approachability that patients say set him apart.

laser treatment to melt the fat and has nothing to do with suction.

grandmothers for him. This is not the case in many plastic surgery

Q Many surgeons have particular Comfort Zones – tell us about yours?

A Just as actors are often stereotyped into a particular role,

After the laser treatment to the fat, I follow with power-assisted liposuction but with very small cannulas to suck out the melted fat. If this suction portion of the procedure is not done, the results would be minimal and may be the reason why so many concerns have been raised about non-plastic surgeons who perform this

Through my development as a surgeon, I have consciously focused

procedure. Smartlipo is not for everyone. If you need total body

on mastering the fundamental building blocks and cultivating that

liposuction, then traditional, power-assisted liposuction is by far the

innate ability to customize and adapt my skills to an individual

best. If you just need love handles, muffin top, inner thighs, arms,

patient's needs. My plastic surgery training at The Mayo Clinic

neck or other targeted areas, then Smartlipo in well-trained hands

gave me the traditional training of the surgical giants, while my

could be an excellent choice. The latest technology, Smartlipo MPX,

fellowship training in New York City allowed my creative side

combines two lasers in one. The combined wavelengths and higher

to flourish. Practicing in Manhattan is a privilege, upholding

power offer a smoother result and a quicker procedure for the

the highest standards in plastic surgery. Aesthetic surgery is

patient.

to create a comfortable and open environment for discussion between doctor and patient.

years. In other cases, a patient may have been born with a breast asymmetry or crooked nose. I apply the same concepts that I use in aesthetic surgery to these reconstructive procedures. Maximizing one’s image using safe and effective procedures is my goal.

<< In the short-term, less invasive and preventive procedures are going to continue to become more popular. However, in the long run, I think the pendulum will shift back to many of the traditional procedures which have time-tested and long-lasting results. >>

Dr. David Shafer

plastic surgeons are often identified for a particular expertise.

consultation-table format strives

is considered beautiful in one culture is not attractive in another

a practice managed with just the optimal amount of support staff to

Dr. Shafer's approach to patient care is also unique. He has

to a prospective patient. The unique

Q Who is the most attractive face today? A I truly think that beauty is in the eye of the beholder. What

Q What is your view on minimally invasive surgery? A There are many people who do not need extensive surgery or

around the globe – many seeing New York City as “the capital of

Thereby, you may prevent more extensive and invasive procedures,

rejuvenation, breast enhancement, and liposuction. For men,

as the silhouette of a woman in a tight fitting dress with nothing Dr. Shafer’s office tower, located in

well. Take, for instance, wrinkles. Wrinkles are the result of stress

Dr. Shafer describes breast rejuvenation

top surgeons’ definitions of beauty

Dr. Sherrell Aston It is impossible to define beauty but you know it when you see it; whether it is a rose or a woman. From an anatomical and mathematical standpoint one can define various angles and proportions that make a balanced and beautiful face but beauty is in the ‘eye’ not in the ruler.

For example, few would argue that Grace Kelly was one of the most beautiful women in the

world. She not only had an aesthetic harmony to her facial features but also a look of softness and elegance.

Professor Ivo Pitanguy

The quest for plastic surgery... is the attempt to reach harmony

between body and spirit, emotional and rational, aiming to establish an internal balance which allows

Dr. Thomas J. Balshi

the individual to find harmony with his own image and the universe that surrounds him.

Among the most engaging smiles belong to racing hero Mario Andretti and jazz singer Cassandra

I like to think that my patients have the best smiles in the world!

Wilson. I also find the smiles of Christie Brinkley and Faith Hill noteworthy and the smile of Donovan

Professor Yves-Gérard Illouz

Beauty is a symmetry, harmony and emotional reaction.

McNabb particularly strong. There is no beauty in the human face without a smile. The smile is that

The most beautiful women are:

property which magically connects the sheer goodness of the internal spirit with a perfect comple-

Grace Kelly for her perfect symmetry.

ment of designer ‘pearls’ inside the mouth. When the placement of chiselled lines and hues accurate-

Gene Tierney for her perfect harmony.

ly reflects one’s inner charisma, the result is a magnetism known as BEAUTY. It makes the beholder

Marilyn Monroe for the emotional reaction she induces.

look again, and then again, and yet again...with wonder.

Dr. Dan Baker

Dr. Per Hedén

The primary requirements for human beauty are facial and physical characteris-

It is impossible to establish a universal definition of human beauty since this var-

tics which are exceptional and have universal appeal to our eye. There are of course physical varia-

ies from culture to culture, and from time period to time period. However, there are several globally

tions in different races which represent beauty. In addition beautiful people possess an elegance and

universal well established measures and proportions for the human body and face that are regarded

charisma and often sexuality which sets them apart from the overwhelming majority.

as signs of beauty and attractiveness. These signs run like a red thread throughout history and different cultures and are related to biological quality and fertility. For the human body this is exemplified with the so-called WHR (waist-hip ratio), which in all cultures is a sign of fertility and is thus

Dr. Foad Nahai

It’s in the eye of the beholder, I know it when I see it, beauty defies definition,

beauty defies quantification!

Beauty is not limited to any age, sex, ethnic or racial group. There is far more to beauty

Regarding facial features considered to be beautiful, the features are often greatly sym-

metrical with average distribution, but also encompass certain characteristic deviations from normal

than the external appearance. Personality, demeanor, grace all add to physical appearance enhancing

distribution. These deviations are related to good biological qualities documented scientifically for

beauty.

the female face and include a delicate lower jaw, larger eyes, fuller lips, and high cheek bones.

Harmony of facial features contributes more to beauty than each feature in isolation. It is

Examples of beauty icons in the middle of the last century as well as the present moment in-

the overall effect that counts! It is a blending of the features, a blending of personality that result in

clude Marilyn Monroe, Claudia Cardinale, Sophia Loren, Rita Hayworth and Ingrid Bergman as well as

beauty!

Angelina Jolie, Cindy Crawford and Swedish actress Izabella Scorupco. These women all have several

Beautiful faces: Nefertiti, Marilyn Monroe, Elizabeth Taylor, Salma Hayek, Beyoncé Knowles,

Professor Juarez M. Avelar

Beauty is a pleasant sensation originating from all anatomical

and physiognomic information combined with the balance and harmony which fulfils all the demands of the observer.

of the above-discussed facial features such as large eyes, full lips and a delicate lower face. Their bodily features also satisfy what is regarded as universally beautiful.

TOP SURGEONS’ DEFINITIONs OF BEAUTY

Ziyi Zhang, Halle Berry, Catherine Zeta-Jones, Sophia Loren.

regarded as attractive.

The Best of Beverly Hills...

THE BEST OF BEVERLY HILLS...

Photograher: Gabriel Hundiashvili Make-up and hair: Maira Ortiz

Dr. Raj Kanodia Dr. Raj Kanodia is the subject of as much buzz as the celebrities he treats. With a nuanced approach praised by patients and peers alike, he has achieved top rank in his area of specialty--the art of finesse rhinoplasty. ‘The nose is the center of the face’ is his professional mantra, and he strives—with his patients’ active participation—to sculpt a nose around which the other features constellate as brightly as stars. Born in India and trained by plastic surgery legend Dr. Morey Parkes, Kanodia’s technique and aesthetic strike a balance between the most ancient precepts of Ayurvedic homeopathy and the most advanced practices of Western medicine.

Dr. Kanodia’s international clientele is distinguished by many who live in the public eye and whose appearance is the object of continual comment and critique. But whether the patient is a high-profile public figure, a demanding professional, or a young woman about to enter college, all receive the same careful consultation and methodical treatment. He realises that the nose occupies such a central place in our self-image that it is often all but impossible for a person to be socially and professionally at ease once they begin to focus on its lack of balance. For many people, a subtle refinement of the nose they were born with--in areas such as bridge projection, tip definition, and nasolabial angle--becomes an avenue to the full flowering of personality. Dr. Kanodia finds attractive features in almost every nose he sees, and seeks to bring these out. ‘There is no perfect nose,’ he insists, dismissing the longstanding Classical ideal. ‘Only the nose that’s right for your face.’ He uses what is known as a “closed approach”, leaving no scarring in the columella. ‘A well executed rhinoplasty is a series of subtle brushstrokes which no one can identify, leaving the patient a more refined version of herself or himself.’ And function, for Dr. Kanodia, is every bit as important as form. It is through the nose that we draw breath, and in Ayurvedic practice, “breath is life.” In addition to rhinoplasty, Dr. Kanodia’s elegantly appointed Camden Drive clinic in the 90210 district of Beverly Hills offers a full range of treatments for rejuvenation and restoration of the face through the use of injectables and laser therapies. As with rhinoplasty, Kanodia’s practice is known for the exquisitely precise and restrained use of these techniques, as his clients generally prefer subtle changes that look like nature’s work—or the work of a natural artist. An avid collector of art and a lifelong student of beauty, Kanodia first gauges his approach to a face by the way it reflects natural light. ‘I look at the face as if through a lens. The contours of a tired, wrinkly face do not reflect light in a harmonious, coherent way. I “adjust the light” until I am able to establish the youthful vectors in the face. The resulting “photograph” becomes my model.’ To augment and complement facial treatments, Dr. Kanodia has co-created the unique Ayurmedic line of skincare products.

Credentials, Publications, and Awards Dr. Raj Kanodia is a member of the American Academy of Facial

Dr Raj Kanodia

Plastic Surgery, the American Academy of Cosmetic Surgery, the American College of Surgeons, and the

Contact

Royal College of Medicine (U.K.). Along with leading cosmetic dermatologist Dr. Kest, he has combined time-

414 N. Camden Dr., Suite 801

tested herbal ingredients with proven anti-ageing compounds to formulate the Ayurmedic line of skincare

Beverly Hills

products. Dr. Kanodia is currently featured on the popular E! Network T.V. Series DR.90210, and has been

California 90210

profiled in numerous leading fashion magazines. He is often invited to lecture at international conferences

Phone: (310)276-3106

and symposia.

rkanodia@drkanodia.com

Specialties Finesse closed rhinoplasty, facial rejuvenation.

<< You can restore a Rembrandt if it’s damaged, but you have to do it very artistically so that it still remains a Rembrandt >>

dr. raj kanodia

Email:

Dr. Kanodia On Rhinoplasty: Dr. Raj Kanodia utilises a “closed” technique in which all incisions are made inside the nose. This is extremely important because, unlike with an “open” approach, there is no risk of visible scarring. Dr. Kanodia points out that in approximately 30% of the surgeries he performs, there is no need to break bones. In addition to refining the nose’s outward appearance, a side benefit of this procedure is improved nasal airways. Patients will not only be able to breathe better through their nose, but they can look forward to increased endurance and better sleep as well as a heightened sense of both smell and taste. Unobstructed and free airflow through the nose is a life-changing experience. He also performs functional nasal procedures that are designed specifically to correct breathing difficulties. This type of surgery does not alter the shape, or necessitate the breaking of the bones- there is no bruising or need for bandages and patients can return to their normal activities within three to five days. Dr. Kanodia works closely with patients considering rhinoplasty, ensuring that refinements not only look natural, but that they match the individual’s other facial features and personality. He notes rhinoplasty is a relatively painless, approximately one hour procedure, that’s performed on an outpatient basis in his statelicensed and certified facility. Patients generally are able to resume most of their regular routine within five to seven days. Many surgeons may employ a “perfect nose strategy” and focus effort on the creation of an ideal nose for each patient, regardless of its fit to the overall physiognomy. But the perfect nose concept is flawed by the assumption that all parts of the nose which do not meet the criteria of perfection need to be changed. This is an assumption that derives from the surgeon’s perspective, not the patient’s, and its aesthetic consequences can be very disappointing. Most open-approach rhinoplasty performed, for some strange reason has a very strong reconstructive component. Many cartilage grafts are used which interfere with the mobility, smile and expressions of the nose. With his closed approach, he is able to sculpt the tip cartilage, refine the

Facial Rejuvenation

bridge and finesse the nose without altering the fundamental character and personality of the nose. Most

and one which has earned him as much respect as rhinoplasty. With his practice based in the heart of the

patients seeking rhinoplasty are not looking for a “new nose”. They understand intuitively that a new nose

entertainment industry, he is entrusted on a daily basis with the care of some of the world’s most beautiful

would mean a “new person” and they’ve spent many years getting to like the person behind their existing

(and valuable) faces. He is a firm believer that the ageing process can not only be halted, but to a significant

features. Empathy is key. The plastic surgeon’s most indispensable skill isn’t learned in medical school. It is the

extent reversed with proper understanding and treatment. To see evidence of this one need look no further

ability to “look through the patient’s eyes” and see her as she sees herself.

than the stage and the silver screen.

Even when the perfect nose approach works to achieve a pleasing alteration of one aspect of the

Non-surgical facial rejuvenation is another component of Dr. Kanodia’s practice,

Dr. Kanodia has been described by patients and peers as an artist, and like an artist, he has his

nose (the tip, bridge or length, etc.), it often comes at the expense of unintended changes in the others.

favorite paints. His essential palette for facial rejuvenation includes fillers (specifically Juvederm, his pre-

As with any beautifully designed instrument, the elements (cartilage, bone, skin) of the nose are meant to

ferred hyaluronic acid), neuromodulators (Botox), lasers (Matrix-RF), and of course, consistent use of great

work in concert, and the nose, in turn, should smile in symphony with the face. Form, function and fit must

skincare products (his own Ayurmedic and others).

all be given equal weight and a successful rhinoplasty will enhance all of the facial features. Above all else, the aesthetic goal of rhinoplasty is to achieve refinement without sacrificing

Restoring the youthful contours (vectors) is the central element of rejuvenating the face. Identifying the precise areas of concavity and flatness--which differ for each person--is the essential first step in

individual character. The effect should be to make the patient look “more like herself”. The best plastic

selecting targets for volumisation. With the ageing process, metabolism changes and there is a loss of baby

surgeons realize that their practice must go beyond skin to psyche.

fat in the cheeks. It’s more apparent in people who are very cardio-active (ironically, people who keep their bodies healthy are often the first to notice ageing effects in the face). As the process of ageing is ongoing, so should be the efforts to reverse it. To a trained eye like Dr. Kanodia’s, the timeless beauty of youth is visible even in the face of age. All the features remain—they must simply be “uncovered,” as the beauty of a painting is restored by delicately clearing away the patina of age. Therein lies the art and design of restoring the face. Of particular value in this process of restoration is the increasingly refined use of laser technology. The Matrix-RF is a beautifully designed new laser machine with dual functions. It ablates as well as plumps the skin and reduces wrinkles by stimulating the fibroblasts to produce more new collagen. Hollywood directors frequently complain that the overuse by actors of neuromodulators like Botox paralyzes facial muscles and dulls their most valuable tool: expression. As a practitioner in the backyard of the movie business, Dr. Kanodia has developed a way to utilize Botox which may one day be recognized as an essential part of an actress’s preparation for a role. His technique complements the character she portrays, diminishing wrinkles yet allowing her the full range of expression needed for the role. ‘Since we are all actors in the movies of our own lives,’ Kanodia says, ‘Should we not all have the same range?’ Skin, being the largest organ of the body, has to be healthy, with a youthful glow. Ayurmedic’s approach to skincare unites the most advanced dermatological research to date with time-honored holistic principles. Respecting and integrating both philosophies creates a synergy that provides optimal results. Ayurmedic’s advanced formulas are suitable for Rosacea, Acne, Hyperpigmentation, and Polysensitive skin. ing, vibrant skin tone, texture and appearance.

<< Lip enhancement should be natural not only in appearance but in it’s movement and texture >> 34

dr. raj kanodia

Effective cleansers, toners, serums, masks, exfoliants and creams work together to achieve a healthy, glow-

Doctor 90210/Conclusion Beverly Hills, California is arguably the most competitive market for The Consultation Process Because plastic surgery and facial aesthetic work are almost always elective,

cosmetic surgery in the world. Entertainment industry professionals are highly demanding and have

Dr. Kanodia believes very strongly in the consultation process. Hearing his patients out and identifying

many options for treatment. Moreover, when one’s career is inextricably tied to the capacity for

their expectations is key to a successful outcome. There may be ambivalence on the patient’s part, and

facial expression and the conveyance of beauty, the selection of a practitioner is a serious matter.

always the underlying question, “Will it change who I am?” The answer is given definitively by Dr. Kanodia’s

The fact that Dr. Kanodia’s practice has flourished in this environment is a testament to both his skill

aesthetic, which emphasizes refinement, restoration and enhancement to enable patients to feel more truly

and his bedside manner. Although he maintains strict confidentiality in doctor-patient relationships,

themselves. The goal is not transformation, but refinement.

a number of his clients have enthusiastically “gone public” in praise of his technique, among them

During the consultations photos of the patient are reviewed, as are pictures of previous patients

actresses Cameron Diaz and Jennifer Aniston and singer Ashlee Simpson. The subtlety and artistry

with similar features. Dr. Kanodia talks at length with patients about their motivation, observing, absorbing

of Dr. Kanodia’s approach is in part a response to his clients’ special needs, for no public figure wishes

and analyzing before recommending work. His goal is that they be able to “picture” the results before any

to see “before and after” pictures on the cover of People Magazine. ‘The results,’ says Kanodia,

procedure is performed. ‘When patients are informed, realistic and self-motivated,’ says Dr. Kanodia, ‘the

‘should be so completely natural that it is impossible to discern that the patient has had surgery.’

impact of aesthetic surgery on many areas of life can be extraordinary.’

From all evidence, Dr. Kanodia has delivered on this promise.

About the Man Himself: Dr. Kanodia is an avid gardener. Like all true gardeners, his horticulture is less a hobby than a passion. His garden is an enormous sense of inspiration where there is an extreme sense of balance between nature and beauty. This allows for an ongoing nurturing of his artistic creativity at work. Working with the soil connects him and keeps him in tune with nature. His home, nestled in the hills of BelAir, has a garden filled with rare, fragrant, and colorful flowers from all over the world. He has crossbred one of the most indigenous Indian flowers, the aromatic “Champaca”, with oriental magnolia. Skiing is another one of Dr. Kanodia’s passions. For a man to whom “breath is life,” the periodic trips into the rarefied and bracing mountain air of Aspen, Utah, and St. Moritz are nothing short of life-affirming. Moreover, because his work as a plastic surgeon is “up close and personal,” demanding exquisite precision and empathy with patients, being close to nature in the mountains allows him to refresh his perspective and sharpen his creativity. He believes that the full enjoyment and appreciation of life should be the goal of all humans. While some people may “leave their work at the office,” Dr. Kanodia’s work is his art as well as his science, and an artist never really leaves his brushes—nor his eye--at home.

DR. raj kanodia

Dr. Garth Fisher

Dr. Fisher has been selected as “one of the top plastic surgeons in the United States for facial cosmetic and breast surgery” in Best Doctors in America, an authoritative listing of the nation’s most prominent physicians in each medical specialty. He has also been listed annually in the

Dr. Garth Fisher is a world-renowned Plastic Surgeon with

Castle Connolly directory of America’s Foremost Surgeons, an honor bestowed on less than 1% of the country’s physicians.

over 20 years experience, who is board-certified by the Ameri-

Los Angeles Magazine named him as “one of the best plastic surgeons in Los Angeles”; a process determined by his peers.

can Board of Plastic Surgery. His office is located in Beverly

Town & Country magazine also listed Dr. Fisher as one of the best doctors for facelift procedures in the United States,

Hills, California, USA. Dr. Fisher is the plastic surgeon who

and Dr. Fisher additionally appears in Marquis’ Who’s Who in Medicine and Healthcare. He utilizes the most current advances in

started the “Extreme Makeover” phenomenon and was the

technology and innovative medicine, including newer ablative and non-ablative laser applications and scar reduction techniques.

first doctor selected for the ABC hit series. This interna-

His vast experience in performing plastic surgery and creating beauty led Dr. Fisher to appreciate the value of developing and sustaining well

tional television experience coupled with his unprecedented

nourished skin. Dr. Fisher then professionally committed himself to the development of a superior line of skincare products based upon the rigors

vision to utilize the media as a vehicle to bring plastic

of scientific testing and integrity. In order to accomplish these goals he searched for the most capable individual in the skincare industry to assist

surgery information into the public domain has accelerated

him. With Paul Scott Premo, a 35 year veteran and respected leader in the industry, he founded CellCeuticals® Skin Care, Inc.,in 2006 as an international

and expanded patient access on a world wide scale. Medical

skincare company. This company, with innovative proprietary core technology was conceived with a responsibility to develop effective and safe skin treatment

organizations and societies have recognized his contribution

Artistic

reality, Fisher and Premo assembled a team of the country’s leading scientists

IN expanding knowledge and thus enhancing patient care. Dr.

and researchers in the fields of tissue engineering, regenerative medicine and

Superlative Skill

Fisher specializes in aesthetic/cosmetic plastic surgery of

evolution in the world of skin products.

Unparalleled

the face, nose, breast and body. His practice includes enter-

Garth Fisher, M.D., F.A.C.S. created The Biomedical Skin Treatment Institute®

Compassionate

tainers, celebrities, business executives and physicians from

Honored

around the world. His surgical skills and clinical judgement

Prominent

are sought after by a large international clientele.

Innovative Committed Dr Garth Fisher

products based upon scientifically controlled studies. To bring this vision to

therapeutic peptides to create CellCeuticals® Biomedical Skin Treatments, an

in 2008, to offer a variety of comprehensive and complex medical treatments designed to optimize the health and restoration of your skin. The Institute is committed to a complete renewal and makeover enhancing the scope of the cosmetic surgery experience. Utilizing customized complexion analysis in conjunction with targeted laser and injectable skin care treatments, in combination with nutritional analysis and a new generation of growth factor lipopeptide infused skin care products from CellCeuticals® Biomedical Skin Treatments, an exciting and vital world of skin rejuvenation and skin enhancement is now available from the Institute.

Dedicated

Contact 120 South Spalding Drive1 Suite 222 Beverley Hills California 90210 Phone: T 310.273.5995 Fax 310.273.9079 www.garthfisher.com

Dr Garth Fisher Contact 120 South Spalding Drive Suite 222 Beverly Hills Phone; 310.273.5995 Fax:

310.273.9079

Website: www.garthfisher.com

DR. garth fisher

California 90210

insight INTERVIEW WITH DR. GARTH FISHER

The CellCeuticals® Growth Factor Peptide (GFP) Cellular Complex is a groundbreaking technology combining next generation growth factor lipopeptides, retinol, and antioxidants in a proprietary nanoemulsion delivery system that targets cellular skin ageing. The GFP Cellular Complex was designed to facilitate a “proliferation response” and eliminate the “inflammatory response” common with other anti-ageing ingredients and procedures. Studies demonstrate that GFP Cellular Complex triggers cellular stimulation to encourage

Q There is a recognized medical compulsion to keep tweaking one’s appearance. Michael Jackson

the regeneration of vital proteins responsible for firmer, thicker, and youthful-looking skin without

was arguably the world’s best known example of this. Do you ever turn patients away if you feel

irritating side effects. Furthermore, the award winning CellCeuticals® Skin Treatment System has been carefully

their expectations are unrealistic or further plastic surgery would not enhance their appearance?

A The intense desire to continually refine one’s appearance can lead to unrealistic expectations and

formulated and undergone rigorous clinical testing to substantiate both product performance and

unnecessary surgery. Because of my reputation amongst the celebrity and international community,

safety.

I probably see more patients seeking corrective secondary or tertiary procedures than most surgeons. Not all these individuals have poor results, yet the world of plastic and cosmetic surgery

Q If there is an artistic element in rejuvenating or enhancing a face, how important is the

has expanded along with the accelerated pace of twenty-four hour media coverage, the internet and

surgeon’s own perception of beauty?

the other instant informational systems. I decline to perform surgery on approximately 40% of the

consultations I see. The reasons vary, however my goals are clear. I remain confident that the advice

balance between proper surgical skill, judgement and artistic creativity is often a fine line. Facial

I provide avoids the potential for future complications and faulty expectations. My detailed self-

surgical results are readily apparent and reveal much about the practitioner’s surgical skill and

selection process allows me to maintain consumer satisfaction and patient safety at an extremely

perception of beauty. Like a fine canvas by Bruegel or Michaelangelo’s David, the appreciation of form

high level. Though many patients are disappointed that the process excluded them, I firmly believe

and balance relies heavily upon artistic creativity which is inherently married to an appreciation of

that using such a surgical preference process, based upon scientific and aesthetic criteria, saves

beauty.

much heartache.

<< ... people are always surprised to hear that I turn away 40% of those who walk into my office because either they are not a candidate for procedures, have unrealistic expectations, or simply their skin is not in an optimal condition for procedures. >>

Q You treat many famous people. Is there such a thing as a celebrity plastic surgeon? Are you one? Please, tell us a little about Garth Fisher, the man and his interests.

A I have an incredibly urbane, refined and cultured celebrity international practice, perhaps the most extensive and far reaching in the world. Although the opportunity exists to become self absorbed

Not all surgeons are created equal. Neither are high skilled artisans. The combination and

Q Can you please name some of the most beautiful faces of all time – in your own opinion – existing or dead?

A My wife (photo enclosed), Halle Berry, Audrey Hepburn, Megan Fox, Raquel Welch, and Catherine Deneuve

an evolved balance between my family and my time with patients. My children provide me with a

Q Without your help would some of the most recognized faces in the world still be recognizable? A I have encouraged some of the most recognizable faces in the world to NOT have surgery and to

sense of unparalleled value. Fortunately that asset has translated into quality hours in the operatory.

maintain the facial identity and characteristics that the world has learned to appreciate.

in this “celebrity culture”, it is not a path I have chosen to explore. My satisfaction is derived from

Within that balance I find my own sustenance and joy and thus am able to provide unblemished devotion to both worlds.

Q Men and women today are confronted with a vast array of choices in terms of skin care. Some

Q Few plastic surgeons take such a holistic approach. Do you see your role as a beauty guru (for want of a better word), rather than just a surgeon?

My goals are clear. I serve my patients. I have been fortunate to have achieved an appreciation

skin ranges, such as Obagi, for example, rely on a very specific concept of skin care regimen.

for beauty, structure and form which I have developed into an artistic surgical model. This paradigm

Others, such as the Perricone range, have established themselves as a “lifestyle” choice and

has allowed me to sculpt and create physical splendor. This sense of exquisite magnificence only

expand into Dr Perricone’s “philosophy” of daily living. Skincare products are a vast industry.

receives recognition because agreement exists among those who perceive such beauty. I am

Please, articulate how CellCeuticals is different and what is different about it in concrete terms.

constantly aware that this gift must be used with caution and thus an accolade such as guru or sage

Today’s consumer is well educated and keen to find out what actually goes into a skin product and

or guide to the gorgeous people of the world is clearly a misnomer and a superfluous label.

how it works.

Not every individual is a candidate for plastic surgery, and people are always surprised to hear

Q The vast majority of people wish to enhance their appearance. Some are deterred by fear of

that I turn away 40% of those who walk into my office because either they are not a candidate for

surgery, others by financial imperatives. The rewards of plastic surgery often tip the scale, yet we

procedures, have unrealistic expectations, or simply their skin is not in an optimal condition for

are often shown images of people who are both successful and affluent and whose surgery has gone

procedures. Now, with the introduction of CellCeuticals® Biomedical Skin Treatments, I am able to

terribly wrong. Why is it that people who have great resources often end up looking worse than the

offer a clinically effective skin treatment system for those who are not ready for plastic surgery.

average patient?

CellCeuticals® Biomedical Skin Treatments System is the culmination of more than 15 years

Garth Fisher’s choice of the most beautiful faces of all time – My wife, Adriana and Halle Berry

Unsuccessful outcomes occur because consumers are not properly informed and educated.

of protein and DNA research. CellCeuticals’ patent-pending, bioengineered growth factor lipopeptides

Often they have unrealistic expectations, have chosen the wrong surgeon, or have embarked on a

are developed and tested using state-of-the-art DNA Microarrays and represent the next generation

process of change or physical alteration for the wrong reasons. Usually a deficit has occurred in the

of peptides. Many first-generation peptides used in other products increase expression of genes that

communication between the patient and the provider. That is truly an unfortunate consequence of the

code for elastin and collagen proteins; however, they are contra-indicative because they also increase

hurried desire for the “change me now” phenomenon. Plastic surgery can be a life-altering event, but

the expression of genes that code for Matrix Metalloproteinases (MMPs), enzymes that break down

the entire matrix of the individual is involved, and an astute and wise surgeon has come to appreciate

the protein matrix of the skin.

that balance.

The CellCeuticals® exclusive and patent-pending growth factor lipopeptides are targeted to increase expression of certain genes (elastin, collagen) and to decrease others such as MMPs and

DR. garth fisher

interleukins.

the creation of facial BEAUTY

Facial Beautification Procedures

DR. garth fisher

<< The artistic creation of a natural and beautiful face is one of my most satisfying and gratifying realizations.This wonderful patient came to me looking a bit weary, as you can see from the enclosed photographs. She said she actually felt much more energetic and full of life than she looked! >>

the creation of facial BEAUTY

Double Lid Upper Contouring

Facial Beautification Procedures

Facial Revitalization Proceedure

DR. garth fisher

<< During 20 years of surgical experience, I have taken care of some of the most recognized faces in the world and I take pride in providing the highest quality of care with excellent result. >>

Brow, upper and lower lid modification and contouring

Brow modification, upper and lower eyelid contouring

Face and neck contouring

<< My second step is the cosmetic surgical planning. Similar to an architect who first“conceptualizes”a structure, I prepare a detailed and customized plan based on the unique needs, tissue quality, and anatomical features of the patient. I evaluate the many curves, angles and contours of facial features which include size, relationships and proportions. Only after this detailed planning do I use my creative design and my eyes and hands to sculpt a more youthful, beautiful, and very natural face. >>.

DR. garth fisher

<< Before planning a surgical procedure, I initially review a patient’s aesthetic“facial frame”. The facial frame is comprised of many subtle, but also very important aspects of beauty such as skin quality, hair color and style, as well as eyebrow color and density. I utilize a comprehensive facial analysis to map out effective treatment plans which may include appropriate skincare products, injectables and laser treatments. During this initial consultation, the patient is given the opportunity to get to know my staff and me.They can also use this consultation to learn about effective and reliable ways to optimize their diet and exercise regimens to promote a healthier lifestyle. >>

Face, chin and neck contouring

Nose reshaping and cheek contouring

Complex revision of nose and septum

Nose reshaping

the creation of facial BEAUTY

DR. garth fisher

<< My first priority has always been patient safety.Together with my anesthesiologist and operating room staff, I have created a consistently safe, pain free and comfortable environment for our patients before, during and after surgery. >>

Breast augmentation

Complex revision of breast augmentation and lift Dr. Fisher is committed to educating consumers about all the procedures, risks and rewards of plastic surgery. He has created and produced the award-winning and highly publicized 5-part series of informational DVDs on plastic surgery entitled, “The Naked Truth About Plastic Surgery®”. This is one of the most comprehensive sources of information about plastic surgery available to the public. For more information, visit: www.nakedtruth.com. He also created and produced “The Informed Patient Series” which is a DVD series used by other plastic surgeons to inform their patients about the risks and rewards of plastic surgery. Additionally, Dr. Fisher lectures internationally and currently assists other plastic surgeons from around the world in further refining their surgical techniques and sharing innovative and modern concepts. Fellow plastic surgeons from almost every country in the world have travelled to his operatory to learn from him and observe his skill and his techniques. Dr. Fisher completed his internship, general surgery residency and plastic surgery residency at the University of California at Irvine. He completed further aesthetic and cosmetic fellowships as well as extensive training internationally to enhance his skills. In 2006, Dr. Fisher was featured in Vanity Fair’s “Tom Ford’s Hollywood” Special Edition issue and deemed “the enhancer” for his notoriety as the top breast surgeon in Hollywood. He has been consulted extensively for many television, news and magazine interviews. A partial list includes: ABC’s “Extreme Makeover”, ABC’s “Good Morning America”, ABC’s “Oprah”, NBC’s “Today” show, CNN’s “Larry King Live”, “CBS Evening News”, “NBC Evening News”, CNN, “Entertainment Tonight”, “Access Hollywood”, “Extra”, E!, Discovery Channel, Elle, Allure, GQ, Forbes, Playboy, FHM, People, Time, Details, In Touch Weekly, Los Angeles Magazine, Town & Country, TV Guide, Wall Street Journal, US Weekly, Parade, Los Angeles Times and USA Today. In 2006 internationally recognized talk show host Larry King personally selected 120 “celebrated and successful friends” to contribute their favorite memories and recollections about their fathers for his book, “Larry King: My Dad and Me, a Heartwarming Collection of Stories About Fathers from a Host of Larry’s Famous Friends”. Dr. Fisher was personally asked

Complex revision of breast augmentation and lift

Complex breast revision

by Larry King to contribute to this inspirational collection of stories.

<< My staff and I are here to assist you with any questions you may have. You may also visit my website at www. garthfisher.com for additional information and to view examples of my work. For any inquiries, please call the office at 310.273.5995 or email at info@garthfisher.com. >>

DR. garth fisher

Dr. Arthur Glosman DDS Aesthetic & Reconstructive Dentistry Arthur Glosman DDS offers the highest quality in cosmetic and

restorative dentistry in a professional and state-of-the-art

office in the heart of Beverly Hills, California. The beautiful facility is a haven for everyone from celebrities needing smile makeovers and full mouth reconstruction, to high profile clientele looking to enhance their image and overall look. Dr. Glosman has his own master ceramist with over 15 years of

before

experience, trained in Switzerland and Japan. A true artist, Dr. Glosman evaluates the facial aesthetics of each patient, reviewing hair, skin and eye color first. Understanding the shape of the face, lips and nose, and determining the proper proportion of the teeth are all considered before developing a final smile design. Looking at the person and their personality is what helps create the perfect smile for each patient. Dr. Glosman offers complete concierge service to Beverly Hills, California from anywhere in the world and can make attaining your new smile the ultimate experience. You can reach Dr. Glosman at 310-382-1059 or through his website at www. arthurglosmandds.com.

Contact Cosmetic & Restorative Dentistry 414 N. Camden Ave Suite 940 Beverly Hills, CAÂ 90210 Phone: 3 10-382-1059 Website: www.arthurglosmandds.com.

Dr. ARTHUR GLOSMAN DDS

Dr. Arthur Glosman DDS

AFTER

Dr. Kevin B. Sands cosmetic dentistry

A graduate of USC’s prestigious school of dentistry, Dr. Sands uses his artistic sensibilities combined with the latest cosmetic techniques and materials to enhance the smiles of both celebrities and his less famous patients. He has lent his expertise to television makeover programs having been featured on TLC’s “Ten Years Younger”, “2nd Look” on the style network and “Dr. 90210” on E!, and is rapidly becoming

Dr. Kevin Sands studied at the Univerisity of Southern California School of Dentistry and the Las Vegas Institute for Advanced Dental studies.

known as the Beverly Hills’ leading cosmetic dentist for people who want to look younger and feel better about their teeth.

He specialises in cosmetic dental surgery, offering the highest quality dental care to each and every patient.

During your complimentary consultation, Dr. Sands will carefully evaluate your smile and answer all of your questions – because even the most subtle difference in tooth size, shape, texture and color are factors in your overall appearance. Dr Sands

Dr. Kevin B. Sands

considers every detail before presenting you with a solution that best suits your individual needs.

Contact

With an on-site lab and a dedicated ceramist, Dr. Sands’

414 N. Camden Drive

porcelain veneers are individually hand-crafted and carefully

Suite 940

perfected. Dr. Sands considers the patient’s gender, life-style and

Beverly Hills, CA 90210

ethnicity to create a smile as unique as the patient themselves.

Phone: 1 310 273 0111 Website: www.90210dentist.net

His artistry and attention to detail allow him to return structural integrity even to the most chipped, weakened and discolored teeth, while leaving them looking even more incredible than the originals. As his patient, you can expect natural tooth-colored restorations, smooth, white porcelain veneered crowns and more beautiful end results that will last for many years to come. It is always a big decision to change one’s appearance, yet with that decision come major rewards such as improved selfesteem and confidence. While breast augmentation and liposuction are common enhancements, they are not always what makes a very first impression. What people notice first is your smile. The entire team of Dr. Sands’ office is dedicated to providing patients with the highest quality dental care in a very comfortable environment. Top procedures and treatments include: Porcelain veneers Dental implants Dental bonding Digital imaging Tooth whitening Sedation dentistry Invisalign A few thoughtful details, such as wide variety of music and movie selections, heated neck pillows and in-office massage therapy add a nice touch and make patients comfortable and relaxed.

A beautiful style can change your whole image. It is Dr. Kevin B. Sands’ mission to guide your personal transformation by creating a smile that reflects who you truly are. Dr. Kevin b. Sands

Dr. K. Alexander Dastgheib Dr. K. Alexander Dastgheib is board-certified by the American Board of

Q There are so many grateful individuals in the U.S. and across the world who benefit from your groundbreaking discovery in “wet” macular degeneration. How can they and others who wish

Ophthalmology and a fellowship-trained eye surgeon with over 15 years

to contribute to furthering research, do so?

A I am thrilled about the treatment and its wonderful results,

and hope that is now available for such patients (my own father

experience. Dr. Dastgheib’s journey to the top of his field is quite remarkable.

being one). There are many fine and worthy institutions and foundations. My personal preference is Duke University Eye

After graduating from high school in London, he spent 18 years

Center where I did an important part of my training some 15

in pursuit of excellence in medicine and in surgical and research

years ago. At Duke Eye Center, cutting edge clinical and basic

ophthalmology. He gained access to the University of Paris

science research is ongoing to help save vision. I would encourage

Medical School after finishing in the top one percent of students

donors to give as generously as they are able to the K. Alexander

in the fiercely competitive entrance examination (Concours de

Dastgheib, M.D. Fund at Duke University Eye Center.

Medecine, in which only the top 15% were allowed access) while French was his third language. He earned his medical degree

Mary J. Walter, Director of Development at Duke Eye Center can

with Honors from the University of Paris. Dr. Dastgheib then

be reached at (919) 684-0404 or by email at mary.walter@duke.

pursued post-doctoral fellowship training at Dubroff Eye Center

edu

in Maryland, USA followed by a fellowship at the world-famous Wilmer Eye Institute at Johns Hopkins. He then received a

Q What do you think contributes to your outstanding LASIK

prestigious two-year National Institutes of Health Intramural

results? More than 99% of your patients are 20/20 or better

Research Training Award at the National Eye Institute. Dr.

without any re-treatment.

Dastgheib completed his residency in ophthalmology at the

A The key is to match patients to treatment carefully. I find

renowned Duke University Eye Center and completed another

meticulous patient selection for the right technology and

fellowship at John Moran Eye Center at the University of Utah,

surgical technique yields the results you would want for your own

where he sub-specialized in refractive and corneal surgery.

family member. Of course, in eye surgery it does not hurt to be

In 1993, Dr. Dastgheib theorized that a molecule named vascular endothelial growth factor (VEGF) may play a major degeneration (Archives of Ophthalmology 1994;112:813-818). This

Q How has cataract surgery changed in recent years? A New phacoemulsification (ultrasonic cataract removal)

disease, with no effective treatment and inevitable in its rapid

platforms have made great strides in helping make the procedure

progression, was the leading cause of blindness in the western

safer and more efficient than ever before. In addition, patients

world, responsible for loss of vision in approximately a quarter of

can now benefit from a variety of intra-ocular lens implants, some

a million people a year in the United States and conservatively a

allowing patients great freedom from glasses for distance AND near

million people a year worldwide.

vision after cataract removal.

causative role in neovascular or “wet” age-related macular

In 1994, Dr. Dastgheib proved his theory and published his 1995;36(4):S102). This discovery, arguably the most significant

Q What is your approach to your work today? A I feel very blessed in that I wake up every morning looking

in ophthalmology in the past 50 years, has revolutionized the

forward to go to work. After all, restoring sight by performing

field. Today, treatment of “wet” macular degeneration with an

LASIK on a patient with poor vision, or cataract surgery in a

anti-VEGF product halts the disease in 95% of cases and 40% of

visually impaired patient, or knowing that thousands of patients’

patients regain vision of 20/40 or better (driving vision).

vision is being saved worldwide daily by an anti-VEGF treatment

results (Investigative Ophthalmology and Visual Sciences

For the past 12 years, Dr. Dastgheib has focused his attention to the anterior segment (front) of the eye. As a corneal

Contact Newport Beach, CA at 888-eye MD01 Phone: (888-393 6301) Email:

kadastgheib@gmail.com

specialist, Dr. Dastgheib has performed thousands of refractive

Q Where do you see ophthalmology going in the next ten

procedures including cataract surgery, corneal transplantation

years?

and over 15,000 LASIK procedures with outstanding results. He

A The eye is the only organ in the body where blood vessels can

is fluent in French and Farsi and conversational in German. Dr.

be directly visualized when looking through the pupil to the back

Dastgheib is a Fellow of the American Academy of Ophthalmology.

of the eye. The eye is an amazing organ that I believe lends itself

In 2000, Duke University Eye Center established

to further groundbreaking research such as gene therapy for an

the K. Alexander Dastgheib, M.D. Eye Surgery Award. This

array of diseases. I also believe there will be a good procedure to

award annually recognizes a Duke-trained ophthalmologist

correct presbyopia (those who need reading glasses usually at

who demonstrates excellence in eye surgery and in surgical

about age 45).

judgement.

is akin to the miracles described in ancient scripture.

<< The eye is the only organ in the body where blood vessels can be directly visualized when looking through the pupil to the back of the eye. The eye is an amazing organ that I believe lends itself to further groundbreaking research such as gene therapy for an array of diseases. >>

Dr. K. Alexander DASTGHEIB

Dr. K. Alexander Dastgheib

compulsively detail-oriented.

anastasia Anastasia grew up in the Romanian Black Sea port of Constanta, a town famous for being the final resting place of the great Roman exiled poet Ovid. Once the region’s most important port, Constanta is a mix-bag of cultural currents, from the traditional Romanian to the Greek, Roman, and Byzantine styles. Anastasia was exposed to all these influences from an early age, working as an apprentice in her parents’ tailor shop. It was there

Anastasia Soare is widely referred to as “The Definitive Eyebrow Expert”, and that is for good reason. Over the years she has achieved iconic status in

that she first developed a sense of style and became acquainted with proportions and how they apply to the human body. Once in college, Anastasia broadened her field of

the beauty industry for her unique and revolutionary way of

interest with studies in architecture, engineering,

shaping the eyebrows. Anastasia’s Beverly Hills salon has built

drawing, and mathematics. She learned of the

on a steady flow of celebrity clientele which include the likes of Oprah, Madonna, Jennifer Lopez, Naomi Campbell, Jada Pinkett Smith, Lara Flynn Boyle, Melissa Etheridge, Penelope Cruz, Sharon Stone, and others. Anastasia has been featured in the pages of top publications such as Vogue, W, Town & Country, Elle, InStyle, Allure, Entertainment Weekly, Newsweek, People, Flaunt, and Los Angeles Magazine

Fibonacci sequence, as well as Leonardo Da Vinci’s drawings and studies of the Golden Ratio, as it applies to nature and the human body. She then decided to apply her knowledge and sense of style to a career in the beauty industry, so she became a licensed esthetician. Soon after, Anastasia left Romania and moved with her family to California, where she spent a few years working as an esthetician at various beauty salons in Beverly Hills. It was during this time that Anastasia developed her original ideas and technique of shaping eyebrows based on universal standards of beauty. It didn’t take long for Anastasia to open her own salon in order to accommodate her rapidly growing clientele. Placed in the heart of Beverly Hills, Anastasia’s salon is an obligatory stop for everyone looking for an eyebrow shape that perfectly complements one’s facial features. The Anastasia Beverly Hills cosmetics line encompasses a full array of products, including an extensive palette for the eyes, a full range of lip liners, lipsticks, foundation, powder, and brow products. This exclusive collection brings to women the same sense of style and elegance that has made Anastasia the definitive eyebrow expert and a leading brand in the beauty industry today.

438 North Bedford Drive Beverly Hills, CA 90210. Phone: 310 273 3155

raj kanodia

photographer: Gabriel Hundiashvili make up and hair: Maira Ortiz

Professor Laurence Kirwan

3000 Board Certified Plastic Surgeons as active members. It is the largest organization of its kind and Dr. Kirwan has been a member for over 10 years and during that time has given several instructional courses. He is slated to give a new one on some of his innovative breast techniques at the next Annual Meeting of ASAPS in Washington D.C. in April 2010. Although Professor Kirwan is well known for his breast work, his practice today is sixty percent facial surgery including rhinoplasty and of course facial rejuvenation such as

PROFESSOR Kirwan enjoys a reputation as one of the world’s leading plastic

cheek and chin implants, browlifts, facelifts and eyelifts. Many surgeons today promote “minimally invasive surgery”. The term “minimally invasive” is

surgeons, and was named as such in the January 2006 issue of Russian Vogue. He was

sometimes synonymous with “minimally effective” as well as “minimal duration”. Endoscopic browlift is an exception to this, being a highly effective minimally invasive procedure. The same surgeons often promote

also named one of Tatler magazine’s “Top Surgeons” in their February 2004 and May 2007 Cosmetic Surgery Guide.

the idea of a subtle change, but for “a difference to be a difference, it must make a difference” and of course some patients need a dramatic change to correct the effects of moderate to severe facial ageing. Surgery should produce a noticeable result that will last longer than the period of post-operative swelling and hopefully for ten years or longer. Some surgeries such as a rhinoplasty or pinning back the ears, will last a lifetime. Breast implants may last thirty years and counting. Facelifts generally last ten years but even then, the patient will look ten years younger than their stated age. Eyelifts are more durable

Professor Kirwan is widely published in medical journals and is a sought-after speaker around the world.

and can be a once in a lifetime surgery. Cosmetic surgery can therefore be one of the most assured and

He has donated his surgical skills to help several charities working with people who are victims of war and

long-term investments for an individual to make and in these days of economic uncertainty, this is even

natural disaster. He is also author of the internationally acclaimed book “The Cutting Edge”, a revealing

more defined.

look at plastic surgery and the media’s perceptions of aesthetics.

Professor Kirwan on Beauty The most beautiful woman in the world today is 6 foot tall, has legs at Specialty Laurence Kirwan, MD, FRCS, is a Board Certified Plastic Surgeon, specialising in cosmetic plastic

least half that length, no hips, wears a 34C bra and has breasts like half grapefruits. Her eyes are large and

surgery of the face and nose, breast and body. His facelift procedures tailor the procedure to the individual

often blue and she is a sandy blonde. Her hair goes down just below her shoulders and outlines her promi-

with special attention to the ageing neck and the use of chin and cheek implants to rejuvenate the deeper

nent cheekbones. Her nasal tip has a slight upward slant and her bridge is straight and slightly lower than

structures. He has the same individualised approach to his “nose-jobs” or rhinoplasties.

the tip. The nostrils are in line with the inner angles of the eyes and sit over voluptuous lips and a strong

He prefers the closed technique. He also enjoys correcting previous facial cosmetic procedures.

chin. Her skin colour is Mediterranean. Examples: Giselle, Halle Berry, Ana Beatriz Barros, Rebecca Romijn,

He recently published a new technique on Breast Auto-augmentation in the Canadian Journal of Plastic

Elle MacPherson ... there are so many that it seems unfair to exclude the others.

<< A beautiful girl is like a red 430 Ferrari: sleek and smooth and makes you want to show everybody she belongs to you. Barros is that Ferrari. >>

Surgery. Among a variety of procedures, Professor Kirwan offers hair restoration for men and a new line of skin care.

Professor Kirwan on Robert Goldwyn’s foreword ‘The essential problem is a philosophical one - when a patient goes to a plastic surgeon, he or she will get what that plastic surgeon usually does. There are very few plastic surgeons who would vary the treatment according to what the patient needs. Even if one can understand the technique, the problem is that the patient really will never understand the options and will have to go to the

Laurence Kirwan

plastic surgeon about whom he or she has heard does a good job. There are very, very few plastic surgeons who individualize the treatment according to what the patient needs. More often the plastic surgeon does what he or she thinks he or she does best. >>

Professor Laurence Kirwan Contact In the USA: 800A Fifth Avenue, Suite 202 New York, NY 10065 Phone: 00 (212) 838 8844 Also in the USA at: 605 West Avenue Norwalk, CT USA 06850 Phone: 00 (203) 838-8844 Website: www.drkirwan.com

56 Harley Street London W1G 9QA Phone: +44 (0) 20 7637 4455

you go to a plastic surgeon to fix your face. We all have comfort zones but some of us are more versatile than others and therefore individualise our approach whilst others are completely rigid in their technique and do for example, the same nose for every face. I am definitely in the former category. Every patient has different needs and so a surgeon has to have more than one technique in his armamentarium to deal with each unique situation that the patient presents. A well trained plastic surgeon has completed an arduous training and is used to thinking laterally. If he can’t solve a problem with plan A then he will use plan B and if that fails plan C and so on until he reaches Z. He should not feel out of his depth or flustered unless he has taken on a task to which he is clearly inadequately trained. Unfortunately this is an insufficient deterrent for many surgeons who do not complete a full plastic surgery training.’ Many surgeons and non-surgeons metaphorically enter the arena of cosmetic surgery from the side door rather than the main entrance. The buyer must beware. Once the consumer is in the arena there Professor laurence kirwan

In the UK:

This is a tautological argument. You can’t do what you can’t do. You go to a plumber to fix your drains and

will be many surgeons selling their skills and no clear way to distinguish through which entrance they entered. Many plastic surgeons are asked in what procedures they focus. In the USA and the UK, surgeons usually concentrate either on reconstructive or cosmetic surgery. In the United States, cosmetic plastic surgeons usually belong to the American Society for Aesthetic Plastic Surgery (ASAPS). ASAPS has over

<< He practices the belief that no medical procedure that is not needed be performed. >> Ana Beatriz Barros

Dr. Jan Linhart New York’s pre-eminent dental practitioner, Dr. Jan Linhart, offers

exceptional, cutting-edge dental care, including Cosmetic and

Restorative Dentistry (veneers, implants, bonding, bleaching, and gum re-

contouring), Periodontics, Orthodontics, and Root Canals.

Dr. Linhart’s professional affiliations include the

Specialists in my office are leaders in each of their respective

Academy of Contemporary Dental Education (ACDE),

fields since it takes an inter-disciplinary relationship to create the

the Academy of General Dentistry, the American

ultimate result in a beautiful smile. My Ceramist is a true artist and

Dental Association, the New York County Dental

helps us to create these smiles. And, yes, smiles are created and

Society, and the Academy of General Dentistry.

designed; they are not just a row of teeth. There is texture, nuances,

The Linhart practice, one of the finest in the

and porcelain design. They support the lips and curves of the mouth

surgical lasers, and a range of innovative dental

and can enhance them.

techniques. ‘These days, with so many new treatments and

years. How far have the science and/or “art” of cosmetic

outdated, less convenient approach to dental care’

dentistry changed since you started?

Jan Linhart’s background history reads a bit He was born in Prague, Czechoslovakia. His

In order to enhance smiles, the only thing we could do at that point was to cap/crown the tooth. That was a very radical procedure.

a year in Auschwitz and Bergen Belsen, she was

Today, with Porcelain Veneers and Bonding, it is a very conservative

able to return to Prague, where she met, Ernest, her

procedure, which can be completed in several days from start to

husband of thirty-five years. The family escaped the

finish. So these procedures are not just for actors and models,

Communist regime and fled to America when Jan was

but for everyone to be able to have a beautiful smile. Dentistry is

13 years old. Dr. Linhart attributes his compassionate

constantly evolving. Thirty years ago we did not have implants,

nature to his mother and his strong work ethic to his father, a well-

now we can replace a tooth with an implant and place a temporary

respected dermatologist in both Prague and the United States.

crown on it in one day. This was not conceivable years ago and

in Biochemistry and Russian, Jan Linhart attended New York

today the success rate for implants is in the 95% range.

University’s College of Dentistry, successfully completed the

Q Which one modern-day technique do you now consider so

hospital residency at Mountainside Hospital in Montclair, New

fundamental that you cannot imagine working without it?

Jersey, and in 1981, established a private practice at his current location. When asked how he achieved such a flawless, countrywide and international reputation for outstanding dental care and sympathetic doctor-patient relationships, he said that the answer was obvious: ‘By word of mouth.’

A Porcelain Veneers, Bonding and Implants. Lasers (Biolase/ Waterlase MD), which we use in our office to treat patients without

having to resort to drills for fillings, gum re-contouring and various other purposes.

Q Your father was a medical doctor and your son is studying to become a dentist. What, if any, are the advantages of coming

Jan Linhart, DDS, PC

Q Your practice strives to provide expert dental care in all

230 Park Avenue / 46th Street

areas and you have specialists in each area of dentistry on your

A My father was a physician (Dermatologist). He gave me an

New York, NY 10169

team. What makes a dental practice stand head and shoulders

appreciation of the medical profession, compassion and empathy.

Phone: 1 212 682 5180

above the rest?

These are all of the qualities that are needed to be a doctor and I

mailroom@drlinhart.com

Website: www.drlinhart.com

A In my 30 years as a Restorative and Cosmetic Dentist I have

developed relationships with a team of experts that can support the ultimate desired effect of a healthy and beautiful smile. The

from a family with such a strong background in medicine?

hope to pass these on to my son.

Dr. JAN LINHART

Email:

A When I started practicing Dentistry, there wasn’t any bonding

so we didn’t have the ability to adhere porcelain to tooth structure.

mother, Magda, is a survivor of the Holocaust. After

After graduating from Bowdoin College with majors

Contact

Q You have been at the forefront of your field for over 20

options available, there’s no reason to settle for an

like a film script.

Dr. Jan Linhart DDS PC

reflection of light, translucency and many other intricacies of smile

USA, boasts state-of-the-art equipment, including

<< And, yes, smiles are created and designed; they are not just a row of teeth. There is texture, nuances, reflection of light, translucency and many other intricacies of smile and porcelain design. They support the lips and curves of the mouth and can enhance them. >> Q You have developed your own teeth whitening procedure,

Team works with me to make sure we create smiles that are

PearlinBrite. Are there any deficiencies in other methods of

supported by healthy gums, strong bone or implants so that what

whitening that drove you to pioneer this technique? What makes

one sees are just beautiful, healthy, natural smiles.

it so different from other laser procedures?

A Everyoneâ&#x20AC;&#x2122;s teeth have a shade that is dependent on

5 INSIDER TIPS FOR MAINTAINING A BEAUTIFUL SMILE

genetic predisposition and environmental factors. Our exclusive trademarked PEARLINBRITE Laser Whitening System makes use of

> Make sure to see your Dental Hygienist at least 3 times a year

special gels which are activated with lasers and specific lights. Our

(every 4 months) to maintain the cleanliness of the mouth.

system will whiten teeth which have stains from a great variety of

> Exam by Dentist for prevention of disease also 3 times a year

factors. The deficiencies in other systems are their lack of flexibility

during the hygiene appointment as well as oral cancer screening.

to accommodate these different factors. Please see our website

> Home Care (which includes the standard advice of flossing,

for additional information on the PEARLINBRITE System and its

brushing and limit on sweets!)

products. www.pearlinbrite.com

> The use of our PEARLINBRITE Aloe Vera Toothpaste along with

Q Once a cosmetic dentist (such as yourself) has reached the pinnacle of his or her profession, is it fair to say that the work

our exclusive Nano-Silver PEARLINBRITE Toothbrush*. > The use of lasers (Biolase/WaterlaseMD) to maintain the health of the mouth.

involved is more art than science?

A It takes years to develop the ability to design smiles that are of

beautiful and strong. Science enters into every procedure in dentistry. We strive to not violate the principles relating to the health of the gums, and supporting bone of the teeth which includes non-violation

of occlusal and bite relationships. Dentistry is very much a

* PEARLINBRITE Toothbrush (with Nano-Silver) will be available

combination of Science and Art, they are inseparable. My Specialist

after January 1, 2010.

Dr. JAN LINHART

course diverse for different people and for that smile to be natural,

Dr. Henry Mentz

INTERVIEW

surgeons use a variety of surgical and non-surgical treatments, including skin tightening, SMAS elevation and fat grafting for volume restoration. In order to enhance SMAS lifting, various authors have advocated a more aggressive release of ligaments. The Zygomaticus Major Muscle is a facial muscle that runs backwards and upwards across the cheek from the corners of the mouth. Much of the facial soft tissue is anchored to this muscle. The ZMM facelift involves detaching the soft tissue from the

Q Please explain the triple certification. A The triple certification is the joint training and membership of three specialty boards, each of which covers a different medical field: plastic surgery, facial plastic surgery and head and neck surgery. Each

ZMM, allowing the soft tissue to be lifted further and enabling better cheek and jowl elevation.

Q There are several acronyms for facelift procedures – can you list those that in your opinion have merit rather than just marketing appeal?

board carries with it specific techniques and skills, and so the blending of these boards creates a unique

A I think that every new technique expands the repertoire for surgeons in some way. It seems that all

skillset. Dr. Mentz was the first in the U.S. to be honoured with all three.

of the newer facelift techniques are “mini” versions of techniques explored in the 90s. These can suit the requirements of some patients, although a “mini” surgery usually achieves a “mini” result.

Q Please comment on Dr. Goldwyn’s short foreword to this edition: A The essential problem is a philosophical one: When a patient goes to a plastic surgeon, he or she will

Q Please describe the “liquid facelift”. A The term “liquid facelift” refers to facial rejuvenation with injectables. Our injectable strategy would

get what that plastic surgeon usually does. There are very few plastic surgeons who individualize the

include Botox for animation lines like crows’ feet, Radiesse for filling deep soft tissue like the cheeks,

treatment according to what the patient needs. Even if one can understand the technique, the problem

and Juvederm for superficial lines. These techniques can often be enhanced with other treatments, such

is that the patient really will never understand the options and will have to go to the plastic surgeon

as microdermabrasions and pulsed light.

about whom he or she has heard does a good job. More often the plastic surgeon does what he or she thinks he or she does best.>> Most plastic surgeons do have a preferred option for treatment of a particular problem. They usually learned it during training and have achieved expertise with that technique. It requires a large

Dr Henry Mentz

SMAS facelifts require “an update” – are the mid-face and neck lifts a natural progression for the patient whose facelift looks tired?

and busy practice to achieve proficiency in multiple techniques and to develop past a surgeon’s original

A There is no permanent facelift strategy and all results fade with time. Some older facelifts that

education. Having mastered several techniques is, however, a huge advantage as different techniques

have not had the benefit of the newer advances in skincare could benefit from the addition of these for

can be blended to achieve the best results for each individual patient.

improved results. Moreover, newer facial rejuvenation incorporates skin quality, tightness, SMAS lifting

Q Please comment on Paul Tessier’s remark that “there is nothing new since Skoog” and describe the ZMM lift.

Dr. Henry Mentz

Q The SMAS does not arrest the ageing process. Clearly, we all age differently, yet the majority of

and volume restoration. Rebalancing the rejuvenation may reduce any surgical artefact and create a more natural appearance.

A Dr. Tessier is essentially correct that Skoog made a significant contribution to facelift technology

Q Please give a short description of all innovative procedures your name is associated with. Please,

in his advancement of Superficial Muscular Aponeurotic System (SMAS) techniques for lifting and

supply drawings/computer generated images whenever possible, so that the reader can understand the

anchoring soft tissue. The SMAS layer of soft tissue is unattached and thus sags most between the

technique.

Contact

parotid gland (which is just below the ear) and the nostrils and chin. These techniques can be used to

A Most recently, I have been working with facelifts involving the release of the ZMM, as described

Dr Henry Mentz

address advanced ageing changes such as soft tissue ptosis, which results in a jowly appearance instead

above. I am excited about new buttock fat graft techniques that we are perfecting. I have also been

Galleria/River Oaks

of just wrinkles.

involved with abdominal and pectoral etching, a technique which creates an athletic male torso by

4400 Post Oak Parkway

However, facial rejuvenation has benefited from several new techniques since Skoog. Currently,

producing a six-pack and enhanced chest muscles.

Suite 2260 Houston, TX 77027 Phone:

1-877-707-2277

Fax:

713-799-9999

Memorial Location 12727 Kimberley, Suite 300 Houston, TX 77024 Phone:

1-877-707-2277

Fax:

713-799-9999

Surgery Center 12727 Kimberley, Suite 303 Houston, TX 77024 Phone:

1-877-707-2277

Fax:

713-799-9999

Website: www.henrymentzmd.com

Dr Mentz on Teton

DR. HENRY MENTZ

The Mentz team

Q Please say a few words about the history of the Research Center and its capabilities. A The center for clinical research and plastic surgery education at the Aesthetic Center for Plastic

<< ... early surgery is better value. If a facelift can allow a 50 year old to look 40, and when she is 70 she will look 60. >>

Surgery (ACPS) is a 1200 sq ft facility. Its two certified and fully accredited operating suites were designed to educate the novice plastic surgeon or to update the experienced plastic surgeon with the latest procedures. Dr. Amado Ruiz-Razura founded the center in 2003. Following his death from pancreatic cancer in April 2008, the center is currently in a state of transition, as he was hugely respected and his talents will be difficult to replace.

Q Few surgeons offer post-operative facilities. How important is this to your patients? A We do our best to provide as much support as possible, though most patients do not realise what is required for recovery. For our patients, we have four fully staffed overnight recovery rooms, home care recovery nurses that visit for an hour per day and 24-hour home nurses when necessary.

Q Please describe how you see the future of plastic surgery. A More non-surgical techniques will be developed and surgical techniques will become more problemspecific. With the country spending less on medicine, many physicians will be tempted by cosmetic practices. Therefore, the number of “experts” in plastic surgery will multiply. Hospitals will develop cosmetic surgery franchises and eventually dominate the market. The true artisans of the craft of plastic surgery will continue to be valued and will serve only the most discerning patients.

Q What are the realistic goals of the anti-ageing industry in the short term? A The anti-ageing industry is market-driven and will continue to be pushed by the consumer towards less expensive options with minimal risk.

Q What do you expect the advances in anti-ageing to be in either the short or long-term future? A In the next 10 years I expect steady change with subtle improvements in technology for skin Grace Kelly

rejuvenation, for example, in the area of fat destruction through transcutaneous ultrasound. In the next 25 years, I expect significant advances in stem cell transplantation for facial rejuvenation, and age-preserving hormone treatments.

Q Is the rejuvenated face out of synch with the ageing body? If one wanted to keep body and face continually 10-15 years younger than one’s biological age, what would one expect to do in terms of types of surgery and frequency of surgery?

A Most procedures offer a shift backwards in time 10 or 15 years. However, after surgery, each year brings a year of ageing for the patient. Therefore, early surgery is better value. If a facelift can allow a 50 year old to look 40, and when she is 70 she will look 60, why wait till you look 70 to have a facelift that will only bring you to 60? In this case the 50 year old looks 10 years younger for the rest of her life instead of from 70 onwards. Maintenance also plays a large role. Keeping healthy through fitness and nutrition and using sunscreens and microdermabrasions are conservative strategies that will delay, though not remove, the need for surgery.

Q If one walks through an affluent part of any developed country’s capital, it would be hard to spot an individual who looks their age. Are we overly obsessed with youth and beauty or is plastic surgery developing in response to a timeless quest for perfection?

A In large cities, citizens are wealthier and interact with a larger number of people. It is a natural consequence that people want to look their best and be, at the very least, comfortable with their appearance.

Q Who in the public eye do you think has aged most beautifully?

Who in your opinion is the most

beautiful face of all time?

A There have been so many beautiful women in the entertainment world, but my all time favourite has been Grace Kelly. Although she died at 52, she exuded flawless beauty her entire life. There was harmony in her striking features, strength in her cheek and jawline, delicate elegance in her eyes and

Grace Kelly

DR. HENRY MENTZ

nose, and luscious and soft warmth in her skin and lips. Truly a classic beauty!

Dr. Eric Auclair Dr. Eric Auclair was born in Paris where his study of medicine culminated IN being accepted to practice at the highly competitive Paris University

The principles of this technique are simple. The face is divided into 4 sections: the forehead, the eyelids, the cheeks and the neck. The signs of ageing are studied on each section. Based on this analysis a procedure can be recommended and adapted to each patient. One can choose to treat all 4 sections depending on the number of lesions and the wishes of the patient. Later in time we can treat sections that were not subject to previous procedures. The surgery can be complemented by injections, laser treatments, pulsed light and chemical peels. The most important thing is to consult the patient regularly in order to maintain

Hospitals. Dr. Auclair began his career as a resident in general surgery before turning to reconstructive surgery.

the benefits of the procedures for as long as possible and to achieve the most natural look. In an ideal scenario one can start with injections around the age of 30 while the first surgical treatment, usually in the eyelid area, can take place at around 40. A decade later both neck and face will be addressed and by the age of 60 further surgery can be done based on individual patients’ needs. A good plastic surgeon would supervise and follow up with the patient over a period of some 20 years for optimum results. Facial rejuvenation with eyelids and lower

As an intern under Professor Raymond Vilain (specialist in hand and cosmetic surgery), Professor Denys

portion of the face treated.

Pellerin (specialist in children’s surgery), Professor Serge Baux (burn specialist) and Professor Paul

REMODELLING OF THE BREASTS

Banzet, Chief of Surgery at the St. Louis Hospital, he continued to develop his expertise in plastic and re-

The surgical remodelling of breasts has benefited from the major technological advances of recent years.

constructive surgery. He served as Senior Resident for 3 years at the Boucicaut Hospital, Paris in the de-

This is linked to innovations in the production of breast implants and the development of new surgical

partments of reconstructive surgery and emergency hand care. During this period, he further developed

techniques. Plastic surgeons can now offer operations with perfect visual results which are natural to the

his knowledge of reconstructive surgery, microsurgery, hand surgery and facial surgery, most notably in

touch. The surgical procedure does not preclude child bearing, breast-feeding or undertaking regular mam-

association with Vladimir Mitz MD, Daniel Marchac MD, Dominique Le Viet MD and Professor JM Servant,

mograms post-operatively.

professionals of international acclaim. Dr. Auclair has published several scientific articles concerning mammary surgery, the microsurgical reconstruction of limbs and the cranio-facial region, facial rejuvenation surgery and mammary implants. He has had a private practice in Paris for 15 years, which focuses mainly on aesthetic surgery.

Our aim is to obtain the most natural results through the techniques we have developed. Each incision of 4-5 cm long is situated in the armpit and the implants are placed in front of the pectoral muscle.

Q Why place the implants through the armpits? A The placing of the breast implants depends on several factors, some of which are summarised below.

COMMENTS ON Dr Robert Goldwyn’S FOREWORD

a. Patients’ habits, in particular whether they sunbathe topless, a practice that is more popular in France

I totally agree with Dr Robert Goldwyn - I think he has provided at least a partial insight into the

than in England and the United States.

prospective patient’s dilemma.

b. The patient’s profession. For example, a model would not want to have scars on their breasts, while a

Apprenticeship of plastic surgery has several stages: first learning about general surgery, then re-

Intra-auricular scar

patient who works in an office may not be bothered about that.

constructive surgery and finally gaining practice in the techniques of aesthetic surgery. It can take around

c. If the size of the nipples is less than 4 cm in diameter, it would be difficult to place the implants through

15 years to complete this training and the apprentice can only carry out plastic surgery regularly after

the areola itself.

these stages. It is at this point that the apprentice becomes a plastic surgeon and must cross over from simply technical surgery to a more rounded approach based on the patient’s requirements.

A surgeon should always use a technique with which he is greatly familiar in order to avoid complications.

At this stage one should never forget that the result of plastic surgery is, in fact, a psychological comfort

For all of the above reasons, I prefer to place the implant through the armpit so as to leave a very discreet

enhancement.

scar, as you can see on the

Plastic surgery is aimed at helping the patient to feel better in their skin. Before operating, one

illustration.

should scrupulously analyse each person’s unique needs and wishes. Based on this analysis the surgeon can provide a strategy that is best adapted to the patient’s wishes. The treatment is not always surgical, it

Q Why place breast implants in

can be a medical one, based on injections, but should always be bespoke. One learns this process through

front of the pectoralis muscle?

A The old style implants were

experience and through striving to improve.>>

filled with serum, which imposed

COMFORT ZONE

to place the implant behind the

Although I am acquainted with all surgical techniques, certain areas have attracted more of my attention.

pectoral muscle in order to hide

These are: facial rejuvenation, remodelling of the breasts and body and lipo-remodelling surgery.

Dr. Eric Auclair Contact

FACIAL STEP LIFT

As the new implants are pre-

additional lipofilling;

filled with cohesive implant gel,

I have now been using this technique for 15 years, though it has undergone a technical evolution since first put in place. It has two important merits:

Dr Eric Auclair 138, Bd Exelmans

the seams of the implant. Breast augmentation with 240cc breast implants, pre-muscular with

this imperative no longer exists. Therefore, I have returned to positioning the implants in front of the muscle, which is much less painful and gives a much more natural movement to the reconstructed breasts.

1. We suggest a bespoke treatment for patients best adapted to their case requirements.

Phone: 00 33 1 47 43 43 43

2. Early start to the ageing process, so that it is more a slackening of ageing process rather than the

Q Why use an implant filled with silicone? A The new gel silicone pre-filled cohesive implants are more dependable than those of the previous

Fax:

00 33 1 47 43 43 47

classic lifting. For example, the first treatment is recommended around 40-45 years old, to achieve a leap

generation and last the entire lifespan (20 years according to manufacturers’ guidelines). The consistency

Email:

dr-auclair@orange.fr

back in time 7 to 10 years, after which further surgery can be used to maintain this dynamic and natural

of the implant is very similar to that of the mammary glands, so much so that in most cases you cannot feel

appearance for as long as possible.

it by touch. The rate of infection is extremely low: 1-2 percent according to the manufacturer.

75016, Paris

Website: www.dr-auclair.com

Q Why use a teardrop shaped implant? A The teardrop or anatomically shaped implants should be used for very slim patients so that the upper

discreet scars.

border of the implant does not show in a low-cut dress.

Dr. ERIC auclair

The entire treatment is less invasive, meaning a return to normal life in under a week, with minimal,

The advantages of this technique are numerous:

The physical changes are less visible and the over-operated look is avoided. We can thus maintain the physical appearance of a 40 year old for another 20 years and renew the

With very slim patients it is possible to inject fat under the skin in order to cover the border of the implant

intervention at 60 with more traditional lifting.

and make them invisible. It is also possible to use this technique for those who already have implants. Liposuction with 10 kg weight loss.

Remodelling of the Body The recent developments in liposuction and fat grafting techniques have revolutionised the surgical approach to body contouring. One can take a small extraction of fat from any part of the body and re-inject it wherever else it is needed. This opens a vast field of options for remodelling various parts of the body, including:

> Buttocks

> Legs and thighs

> Stomach

> Breasts

> Arms

> Neck and chin

> Face

<< A slender silhouette... A graceful and relaxed posture... An affable character. >>

Personal interests Throughout my studies I had a part-time job at an antique dealers who was a friend of my family. In the process, I learned a great deal about 18th century furniture and Art Deco and had the opportunity to meet some incredible personalities such as Andy Warhol, Yves St-Laurent, Pierre Berge, Valerie Giscard dâ&#x20AC;&#x2122;Estaing. I retain some unforgettable memories from those days, as well as a passion for beautiful furniture and interior design. My family, golf and sailing are other pivotal interests in my life.

Q What do you admire the most in terms of physical beauty in men and women? A The main characteristics that make people attractive in my opinion are:

> A slender silhouette

> A graceful and relaxed posture

> An affable demeanour

These elements work together at a subliminal level to give any man or woman a natural sophistication which, in my opinion, is the height of charm and elegance.

Q People who embody the above features? A > The Kennedys

> George Clooney

> Stephanie Seymour

> Carla Bruni

> Sophie Marceau

> Sean Connery

> Christie Turlington

> Giovanni Agnelli

Q French-style facelift v. American-style facelift? A From a technical point of view there are no differences between European and American facelifts. Rather, surgeons use the techniques in a different and more individual style. In France, the majority of surgeons and patients are looking for discreet, almost undetectable results. Striving for a natural result is probably less important in the U.S. I would venture that N.Y. and San Francisco surgeons are closer to European surgeons in terms of style than, say, Texan surgeons. The same is true of different breast augmentation practices.

Dr. ERIC auclair

Dr. Alan Matarasso I begin my conversation with Dr Matarasso by asking him to com-

in the crease behind the ear. There is no cut in the hairline which is

ment on the following observation by a now retired plastic surgeon:

why this has been dubbed the ponytail lift.

‘When a patient goes to a plastic surgeon, he or she

The necklift results in a sharper jaw line. Although in the

will get what that plastic surgeon usually does. There are

rare patient with protruding salivary glands this is not as easy

very few plastic surgeons who individualize the treatment

to correct. Excision of the glands is a controversial surgery, so

according to what the patient needs. More often the plastic

Matarasso prefers to tuck them in and tighten the overlaying tissue.

surgeon does what he or she thinks he or she does best.’

Other little known but eminently effective surgical intervention includes the removal of the buccal (cheek) fat pad

inhabit a fishbowl – the demands on them to look immaculate at all

liposuction and muscle tightening. He has pioneered a classification

times are far greater than on the rest of us which fuels the demand

system that bears his name that helps educate patients on which

for plastic surgery at the top end. The rules here are that the public

procedures they are most likely to benefit from.

has an image of how they see a public figure, therefore it is even

The “last horizon”, however - the intra-abdominal or “apple

more incumbent on those that are in the public eye not to have a

fat” that causes the pelvis and belly to widen in middle age has not

radical overall, but instead to have small maintenance procedures

yet been conquered and is not within the realm of plastic surgery. It

so they don’t look drastically different.

can only be treated with diet and exercise, not surgery. Dr. Matarasso and a colleague first published a paper on breast reduction technique completely avoiding scarring, and

many more doctors performing different procedures for an ever

breast reduction by a method of liposuction. He uses three different

growing and ageing population. Less invasive procedures with

incisions for breast reduction

shorter downtime will be in greater demand.

and its excision results in a thinner face - if the waif look is desired

b) lollipop

practice, the public needs to be on constant guard to avoid

category (i.e. SMAS vs. subperiosteal) the surgeon will tailor the

this gives the appearance of someone gently sucking in on a straw.

c) inverted T

practitioners who are not as well qualified as they ought to be.

procedure to the nuances of that particular patient.

This can be done alone in a young person, or combined with a

Breast augmentation

facelift or facial liposuction. Also procedures that add volume (e.g.

Enlarging breast by injecting fat is still a controversial

Most surgeons, he tells me, would try and tailor the

To avoid, are nonsurgical procedures that are touted as delivering results equivalent to those consistent with surgical

technique on which more data will be available in the near future.

intervention. Non-surgical procedures complement and enhance

neck surgery.

Currently he uses the new silicone or saline implants through a

surgical procedures, though they do not take the place of them. The

hidden incision tunnelling below the muscle to produce a large

source of the greatest disappointment is the misconception that

procedure that they feel is best and modify it based on the unique

With age, the earlobes get elongated and earrings start

anatomical requirements of their patient. Yet results are subjective

sagging. Reducing them back to size is another minimal but

breast. Many well-known actress have undergone this procedure

non-surgical procedures (which are excellent as indicated; lasers,

and there are many ways of achieving a good outcome.

effective surgical procedure.

only to become the subject of tabloid in court inquiries “did she or

Botox and fillers) will achieve the same result that surgery does.

didn’t she?”

‘It is important to distinguish fantasy from reality,’ Dr. Matarasso

Most surgeons would thus try and operate within their

Dr. Matarasso is a firm proponent of the SMAS procedure.

comfort zone and offer what they have mastered through routine

Every surgeon, he says, clearly has to address the needs of their

and experience (and what they believe works best).

patient. ‘We all stand on the shoulders of those before us,’ he says.

mammary glands in men, making gynecomastia or removal of

machine that will deliver fantasy results with no complications or

After all, would you, as a patient want your surgeon to

One of the problems in today’s society are enlarged

cautions. ‘There is a never ending supply of the next greatest

If a surgeon claims to have “invented” a technique pioneered by

breast-like formations in the chest of male patients, an increasingly

downtime, unfortunately “the basements of hospitals are littered

experiment on your face/body, using a technique he is not perfectly

a predecessor, this is misleading and often dilutes the accepted

popular procedure. A tiny liposuction hole is used to suction out fat

with yesterday’s technology!” However we do have wonderful new

familiar with?

standards. Rather, advances come in increments and refinements,

and to reduce the mammary gland using a shaver- a revolutionary

non-surgical technology that tightens, enhances and improves the

which numerous surgeons add too.

technique which has obviated the need for a previously complex

skins texture and color.’

This neatly leads us to the various procedures and techniques that Dr. Matarasso himself is renowned for and considers his own “comfort zone”. The face consists of three distinct parts. The upper one

‘There is,’ he says, ‘clearly more than one way to get good long-lasting results. A surgeon and their patient have to ask themselves if this technique or that offers a better end result, is

operation, without a large incision. On a general note, Alan Matarasso points out that there is now an integrated approach to treating and correcting the body.

more extensive procedures will become the norm. There will be

safe, is the recovery faster and what the longevity of it is. SMAS and

area.

deep plane facelifts have been published in plastic surgery journals

the legs, calves and the thighs as well as the upper arms (the bra

non-surgical procedures in combination (Botox is a good example of

that support the case for the former.

strap fat).

this). SMAS will remain as “the icing on the cake” in terms of facial

Ultimately, results depend on the anatomy of the patient’s

Excess knee skin and fat can be treated, as can the back of

The future of rejuvenation through plastic surgery is bright. Reduced incision techniques that achieve the same outcome as

third is from the corner of the eye to the hairline or the eyebrow

Multiple areas of the body can be contoured simultaneously

obstructing the vision-the body wants the eyebrow to be at the

face/body and the degree of tissue damage (90% of sun damage

bone or just above. This constant pulling upwards (similar to how

occurs by the early 20’s but is manifested in middle age) and

we involuntarily hold our stomachs in) creates forehead wrinkles

the skill of their surgeon who would necessarily recommend the

around the knee and elbow joints-precisely because they are joints,

that get deeper with age. The lateral temporal lift is an eyebrow

procedure he or she is most proficient at and believes in.

they need to preserve the 360-degree motion and are not subject

There is one certainty, whatever technique is used: all

skull and addresses this sagging. It rejuvenates the eyes without

patients who have had good facelifts look better as they age than

giving a startled appearance. Also if patients want Botox but were

they do pre-operatively.

afraid to have it because the eyebrow would sag, now they can have it. The middle third of the face is the cheekbone to the jowl

Matarasso uses the closed approach to rhinoplasty, a

and successfully through lipo-sculpture and fat redistribution. Perhaps the most difficult areas to address are loose skin

evolving. However people choose to change their appearance, one

a nose that “fits” their facial features and looks like they were born

thing remains constant, they want to improve certain areas while

collarbone area. In conjunction with the eyebrow lift, Dr. Matarasso

with it.

maintaining their ethnicity. Women today who embody the beauty ideal are Halle Berry,

Contact

side SMAS facelift, using tissue sealant and barbed quill sutures,

one is aware his patient’s even had surgery because the look is so

Katherine Heigl, Charlize Theron, Sharon Stone, Jane Fonda, Natalie

Phone: 212-249-7500

reducing scarring dramatically, and shortening the healing period.

natural! Or they ask “will my future children get the same nose?”!

Portman, Scarlet Johansson, Susan Sarandon, Christie Brinkley.

re-shaping techniques, including abdominoplasty and scar free

has the same concerns as everyone else. It’s universal. A number

anatomically different to the face. Consequently the neck area

breast reduction by liposuction.

of stunningly beautiful actresses have continuously had plastic

In terms of a tummy tuck (abdominoplasty), the first

surgery both for professional reasons and to alleviate insecurities.

neck - or are just bothered by the neck) a necklift alone can be

important thing is to reconcile the patient’s anatomy, loose,

Plastic surgery is part of a healthy lifestyle along with proper

performed.

damaged skin, excess fat and muscle separation in order to attain

diet, exercise and nutritional supplements. Basically nothing that

their goals. The abdominoplasty causes the abdomen to improve,

surgery achieves can be achieved without an operation. No amount

flatten, and shrink loose skin whereas no amount of exercise can

of sensible lifestyle will remove bags from the lower eyelid, or

The necklift corrects the area between the jowl and the collarbone. Incisions are made behind the ear and scarring is hidden

will all improve.

<< It is important to distinguish fantasy from reality, Dr. Matarasso cautions. There is a never ending supply of the next greatest machine that will deliver fantasy results with no complications or downtime, unfortunately “the basements of hospitals are littered with yesterday’s technology!” >>

Dr. alan matarasso

Regardless of how famous and celebrated a woman is, she

region. The neck and the upper chest age differently and are softens and in patients who have had a facelift (which includes the

Products to use, operating room technology, procedures, and safety

The ideal of beauty is changing as we speak. There are in newer permutations all the time, our standard of ideal beauty is

Alan Matarasso is known for a number of pioneering body

age damage and encouraging skin maintenance procedures.

the world so many ethnic variations and with race mixing creating

scarring on the nose and no packing is put in the nose. The goal is

The lower third is the jowl to collarbone area or the neck

rejuvenation. Patients will benefit from early intervention, avoiding

On the perception of beauty

procedure described elsewhere in this book that leaves no outward

He says the most frequent “complaint” he gets is that no

an integrated approach to rejuvenation, using both surgical and

to surplus skin excision.

area, but when surgery is done includes the neck down to the has developed his own version of the short scar - earlobe to

Website: www.Alanmatarassomd.com

With the relaxation of standards in terms of scope of

fat, fillers) and youth to the face are done along with the face or

lift performed without endoscopic equipment or drill holes into the

Matarasso@aol.com

Demand for plastic surgery will expand exponentially with

will switch for one case to a subperiosteal facelift. Within the

older; the body keeps lifting the eyebrows involuntarily to avoid

Email:

On what the future holds

a) around areola

The brow is anatomically prone to sagging as we get

reduce breasts or remove muffin top flanks. People in the public eye

sutures, makes it possible to perform a combination surgery:

using a tiny incision inside the mouth. The fat pad is grape sized

a self-endorsement.

Dr. Alan Matarasso

remove the bump from the nose, tighten a loose neck, enlarge or

advanced techniques, as well as different types of sealants and

For example it is unlikely that a SMAS short scar facelift surgeon

Alan Matarasso offers a philosophical overview, rather than

After all, would you, as a patient want your surgeon to experiment on your face/ body, using a technique he is not perfectly familiar with?

achieve this. The treatable layers are skin, fat and muscle. Using

Dr. Renato Calabria

at the cellular level - that is the reason why you see a dramatic improvement in the texture of the skin itself along with a younger

relative to the investment in time and the inherent risk of nerve

include endoscopic brow lift – do you feel this is a procedure

injuries. The newer generation of face lifts are now multi-vectorian

integral to most rejuvenation- style surgery?

in direction of pull and volume-enhanced.

facial rejuvenation. Often, people overlook the upper third

Q Fat injections to the face, and orbital area in particular,

portion of the face and concentrate on the jowls and the neck. A

are a somewhat controversial procedure because fat is easily

we know the adult stem cells are present in a sort of dormant

youthful forehead and periocular area (the area around the eyes)

re-absorbed and occasionally leaves an uneven surface. Can

state as we age, but it appears that once they are placed in a new

are essential to match the rest of the surgically enhanced face.

you explain how you achieve your remarkable results with this

environment, they react to different stimuli and could play an

Furthermore, both surgeons and patients focus their attention on

procedure?

A Fat grafting has been a controversial procedure because it is

important role in tissue regeneration.

the upper eyelid for the wrong reasons. An overdone blepharoplasty results in a changed shape of the eyes – they become smaller and

very skill-dependent: the great variation in results is subject to who

Q We accept that everyone ages differently and responds to

rounder – a tell tale sign that is difficult to disguise.

is performing the procedure.

surgery differently, but what is the maximum number of years a

The endoscopic brow lift will give the patient a much more open

Neither skill nor results are easy to replicate, which makes

appearance. Used in combination with the new generation vertical facelift, it can address laxity in the neck and other problematic areas. The full potential of this procedure is yet to be discovered:

surgeon can reverse the clock by?

and natural look of the eye area, by repositioning the brow and

the issue controversial. The fact that the re-absorption rate varies

A It is really not important how many years we can set the clock

avoiding the “done” look after eyelid surgery.

from 20% to 90% is also a part of the problem. Fat is not easy to

back but how we do it. Can we really make somebody look younger

inject and can cause irregular contouring and an uneven surface. To

or would they always look like an old patient whose face has been

complicate things further, if a patient who has had facial injections

lifted? THAT’s the key. The trend towards regenerative medicine

puts on weight, this is reflected in the face, occasionally creating a

and its application in surgery may be the key to open the door of

bizarre appearance.

eternal beauty.

Q Please, explain the minimally invasive brow lift – where are the stitches exactly and where is the incision?

A With the minimally invasive brow lift, the incisions are kept hidden in the scalp, so are not visible to the naked eye.

The (stem) cell-enhanced facelift was developed to circumvent

Furthermore, because this is an endoscopic technique, the incisions

some of the above problems. A new revolutionary technology,

Q Beverly Hills is the home of celebrities and celebrity plastic

themselves are very small (1-2 cm). Lastly, the side effects, such

developed in Southern California, allows us to harvest fat and then,

surgeons, yet few and far between are the people in the public

as swelling, bruising, hair loss and numbness are much lesser than

through a sophisticated device, process it and isolate regenerative

eye who admit to having had surgery. Given that most of us

with the traditional brow lift, as is the recuperation time. It is a

cells, including adult stem cells, blood vessels forming the cells and

colour their hair, replace bad teeth, use make-up and photoshop

procedure often used to correct a genetic tendency to a lower brow

growth hormone secreting cells. These are separated from the adipose

whenever possible, why is admitting to having had surgery such

position in younger patients as early as in their thirties.

matrix and therefore don’t carry the same ‘side effects’ that fat does.

Q Please, explain the difference between the vertical lift v. the horizontal facelift?

A A new trend is taking the plastic surgery world by storm. It is based on a new concept of interpreting beauty and facial rejuvenation. I refer to it as the ‘deflation theory’.

Additionally, the stem cells are much more concentrated. These regenerative cells then can be re-injected during a

a great barrier to cross still?

A Celebrities are always going to have a hard time admitting that they’ve had plastic surgery but, in my opinion, it is rare in

facelift or as a stand alone procedure. It is postulated that these

Hollywood to cross the ”forties” barrier without having anything

cells not only act as a “voluminizing” agent but they could also

done. On one hand, celebrities are entitled to their privacy like

jump start the rejuvenation process at the cellular level.

every patient, yet on the other hand it is a bit hypocritical to claim

In the face, the ageing process causes atrophy of the skin and

Q Minimally invasive surgery seems to be the buzz word

underlying layers while the effect of gravity causes the facial

amongst plastic surgeons today. Is this patient-driven?

that their forever young looks are only due to good genes. The general public today is very sophisticated and not easy to fool.

tissues to droop in a vertical direction creating redundant skin and

A Less is definitely more and minimally invasive procedures are

Q Who in your opinion are the most beautiful woman and man

“jowls”. The end result is an absolute loss of volume in the face (the

in demand, the downtime being as much of a priority as achieving

in the world and why?

Contact

deflation effect) and a relative shift of volume from certain areas

natural results. Nevertheless, patients want to see tangible results.

Who has aged most impressively – with or without the help of

Beverly Hills

of the face to other, less desirable ones, such as the nasolabial

That is why the one stitch facelift has been such a hit among

enhancements?

436 N. Bedford Drive

fold, the jawline, the areas below the eyes and the neck. Traditional

Hollywood celebrities. It is based on an old Hollywood trick that

What is your definition of beauty?

Suite 200

facelift surgery attempts to correct the problem by pulling in an

consisted of using scotch tape placed strategically under the hair

Beverly Hills, CA 90210

unnatural, lateral direction, producing the so-called ‘wind-swept

to pull the skin upward in close-ups. The one stitch face lift is a

kinds of Beauty:

Phone: (310) 777-0069

look’. Also, conventional facelifts cause a flattening effect on the

true lunch time lift done under local anaesthesia with very limited

Fax:

face by pulling the skin tight. Thus, facial rejuvenation has been

down time, where through a tiny incision at the sideburn a dermal

Angelina Jolie kind of beauty. It comes with your genes. It is the

(310) 858-3150

Beauty is an emotion perceived. In my opinion there are two The “devastating beauty” that is obvious to everyone - the

plagued for decades by two major mistakes: wrong direction of the

suspension flap is developed and then anchored superiorly, causing

perfect beauty: the kind you have been born with, the kind you

Rancho Mirage

pull vector (lateral v. vertical) and the bi-dimensional, skin-only,

flattening of the naso-labial fold and improving the jowls area.

don’t need to work on – you have it and everybody is aware of it.

71-511 Highway 111

(flattening) procedure.

Q Isn’t minimally invasive surgery shorter lived than the

you cannot quite figure out. It is the most common beauty, the one

classic Smastectomy?

you can achieve if you work hard enough. It is a combination of looks,

Rancho Mirage, CA 92270

If you look at how Botticelli painted Simonetta Vespucci in his Primaveras, you can appreciate the ’volume theory’ in a

Fax:

youthful, beautiful face. The ultimate goal of facial rejuvenation

A The classic Smastectomy is a good procedure, but I’d rather not

should be to restore the lost volume resulting from the ageing

take anything away from the face, instead adding the volume that

Italy

process. The vertical facelift was conceptualized in the same way

we have lost through ageing.

Phone: +39-346-4662323

Botticelli created his paintings: thinking in a tri-dimensional fashion

Contact: Anna Maria

by restoring volume and, therefore, youthful shape and beauty.

(760) 836-0067

anna.gold@rolmail.it.

Website www.drcalabria.com Website www.verticalfacelift.com

Q What are your views on the deep plane facelift? A Deep plane face lifts are a thing of the past: too long in terms of recuperation time, too short in terms of gain for the patient

Q Please, explain the limitations of the stem cell enhanced

The second kind of beauty is the imperceptible one: the one

charm, class, mannerisms, intelligence, attitude, health and character. Plastic surgery can help achieve the second one, but you would only be successful in getting there if you work on the other factors of the equation. A good plastic surgeon has two essential gifts: the capacity

facelift? Presumably the Celution device cannot address

of imagining in the third dimension and the ability to translate this

gravity in the neck area, for example, or very lax skin. Also, the

into reality.

procedure seems more effective with the use of younger fat cells, which is clearly not an option for older patients.

Beauty can at times be superfluous but as Orson Welles said, ‘We live in a time in which the superfluous is our only necessity’.

<< A good plastic surgeon has two essential gifts: the capacity of imagining in the third dimension and the ability to translate this into reality. >>

Dr. renato calabria

Phone: (760) 836-0077

Email:

the rejuvenation process not only at the tissue level but also

Q Virtually all before and after images on your website A The endoscopic brow lift is an intricate part of a complete

Dr. Renato Calabria

A The (stem) cell-enhanced facelift has the potential to address

50 years old patient who underwent vertical lower face and neck lift and endoscopic brow lift.

45 year old patient who underwent

44 year old patient who underwent

49 year old patient who underwent

63 years old patient who

49 years old patient who underwent

short scar facelift.

one stitch facelift.

underwent vertical lower face

cell-enhanced vertical face and neck

and neck lift, endoscopic brow

lift and endoscopic brow lift.

lift, fat grafting cheeks, chin implant. Dr. Calabria graduated from the University of Padua, Italy, one of

TV media has also recognised Dr. Calabria’s expertise in

the oldest and most prestigious medical schools in the world. His

cosmetic surgery by featuring him on CBS News, NBC News, Extra,

post-doctoral training includes two Research Fellowships in Surgery,

Inside Edition, KTLA News, Channel 9 News, The Insider, VH1, The

one at Harbor-UCLA Medical Center and the other at Wadsworth-VA

WE Channel and the Tyra Banks Show.

Medical Center in Los Angeles. This was followed by a Residency

Dr. Calabria has also been invited to be on the faculty of

in Pathology at Wadsworth-UCLA Medical Center. After completing

numerous aesthetic workshops in the US and Europe. He has been

five years of General Surgery training at Kern County-UCSD Medi-

at the forefront of endoscopic facial plastic surgery, referred to as

cal Center, Dr. Calabria moved to the Bay Area where he trained in

“Minimally Invasive” surgery, participating in various panels on the

Plastic and Reconstructive Surgery at St. Francis Memorial Hospital

subject. He is a Member of The Editorial Board of Body Language

in San Francisco, the oldest Plastic Surgery Training Program on the

Magazine.

West Coast. He then moved back to Beverly Hills where he has been practicing since 1995.

Devoting time to help children with congenital defects has always been one of Dr. Calabria’s priorities. He has participated in several third world missions, mostly in Central and South America,

by The American Board of

where he has performed hundreds of reconstructive surgeries. Dr. Calabria’s procedures have been profiled by national

Plastic Surgery. He is a Mem-

and international media and have earned him a reputation of a true

ber of the American Society

artist surgeon. His is a select, high profile boutique practice with

of Plastic Surgeons, a Fellow

locations in Beverly Hills, Palm Springs, Rome and Milan whose

of the American College of

patients appreciate his Italian sense of aesthetics and beauty.

Surgeons, and a Fellow of the Royal Society of Medicine in

Dr. Calabria’s work doesn’t scream “FACELIFT” - no exaggerated lips and breasts or tightly pulled facial skin.

London. He is also a Member

His approach and philosophy are summed up by:

of the Los Angeles Society of

‘Never too excessive, never too flamboyant.’

Plastic Surgeons. Dr. Calabria

He favours the natural, “not done” look.

is part of the Voluntary Faculty of the Department of Plastic Surgery at the University of Southern California

at 30 BEFORE

after

a patient new or renewed confidence. While many patients have

the latest techniques in cos-

become blasé about having plastic surgery, for the majority of

metic surgery.

people it is a decision not to be taken lightly. If you are seriously considering plastic surgery you need to educate yourself about

law) who underwent vertical lower

authored and co-authored numerous publications and lectured at

the procedure you are considering. If you know someone who has

face and neck lift and endoscopic

national and international meetings including the American Society

had the same procedure, by all means talk to that person. Most

brow lift. Centre: my mother-in-

of Plastic Surgery, The California Society of Plastic Surgeons, The

reputable plastic surgeons would introduce you to patients who

law at 30

American College of Surgeons, the Italian-American Society of

have already undergone the procedure you are considering.

Plastic Surgeons. He is a leading expert in his field and has been

‘Some procedures are carried out for the purpose of giving

where he teaches residents

Dr. Calabria has

56 year old patient (my mother-in-

Plastic surgery has come a long way over the past few decades. Says Dr Calabria:

The internet is a great source of information. I, in common

interviewed for articles that have appeared in The Wall Street

with fellow plastic surgeons, have developed www.drcalabria.com

Journal, The Los Angeles Times, USA Today, Forbes Magazine,

for the purpose of providing adequate information to prospective

Vanity Fair, Vogue, LA Confidential, Glamour, Cosmopolitan, People

patients so that they don’t rely on hearsay alone. I would encourage

Magazine, In Touch Magazine, Star Magazine, More Magazine,

you to investigate a surgeon’s credentials, to seek a second opinion

US Weekly, Men’s Journal, The National Enquirer, Repubblica,

and to never choose a surgeon based on price alone. Practically

L’espresso, Class, Anna, Oggi, Gente, Bunte, Chi, Diva e Donne, and

any doctor can perform plastic surgery, but not every doctor can

many more.

perform it well!’

<< The vertical facelift was conceptualized in the same way Botticelli created his paintings: thinking in a tri-dimensional fashion by restoring volume and, therefore, youthful shape and beauty. >>

Photographer: Ron Goldstein @ www.photomovement.com Model: Katarzyna Dolinska for Elite Models NY Hair stylist: Olivier Chomienne @ Chomienne.com Make Up Artist: Susana Santos @ www.Susanasantosmakeup.com Photographer Assistent: Joseph Tejeda

Dr. Calabria is Board Certified

Professor Dan Reinstein

<< The soul that can speak through the eyes, can also kiss with a gaze. >> Q What is the relation between healthy eyes and beautiful eyes?

Professor Dan Reinstein has been using very high-frequency ultrasound with digital

signal processing for research in refractive surgery for over 15 years and has published

extensively in the fields of corneal and anterior segment biometry, the prevention of

ectasia by mathematical modelling, sizing of phakic intraocular lenses and the early

detection of keratoconus.

noticeable effort.

therapeutic laser treatments on patients with certain medical

aside, are there any other treatments or a care regime to keep

Blended Vision is the solution. Very few people are unable to adjust

corneal conditions as well as rehabilitation surgery for patients

eyes youthful and attractive?

having undergone LASIK complications in the past.

A Everyone develops presbyopia during their life. Most people,

their vision and for most, it is highly successful.

Post operative = Artemis scanning is useful in confirming adequate

whether they have previously worn glasses or not, experience

Q What is elective ophthalmology? Please, describe the future

tissue reserves for enhancement surgery and for screening for

the symptoms of presbyopia in their 40’s. Effectively, the zoom

of lasers in eye correction, one of the most widely undertaken

ectasia (an abnormal progressive corneal thinning condition that

system that allows your eyes to change focus from distance to near

beautifying procedures?

that makes a patient unsuitable for enhancement surgery.)

becomes weaker. Your ability to read small print (i.e. newspapers)

A Elective ophthalmology involves ophthalmic surgery that is

diminishes and you require different lenses for focusing on close

undertaken as a non-urgent surgery at an elected time point, i.e. a

Q Are any other ophthalmologists using it? A No, London Vision Clinic is the only clinic in the world using the

A Laser eye surgery is able to correct a patients refractive error

(a patient’s need for glasses for focusing). It cannot correct blur not

life ( usually above the age of 65). They can be removed and vision

refractive surgery at the University of

improved with glasses caused by other ocular conditions.

restored through outpatient day surgery.

British Columbia, Vancouver. He was

Q What are your views on cosmetic eye surgery – should

Q What type of treatments to do you offer to presbyopic

at the University of Paris in 1999.

surgeons be anatomically AND ophthalmologically trained to

patients?

Professor Reinstein relocated to

achieve the best results?

A All surgeons performing refractive eye surgery should hold full

with engineers at Carl Zeiss Meditec,

registration as an eye specialist having undergone a full residency

who recruited him as the lead clinical

training programme in ophthalmology. In addition to this they

consultant for their new excimer laser,

should also have undertaken further sub-specialist training in

the MEL80. In 2002, he established

Laser refractive surgery and in addition preferably corneal surgical

the London Vision Clinic, where he

training as well. During the 1990’s many surgeons began to do

continues as Medical Director.

laser surgery after attending one or two weekend courses, with College of Ophthalmologists introduced training and accreditation

applications including biomechanically

in laser eye surgery into the curriculum of trainee eye surgeons.

based ablation profiles using non-

A number of specific refractive surgery fellowships also exist.

linear aspherics for treating very

Fellowship training in refractive surgery prepares the surgeon for

high myopia with very low induction of aberrations, and very low

dealing with all the complications of refractive surgery, so that

tissue consumption, and has further developed these to enable

when he encounters them, he is prepared.

Meditec for future product releases. Concurrently with his medical

PRK, and non-laser procedures such as IOLs (Intraocular Lenses),

The 606 Club in Chelsea on a regular basis with his own quartet.

CK (Conductive Keratoplasty). Not all surgeons can treat all

Professor Reinstein lives in central London with his Austrian wife

prescriptions; if you have a more unusual prescription some

Contact

Ursula, herself a veterinary surgeon, and their three young children,

surgeons will very appropriately refuse to treat you, because they

London Vision Clinic

Julia, Maxwell and Oscar.

lack the experience or technology to treat the particular condition.

Q Please, summarise the significance and importance of using

Gustavo Adolfo Bécquer is one of several writers who have

the “Artemis” technology.

celebrated the eyes as the most beautiful and expressive feature of

A There are three areas of use.

Email:

info@londonvisionclinic.com

Pre operative = Artemis is the most sensitive screening tool for keratoconus, a condition that excludes a person from being a

A Laser Blended Vision. Laser Blended Vision can be undertaken

using Lasik techniques or LASEK/PRK methods, depending on the

the human face.

Photographer: Ron Goldstein @ www.photomovement.com Model: Tamara Pleshakov for Elite Models NY Hair & Make-up: Theresia Pistel @ www.the-make-up.de Photographer’s Assistant: Joseph Tejeda

PROFESSOR DAN REINSTEIN

different types of refractive surgery, including LASIK, LASEK/

USA; he continues to play at one of London’s top Jazz venues

+44 (0)20 7224 1055

A My wife!

Q What separates a great eye surgeon from an average one? A You are looking for a surgeon with experience in the specific

Fax:

Q Who, in your opinion, has the most expressive and beautiful eyes?

or without supervision on their first few cases. In 2007, the Royal

developed advanced excimer

of ophthalmology, not all ophthalmologists are versed in all the

Phone (Overseas): +44 (0)20 7224 1005

the age of 45. Cataracts will affect each and every one of us in later

made full professor of ophthalmology

performance scholarship at the Berkley College of Music, Boston,

0800 587 4705

Some ocular conditions are more prevalent in older age

of Cornell University, and cornea and

procedure you seek. While laser eye surgery is a sub-speciality

Phone (Local):

urgently required.

engineering at the Weill Medical College

career Professor Reinstein has continued his passion for jazz and

138 Harley Street, London W1G 7LA

planned surgical procedure. It encompasses both refractive surgery as well as surgery on various ophthalmic conditions that are not

groups. Glaucoma screening should be performed annually over

London in 2001, in order to work closely

bifocals or varifocal lenses to correct this, however, some of the

candidate?

Q In terms of laser surgery, is everyone with poor eyesight a

For many older patients, frustrated with their glasses, Laser

or distant objects. Traditionally, people have used reading glasses,

now treat the symptoms of presbyopia.

the saxophone for over 35 years including two years of study on a

Professor Dan Reinstein

more advanced laser systems coupled with surgical expertise can

cornea. Both these applications have been adopted by Carl Zeiss

will only be able to focus on distant objects to a limited degree. The

Q How do eyes deteriorate with age and, cosmetic surgery

presbyopic LASIK based on increasing the depth of field of the

a little on close-up objects. The other eye is manipulated in such a way that it will focus on near objects and

Intra operative = Artemis guided treatments are useful in

candidate for laser refractive surgery.

Artemis for clinical management of their patient care.

Professor Reinstein has

oriented, although it will be able to focus

brain compensates and patients can focus both near and far with no

University Medical School, England, did his ophthalmology and fellowships in ultrasound bio-

adapts one eye to be mainly distance

A Beautiful eyes ARE healthy eyes.

Professor Reinstein graduated in medicine from Cambridge residency training at the Mount Sinai School of Medicine, N.Y.,

patient’s individual suitability. The surgery

Dr James Stuzin is a Clinical Assistant Professor of

Photographer: Marko Tardito

Dr. James Stuzin he witnesses this process of their visual sense evolving from the two-dimensional to the three-dimensional. His own approach to facial surgery is highly individual.

Plastic Surgery at the University of Miami, School of

He looks at pictures of prospective patients from an analytical point of view – the ultimate purpose of every surgeon is to restore youthful contours while minimising the signs of surgery, yet what is

Medicine and former President of the American Society

often missing is not so much the technical solutions but adequate analysis, he says. Any technique can deliver a good result, so long as an

for Aesthetic Plastic Surgery.

artistic approach is present. As we age, the shape of the face changes: loose fat pulls away from the skeleton and the neck muscle, the platysma fails to conform to the framework beneath the floor of the mouth and

Dr. Stuzin is also the former Chairman of the American Board of

the jawline. The neck lift is a difficult operation, involving muscle

Plastic Surgery, which is the certifying organization for Plastic

manipulation, which can give patients a radical new appearance if

Surgery in the United States.

correctly done. Adding lost volume to the face through fat transfer

James Stuzin received his medical degree from the University of Florida in Gainesville. He served his internship and

<< Sooner rather than later a new wave of injectables will be developed and stem cells will play a major role in facial rejuvenation. >>

underlying tissues, i.e. the SMAS. The surgical intervention takes,

Seattle. He completed a plastic surgery residency at New York

or should take into account, a number of individual factors, such as

University Hospital in New York City, followed by two fellowships in

the skeletal support, the strength of the jaw and the condition of

cranio-facial surgery at the University of Miami and the University

the skin.

of California, Los Angeles. He was certified by the American Board of Plastic Surgery in 1989. Stuzin is a co-editor of the Journal of Plastic and Reconstructive Surgery.

aesthetics. Most importantly, Skoog didn’t understand the anatomy

surgeons of his generation, Dr. James Stuzin doesn’t have a website

of the SMAS, nor did the surgeons who first trained in performing it

or much of an internet presence, so information about him is not

– they didn’t understand the different layers of the face.’

immediately available unless one is either a medical researcher or a very determined one. Nor does he offer any before and after pictures to prospective patients. If they ask, he suggests that they research medical archives instead. His practice is entirely built on referrals from existing

Dr. Stuzin says the subject is commonplace lunchtime conversation in smart Miami restaurants. In Europe, of course, this is still “the great secret” and the beautiful people like the world to believe they owe their tight jawline to the Methuselah gene. Dr. Stuzin is a firm proponent of the SMAS lift. It offers, he says, greater aesthetic versatility and control of movement than the deep plane lift.

Suite 100-200 Coconut Grove, Florida, 33133 Phone: 1 305 854 8828 Email:

jms3225@bellsouth.net

‘Skoog showed us the possibilities. We have since learned

Conversation One of the most celebrated and widely respected

acceptable it is to own up to having had it.

3225 Aviation Avenue

The SMAS facelift, originally invented by Skoog, has evolved considerably, says Stuzin. to manipulate the SMAS much better and have developed our

plastic surgery is on each side of the Atlantic or rather, how

Contact

Some patients have greater laxity of both skin and the

general surgery residency at the University of Washington in

patients. This brings us neatly to the question of how acceptable

Dr. James Stuzin

has its own aesthetics.

His approach to facial rejuvenation is, in fact, firmly

‘The future of the SMAS is by no means secure,’ warns Dr. Stuzin. New surgeons don’t train in sophisticated techniques and are afraid of performing them, focusing instead on minimally invasive procedures that give minimal results. ‘They should see plastic surgery as their life’s work, not as a job. Good work takes time and commitment.’ What does the future hold for plastic surgery? Sooner rather than later a new wave of injectables will be developed and stem cells will play a major role in facial rejuvenation. ‘Stem cells and fat injections are not effective at the moment as not enough research has been done. This is a good example of marketing being ahead of science.’ I ask Dr. Stuzin what his definition of beauty is. I wouldn’t want to articulate it, he says, but I know it when I see it: it is a soft, heart-shaped face. Is only youth beautiful? He disagrees. There is beauty in the mature face as well and there is beauty in the surgically rejuvenated

grounded in the aesthetics, to the extent that he sees ‘technique as

face – so long as you find a surgeon with a highly developed sense

subservient to the aesthetic destination’.

of aesthetics, and there are no signs of surgical distortion.

Every surgeon needs to perfect the techniques and their

The ultimate question for everyone contemplating plastic

skills which in turn allow them to achieve greater subtleties. The

surgery, in fact, is the least asked: are the aesthetic sensibilities

ability to see a face in three dimensions is something that comes

of the plastic surgeon on a par with his skill and is his judgement

with experience, however.

based on adequate experience? That is what defines a great

Stuzin explains that when he trains new resident surgeons,

surgeon as opposed to an adequate one.

Dr. Rod J. Rohrich

push the boundaries of plastic surgery. Is there an overriding, more classical and less transient

The preferred open approach to

aesthetic and what is it?

rhinoplasty to reveal the nasal

Please, describe the timeless ideal, if in fact there is one.

nasal anatomy clearly.

Do you as a plastic surgeon see a dichotomy between a timeless aesthetic and the prevailing aesthetic of the day? If so, do you

Dr. Rod J. Rohrich is based in Dallas, Texas, but is, by all accounts, a plastic surgeon of

instinctively go for one or the other, the patient’s preferences being equal?

outstanding international stature. After growing up on a ranch in North Dakota, Rohrich

A The overriding aesthetic of today is still that of natural beauty, the so-called ‘Golden Triangle’ (The 2500 -year-old formula for defining perfect beauty, established by intellectuals as a ratio of

graduated with high honours from North Dakota State University and the Baylor University

1:1.618. Known as ‘phi’, the ratio applies to a ‘triangle’ of aspects for facial beauty - the width of the mouth to the width of the cheek, the width of the nose to the width of the cheek and the width of the

College of Medicine.

nose to the width of the mouth.) It’s one of a youthful, non-operated natural appearance He trained in plastic surgery at the University of Michigan from

– not looking ‘wind-swept’ or ‘the Hollywood’ appearance. As Plastic

1979-1985 and then undertook a fellowship in hand surgery at

Surgeons we are supposed to be in the FACE PROTECTION, NOT

Massachusetts General Hospital. In 1986, Dr. Rohrich accepted a

WITNESS PROTECTION PROGRAM. Most patients do not want to

position in the Department of Plastic Surgery at the University of

look like someone else or to look significantly different. People want

Texas Southwestern Medical Center at Dallas College of Medicine

to look as good as they feel. The wind-swept look of past decades

(UTSW) and became chairman of the department in 1991.

is out.

Since then, Dr. Rohrich has become well known as one of the pre-eminent plastic surgeons in the world. He has chaired over one hundred national and international symposia and delivered Rohrich is author or co-author of over five hundred peer review

age-appropriate plastic surgery so that the patient and their plastic

articles and fifty chapters in plastic surgery, ranging across the

surgery will age well and proportionally with them. For example,

delivers the desired result. The nose is the most looked out facial

Q Most people’s faces are not identical on each side and as

board from cosmetic surgery to craniofacial surgery. Many of these

when performing a rhinoplasty on a 50 year old, one should make

feature so it must not shout out rhinoplasty.

they age, the difference between left side and right side is often

publications are considered to be landmark papers on their topics.

minimal changes in proportion to the patient’s facial features.

five textbooks in plastic surgery ranging from rhinoplasty,

breast implants that are out of proportion to the rest of her

means you make a very small 6 mm incision in the middle of the

craniomaxillofacial trauma, secondary rhinoplasty and ultrasound-

body. We need to avoid the infamous “Cat Woman” and overdone

columella (the structure in the middle of the bottom of the nose).

A Of course, everybody’s face is asymmetrical. One eye is always

assisted liposuction. In 2005, he was also appointed editor-in-

distortions seen in the ‘Michael Jackson nose’. This simply is not

The procedure allows the surgeon to look directly at the nasal

bigger than the other; one side of the face always appears shorter

chief of Plastic & Reconstructive Surgery, the leading and most

good plastic surgery!!!

deformity, while with the closed approach he has to do everything

than the other. The beauty is in each face’s individuality. I ask my

in a blind way, so to speak, which means he doesn’t have the same

patients to look at the mirror and compare each side of their face

level of control.

and then to tell me which side they prefer. The goal of the plastic

shaped eyebrows. Innate or unique asymmetries are also beautiful.

teaching curriculum of plastic surgery training programs in the

When we turn the clock back through surgery we must try to

United States and thirty-eight foreign countries.

preserve these unique asymmetries rather than try to make the

Website: www.drrohrich.com

And rhinoplasty is all about controlling every aspect of the procedure…

face look like someone else’s.

In the open approach, the surgeon can see the deformity

use different procedures in combination or the same procedure, but in different measure?

surgeon is to accentuate the better side; to enhance the asymmetry by improving it. The most important thing at this point is to analyse the patient’s face. We all age differently. The ageing face is not just

and correct it with the patients’ own tissue – and reshape the

about sagging skin but about losing facial fat and volume. There are

cartilages using sutures and/or invisible grafts.

21 facial fat compartments in the face.

of Plastic Surgeons and the Texas Society of Plastic Surgeons. He

Q When a patient goes to a particular surgeon, they would

is a Founding Member of the Board of Governors of the National

necessarily end up with a result reflecting the aesthetic

Endowment for Plastic Surgery and currently serves as President of

sensibilities of that surgeon. Should patients discuss this, as

as it is impossible to see the deformity – so, instead of correcting

patient, I would carry out different procedures or a combination of

the Association of Academic Chairmen of Plastic Surgery.

well as the procedure?

it, the surgeon has to camouflage it. Not the best thing to do long

procedures on each side of the face to provide for correction of that

term as visible grafts can become distorted after a while…

patient’s aesthetic concern, as well as restoration of the patient’s

A This is a very important point for the patient and their surgeon

In the closed approach the surgeon has to use more grafts

Plastic Surgery societies in America and worldwide, Dr. Rohrich

to discuss at the outset of the consultation. I fell this is an essential

actively engages in many philanthropic enterprises. He has served

element – I need to feel very comfortable, as does my patient, that

and ages well with the patient, without the need for revision in most

on the boards of charities such as the March of Dimes, Save the

I fully understand what they want and also what I can realistically

cases.

Children - Dallas, Dallas Chapter of the American Cancer Society,

deliver in the operating room. If I am not comfortable with the

the Evergreen Gala Advisory Board which directly benefits the

patient’s expectations, I would not operate.

Dallas community breast cancer efforts of the ACS and he is

optimal facial contour I perform what is known as a LIFT AND FILL FACELIFT based entirely on the patient’s pre-op analysis, so that each

Rhinoplasty is a surgical procedure of millimetres. It is the most precise technique in cosmetic plastic surgery, therefore if you

patient’s operative plan is entirely customised . I build up the centre-face by refilling the medial or central

are off by a mm one way or the other you can have either great

facial deep fat compartments, together with lateral or outer face

a Founding Member of the Dallas for Children Foundation. He

never know the end point that I would be seeking in the operating

or phenomenal result vs. a poor outcome. Rhinoplasty, in fact,

lifting. — These are the essence and fundamental cornerstones of

personally established The Rod J. Rohrich, M.D. Foundation to

room. One would be in Michael Jackson and Joan Rivers territory. I

epitomises plastic surgery as a whole because it is a surgery of

modern facial cosmetic surgery.

annually support a medical student who will practice primary care

need to be at one with my patients and their aesthetic sense has to

such great finesse and three dimensional thinking and execution,

in North Dakota. He has also performed and taught plastic surgery

match mine, otherwise I would not be able to operate on them.

as well as precise pre-op planning –all of which requires constant

Q In the introduction of this book we give a summary of the

learning and takes years to master if you truly want to be a real

different face lifts offered by surgeons today. In practice, how

expert. Experts are not born but are made through tireless learning,

important is the technique v. the skill and judgement of the

critical self-analysis and always seeking a higher level of excellence.

surgeon?

in Third World countries, focusing specifically on reconstructing severely burned and congenitally deformed children.

I cannot go outside of my own aesthetic norm; else I would

With the open approach, the nose looks more natural longer

In any facial cosmetic surgery, based on my analysis of the

Q Are there different techniques for achieving an excellent result in rhinoplasty? Please, describe them briefly.

Q Today’s aesthetics are shaped by the media, whether print,

A Yes, there are different techniques. However, it is not so much

film, Internet or advertising, which in turn fuel demand for and

about the technique used as long as that particular technique

It takes an average of about 10 years or 10,000 hours to become a

A In the hands of a greatly skilled plastic surgeon, any technique

true expert in anything in life!!!

will provide good results, however, if you want to go to the next

Revolutionary concepts on how we age with loss of fat in special fat compartments of the face which will guide how to do a natural facelift without distortion.

Dr. ROD J. ROHRICH

Phone: +1 (214) 821-9114

The timeless ideal is an oval face with full eyes and well

for Selected Readings in Plastic Surgery, a supplement to the

In addition to serving on the boards of numerous other

Dallas, Texas 75231, USA

accentuated. How does a plastic surgeon address this? Would he

rhinoplasty. I prefer the open technique in most cases. This

Dr. Rohrich has served as a Director of the American Board

Suite 600

The main different techniques are open vs. closed

Likewise, it would not be wise to give a 50-year-old woman large

of Plastic Surgery (ABPS) and as President of the Dallas Society

9101 North Central Expressway

As Plastic Surgeons we must be always aware that we need to keep in mind the concepts of ‘Timeless Beauty’ by performing

prestigious journal in the world for plastic surgeons, and an editor

Contact

surgery is rhinoplasty or facelift.

over 1500 scientific presentations on all aspects of plastic surgery.

As well as papers, Dr. Rohrich has also published

Dr. Rod J. Rohrich

There should be no surgery tell-tale signs, whether the

level of excellence, the skill and judgement of the surgeon by

Q What are the limitations of plastic surgery in terms of

Q Fat replenishing seems to be the procedure of the moment.

far outweigh the technique. The technique eventually becomes

shedding years? Ten? Fifteen? More than that? Please, define an

If faces age outward rather than downward, would it not be

secondary.

unrealistic expectation.

possible to have a fat transplant facelift?

A There is no perfect operation. In terms of facelifts you can

A Even though fat compartments are the key component to

the surgeon’s sense of aesthetics as we have discussed. Everyone

turn the clock back somewhere between seven and ten years. The

understanding facial ageing, not every face can be rejuvenated

starts as a Da Vinci type of plastic surgeon - one who measures

results of browlift surgery will last that long as well and eyelid

through fat injections alone. We being to age after 30 and skin

things precisely - yet only few transcend this level to become a

surgery may last up to 15 years

starts sagging. The important thing to do is what I refer to as a fat

The other most important element of plastic surgery is

Michelangelo type of plastic surgeon - one who can combine the

A properly done rhinoplasty lasts a lifetime while breast implants done for breast enhancement last ten to fifteen years as

especially in the deep central fat compartments. These are fixed

in achieving what is right for that particular patient.

all man-made implants need to be replaced every 10-15 years. Body

by injecting fat deep into each compartment. This alone will work

contouring could last a lifetime provided it is combined with proper

in the late thirties to forties using either fat or an FDA approved

innate and learned artistic sense which is integrated into making

diet and exercise. There is no point in liposuction unless people

filler like a hyaluronic acid filler or Radiesse. The key is to fill the

the most of each patient’s underlying best features – whether I am

change their lifestyle, i.e. change their diet and exercise routine for

fat compartments centrally and then do the face lift laterally, as

performing a facelift, rhinoplasty, breast lift or a body contouring

the better.

and when needed. This is a very exciting new arena for not only

surgery.

Q Your thoughts on the deep plane facelift? A The deep plane facelift is essentially dead as it never made good

Q If a woman of fifty has a facelift which makes her look around forty years old, if the same woman at sixty had another

restore facial youthfulness.

based and did not integrate with what a patient looked like or what

A No, at fifty after your facelift, you would look ten years younger

Q Is the mid-facelift a misnomer or a valid procedure? A I don’t espouse the mid-facelift. It looks out of synch with

they would look like after. The end result produced, in many cases,

but will continue to age as time goes on. One can not stop the

procedure - it is in my opinion a procedure out of step with facial

facial distortion and the over-operated appearance which is out of

ageing process but merely turn it back in time. Therefore, when

ageing. It does not have a major role in surgical restoration of the

synch with modern facial aesthetics.

you turn sixty- ten years later - and have another facelift you would

ageing face

It was a great anatomic innovation however, which provoked

facelift would it ‘take off’ another ten years and would she look

still achieve a great improvement, but you will not remain forty! At

the rest of the face. I don’t see a role for an isolated mid facelift

Q Who in your opinion most closely embodies the ageless beauty

us to look at the deeper layers of the face. Modern facelifts are

this stage, you can turn the clock back by five to seven years. Why?

about the operative manipulation of multiple layers, based on

Because other features would have changed as well in those past

individual facial analysis, not on a particular technique. The

ten years, such as you will have more facial fat loss especially in the

component facelift which uses multiple layers to reshape the face

orbital and temporal area, all of which will contribute to making you

Allie McGraw... Each of these women have the same facial beauty

without distortion is ideal for a natural facial rejuvenation.

look older.

traits: great oval faces with wonderful natural asymmetries that

Q Minimally-invasive seems to mean many different things,

avoid looking tired and to keep the patient looking their best at

types that tend to over-amplify the central face or excessive lip

yet is often misunderstood by the average consumer. It often

each stage and phase of their life People who have unrealistic

fullness.

describes a complex procedure that is done endoscopically,

expectations are headed for disappointment. Another major factor

however, most scars are subject to the skin’s capacity to retract

of how each of us ages is genetic pre-determination. It is also

There are also many plastic surgery myths that tend to be

and the patient’s age, among other factors. In this context,

predicated on the shape of the face – whether the face is thin or fat.

perceived as truths as marketing hype has overtaken facts.

does it really matter how long or short the scar is?

For example, fat faces don’t age as fast as thin faces. The greatest

On the next page are some of my favourite myths debunked.

A Minimally invasive can indeed mean a number of different things

The objective of repeat or secondary facelift surgery is to

myth of plastic surgery was that taking fat out of the face and eyes

A deep layer facelift to reshape the face

in the field of plastic surgery but for the patients it means only one

was a good thing – that was the hardest lesson we had to learn. In

along with replenishing the facial fat

thing – fewer incisions and less recovery time. The true definition

most patients it is not a good thing at all; in fact it accelerates the

compartments.

and the ideal of a minimally invasive lift is the three incisions

ageing process.

endoscopic brow lift. In this procedure the patient can expect much shorter recovery, less discomfort and an improved overall result.

Q A youthful face on an old body is an unsightly thing. Do

Our job as plastic surgeons is to hide the scars or to make them

patients tend to focus too much on face and breasts and not

almost imperceptible – that is the ultimate result. The length of

A People focus on what they can see or want to have others see.

is irrelevant, so long as you do. Most of the things written about

Young women tend to want to have breast augmentation surgery.

minimally invasive or short-scar procedures in relation to facelifts

As they get older they focus more on their nose, face and hands.

are primarily MARKETNG HYPE ONLY AND NOT BASED ON TRUE

The body and face also have to be in synchrony. Hands can tell

PATIENT OUTCOMES OR SCIENTIFIC DATA TO SUPPORT THE

the biological age and are highly visible. Often, in conjunction with

MARKETING EFFORTS.

a facelift, we will also perform fat compartment autologous fat

emphasise their individual beauty. I don’t like the Angelina Jolie

The most important thing a consumer should remember is to do their homework. Wherever you live, find a board-certified plastic surgeon in order to get good advice. The most important determinent of

Pre and post op 2 years — natural appearing facelift using LIFT AND FILL FACELIFT with fat replenishing of the fat compartments centrall and lifting of the deep layers in the outer face

your safety and outcome in plastic surgery is who you choose to do your plastic surgery.

injections in the hands, combined with later skin resurfacing. This will greatly enhance and replenish the top of the hand and last

the past. Are there new developments in face lift techniques

several years.

that will define the near future?

In the ageing cycle, cosmetic surgery is performed in the following sequence: young women will have a rhinoplasty and/or breast

different stages of ageing in different parts of the face. Modern

enhancement surgery first. As they get older and have children,

natural facelift techniques like the new Lift and Fill technique that

they are likely to have a tummy tuck and liposuction along with

I have described are based primarily upon each patient’s individual

facial fillers and Botox

facial analysis, which in turn determines which facelift technique

Then, at about age 50, they will have a facelift, eye surgery, a brow

should be used to obtain the desired result.

lift and at sixty-sixty plus they will probably re-do the face and rejuvenate the ageing and drooping nose.

Dr. ROD J. ROHRICH

A Plastic surgeons have reached an epiphany in understanding

we asked you to describe in question 1?

A Sophia Loren, Elizabeth Taylor, Julia Roberts, Jackie Onassis,

enough on limbs/rest of body?

the scar is irrelevant. Indeed, how you attain the ultimate result

Q All educated consumers know that the skin lift is a thing of

understanding how we age but also how we can rejuvenate or

perpetually forty?

sense either anatomically or surgically. It was more anatomically

finess open rhinoplasty.

loss GPS mapping of the face and to target the areas of fat loss,

precision of the measurement and combine it with the artistic sense My sense of the best aesthetic is a combination of the

Pre and post op 2 years —

UT SouthWestern Department of plastic surgery Dr. Rohrich’s plastic surgery myth-busters General myths about plastic surgery Myth: All cosmetic surgeons are real plastic surgeons. Reality: Unfortunately, anyone with a valid medical license can call themselves a plastic

Myth: Only real plastic surgeons can perform any type of plastic surgery or cosmetic procedures. Reality: It may be hard to believe, but anyone with a valid medical license can call themselves a plastic surgeon. The consumer must investigate carefully before he or she goes to see a physician. Myth: All plastic surgery procedures are done in an accredited operating facility.

safe and don’t cause cancer or rheumatoid diseases.

devices. However, they can be a good choice to correct sun damage, discoloration, fine lines and even acne scars. A small percentage of patients may achieve some skin tightening, but this is not a predictable benefit. While fractional lasers offer minimal downtime, other types of lasers can offer more visible results. The rule of thumb is: the shorter the recovery time, the

more studies are needed. They are being done now.

less improvement you can expect.

Reality: After a certain age, nothing can produce the results of an actual surgical facelift.

you must pass a rigorous written and 2-day oral exam.

SouthWestern have consistently shown and proven that both saline and silicone implants are

Reality: Despite lots of advertising to the contrary, fractional lasers are not skin-tightening

Reality: Both types of implants are approved by the FDA and there are benefits and drawbacks

beware” specialty.

plastic surgery of the face and body. It takes from 6-9 years to achieve this training, and then

Reality: Rigorous and long-term studies done all over the world from Harvard to UCLA to UT

Myth: Fractional laser skin resurfacing tightens the skin non-surgically.

Myth: Saline implants are just as good as silicone implants.

Myth: Fillers and Botox are the new non-surgical facelift.

Reality: Only the American Board of Plastic Surgery certifies that someone is fully trained in

Myth: Breast implants are not safe.

face with less discomfort and recovery.

there is preliminary data to show that it does diminish acne and may stall hair loss as well, but

surgeon, hang up a shingle and begin treating patients! so plastic surgery has become a “buyer

Myth: All plastic surgery board certifications are the same.

However, the proper and skilled combination of Botox and fillers can certainly postpone the

with each type. At UT SouthWestern we perform surgeries using both saline and silicone implants, following extensive consultation with our patients regarding their health, lifestyle and personal preferences, as well as the outcome of a physical examination.

Myth: Mesotherapy is an easy and safe way to spot-reduce fat and lose weight. Reality: Mesotherapy is not approved by the FDA. It can be dangerous and very painful and yields little or no results. Also known as “the French method,” mesotherapy uses multiple

appearance of ageing in younger patients. Botox can smooth the forehead while lifting and

Myth: The new jelly bean silicone implants last forever and are better than what is now

needle injections to deliver small amounts of herbal and vitamin compounds to the middle

shaping the brows. Fillers can plump up the lips and cheeks and soften the nasolabial folds. The

available.

layer of the skin. Touted as a minimally invasive procedure that treats everything from cellulite

results are not permanent, but they require very little downtime.

Reality: All man-made implants – both saline and silicone – last about 10-15 years maximum.

to sagging skin to excess weight, most of mesotherapy’s claims are completely unfounded.

Myth: The “new” Botox – Dysport – is better and lasts longer. Reality: The efficacy of Botox and Dysport is about the same. Both injectables are essentially

And the new jelly bean implants have not been proven to be better since we have no 10-year data to evaluate. That is important for all implants placed into humans.

purified forms of botulinum toxin a. Dysport may act somewhat faster and is expected to

Myth: Fat taken from the buttocks is now the preferred choice for breast augmentation.

be about 15 percent cheaper. Dysport is currently being used in Europe and is anticipated to

Reality: It is still very experimental and not cost-effective – taking three times longer with

launch soon in the USA with FDA approval.

inconsistent results. Furthermore, it may mask breast cancer if it develops, so this is a major

Myth: There are over a dozen FDA-approved fillers on the market. A person should be able

drawback. This needs to be further investigated before we can reach a conclusion.

Myth: Cosmetic laser vaginal rejuvenation can tighten / tone / shrink the vaginal walls. Reality: This is primarily marketing hype and does not work. Period. Cosmetic surgical labiaplasty is different and is effective for reshaping or reducing the external genitalia. Myth: Liposuction or a tummy tuck can jumpstart me to eat better and exercise. Reality: Eating right, exercising and lifestyle changes are imperative to optimising success in body contouring. This must begin before surgery.

to pick the newest one or the one that best fits their budget since they are all government-

Myth: Fat injections to the breast will replace breast implants.

approved.

Reality: Fat injections are truly experimental and are not going to replace conventional saline

Reality: A practicing board-certified plastic surgeon or dermatologist is the most

or silicone implants any time soon. With current technology, only 50 percent of transplanted fat

knowledgeable person to determine which fillers to use on the different parts of the face to

successfully grafts to a new location (the rest scars or is absorbed by the body). However, fat

Myth: It is disrespectful to ask a plastic surgeon tough questions about their experience or

give you the best results in a cost-efficient manner. A combination of different fillers with

injections may be useful in making small modifications to breast size, such as correcting breast

expertise, or to ask them to show you some results.

different properties is the preferred way for achieving facial rejuvenation. Some fillers are more

asymmetry.

Reality: Board-certified plastic surgeons prefer informed patients. Knowledge is power and it

viscous and don’t migrate as easily; others are more fluid and can plump larger areas. Some cost more because they last longer (like Radiesse, which can last well over a year in comparison

Body contouring and laser myths

Myth: Herbal diet medications are safe and effective for weight loss.

is very important to make the right decisions. It will determine not only your outcome, but your safety as well. In general, an educated patient recovers better because there are no surprises

to some other hyaluronic acid fillers which act for 6-9 months). Your plastic surgeon should be

Myth: There is now a permanent cure for cellulite.

never really know what you’re going to get. They can often contain “stimulants” which may

your guide.

Reality: There is no permanent cure for cellulite, which is present in all females from age 11–99.

react adversely with other medications or your body.

Reality: Unless you’re a board-certified plastic surgeon by the American Board of Plastic Surgeons, you aren’t required to perform plastic surgery in an accredited facility. That may put you in harm’s way if there is a problem.

and less anxiety about the procedure.

Facelift and skin-care myths Myth: Everyone ages the same in the face, so the same facelift procedure will work for everyone. Reality: Recent groundbreaking work at UT Southwestern on facial fat compartments has

Myth: Permanent fillers are better and everyone should use them.

It is due to estrogen. There are exciting things on the horizon, but they’re not here yet.

Reality: Permanent fillers in general have more permanent problems that cannot be

Myth: Laser liposuction is the best form of liposuction today.

removed without disfigurement. And they don’t age well with the patient – so don’t use them.

Reality: Not true. It has not even been proven to work as effectively as traditional liposuction.

Temporary fillers that last longer – up to 1-2 years – are optimal at this time.

The best and most advanced liposuction remains “UAL,” which gives the best contour and

shown that we all age differently. This has led to new and more natural ways to customise

Myth: Stem cells from fat work so well they will replace all facial fillers used today.

facelifts for the future. Additionally, the environment clearly plays a role in how we age. There

Reality: Perhaps in the future, but not now, as we still have to refine how we harvest, grow and

are adverse effects on our skin from the sun, wind and tobacco, among other things.

stimulate stem cells. But we’ll get there in the next five years!

results with the least downtime. We are working on this technology at UT Southwestern, trying to develop standardised techniques that may yield more consistent and reliable results. Myth: Fat can come back after liposuction and “reverse” the procedure. Reality: Fat doesn’t come back in the same areas unless you gain over 30 percent of your

Myth: Exercising is the most important component to a weight-loss program. Reality: That’s incorrect. While exercising on a regular basis helps tone your body, it is your daily diet that will determine how effectively you lose weight and then maintain it. A balanced diet will allow for a slow and steady weight loss. Fad diets often yield only temporary weight loss results.

Reality: Herbal medications and supplements are completely unregulated by the FDA, so you

Ageing myths Myth: Your genes are responsible for how you age. Reality: This is partly true, but it is also true that ageing is directly related to how we live. In a few words, ageing is impacted by our environment, diet and habits (like smoking). Excessive sun exposure is a major cause of premature ageing, as is excessive eating. Unfortunately, the latter is becoming a major problem in our society: almost 60 percent of adults in the USA today are estimated to be overweight and 30 percent of our children are obese. Myth: Supplements can help slow down the ageing process.

Myth: Facelifts marketed as in-office procedures – usually taking just one hour with local

Myth: You won’t age naturally if you have cosmetic surgery.

anesthesia and minimal recovery time – are safe and effective.

Reality: When plastic surgery was in its infancy, surgeons focused on tightening the loose skin

Reality: Many patients have been disfigured or experienced complications from procedures like

of the ageing face. With further research done by UT Southwestern plastic surgeons, we now

these. If you want long-lasting changes that you’re going to be happy with, it is better to get a

know that an aged appearance is not only caused by loosening skin but by the loss of facial fat.

real facelift from a board-certified plastic surgeon performed in a real operating room under

We can naturally rejuvenate the face by techniques that both lift and fill the face. Using these

Myth: Non-surgical fat removal doesn’t really work.

as Chondroitin for prevention or treatment of joint aches. The newest fad is Resveratrol, the

sterile conditions.

new concepts of fat compartments and fat replacements within the deeper layers, we have

Reality: Yes, it does. While it is not a replacement for liposuction, in some patients there may

active metabolite of red wine thought to be capable of increasing lifespan, but scientific data

moved to the next generation of facelift technology.

be some benefit to both external ultrasound treatments as well as low-level laser treatments.

is still inconclusive. All supplementation should be considered under the advisement of your

This is an area of intense research at UT Southwestern and we anticipate more advances in

physician.

Myth: Topical Botox is replacing injectable Botox.

Myth: Non-surgical rhinoplasty can provide the same results as surgery.

Early indications are that it may work in small areas around the eyes (crows feet) and that it

Reality: Not really. Fillers can help make some bumps and depressions go away temporarily –

may help make injectable Botox last longer. However, it is difficult to say it will ever replace

the best ones to use are based on hyaluronic acid – but this solution doesn’t work for significant

injectable Botox as it doesn’t have the same ability to deliver the toxin to specific muscle areas

changes, nor do the results last more than 6-12 months. Myth: You can remove dark under-eye circles with a cream.

Myth: Botox is Botox. You can get it for $100 at a hair salon or spa, or pay a lot more to get

Reality: Unlikely. Under-eye circles can have many causes, including skin pigmentation,

it from a doctor.

shadowing, thin skin and visibility of underlying blood vessels. Different procedures to treat

Reality: in Botox, as in life – you get what you pay for! The price of Botox is set by the company

these problems may include the use of Retin-a or bleaching creams, chemical peels or lasers,

(Allergan) that produces it. If you purchase Botox at a severely discounted rate, it is possible

and potentially surgery to blend the eyelid-cheek junction.

that you are receiving a very diluted form of Botox or perhaps something that is not even real Botox at all. What’s more, in salons the product is often injected by people with insufficient training, which can result in problems like asymmetry and droopy eyelids or brows. Myth: Botox cures migraine headaches, acne and hair loss.

Myth: You can grow thicker, longer eyelashes by applying a liquid gel daily. Reality: True. The gel is called “Latisse” and its active ingredient was originally developed as a drug to treat glaucoma. When used as directed, you can grow thick, long eyelashes in about 4-6 weeks. There are some side effects to consider, e.g. it can potentially darken light-colored eyes.

body weight after liposuction. Then you can actually grow new fat! Long-term results in body contouring demand that you change your lifestyle. With regular exercise and proper diet, you shouldn’t see fat reappear in the liposuctioned areas.

the future. It has good science behind it as well. In research done at UT Southwestern we have shown that by using focused ultrasound beams you can remove a modest amount of unwanted fat in certain areas. This is a very exciting new field. Remember that diet and exercise are required in order to achieve optimal results using these non-invasive treatments just as they are with surgery. Myth: Extreme makeovers as seen on TV are commonly done and are very safe. Reality: It is a total misconception that you can perform total body contouring and breast augmentation and teeth whitening in one setting. In general this is not safe or recommended for most patients.

Reality: There is scientific evidence that we should consider one baby aspirin daily (82 mg) for heart attack prevention; omega-3 supplements or having 2-3 fish meals per week; and a good once-a-day vitamin. There is softer data for coenzyme q-10 (an enzyme activator), as well

Myth: As we age, it is the sagging skin of the face and neck that makes us look old. Reality: It is the sagging skin, but more than that, it is the loss of facial fat, especially around the eyes and cheeks that makes us look older beginning at age 30. We have discovered these fat compartments in anatomic studies at UT Southwestern and have determined how to add fat to make you look young and more natural longer. Myth: There is an anti-ageing cream that will keep you looking younger longer. Reality: it is true! This product does exist and it’s called “Retin-a.” This cream or lotion works by forcing skin cells to turn over faster. With long-term use, it can improve acne and fine wrinkles, smooth the skin and remove age spots. The other great ageing prophylactic is a

Myth: Skin tightening lasers work well and will replace facelifts in the future.

sunscreen with both UVB and UVA protection. The combined usage of these two lotions, Retin-

Reality: There isn’t a predictable and reliable way to tighten the skin non-invasively. However,

a and sunscreen, will make a big difference in how fast your skin shows visible signs of ageing.

we do have advances in laser resurfacing that allow us to treat fine and moderate lines of the

PLASTIC SURGERY MYTH-BUSTERS

Reality: Not true… yet, topical application of botulinum toxin a is still in the clinical trial phase.

with pinpoint accuracy.

Reality: It is very effective for both stress and migraine headaches if placed correctly. And

Breast augmentation myths

Dr. Tomaz Nassif

persistent swelling. It is preferable to perform fat injections or to fill the malar (cheek) area with hialuronic acid.

Q Please, explain in lay language the technique of SMASplatysma suspension by a “round-block” plication, in particular

skilled the surgeon, tissues (skin, muscles and bones) will suffer progressive

degree in Microsurgery, Hand Surgery

degeneration with age and this cannot be overturned or entirely concealed.

and Cranio-Maxilo-Facial Surgery. He

Q Is face transplantation the ultimate beauty

has worked in France with Dr. Daniel

procedure and provided a patient can afford it, do you foresee it becoming

Marchac and Jacques Baudet. Dr Nassif

commonplace in the future?

A The future will certainly

has been a Chief of the Department of Reconstructive Microsurgery of

have face transplantations and stem cell treatments for cosmetic purposes. In the

the “Hospital dos Servidores do Estado” in Rio de Janeiro, since 1985.

case of face transplantation, it is still too early to think of it as a rejuvenation technique. The rejection

He is also a Professor of the Post-Graduation Course in Plastic

process is something very

Surgery of Professor Pitanguy’s residency program and a

difficult to overcome. There

Consultant of the Pitanguy Clinic for Microsurgery since

is a need for anti-rejection

1987. Dr. Nassif is the Ex-President of the Brazilian Society of

drugs such as tracolimus

Reconstructive Microsurgery and a director of the Clinic of

and corticosteroids that

Plastic and Reconstructive Surgery of Rio de Janeiro.

really shorten the life

Q Reconstructive microsurgery is mostly associated with nerve repair or limb transplant. What are, or could be its applications in elective surgery?

Rua General Garzon 22/ste. 303 Rio de Janeiro- Brazil ZIP: 22470-010

Q You advocate

naturalness and simplicity as the epitome of beauty, however,

and his knowledge of the deep and special anatomy related to

“natural”, after a certain age, is not “beautiful” – or at least, we

microsurgical procedures.

as a society no longer perceive it so.

Personal: 55 21 9986 1647

I use the word naturalness to mean the absence of surgical signs

during surgery) and its branches that are responsible for the facial

that give a person an operated look or give away the fact that

movement.

they’ve had surgery at all.

Email:

tomaznassif@uol.com.br

loupes or surgical microscopes, the surgeon develops an excellent

Q What are your views on the effective repositioning of the

perception of the trauma he could inflict to tissues by grasping

malar fat pad (lifting the cheek)? Is there such a thing as a

and pinching with the various surgical instruments. He or she is

permanent suture suspension/solution to sagging cheeks?

therefore much more conscious, cautious and delicate. For the

A There are no permanent suture suspensions. There is an

patient, this means more security and less trauma.

almost permanent tissue repositioning by means of dissecting and

restore youth, are there any limitations in how far he can turn back the clock and what are these limitations?

A Of course there are many limitations in turning back the

clock. Could a surgeon perform a miracle and keep a patient

is equally true for the breast, abdomen and the face. The more lax the skin = less collagen and thickness = shorter lasting effects of of the capacity of the skin to retract after a liposuction procedure. I think there is no easy solution for these patients. For sure, a more

fix ed

aggressive technique in rejuvenating the face can give a more lasting result in these cases.

Q What are your views on the deep plane face lift and, recuperation time aside, why is it that the overwhelming majority of surgeons are opponents of it?

A Deep plane means more risks and long recuperation time (I know you asked to put it aside). It is more aggressive and gives, from my point of view, not exactly natural results. I think that the face seems a little bit artificial and I don’t like this. The patients don’t like it. That is why the vast majority of surgeons are opponents of it. They listen to their patients…

m obile

Q Below is Dr Robert Goldwyn’s comment on plastic surgeons and the choices patients have. Can you please comment on it?

A The ear is the “center” of the “round-block” plication as you

“The essential problem [of finding the best plastic surgeon] is a

can see in the illustration above. The thread is passed under the

philosophical one: when a patient goes to a plastic surgeon, he

scalp in the upper pole of the ear and in a wave like mode into the

or she will get what that plastic surgeon usually does. There are

SMAS-platysma tissues. The superior scalp part is fixed and does

very few plastic surgeons who would use a technique that some

not deform, unlike the anterior and lower facial and neck parts that

of your participants have advocated and vary the treatment

pick the SMAS-platysma and are loose and mobile. (See illustration)

according to what the patient needs. Even if one can understand

When the thread is pulled and tightened, the tissues migrate in

the technique, the problem is that the patient really will never

a centripetal way towards the fixed position, thus elevating the

understand the options and will have to go to the plastic surgeon

tissues of the face and neck. This technique was described by

about whom he or she has heard does a good job.”

Ithamar Stocchero, a plastic surgeon from São Paulo, Brazil.

Q Given that the malar fat pad (cheek pad) is only loosely connected to the SMAS, but mostly to the skin, what are the

A I agree with the essence of the idea. That’s why I am against TV reality shows that now invade the operating rooms. The patients don’t have the knowledge and are not equipped to choose among

implications for a patient with naturally lax skin? Is there a

the different techniques available for the same purpose. I agree

solution for such a patient, other than revisiting their plastic

that candidates for plastic surgery will choose the surgeon because

A I am referring here to a younger “natural” look.

have to work very close to the facial nerve (which can be lesioned

Q If a plastic surgeon is indeed God-like in his ability to

preservation of the aesthetical results after a surgical procedure. It

elevating, using sutures to maintain the tissues in position while healing. The malar fat [cheek] pad is easily re-positioned by subperiosteal [deep plane] dissection and elevation. Fixation can be made securely in the orbital rim [the bones surrounding the eye] by transfixing the bone and threading the sutures that will hold

perpetually young? No surgeon or technique can deliver such

the tissues in need of lifting. The problem is that this dissection is

a miracle. However excellent the surgical method and however

more aggressive and has a long period of recovery because of the

Dr. Tomaz Nassif

Phone: 55 21 2512 7497

the future.

A I believe that the most important issues when it comes to

Additionally, when working with and under magnification

Contact

toxicity. But the future… is in

working close to nerves and blood vessels are the surgeon’s skill

In the field of facial aesthetic surgery, for example, we

Dr. Tomaz Nassif

expectancy because of their

<< I am referring here to a younger “natural” look. I use the word naturalness to mean the absence of surgical signs that give a person an operated look or give away the fact that they’ve had surgery at all. >>

A The quality of the skin is an important differential in the

the rejuvenating surgery. Much more important is the evaluation

the “round-block” part.

Dr Tomaz Nassif is a Rio de Janeiro Plastic Surgeon, with a post-graduate

surgeon with greater frequency than most?

they have seen a good result in someone else they know.

is much larger than in European countries.

“There are very, very few plastic surgeons who individualize the

Q The vast majority of South American surgeons (and not

treatment according to what the patient needs. More often the

a few North American ones) claim status for having trained,

plastic surgeon does what he or she thinks he or she does best.”

however briefly, under Ivo Pitanguy. Is anyone taking on Pitanguy’s mantle, now that he is no longer operating?

I think that I am among these “few” plastic surgeons that

A Pitanguy is the most famous plastic surgeon in the world. He

individualise the treatment according to the patients’ needs. Yes,

spread all over the world the culture and understanding of plastic

the plastic surgeon has to be skilled and experienced in many

surgery. But he was always a “one man” personality. Nobody ever

different techniques applied to the same, yet slightly different,

knew his assistants. No one reached his high. He will leave a lot of

purposes.

very good and skilled pupils but it is difficult to single out one or

Q If you agree with the premise of it, what would you say is your own “comfort zone”?

A I think the more comfortable the surgeon is in many different

even a few…

Q Who, in your opinion, is the most attractive face in the world and why?

zones, the best for the patient. That’s why I did reconstructive

A I love the face and body of Gisele Bündchen. She has European

surgery, microsurgery and cranio-facial surgery. I think Barry Jones

roots but a Brazilian miscegenation that have given her that magic

has summarized this very well:

that fascinates people all around.

“Very few plastic surgeons would venture outside their comfort zone, but then, the wider that zone, the farther they would be able to venture. Surgeons who do cranio-facial and reconstructive plastic surgery have a much deeper understanding of facial anatomy and are therefore much more confident in terms of adapting aesthetic procedures to individual patients.”

Q Brazil has long since been considered the berth of plastic surgery as we know it today. Do you think the U.S. has dislodged it from its position in the last two decades?

A I believe that Brazil is still leading

in the field of plastic surgery, but at risk of losing ground because plastic surgery programs are no longer as good as they should be. It seems to me that the majority of new residencies created in the last 10 to 15 years are incomplete and do not have the broad vision and knowledge of plastic surgery in its entirety. In the other hand, the public medical welfare system is also responsible because of its low budget to hospitals and residency programs. We (the Brazilian Society of Plastic Surgery and the government) need to take this seriously or lose our pole position.

Q If you had to offer a persuasive argument for a European patient to travel to Brazil for plastic surgery, what would that argument be?

A I could offer no compelling argument for facial aesthetic

professionals in our country than in Europe, just because we are much more numerous. But I would say also that in Rio de Janeiro people have a culture of maintaining their bodies young, healthy and beautiful. This offers plastic surgeons plenty of scope for experience and the number of plastic surgery clinics operating on breasts, abdomen and specializing in body contour, like liposuction,

Dr Tomaz Nassif

procedures except for the fact that there are more good

<< I think the more comfortable the surgeon is in many different zones, the best for the patient. That’s why I did reconstructive surgery, microsurgery and craniofacial surgery. >>

Dr. Marco Antonio Guedes cosmetic dentistry Dr. Marco Antonio Guedes is Rio de Janeiro’s most renowned specialist in dental prosthetics and implants. His private practice has been established for 22 years. He has trained in laboratorial prosthetics and aesthetic odontology* in both Germany and the United States, and now teaches other dentists at his training centre in Rio de Janeiro, Brazil (grupoarcalis.com.br).

Asked to comment on the aesthetics of cosmetic dentistry, he offers

order to correct a width/height ratio problem, it is necessary to

the following:

either increase the teeth or decrease the gums.

Basic Concepts:

5) The amount of gum that is exposed when we smile - This

‘I am listing below five factors that truly influence the beauty of

is a problem that may require surgery as a solution. Modern

a smile. Smile disharmony can be corrected through a simple, yet

oral surgery techniques make it possible to achieve a maxillary

vastly beneficial procedure of teeth whitening, for example. At the

realignment which in turn improves the other facial proportions.

other end of the scale, there are complex treatments, involving

Sometimes a simple surgical operation to increase the size of the

different specialists, working as an experienced and well structured

teeth would bring a great improvement to the patient’s smile.

team. The selection of this team directly determines the quality and duration, as well as the physical and emotional toll, of the

Thus, just as in plastic surgery, the key to great dental aesthetics is

treatment.

in the right “dose” of treatment.

1) Tooth Colour - The lighter the teeth, the more youthful and clean

absolutely perfect and pristinely white as that of a 15 year old.

they appear to be. This, in turn, gives a perception of beauty by

Harmonising the beauty of the smile with the beauty of the face

contemporary standards. One must be careful, however, not to

is the secret of the aesthetic dental procedure at its best. One

Dr. Marco Antonio Guedes

overdo the whitening treatment.

must always apply a sense of proportion – of the right “dose”, as

Contact

2) The alignment of teeth in relation to the mouth and face - The

A face that is 60 years old cannot have teeth that are

Av. das Américas 500 Bloco 10 Sala 302 Barra da Tijuca - Rio de Janeiro - Brasil Phone:

5521-2493-2565

Email:

marco@marcoguedes.com.br

Website: www.marcoguedes.com.br

described above. Aesthetic sense in dental surgery is respecting the

alignment of the teeth is perhaps the

proportions of the face and a good dental

most common perception of a need for

surgeon would study these before initiating

correction. What we consider important is

any procedure.

that the alignment of the teeth respects

We have the ability to construct temporary

the ratio and relativity to the face. Small

restorations in the course of a treatment and

discrepancies are acceptable but crooked

discuss the desired result with the patient before

teeth don’t look good in anyone.

finalising it.

3) The border of the upper and lower

of the patient both in terms of colour and

teeth must have a curve that ascends

appearance.’

This allows us to achieve the expectations

- The alignment of the teeth must follow the line of the lower lip. If this alignment

Cosmetic dentistry today

is inverted, it gives the impression of an

Investments in scientific know-how and increased

aged or “sad” mouth.

awareness of how best to treat patients have resulted in greatly improved procedures. In terms of better treatment, I am

height - The width of teeth should be

referring to a certain work philosophy: focusing on

Students in Training

more or less 80% of their height. In

high quality procedures carried out in fewer visits and with the minimum amount of discomfort. We adhere to and teach this principle. Today, a competent odontological clinic with a well trained team can accomplish veritable wonders. •Odontology - the study of the structure, development, and abnormalities of the teeth

DR.marco antonio guedes

4) The proportion between width and

Dr. Marco Antonio Guedes’

Dra. Dayana Garcia Alves Dayana Garcia Alves is one of the up-and-coming professionals

With ten years of experience, Dayana has studied and perfected her technique with some of the world’s most accomplished surgeons, including Professo Oswaldo de Castro.

in Brazil’s new generation of plastic surgeons.

Based in São Paulo, Dayana has a varied practice in cosmetic and reconstructive surgery. In 2009, she opened her own clinic, Clínica Plástica e Saúde, with state-of-the-art facilities in a bright, warm setting. Operations are performed in Brazil’s leading private hospitals, which are nearby. Dayana most enjoys the personal contact with her patients, helping them improve their appearance and enhance their lifestyles. No two patients have the same bodies, concerns or dispositions towards surgery. Dayana invests the time to get to know each patient in order to make the most appropriate recommendations for treatment and to ease their way through the entire surgical process. Recognising that the post-operative period is as critical as the operation itself, Dayana maintains active, caring supervision until the patient is fully recovered. As a woman, Dayana well understands the special aesthetic concerns of female patients; her advice has been highly sought after by women of all ages. Although most of her patients are Brazilian, an increasing proportion of referrals are international. Dayana is a medical graduate of Universidade de Mogi das Cruzes. She has a masters degree in which she studied surgical correction of eyelid ptosis – a condition on which she has since become a local expert in Brazil, donating time every month to a public clinic to restore full eyesight to afflicted children.

Contact Clínica Plástica e Saúde Rua Vergueiro, 1353 – 20 andar Paraíso, São Paulo – SP Brazil Phone:

+ 55.11.4508.7551

Email:

dayanagarcia@bol.com.br

Website: www.dayanagarciaalves.com.br

DrA. DAYANA GARCIA ALVES

Dra. Dayana Garcia Alves

Dr. Ortiz Oscoy

An innovator and a spiritual scientist, Dr Ortiz Oscoy has focused on a fusion between oriental studies and science, and dedicated the last several years of his life to the effect of meditation and comparative religions on the development of the brain and the psychological conscience. Ten years ago, Dr Ortiz Oscoy opened his own clinic, the Centro de

Doctor Ortiz Oscoy is a Mexican surgeon specialising in

Cirugia y Auto Imagen, where patients can recuperate from surgery and achieve a sense of harmony between body and soul.

aesthetic and reconstructive surgery whose career spans

Dr Ortiz Oscoy is unique in his approach – he believes that is it important to achieve integral harmony between body and spirit and has published a number of books on the subject. His work in this

three decades. He is known for his excellent results in

field was recently presented at the World Congress of Psychiatry and instigated a lot of interest within the scientific community.

rhinoplasty and operates at the Instituto de Transplantes

Along with a number of distinguished neurophysiologists, psychiatrists and therapists, he organises workshops on meditation

de la Ciudad de Cuernavaca as well as in a number of private hospitals in Mexico City, such as the Angeles Hospital.

at the holistic resort Hostal de la Luz in Tepoztlán.

Q Why did you decide to become a plastic surgeon? A When I was four, my father asked me what I wanted to be when I grew up, to which I replied “A doctor”. Over the years I never changed my mind, even though I was very attracted to a career

Dr. Ortiz Oscoy Contact Ortiz Oscoy, Louis A. Palmas 745 Mezzanine 505 Col. Lomas de Chapultepec Phone: +52 55 55205811

in art, particularly painting, sculpture and architecture. When I finished my medical studies, I knew that I wanted to specialise in surgery. While on community service I performed reconstructive surgery on several accident victims, which influenced my final choice of plastic surgery. Finally, I was accepted to study with Dr. Fernando Ortiz Monasterio at one of the leading schools in the field

Q There is very little about you on the internet in the English

of plastic surgery.

language. One translated comment refers to your “objective, which is to transcend the physical and transform the patient at a deeper, more spiritual level.” Please explain how you achieve this.

A For the last 40 years my academic interests have spread to comparative religion, alongside medicine. I am interested in the remedies that were used by healers in other parts of the world and the inexplicable but extraordinary brain skills that some people possess. I have come to realize that humans exist in more than just their bodies, and are essentially composed of body, mind and spirit. That is why I consider the patient as a whole. What is the point of improving the external appearance without affecting the most important elements of a person: the mind, spirit and emotions?

Q Please, comment on the link between neuroscience and beauty enhancement in general

A All human life experiences and survival techniques are stored in and controlled by the subconscious. When a person is truly in

<< Before surgery, the patients enjoy stress-reducing massages, special mud treatments, facial cleansings, meditation exercises and emotional therapies such as resonance re-patterning. >>

harmony with their looks, they will feel that they are more attractive. This visual information gets into the subconscious part of the brain. Now, when this part of the brain finds that it is in harmony with the body, a process of recovery begins and all the bodily functions improve. The immunological system also functions better and the body’s regenerative cells are activated. All this happens because we have changed the person’s self-image stored in the subconscious Tell us about the Center for Cosmetic Surgery and what

treatments are available there.

A This plastic surgery and self-awareness center was founded to treat all aspects of the patient’s body and spirit. Our aim is to emulate Hippocrates who, centuries ago, talked about uniting all the elements of a person to achieve the ideal recovery of that patient. Our center is located in Cuernavaca, 35 minutes away from Mexico

Dr. Ortiz oscoy

since knowledge belongs to everybody. There are certain procedures, however, which produce extremely satisfying results for me. For example, I advocate using minimally aggressive procedures for facial rejuvenation, resulting in a shorter surgical time and less inflammation. These create lasting results without any change in the facial expression. This is also my aim when I perform navel-shaping procedures – to produce a natural result. My goal is to achieve facial and body harmony without using techniques that bring about obvious changes in the facial or bodily features.

Q What percentage of your practice is reconstructive plastic surgery as opposed to elective?

A Ninety percent of the plastic surgery that I perform is aesthetic and ten percent is reconstructive. The reconstructive surgery is a social service that is not about making a profit.

Q Please, elaborate on your interest in meditation, brain development and comparative religions?

A I found out when I was very young that human beings only use ten percent of their brain’s potential. Since then, I have been extremely curious as to what could be hidden in the other 90 percent of cerebral potential that isn’t used. So I have studied not only neurological science but also learned a lot in the monasteries

<< I think Sean Connery is the most attractive male and Sofia Loren is the most attractive female. >>

of Tibet, Nepal and India. I also studied the shamanism of Mexico, North America and the Amazon. I have always tried to understand and incorporate this knowledge into Western science. In tandem with my career as a plastic surgeon, I have written several books about this and I have also produced several meditation CDs. In the past ten years, I have given conferences all over the world on these subjects and become the president of the Association of Neuro-

City. Cuernavaca has been renowned since the time of Montezuma, King of the Aztecs, and Hernan Cortes, conqueror of Mexico. Many famous people, such as the Shah of Iran, have considered this city a very special place. It has an excellent climate throughout the

Q Do we as a society undervalue spiritual, inner beauty and place too much emphasis on outward beauty?

whole year, an ideal altitude above sea level and beautiful views of

A Perhaps due to the infinite means of communication at our

the countryside. Before surgery, the patients enjoy stress-reducing

disposal, society today lives in a state of intense comparison and

massages, special mud treatments, facial cleansings, meditation

competition that has never been seen before in human history.

exercises and emotional therapies such as resonance re-patterning.

Concepts of beauty are influenced by fashion, the internet, and

The surgery is performed in an excellent hospital and 24 hours after

movies among other factors. Meanwhile, the aesthetic plastic sur-

the operation, our patients return to the Medical Health and Aes-

gery industry is celebrated all over the world for its ability to give

thetics Spa to recuperate, where massages, Reiki and reflexology

people what they desire. However, due to the pressures of society,

exercises speed up their recovery. On average, our patients stay at

the patient may have expectations that often just cannot be fulfilled

the Center for between one and two weeks.

due to skin and body issues such as skin thickness or colour. All

Q Dr Goldwyn, who has written the preface of the Beyond

this, in the end, only creates a great vacuum because we are only looking at the person’s appearance. When our society realizes that

Beauty book, makes a reference to plastic surgeons’ “comfort

we are not defined by how we look, we will be happier as a society

zone” – i.e. every plastic surgeon offers what he or she feels

and will then be able to turn to aesthetic plastic surgery only to

most comfortable with. Do you have a “comfort zone” or a spe-

improve small imperfections or to harmonize our body. The big

ciality in the area of aesthetic plastic surgery?

mistake, in my opinion, is trying to change the essence, the deeper

A After working for 30 years in this field, I think that I feel most

significance of the physical makeup of a human being. This, in the

comfortable with operations where surgical dexterity is solely

end, is impossible and in attempting it we only create hybrid human

responsible for the results. It is difficult to work against factors

beings without any inner depth.

such as how the body reacts, or mammary or gluteal protheses. So I feel more secure performing plastic surgery procedures such

as facelifts, rhinoplasty, breast and abdomen shaping and liposuc-

today and why you consider them to be so.

Please, name a few of the most beautiful people in the world

A This is a difficult question. However, I think Sean Connery is

experience play a large role in achieving successful results.

the most attractive male and Sofia Loren is the most attractive female. The reason is that these individuals have not only physical

Do you have a procedure that you would call your own and if

so, what is it?

A I can’t say that I have techniques that are completely my own,

harmony but they also project personality and strength. They possess an inner depth as well as outer beauty, and this is the essence of humanity.

Dr ERIC auclair

tion. With these treatments in particular, my surgical dexterity and

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sciences and Human Development.

101

Dr. Goin Dr. Goin has been a practising plastic surgeon since

Q You say on your website that you study prospective

Q We all age differently, yet there is a particular window of

procedure that requires a great deal of experience. Thus, many

patients’ photographs at the age of 18 to 25 when preparing for

time when one can get the maximum benefit from a facelift.

of these operations are done at the cost of unsightly or badly

a facelift. What should a patient realistically expect in terms

What is the average optimum age to have a facelift?

of turning back the clock? How many years on average does a

A One can’t pick a particular age as ideal for a facelift, because

positioned scars, lost or oversized belly buttons.

facelift take off a face?

our physiological age depends on our lifestyle (nutrition, alcohol

to limit the size of the scar, relying instead on the skin capacity for

or drug consumption, smoking, sun exposure…). Certainly, ageing

retraction. Abdominoplasty with repositioning of the belly button

techniques than ever before, as well as being better equipped to

evolves in stages and surgical intervention should be avoided

should only be carried out in cases that require bariatric surgery

achieve natural looking results, avoiding the waxy and stretched

at critical moments, aptly described by the French as “coup de

when there is a lot of skin excess.

look of older style procedures.

vieux” or taking a turn for the worse. It is always best to wait for

The making of a new belly button is

a period of relative stability in the ageing process – such a period

seldom an aesthetic success.

avoidance of all signs of surgical intervention, especially if poorly

could last between 6 to 8 years, followed by an accelerated ageing

The scar should be placed as low as

done.

over a period of a few months. These processes happen at regular

possible, lowering the existing belly

intervals.

button by internal dissection, which

A The new facelifts have evolved towards much less invasive 1979 and is a past president of s.o.f.c.e.p. (French society of aesthetic and plastic surgery) and member of S.O.F.C.P.R.E (French Plastic, Reconstructive

The buzzword is “natural look” at any price and the

Both female and male patients (who are increasingly

Dr. Goin Contact

and Aesthetic Surgery Society). He has published

shed 10 to 15 years.

two medical books: Breast Surgery (written in

Dr. Jean-Louis Goin American Hospital of Paris 63, Boulevard Victor Hugo

collaboration with Gaston Maillard- Lausanne and

It is a mistake to look for an extreme rejuvenation result – rather, one should strive to perpetually remain in one’s 40s,

Denis Montandon - Geneve ) - Masson editions, and

maintained through a series of small subsequent interventions. 18-25 is not for the purpose of restoring their youth, something that would be both unrealistic and unrealisable, but to evaluate exactly

National Report on the New liftings (in collaboration

where volume has been lost and to restore it.

harmoniously.

moment to operate without causing dramatic changes is around the

We mustn’t forget that we are performing

age of 45 to 55.

an aesthetic surgery which aims to

Facelifts at the age of 65 to 75 that have not been preceded by other treatments do not give such striking results.

Q Please, explain the suspension technique and how it compares with the traditional SMAS facelift?

A The absorbable or non-absorbable sutures suspension

achieve as normal a result as possible, avoiding the overstretching of the stomach.

Q What is the difference between liposuction and liposculpture?

A The difference between the two is

than the rest – the sutures lift and reposition the sagging tissues.

considerable.

the area of natural rejuvenation.

The latero-facial region is less prone to sagging, as you can see in

Liposuction allows us to vacuum

pictures of profiles, where the cheeks determine the limit of the

excessive fat followed by injecting fluids

specialising in skin restoration and additional treatments such as

mid-face region. The classic pulling of the SMAS laterally has less of

that prevent bleeding. Liposuction allows

laser, botox and fillers, allow us to take complete control of the

an effect because it doesn’t respect the vertical vector. The

the selective remodelling of certain areas.

patient and improve the quality of long term maintenance.

mid-face traction can be equally effective if it is done during the

The thinnest canulas are used to obtain

facelift by suspension of the malar area or done by the incision of

the best retraction of the skin.

lower blepharoplasty.

Liposculpture, on the other hand, aims to

Q Paul Tessier pioneered the deep plane facelift, a procedure

add volume where it is needed. Fat is harvested from areas such as the

that few plastic surgeons in the world perform. Recovery

stomach and the thighs and re-injected in

time aside, how does the deep plane facelift compare with the

areas such as the breasts or the face.

suspension facelift in longevity terms?

A Paul Tessier was a great teacher and pioneer of the deep plane

Q Most men and women gain weight

facelift, creating a new concept and a new chapter in aesthetic

around the midriff after a certain age. Can this be remedied with

surgery. He was also an ardent proponent of bone grafts in the

liposuction?

malar (cheek) and chin areas in order to restore volume, discarding

A The increase of fat deposits in the midriff is always a problem

artificial implants, with all the discomfort they caused. However,

because of the close and dense type of the fat. Another frequent

the complexity and length of these interventions as well as the

problem is the associated laxity of the abdominal rectus muscles

unreliable resorption rate of the grafts made recuperation very

above and underneath the umbilicus. A simple liposuction is not

long.

enough. The best results are obtained using humid liposuction with The lipostructure (pioneered by Franck Trepsat) and the

the injection of diluting fluids. Laser assisted liposuction which

suspension lift have achieved remarkable results in volume restora-

melts the fat is the subject of new research and could offer the

tion and have opened a new chapter in aesthetic surgery.

solution in the future, however clinical results are insufficient at

At the same time post-operative recovery has shrank to 12-15 days. Patients today are not prepared to have prolonged surgical

present.

Q Lipostructure, or fat grafting on the face and in the eye

interventions, persistent swelling and extended downtime.

area is controversial in the sense that many surgeons wouldn’t

In any event the rejuvenating aspect of today’s procedures is

use the technique because of uneven fat distribution after the

enhanced by the absence of visible intervention, playing to the

operation. How can you ensure even fat absorption?

quasi-obsession with “the natural look”. The patient achieves

A The results of this depend entirely on the experience of the

shedding 8-10 years without suffering excessive discomfort.

surgeon, as it is an intricate procedure, mastered only after

surgery?

A Abdominoplasty is often handed over to young and less experienced surgeons, which is a mistake because this is a complex

considerable practise. One can limit the resorption rate through having exact knowledge of the patient’s anatomy (having studied old photographs), using the correct/tiny amounts of fat and immobilising the area that needs to be treated.

dr. goin

Q Where do you position the scar when you perform abdominal

102

allows for the area to be retightened

technique allows us to lift the mid-face which ages much faster

Establishing a team that includes dermatologists

– Sfcpr.

should be considered, such as lipostructure. The most propitious

lipostructure as a component of the facelift is a major advance in

One cannot restore youth by simply pulling the skin – using

with Trepsat, Thion, Delmar, Cornette de st Cyr )

From the age of 45 onwards, minimally invasive steps

when a woman has reached a perfect “ripeness”. This look can be Referring to photographs of the same patient at the age of

92200 Neuilly sur Seine, France Phone: +33 1 46 41 27 60

becoming plastic surgery consumers) can reasonably expect to

Liposuction, carried out together with abdominoplasty allows us

103

<< Results are the best publicity for a plastic surgeon. This is a profession where reputations change swiftly if they are not underpinned by good and consistent results. >>

Q Can you list your special areas of expertise and interest in the field of plastic surgery?

A I am most passionate about facelifts, as the technique varies with each patient. It is a procedure where the results are in direct proportion to the experience of the surgeon. Rhinoplasty is another passion of mine because it requires great precision and refinement, as well as experience in scar tissue and the ability to evaluate patientsâ&#x20AC;&#x2122; needs.

Q Is the skill of a plastic surgeon intuitive or precision-driven? A For me the skill of the surgeon is intuitive in the pursuit of an aesthetically good result and the sum total of his cultural and artistic antecedents. However, it is also precision-driven in the evaluation and execution of the actual surgery.

Q You are one of a small group of French plastic surgeons whose reputation travels by word of mouth. How difficult is it to establish oneâ&#x20AC;&#x2122;s credentials among the Parisian elite?

A Results are the best publicity for a plastic surgeon. This is a profession where reputations change swiftly if they are not underpinned by good and consistent results.

Q Who in your opinion is the most beautiful woman in the public eye today and why? Who has aged most gracefully?

A I find that Liz Hurley has a natural beauty, almost perfectly balanced in an aesthetic sense. Among the youngest, Ana Beatriz Barros is close to perfection, whereas in terms of having aged most gracefully, Sophia Loren has done so fabulously, with Joan Collins as a close runner up.

Dr. Plante Dermatopathologist and Dr. Goin

dr. goin

104

105

Dr. de Benito

HRT is carefully approached by Dr. Beltran who is keen to point out that some of its side effects could outweigh the benefits. Most importantly, the predictive capabilities of the genetic screening test allow patients to adjust their exercise program and

I met with Dr. de Benito at his Institute (IDB) located at the world class Dexeus hospital in Barcelona. An engaging man, with a broad Mediterranean smile and confident manner, he opens the conversation with a compliment. This may be standard professional courtesy that puts prospective patients at ease, but no less

eating habits and acquire awareness to any disease predispositions.

held by a vast majority of his fellow surgeons today to a greater or lesser extent.

Goldwyn’s comments in the preface of the book before I have even

Definition of beauty How do we define beauty,

had a chance to put them to him.

I ask? ‘Beauty is the expression of harmony which

‘One key doesn’t fit all locks,’ he says when we discuss the many

delights our mind through the senses.’

minimally invasive technique. He says he tailors his approach to each patient and often performs a combination of procedures – from the deep plane to the endoscopic, depending on which section of the face he is treating Patients are in the driving seat when it comes to

The procedure involves making an incision in the crease area of the buttocks and inserting colour-coded sutures (much

range of procedures the silhouette suture lift.

bigger sutures and cones are used as these have to support greater

Hollywood in particular, the latter shaping our perceptions of

weight than the facelift ones).

beauty more than anything else.

whom shorter recovery and minimal or no bruising are a priority. It is also a good option as a follow up to a full facelift.

The sutures are left for a few weeks so that they can

The definition of beauty changes with the times, besides… Thirty years ago, the male symbol of beauty was the rough, angular type and actors who epitomised it were quintessential “bad boy” Jean-Paul Belmondo, Kabir Bedi (in Sandokan) and Sean Connery (in the Bond movies) Women had curves – ample hips and breasts – and aspired to look like the unforgettable Marilyn Monroe.

incision is re-opened, the sutures are anchored to the base of

fashion and precipitated advancements in liposuction – a technique

predominance generation – a theory that seems to be supported by

the buttocks and tightened, so that the buttocks are lifted in the

developed for the purpose of getting child-bearing hips shoehorned

the seemingly female hormone dominated generation of the baby

direction of the crease. Some fat is grafted in if required to obtain a

into the iconic garment that jeans are today.

boomers.

The suture itself consists of absorbable cones, the size of a grain of rice, which anchor the underlying tissues and muscle. The procedure is done with a small incision, 1cm only, in the temples area, from where threads are inserted down to the nasolabial lines area of the face and mouth corner. The sutures are then tightened to a desired degree and can be re-tightened two or so years further down the line, or when flaccidity of the skin recurs. The IDB has been extensively profiled in the media for successfully correcting the appearance of facial palsy sufferers using this method. Another procedure done through minimally invasive surgery is the endoscopic browlift. The incision is buried in the hairline just above the forehead, leaving very little scarring and a long-lasting result. There are a number of refinements one could request that add to the rejuvenation process, such as the lifting of the corner of

youthful contour.

Today’s symbol of beauty is largely androgynous, although ample breasts are still appreciated in women. The female face of beauty is oval, with full lips, while the male counterpart is almost child-like, with an underlying

He has developed an elaborate chart for the purpose of selecting

vulnerability.

the best size anatomical implant for the desired look in relation to the body proportions. De Benito uses anatomical high cohesivity silicone rather than round implants that give a better projection and a more natural curve. The full spectrum of body lifting and correction surgeries are carried out at the institute. Responsble for some of the most remarkable tummy tucks I’ve seen is Cuban-born Dr. Orestes Fernandez. The ability to estimate the retraction of the patient’s skin is vital when deciding whether to carry out liposuction only or combine lipo with abdominoplasty. Dr. Juan Aquiar has achieved equally remarkable results reducing fat volume in the abdomen area without resorting to surgery.

The Institute de Benito (IDB) The institute is a testimony to de

jaw projection or widening.

Benito’s nous for building a team of top surgeons to work alongside

Neck Lift From an idea by the Brazilian surgeon Dr. Raul Gonzalez,

whom has their own speciality. The de Benito Institute includes an

Contact

Dr. de Benito has developed a non invasive neck lift, tightening the

anti-ageing section headed by Dr. Beatriz Beltran.

IDB

platysmal muscle and making incisions in the hairline behind the

him. His team consists of carefully selected physicians, each of

both in front and behind the ear and under the chin). There is no

tighter and tighter facelifts.

That generation, de Benito opines, was the male hormone

illustrious record in the field of breast augmentation surgery.

earlobe which elongates with age, and chin implants to add more

ear only (the traditional neck lift requires incisions and sutures

Patients can and do get addicted to surgery and as they get older, some occasionally lose sense of perspective, requesting

Other body procedures De Benito himself has a long and

the mouth, originally developed by Dr. George Weston, reducing the

Anti-ageing is a much abused word in the cosmetic industry at large and especially so by topical cream manufacturers. One of only three scientific anti-ageing clinics in Europe,

bruising, swelling or hematoma in the middle of the neck or under

IDB offers a complete genetic screening, treatments based on

the chin and recovery is fast - 5 to 7 days. This new procedure is yet

individual genetic profiles and lifestyle recommendations.

to be documented and published in medical journals.

What may be an adequate dose of antibiotics for one person, may not be so for the next and the same applies across the

106

ideal partner.

challenged patients can return to normal life in three days.

especially in Japan.

Website: www.institutodebenito.com

those interviewed look for sense of humour in their

The procedure is performed under local anaesthetic and time-

Silhouette Lift Company; and is now used in Europe, USA and Asia,

info@institutodebenito.com

By way of example, Dr. de Benito cites the advent of the

that in addition to physical attractiveness 67% of

jeans. The once humble working man trousers revolutionised

a San Diego plastic surgeon, then imported to Europe by the

Email:

They are in turn influenced by the media at large and

Dr. de Benito cites a recent study which says

integrate with the underlying tissues, after which the original

The silhouette suture was first developed by Dr. Kolster,

Dr. de Benito

innovations or ever-evolving procedures in plastic surgery.

patients’ demand for less downtime, he has added to his impressive The silhouette facelift, he says, is suitable for patients for

Plastic surgery improves one’s appearance, but unrealistic expectations of looking perpetually young and beautiful are nothing but self-delusion.

and on the patient’s needs.

Non-invasive silhouette suture facelift Responding to

fixed, rigid look of some older generation actors.

Philosophy and patients Dr. de Benito addresses Robert

different options open to patients whose imperatives preclude the

pleasing all the same. Dr de Benito is convinced that the future belongs to less invasive surgery, an opinion

Too many facelifts, warns Dr. de Benito, create scarring tissue and are responsible for the

Buttocks lift The silhouette principle can also be applied to the

board in terms of taking supplements, antioxidants and hormone

buttocks lift.

replacement.

Men are drawn to the sensually appealing characteristics in women, while women look for leadership qualities – as well as tight buttocks. Dr. de Benito’s nominations for today’s most attractive women in the public eye are Angelina Jolie, Charlize Theron and Scarlett Johanssen.

Barry M. Jones

A plastic surgeon is not a salesman, hairdresser or beautician - medicine should be about providing a service, not about selling. In terms of turning the clock back, this again has to do with genetics and is a very individual thing but most modern facelifts should provide a continuing

England doesn’t have “celebrity plastic surgeons” in the way America, for example, does.

thread lifts, costing up to $8-9k would last 6-12 months. Patients

benefit for ten years or more.

will seek surgeons who suit them to a certain extent. There has been in recent years a vast commercialisation

Tatler magazine has long been the self-appointed arbiter of quality when it comes to

surgeon who invented the subperiosteal (mask) facelift,

questions to which there are no easy answers.

who said ‘there’s been nothing new since Skoog’. Tord

To put this into context, let’s look at marketing v.

featuring top surgeons, but one has to wonder about the PR input in the selection process.

information. People will respond to strong marketing campaigns, but

Barry Jones’ prominence as the plastic surgeon of choice in the

taking a plastic surgeon’s service to market is still in the realm of

UK is not PR-driven - quite the opposite. He hardly ever gives

social taboo in Europe, and in fact, illegal in some countries.

interviews and has historically eschewed the TV makeover shows. I ask Mr. Jones to comment on Robert Goldwyn’s short foreword to the book and specifically Goldwyn’s comments on most surgeons offering that which they are comfortable with.

Yet, unless an excellent surgeon provides information about what he or she specialises in, the consumer would likely go to the more publicised plastic surgeon whose skills may be inferior. If you market an ineffective face cream and someone buys it, wasting an X amount in the process, even if it does no good, it is unlikely to cause harm. As soon as you pick up a knife or needle,

‘In general I agree, absolutely. Very few plastic

SMAS v. Subperiosteal It was Paul Tessier, the

of medicine and this poses interesting moral and philosophical

there is real potential to do someone a great deal of harm.

Skoog, a Swedish Plastic Surgeon, described a “deep plane” face lift based on supporting a layer of tissue later named the SMAS (by Tessier) in 1973. Techniques for manipulating the SMAS have become much more sophisticated since Skoog but the fundamental principles are the same. Tessier’s facelift, “the mask lift” involves freeing of all of the facial soft tissues from the underlying bone and repositioning them to achieve a younger appearance. This type of surgery can sometimes be too radical for my taste and for that of the majority of my

surgeons would venture outside their comfort zone,

The reason I feel uncomfortable with the extent of

but then, the wider that zone, the farther they would

commercialism is that once you start selling medicine, you run the

but want to look a younger and/or more attractive

be able to venture.

risk of persuading people to have something done that they don’t

version of themselves. However, I have developed it into

really want to have done.

an endoscopic or keyhole type operation which is more

Surgeons who do cranio-facial and reconstructive plastic surgery have a much deeper

The debate on where the comfortable respectable line lies

patients – who do not want to change their appearance

flexible and leaves tiny scars, or scars hidden inside the

understanding of facial anatomy and are therefore

between commercialisation and information in the area of plastic

mouth. I have done 160 of these which do seem to be

much more confident in terms of adapting aesthetic

surgery has vast ethical implications that ultimately affect the

both effective and durable. It is not a procedure suitable

procedures to individual patients.’

patient and their choices.

for everyone. It wouldn’t for example work for a patient

Philosophy ‘My comfort zone? – anywhere that I

Expectations and realism in plastic surgery An assumption

understand the anatomy of.

or an expectation that could never be achieved in the first place

originally conceived by Bill Little, which combines a

is a major reason for unhappy patients and this is important for

subperiosteal approach to the midface with a variety of

on a particular face lift that can be described with a

surgeons to understand. I don’t operate on people I don’t think

SMAS lift. Like the Endoscopic lift it genuinely makes

catchy acronym or called a “Barry Jones facelift”, nor

would do well either physically or mentally. Expectations placed in

people look younger but is more effective in those with

do I believe that one size fits all patients.

the realm of reality are an important part of the key for success.

work to do in the neck.

who has a lot of fat in the neck area.

My approach to plastic surgery is not based

I believe that results are skill-driven rather than based on a particular surgical method. There is no right or wrong approach and different types of procedures could produce equally great results, depending on the surgeon’s skills. There are today a great many acronyms and titles

expectations (which need to be within the bounds of what is realistic), but also what their concept of beauty is. If they expect to look perpetually 35 (or have Angelina Jolie’s lips, Liv Tyler’s eyes, etc.), I’d say I’m not the surgeon for you. I recall a female patient talking to me about a well known

purporting to describe “new” or “different” techniques but most

personality and wanting to acquire their look. My reply to this was

are marketing tools, neither descriptive or new – for instance: The

“you look no more like that individual than I do”!

MACS lift, the SMILE Lift, the RSVP life, the FAME lift, the Lifestyle lift etc. Acronyms are part of modern culture but can lead to confusion – I give a lecture, which I am currently writing as an editorial, called APE – it stands for Acronymitis Plasticsurgicus

In order for a woman of 50 to look as attractive as a

The average age of my facelift patients is 51.5. For the majority two weeks is a long enough recovery time to return to work and a social life. These are mostly people who have busy professional and social lives. For anyone living in any capital city in the world, one of the most important things is downtime. The skin lift is a dated procedure which pulls the skin and flattens contours rather than repositioning the underlying

treat love handles up to a point. Subcutaneous fat makes a limited

supermodel, she needs to have looked like a super nbbbmodel to

tissues. It doesn’t do most patients any favours, but it is surprising

contribution to the whole abdominal contour so liposuction alone

begin with.

how many surgeons in the world still practice it, which is why

produces a minimal change only.

No surgeon can deliver on such an expectation and if they

prospective plastic surgery consumers need to be well informed.

do promise such things, they are being both foolish and dishonest.

Loss of abdominal contour is associated with pregnancy, weakness in abdominal muscles and intra-abdominal fat. Causes for

Body surgery Body lift, for the right patient, can be a very

weight gain in mid-life are attributed to HRT, high blood pressure

Barry M. Jones

Names such as the subperiosteal or mask lift, have some logic and

anything. A plastic surgeon can change anatomy within certain

effective operation. It is similar conceptually to the deep plane

medication, eating more and exercising less or just being less

Contact

are descriptive.

safe parameters, however, we do not all start with the same basic

facelift in that strong deep tissues are used to reposition and

active. Hormonal changes also affect the distribution of fat.

genetic material.

support skin and fat. It addresses problems that can’t be corrected

Epidemicus and is a slightly tongue in cheek dig at this trend.

Scars from facial surgery should be hidden around the

This is playing God – you can’t give somebody absolutely

I see my job as interpreting what each individual wants

In terms of weight, there is a simple equation between

London W1G 6LR

natural contour of the ear. If hair follicles are included in the base

with tummy tuck alone such as lack of definition in the waist,

intake and output – it works like a bank balance. General weight loss

Phone: +44(0) 7935 1938

of a scar in a hair bearing area, hair will grow through the scar to

– and making clear what can be achieved realistically. In order to

sagging thighs and buttocks and a skin roll beneath the shoulder

would result in losing that intra-abdominal fat that is responsible for

Fax:

conceal it. Well executed surgery will result in a barely visible scar.

gain an insight into a patient’s goals I find it helpful to ask “if you

blade. It is also especially useful in people who have lost a great

the apple-shape appearance.

could wave a magic wand what would you change?”

deal of weight. The resulting scar is below the bikini line and

Email:

+44(0) 7935 6607 bmj@barrymjones.co.uk

Website: www.barrymjones.co.uk

It takes an educated patient to see through the publicity and hype of selling minimally invasive techniques and understand the reality of what these techniques would achieve. For example,

If a patient asks “do I need a facelift?”, my answer is, “no one needs a facelift”.

extends round the midriff. Liposuction is not effective for middle age spread but does

The body lift is a dramatic solution to a difficult problem. It is possible to move fat from the midriff and graft it into the buttocks to give them a better shape but augmenting the

BARRY M. JONES

14a Upper Wimpole Street

108

I discuss with prospective patients not only their

A further version is the Volumetric facelift,

109

Photographer: Ron Goldstein @ www.photomovement.com Model: Cynthia C Carvajal Hair stylist: Olivier Chomienne @ Chomienne.com Make-up Artist: Susana Santos @ www.Susanasantosmakeup.com

<< In order for a woman of 50 to look as attractive as a supermodel, she needs to have looked like a supermodel to begin with. No surgeon can deliver on such an expectation and if they do promise such things, they are being both foolish and dishonest. This is playing God – you can’t give somebody absolutely anything. A plastic surgeon can change anatomy within certain safe parameters, however, we do not all start with the same basic genetic material. >>

buttocks requires lots of fat so most patients would need to put

in London provides plenty of opportunity.

on weight to make it possible to harvest enough. As a concept I wouldn’t recommend it. The only other option is to use an implant or to lift the buttocks but that really means a body lift. Middle-aged men tend to develop a tummy and thinner

I soon discovered that a number of other surgeons played instruments so we teamed together to create our own band - TUCK THAT. Martin Kelly was a member of the band and suggested that we start playing at private gigs. Coincidentally, a friend who was in

legs, something which can be rectified to some extent with regular

the music business opened a new store in the city and invited Brian

exercise and a fitness programme.

May to launch it.

Middle-aged women need to keep a fine balance between

I was introduced to Brian, mentioned TUCK THAT and as a

figure and face - between looking hollow and heavier. Being very

result the band was invited to open a gig for the Freddie Mercury

slim over the age of 40 or 45 isn’t usually complimentary with

Phoenix Trust at the Shepherd’s Bush Empire.

obvious exceptions such as Mick Jagger or Keith Richards.

This was well outside of my comfort zone - I was absolutely terrified to play in front of a paying audience at a proper rock

Future of plastic surgery? Future trends are towards less

venue, alongside high class rock performers but it was tremendous

invasive procedures, long term biochemical manipulation… genes

fun and a great experience. Curiously, playing in front of 17,000

and stem cells may have a place in the future of plastic surgery.

people in Hyde Park was much less stressful!

With regard to facial rejuvenation, less invasive is good so

Sadly, TUCK THAT no longer exists. Martin tragically died

long as it produces the same result, but I don’t think we have got

last year and it is very difficult for a number of busy surgeons to

there yet.

find the time to get together and practice.

Personal interests I played the guitar at school and university,

play acoustic sets at private gigs with a Maxillo-facial surgical bass-

then didn’t play for about 25 years.

playing colleague – we call ourselves The Plastic Denture Band and

Music continues to be a big part of my life. I now mostly

When my son was 10, he wanted to play classical guitar and I decided to have lessons together with him. Much as I enjoyed it, this

play in beach bars in Portugal with a chum there. I go to a lot of rock concerts and have an abiding interest in

was not really my scene so I started to play blues and rock guitar

the history, structure and theory of music – this is another life for

again and enjoyed it hugely.

me which is as absorbing as what I do for a living.

I have had the good fortune to meet many different people

Interacting with people from the music world is incredibly

involved in the music industry from whom I have learnt a great deal,

refreshing as they are so very different – it adds a different

some have become close friends I frequently go to live gigs. Living

dimension to my life. BARRY M. JONES

110

111

Dr. Grant Stevens

combine skin care treatments with arm lifts, tummy tucks and body sculpting to complete the rejuvenating process. In additional to traditional procedures, Dr. Stevens also offers genital rejuvenation to reverse the unwanted effects of vaginal deliveries.

Dr. Grant Stevens is an internationally renowned and ground-breaking surgeon and the Medical Director of Plastic Surgery Associates in

Ground-breaking procedures Dr. Stevens and the Marina Plastic Surgery Associates are internationally recognised for their

Marina del Rey and Palos Verdes, California both specialising in cosmetic plastic surgery.

experience with cutting-edge technology including laser breast surgery, power-assisted liposuction and minimal incision facelifts. The team’s pioneering research with laser surgery and power-

Dr. Stevens graduated with honors from Washington University

He continues to be one the world’s leaders in introducing

Medical School in St. Louis where he was awarded the Senior Prize

and developing the use of the laser and other high-tech instruments

in Surgery.

into the field of aesthetic cosmetic surgery.

Dr. Stevens is a member of many medical societies including

Marina Del Rey 4644 Lincoln Blvd. Suite 552 Marina Del Rey, CA 90292 Phone:

866.588.7507

South Bay 927 Deep Valley Drive Suite 175 Palos Verdes, CA 90274 Phone:

866.588.7507

Dr. Stevens has perfected a new technique called the

The American Society of Plastic Surgeons, The American Society

Speciality Dr. Grant Stevens specialises in full body make-overs

Augmentation. The Stevens Laser Bra technique uses a CO2 laser

for Aesthetic Plastic Surgery, The International Society of Aesthetic

performed during a single surgical session. He has gained an

combined with surgery to correct sagging breasts that occur

Plastic Surgery, The International College of Surgeons, The

international reputation for his ability to restore a slim, youthful

because of aging and childbearing. As the skin loses its elasticity,

American College of Surgeons and The American Society for Laser

and buoyant appearance to women who have had several children.

the breasts lose their firmness and shape leading to a drooping

‘Although motherhood is a profoundly fulfilling experience,

effect on the chest. In the past, plastic surgeons would perform

Medical Association Advisory Panel on Plastic Surgery. Dr. Stevens

childbearing put considerable strain on a woman’s body and takes a

a traditional procedure such as mastoplexy or a breast lift that

received the California State Assembly and California State Senate

predictable yet distinctive toll. ‘

attempted to surgically correct the issue with varying results.

Certificate of Recognition. He has received The Distinguished

Contact

the field of body contouring. Stevens Laser Bra for Breast Reduction, Breast Lift and Breast

Medicine and Surgery. He is the past chairman of The California

Dr. Grant Stevens

assisted liposculpture contributed to the recent major advances in

Service Citation from The Medical Board of California. The American Society of Aesthetic Plastic Surgery has

His objective became to utilize cosmetic surgical

Dr. Stevens noticed the advantages of laser assisted face-lift

procedures to reverse and correct the visible, unwanted effects of

surgery that shrunk the sagging skin on the faces of his patients

childbirth, breastfeeding and childrearing. His results in reversing

and believed that lasers could do the same for breasts. By

accredited Dr. Stevens’ aesthetic surgery fellowship as one of only

and correcting the unwanted effects of childbirth, breastfeeding

effectively creating an internal brassiere using the CO2 laser, his

repeatedly hearing “I want my figure back” from women who

15 nationwide. Dr. Stevens is the director, and applicants routinely

and childrearing have become a benchmark of success in body

new technique produced a beautiful, long lasting lift of the breast.

have had children. His pioneering research into combined surgery

apply three years in advance for acceptance into this prestigious

remodeling. He has carried out thousands of operations that

Compared to traditional methods, the laser procedure can decrease

showed that multiple procedure operations were a safe and

fellowship.

have effectively turned back the clock to reinstate the natural

the time needed to complete the surgery, making it a safer option

effective way to achieve maximum benefits with minimal recovery

appearance of his patients’ youth.

as less time is required under anaesthesia. Recovery time is quicker

time. This surgery generally takes less than four hours and

and scarring is minimised by utilising dissolvable sutures placed

frequently fly-in patients can return home within a week to 10 days.

Dr. Stevens has been an invited visiting professor at Loma Linda University, University of Southern California, Switzerland and Denmark. There he has taught plastic surgeons, performed surgery,

Individualising the approach From listening to this particular

deep beneath the skin to eliminate the need for painful suture

Most patients receive a laser breast lift along with a tummy tuck

lectured on ultrasonic liposuction, breast augmentation, laser

group of patients, Dr. Stevens has developed and refined

removal. The CO2 laser de-epithelialises the patient’s own skin and

and body sculpting. Dr. Stevens’ key to successful body sculpting is

breast reduction and lift surgery and advances in laser surgery.

techniques that allow him to recreate their pre-delivery figure

creates an internal bra that is attached to the chest wall, holding up

the Power-Assisted Liposculpture, which utilises a vibrating cannula

and appearance while maintaining the bodies natural function. Dr

the breast tissue. This creates a more aesthetically pleasing shape

inserted through tiny incisions to gently shake the fat cells loose.

cosmetic surgery but in non-invasive cosmetic interventions as

Stevens recognises that each patient comes with individual-specific

to the breast maintaining a perky uplifted contour that mimics

This facilitates suction removal of fat with more precision and less

well. His Stevens’ Institute Medical Day Spa is acknowledged as a

requirements and customises his approach to their precise needs.

nature. Over the past several years, Dr. Stevens has performed

trauma than other liposuction techniques. Recent innovations in

leader in non-surgical cosmetic solutions with treatments ranging

Each procedure is highly personalised and Dr. Stevens takes into

hundreds of Laser Bra surgeries with impressive postoperative

liposuction make this procedure highly desirable among healthy,

from state of the art lasers to skin care, fillers injections and Botox

account the whole body combining different procedures to create a

results withstanding the test of time.

active mothers who just need a little extra help getting rid of the

wrinkle reduction.

complete transformation.

He is not only recognized as an expert in aesthetic and

Dr. Stevens developed the Mommy Makeover after

<< Dr. Stevens’ bedside manner and focus on the individual have gained him an international following. >>

extra fat deposits remaining after their pregnancy.

This may include erasing the lines and wrinkles around the eyes, rejuvenating the face with a facelift, enhancing the cheekbones or chin with implants and fixing the nose to balance facial features. For patients requiring breast work, he offers Laser breast reduction, Laser lifts and augmentation with Gummy Bear Breast Implants to reverse the effects of breastfeeding. During these procedures, Dr. Stevens takes special care to ensure that nipple sensation and the ability to breast feed in the future is preserved by using state-of-the-art laser technology that does not remove the nipple. Through power-assisted liposculpture, Dr. Stevens is able to remove excess fat that does not go away with diet and exercise and

112

dr.grant stevens

<< Although motherhood is a profoundly fulfilling experience, childbearing put considerable strain on a woman’s body and takes a predictable yet distinctive toll. >>

113

properties to erase even the most difficult scars, red spots, brown

<< Beauty captures our attention. It is natural, unrehearsed and defined by confidence. It is both a perceptual and subjective experience. It delights our senses. It is not a function of intellect, but rather an innate excitement, on the level of our soul. Grace Kelly exemplifies this eloquent confidence and beauty! >>

spots, vascular lesions and wrinkles. The team of experienced Physician’s Assistants are all experts in the latest injectable products to include Juvederm, Botox, Restylane, Radiesse, Sculptra, and ArteFill.

Out of State and International Patients Dr. Stevens draws an international clientele for his renowned procedures and over 40% of his patients come from outside of California and many from outside the United States. To accommodate these patients, Dr. Stevens has developed his Fly-In for Surgery program at the Marina Plastic Surgery Associates. The initial virtual consult process allows anyone from any country to become a perspective patient and closes the distance between the patient and one of the top surgeons in the world. The program offers a complete package including transportation, accommodation and medical care for out-of-town patients and guests. Patients and their families have the option of staying at the famous Ritz-Carlton, Marina del Rey, where on-site private duty nurses are available for post-operative assistance. Patients requiring more intensive postoperative care can stay at the purposely designed Serenity facility, which offers complete medical aftercare with nurses in private suites. ‘Dr. Stevens has dedicated his career to women with the stated goal of helping women remain beautiful. His focus on mothers has redefined the field and encouraged the development of new techniques to fit the specific needs of this specific group of patients. Through The tummy tuck or abdominoplasty is an essential part of

the use of laser technology, power-assisted liposuction and multiple

the Mommy Makeover. Once skin and muscle tissues have been

procedure single surgery, Dr. Stevens has revolutionised the way

stretched from pregnancy, they frequently will not retract to their

cosmetic surgeons practice. In addition to his surgical innovations,

pre-pregnancy form. Stretch marks, belly button deformities and

Dr. Stevens’ bedside manner and focus on the individual have

skin laxity are all reasons Dr. Stevens would include the tummy

gained him an international following. For these specific skills, he

tuck in a Mommy Makeover. The tummy tuck surgically tightens

is sought out by patients the world over to achieve what was once

the abdominal muscles and removes excess skin and fat to create

thought impossible ‘

a svelte waistline. As with most of Dr. Stevens’ procedures, the tummy tuck can be performed on an outpatient basis under general anesthetic. There are several different types of tummy tucks, but all of them involve the removal of excess skin and fat using a lower abdominal incision. The abdominal muscles are tightened and the remaining skin is then pulled downward. After the procedure, many of Dr. Stevens’ patients have been inspired by their improved shape

<< Excellent surgical results start with healthy skin. >>

to lose additional weight. In addition to surgical treatments, The Stevens’ Institute Medical Day Spa, specialises in non-invasive aesthetic therapies such as laser treatments, skin peels and cosmetic makeovers to maintain long lasting, natural results. ‘Excellent surgical results start with healthy skin’, says Dr Stevens. He has bridged the gap between surgery and skin health and created one of the first medical day spas. Today, many nonablative and non-invasive treatments are performed in The Stevens’ Institute Medical Day Spa, to not only prepare the skin for surgery, but also as a maintenance and preventative measure. The Spa

the international aesthetic research labs. Clients can enjoy a vast array of services, such as permanent makeup, laser hair removal, Therma cool non-surgical facelifts, botox wrinkle reduction and injectable fillers to sculpt the facial contour and replace the loss of fat beneath the skin. Dr. Stevens has ten lasers at his disposal including a Fraxel and Cynosure Laser, each having individual

114

Photographer: Marko Tardito

the cutting edge procedures and products that are developed in

dr. grant stevens

gives patients early access to the “The Technology of Beauty”,

115

Dr. Jean-Louis Sebagh

Q A

I believe in protection, anti-ageing, hydration and glow. In

What makes a “better than most” injectables’ physician? I enjoy and appreciate all types of beauty and have always been

interested in and felt uplifted by the aesthetic of shape and form. I

my products we use many ingredients but some of my favourites include:

have been a plastic surgeon for more than 25 years, firstly learning

a. Protection/Antioxidant

my skill, then improving my skill and finally being in a position to

Vitamin C, Resveratrol & EPF

create a technique to perform surgery without using a knife. (the Dr.

b. Anti-Ageing Peptides

Sebagh Facial Sculpture).

Trilagen, Antarticine & Natural Growth Factor

For me beauty is one of the joys of life . I have worked hard

c. Hydration

Dr. Jean-Louis Sebagh

(and continue to do so) to hone and perfect my technique and this

Hyaluronic Acid

Contact

is something that any respected cosmetic doctor must do, along

d. Glow

with being able to utilise an aesthetic eye to create a result for the

London: French Cosmetic Medical Company, Ground Floor, 25 Wimpole Street, London, W1G 8GL Paris: 64 rue de Longchamp, 75116 Paris Phone:

London: 020 7637 0548

Phone:

Paris: 00 33 1 47 04 65 75

Email:

doctor@25wimpolestreet.com

Website: www.drsebagh.com

Zinc, Copper & Magnesium

patient which enhances the way that they look.!

The higher the concentration of these ingredients the better.

How were your skin range products developed, what is dif-

ferent about them and in what way do they work?

I work very closely with my team of scientists, working on

What is your definition of beauty and who in the public eye

(man or woman) is the most beautiful in your opinion?

discovering and utilising the latest innovations and ingredients

in skincare, to produce a range of products that were unlike any

beauty which is individual to each person. It is a matter of principle

others. For example, Dr. Sebagh Supreme Maintenance contains

that I never name any one person or persons as being the most

95% active ingredients and has the highest concentration of ANY

beautiful - everyone is beautiful. I believe in enhancing a person’s

product currently being sold on the market.

natural individuality.

My goal is to focus on the quality of my products by focusing on

I have always been an advocate of “emotional beauty”: this is a

the ingredients and formulations, in order to deliver the best possible product for our customers to be able to maintain their skin.

Dr Jean-Louis Sebagh 28 September 2009

<< I have always been an advocate of “emotional beauty”: this is a beauty which is individual to each person. It is a matter of principle that I never name any one person or persons as being the most beautiful – everyone is beautiful. I believe in enhancing a person’s natural individuality. >>

Dr ERIC auclair

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Three prominent trichologists answer nine hair care questions

Q What are the 5 top natural products that promote healthy hair?

as a lather has been achieved gently move the scalp with the fingers in a claw like position. Progress all through the scalp for approximately three minutes then rinse. Carry this out

A lot of “natural” ingredients are present for advertising purposes and do little to help

every time you shampoo. It will not cause greasy hair.

the hair. However, ones with plant proteins, vitamin E, oils (such as olive, jojoba, and castor), panthenol, and aloe may be helpful depending on your hair condition.

VB Scalp massage on a monthly basis is a good idea, if only to reduce the effects of stress. Massage can loosen a tight scalp and could therefore help reduce tension, useful because

Q Chemically processed hair can never be restored to its original health condition. What would you recommend to do with this sort of hair?

FC Contrary to what you may see advertised there are virtually no 100% natural products

we cannot exercise our scalp in the same way that we can exercise the rest of our body, so

FC Dandruff can be controlled rather than cured using mild shampoo containg Piroctone

in hairdressing products. Manufacturers use similar synthetic products i.e. detergents,

regular scalp massage is recommended. It won’t result in greasy hair; our oil production is

Olamine or Zinc Pyrithione. These products slow down skin cell formation and can reduce

fragrance, colour. To make these appear natural they add some natural ingredients such as

based on what happens inside our scalps.

irritation of the scalp.

balsam or fruit extracts or vitamins and “naturalise” the product. These additives are rarely

Dr. David H. Kingsley, PhD, Author of “The Hair-Loss Cure: A Self-Help Guide”:

A Frequent conditioning (with or without shampooing) plus deep hair-strengthening

A teenager (or anyone with dandruff) should shampoo daily. They can still use gels and spray etc. but a daily shampoo is essential to keep the scalp healthy and promote healthy

what people require. For instance consumers fill in research forms (with the ladies who stand

hair growth.

outside shopping precincts with little boards and pens) Requirements are usually based on;

Q Is there any product out there that can help excessive dryness in ageing hair?

nice smell, nice colour, good viscosity, plenty of bubbles and pretty packaging. (I am not a

cynic!)

use the one you are most satisfied with.

scalp. Due to hormone changes in teenage years, scalp oil production also changes and an

VB There really aren’t any products out there that are natural I’m afraid, if you mean

increase in fungi production is common at this time.

shampoos and conditioners and the like. However, there are certain foods, which are natural

is light and easily removed from the hair. Apply the oil, leave overnight if possible. Shampoo

of course, which could really promote healthy hair, these are:

in the morning applying neat shampoo to the hair and massaging in to break down the

conditioner each week. Depending on the damage done by chemical processing, the hair can still stay in very good health.

more than 1% of the product. Unfortunately products are based on Market Research on

Dandruff occurs due to the skin of the scalp being overly sensitive to the natural fungi

As in point 3, purchase two or three products specifically made for that hair type, and

spores the skin produces, these fungi spores are found in the oil or sebum production of the

Frank Cunningham, member of the Institute of Trichologists:

A The best answer is not to have chemical processing at all but appreciating that very few

A teenager with recurring dandruff must shampoo every day, this helps keep on

people are happy with what they have got, it is important to ensure that as little damage as

top of the removal of fungi spores. If the scalp is left unwashed for a couple of days then

possible is perpetrated on the hair shaft.

further oil production is left to build up, therefore increasing fungi spore population and

> Red meats, such as beef and lamb.

therefore increasing the chances of dandruff to build up again. Any hair conditioners or

> Fish, including oily fish.

damage to the hair structure which cannot be repaired. Intensive serums that penetrate the

hair styling products must only be used sparingly on the hair alone; dandruff sufferers must

> Eggs.

VB An intensive conditioning hair pack would be recommended; these sorts of conditioners

hair are helpful but basically only mask the damage. Most conditioning treatments only last

never massage these products into their scalps as this can encourage a further build up of

> Dark green leafy vegetables, such as spinach and broccoli.

are applied to hair and left on for about twenty minutes before being washed off, unlike usual

from one shampoo to the next so they have to be used continually. Serums usually contain

dandruff.

> Fruits, including dried fruit.

conditioners that are applied only for a few minutes straight after shampooing. Intensive

Keep as much time as possible between applications. Multiple applications cause

a substance called Panthenol which penetrates the hair shaft and helps to strengthen it. Its

It would be a good idea for a teenager with recurring dandruff to use an anti-

effects are cumulative but don’t expect more than a 10% improvement in tensile strength of

dandruff shampoo product and a normal shampoo product on an alternate basis; one day

the hair.

anti-dandruff, the next day normal. Anti-dandruff shampoos are anti-fungal in their effect so

Vanessa Bailey MIT FRSPH, Consultant Trichologist, Member of the Institute of at the Hair Clinic at John Bell and Croyden Pharmacy Author of The Good Hair Guide: All Your Questions Answered. Published by The Book Guild Ltd.:

A Chemically processed hair requires really careful handling. The time when it is most

Q Top 5 tips for improving scalp health? DK

product gives the hair a break from the potential drying effects of anti-dandruff shampoos.

Shampooing frequently (every 1-3 days depending on your hair type).

A healthy diet would also be recommended, a lot of spicy foods, high fat dairy foods and alcohol may fuel dandruff.

Q The majority of over the counter products contain the same ingredients with minor variations. Only difference is the packaging and marketing. What products would you say are the ones to look out for?

vulnerable is when it has just been washed, when it is wet. While chemically treated hair is soaking wet it is always recommended that it is combed through, it must never be brushed at

this stage. A wide toothed comb is best. To remove tangles, combing must start at the ends

lines that are more specialized for ‘your’ particular hair type (such as dry, curly hair or fine,

or tips of the hair first before combing the hair through from the scalp to the tips. Otherwise

limp hair) rather than generic ones that could be used by everyone. Also trial and error ... try

chemically processed hair could snap very easily.

a few products and keep using the one you like the best.

I don’t recommend specific products (except my own!), however, I suggest looking for

Along similar lines, it is always a good idea to use a medium heat setting rather than

oil. Then add a little warm water, work into a lather and shampoo as usual. If the hair is genetically dry, resist from use of chemical applications.

conditioners usually contain higher quantities and better quality moisturisers and proteins than usual conditioners, which ageing hair requires most. Old fashioned hot oil treatments have their place with this hair type too. If the recommended once a week usage doesn’t seem

these products should guard against a build up of fungi spores, but a day off with a normal Trichologists, Fellow of the Royal Society for Public Health, Senior Consultant Trichologist

Shampooing with the correct shampoo.

Wearing a hat in the sun (scalp sunburn is a common problem). Healthy diet (see point 2). Supplements such as omega fatty acids.

FC The top tips for healthy hair are, good diet with plenty of protein and iron rich foods,

enough then they can be used twice a week if this gives the best result without weighing the hair down.

Q How do people in the public eye maintain the appearance of healthy hair even though it is aggressively colour-treated? Madonna is a good example of this. Does she wear wigs or is it Photoshop? Any celeb secrets you can share with us?

fresh fruit and vegetables. Regular exercise, Use of a professional stylist rather than self administration of chemical processing. Assessment twice yearly by a registered trichologist.

(Most people have a dental check twice yearly) Hair is of equal importance. Regular

confidential. However, in general, many wear extensions, hair pieces, or wigs. They often have

shampooing, daily is best.

conditioning/hair strengthening treatments almost daily and, when not working, refrain from

I’m sorry but I don’t discuss my patients (famous or not) as my services are

over-processing their hair. For the models or actors/actresses on a busy schedule their hair is

VB A. Shampoo every day. You can’t strip your natural oils from your scalp; these are always

often damaged, but “post-work” strengthening treatments, hair cuts, etc. are often carried out.

being produced or manufactured from the inside of your scalp, under strict hormone control.

a high heat setting on heated styling aids whilst drying and styling this sort of hair; excessive

FC As you say most products are similar and it is a minefield to find something that suits

Shampooing can’t interfere with this; it is therefore a myth that you can over-wash your hair.

FC When you see a photograph of a celebrity (i.e. like Madonna) She has had her hair

heat could also aid hair breakage.

the individual. Trial and error maybe until you find something that suits you personally.

B Don’t apply conditioner to your scalp, otherwise the chance of scalp irritation is increased

professionally done immediately prior to the photography. I doubt if you will ever see

Good trichologists who manufacture their own products can tailor-make a shampoo and

or you could encourage an outbreak of dandruff if you are prone.

a photo of her or any other celebrity when they have just got out of bed after a night’s

guard against breakage, it is always advised on a weekly basis to coat the hair in an intensive

conditioner for you after examination of your scalp. This is probably the only way to find top

C Whilst shampooing never use your fingernails, always shampoo your scalp using the pads

sleep. Unfortunately the general public think the photographic image is normal and cannot

conditioning treatment and then cover the hair in a towel to help boost results of such

products. Trichological products usually only use very mild surfactants (detergents). The

of your finger tips. Infections could develop if you scratch your scalp.

understand why their own “hairdo” doesn’t look the same all the time.

products. Body heat that gets trapped under the towel will aid absorption of these products

majority of shop-bought shampoos contain detergents that are also used as de-greasers in

D Never massage hair gels or styling mousses into the scalp, apply them through the hair

into the hair shaft, therefore boosting the shine of the hair as well as protecting from

Industry.

only. They can cause irritation of the scalp and could bring on dandruff or scalp dermatitis if

you are prone.

invest a lot of time and money in obtaining specialist treatments, as a trichologist I do see

To help improve the elasticity of chemically processed hair and therefore to help

breakage. Chemically processed hair must also be trimmed at least every six weeks as the tips

VB The products to look out for are the ones that describe that they are for particular hair textures or hair problems, like frizzy hair, flyaway hair, chemically treated hair, greasy

completely and prevents further splitting higher up the hair shaft .

limp hair for example. On the whole, the products that say they just cater for dry, normal or

offer temporary relief at best. What would you recommend for a teenager with recurring dandruff?

Q Should we have regular scalp massage or does this result in greasy hair?

a lot of cases where continual harsh styling for photo shoots or for filming requirements really damages the hair, that’s on top of the effects of any harsh hair colourants that are also usually used. For these cases, treatments are applied in the clinic where moist heat is used so

greasy hair may not be so specific and may not work as well as you want. The descriptions on

the bottle should tell you everything you are looking for to aid your hair health, so that you

hair. Unless done correctly, I wouldn’t recommend massaging dry hair as the risk of breakage

can fairly easily marry up your particular hair concern to what the product label is saying the

is increased. Greasy hair after massage is largely dependent on when your hair was last

the hair, clients sit under these machines and a steady stream of steam is concentrated at

product can do.

washed and the type of scalp you have (oily, normal, etc.). Shampooing after massage should

the hair itself. The effects of these treatments last around two weeks, if carefully planned;

take care of this potential problem.

the results of these treatments can cover any filming or shooting requirements. But if these

Massage is fine (and relaxing) if done with a lubricant (shampoo or conditioner) on the

Frequent (daily) shampoo. Use anti-dandruff shampoo once or twice a week. Reduce

foods that may worsen the condition such as chocolate, fried foods, cheese, etc.

I’m afraid I couldn’t speak for Madonna. However, many people in the public eye do

that any products applied actually work into the hair shafts really well. Amongst other treatments, a contraption that is commonly used is a mini sauna for

treatments are carried out regularly in the long term, they could help reduce the damage

A professional scalp massage is not necessary. Scalp massage improves blood flow to

the scalp and can assist nutritional take up. It can be carried out whilst shampooing. As soon

that colourants do to the hair and the positive cosmetic affects these treatments produce start to last longer and longer; it’s a case of prevention and maintenance.

NINE HAIR CARE QUESTIONS

of the hair are twice as likely to fray and split as unprocessed hair. This removes split ends

Q There is no comprehensive cure of dandruff in teenage years - all products

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For excessive dryness in hair of all ages a weekly or bi-weekly oil treatment. Almond Oil

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Q Is there a hair equivalent of a facelift? Or anti-ageing for hair? DK

Good question. The hair re-cycles, so each fiber theoretically can be in good shape

whatever your age. However, the hair can thin with age and also the scalp becomes drier, leading to drier hair. I suppose the answer wouldn’t be a one-deal surgery, more like a lifestyle and product use over time that keeps the hair in its best condition.

FC I think the hair eqivalent of a facelift would be to visit a registered trichologist for a consultation and hair assessment. You do not need to have a problem. The trichologist will determine your true hair type, conduct a holistic consultation, discussing your medical, environmental, genetic and dietary lifestyle. From this he/she will advise on all aspects and suggest a total way of improving your hair.

VB A hair equivalent of a facelift could be a hair transplant. This is where healthy hair follicles are surgically removed from the back and sides of the scalp and inserted into balding areas on the top of the scalp. This is carried out on men and sometimes women who suffer with genetic baldness; cases where hair growth remains thick and healthy around the sides and back of the scalp but with time, hair growth slowly reduces from the top of the head. Because the hair follicles at the back of the scalp aren’t genetically prone to weakening, they can be moved to another part of the scalp and grow quite happily.

Interviewed by Craig Teeder

Left: Photographer: Ron Goldstein @ www.photomovement.com Model: Tamara Pleshakov for Elite Models NY Hair & Make up: Theresia Pistel @ www.the-make-up.de Photographer Assistent: Joseph Tejeda

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NINE HAIR CARE QUESTIONS

Background: Photographer: Ron Goldstein @ www.photomovement.com Model: Cynthia C Carvajal Hair stylist: Olivier Chomienne @ Chomienne.com Make-up Artist: Susana Santos @ www.Susanasantosmakeup.com

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Jigami is a small salon tucked

Jigami Jigami has pioneered an exciting new range of colours and is delighted to share

away in the heart of Soho, offering organic and mineral hair colour treatments that give the same result

them with other salons wishing to follow its success. The full range includes: H2O a water-based colour that’s as gentle as science will allow.

as mainstream colour without the

A 95% water-based colour that contains no peroxide, ammonia or resorcinol and

chemical overload.

is completely odourless. H2O is very effective in covering grey hair and is the most unique client and stylist-friendly permanent hair colour on the market. H2O is a non oxidizing colour and so the colour molecule is larger and less likely to penetrate your skin. Organic and Mineral colour no ammonia, 100% grey coverage, breaking down the hair myths. Organic and Mineral colour is an odourless soya-based non ammonia permanent cream hair colour. Some shades are PPD free as some people are allergic to hair colour. The oxidizer is mixed with pure avocado oil for a more gentle, slower release and better conditioned result. Seaweed Lightener bright blond and amazing condition. Seaweed Lightener achieves the same level of lightening as

particularly damaging to the hairs’ structure and can make the

traditional bleach, only much more gently. Seaweed is odourless,

structure dry and swollen because the cuticle scales cannot be re-

contains pure avocado oil and gets closer to the root when doing

closed so the hair feels rough and dry.

foil highlights because it’s less likely to swell, so your clients get the best highlights and value for money!

O&M colour Myths > Myth 1: You can’t get the same results as mainstream colour

None of these products have been tested on animals.

Yes you can. The results are as good, if not better than mainstream colour, but ammonia free is different - it’s smarter. O&M is a full professional colour range, specially formulated to deliver lasting

Did you know?

salon quality results.

> Human hair is a fibrous substance with a delicate balance of

> Myth 2: There aren’t as many tones

protein and moisture. Hair is not a living tissue and does not have

Would 75 shades of permanent cream colour and 40 ‘Watercolours’

the ability to repair itself.

suffice?

> Moisture levels in healthy hair are at around 3% and protein levels

> Myth 3: I won’t be able to get grey coverage

are about 83-87%.

Not True. O&M gives 100% grey coverage, our resistant grey series

Jigami

> Inside the structure of the hair we find moisture/water along with

is designed to cover white hair.

Contact

hard and soft protein.

> Myth 4: Bright fashion tones aren’t possible without ammonia

15 Ingestre Pl London, W1F 0JH 020 72870788

Website: www.jigamihairdressing.co.uk

> On the outside of the hair shaft there are up to 11 layers of

You’ll need to add base to calm down our fashion tones, they are as

interlocking clear scales known as the cuticle which form a

bright as you like!

protective barrier.

> Myth 5: It isn’t really permanent

> Ammonia is a strong alkaline that opens the cuticle of the hair

O&M’s permanent colour lasts like its name suggests, it will grow

to deposit artificial colour pigments within the cortex. This can be

out like any other permanent colour.

JIGAMI

Phone:

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Scott’s Advice:

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Clinique La Prairie

Q Is the Revitalization treatment patented to CLP or is it offered elsewhere in the world?

A We don’t sell or export this treatment, the only place in the world where you can benefit from the original CLP cell extract is here in Montreux. No franchise.

Clinique La Prairie is the first name to fall from the lips of anyone discussing medical centres of incomparable international pedigree. Founded in 1931 by Professor Paul Niehans, the centre has long been considered a pioneer in the area of cellular therapy and the acronym CLP is now synonymous with clinical excellence.

Clinique La Prairie has evolved over the years to provide the

1998. Creation of the Clinique La Prairie Foundation for Research

highest standard of treatment in medical services, beauty

into Aging and Immunology (Fondation pour la Recherche sur le

treatments at its Beautymed and Aesthetic Medicine Centres, and

Vieillissement et l’Immunologie).

relaxation therapies at its spa and wellness centre.

2003. A patent on the biological effects observed in a number of

The Revitalization Therapy has drawn international

research works carried out by the staff at the CLP International

attention since its earliest stages of development at the clinic

Research Institute (Institut International de Recherche CLP) is

in Clarens-Montreux in 1931. Professor Paul Niehans tailored his

registered at the European Patent Office in Munich.

approach to Cellular Therapy around an adherence to the Similia

Similibus principle – that like can cure like. As such he began to

Q How often does it have to be administered to patients, or

inject cells from foetal organs into his patients’ damaged organs.

rather, what is the recommended frequency?

Observing positive effects, CLP scientists advanced Niehans’

A Two doses of CLP cell extract are administered orally after

pioneering technique by running conclusive tests on the benefits

complete medical check up. Treatment should be repeated each

of liver cells, given that the liver is known to be the richest organ

18-24 months. Since 2007 the treatment has been taken orally, before

of active substances. The results of continual clinical trials at CLP and elsewhere have shown clear benefits to the bolstering of the immune system in patients, and, subsequently, the delayed effects

that, it was done through intramuscular injections.

of ageing. While the CLP extract has since been refined and is now

Q Please, tell us about the La Prairie brand of face care

taken orally rather than through injection, the principles remain the

cosmetics.

same since Niehans first developed the therapy in 1931. To complement their CLP Revitalization Therapy, Clinique

A CLP created La Prairie cosmetics in 1978. We sold the brand in 1984. It belongs to the Beiersdorf group (Germany). Since 1992

La Prairie also offers medical care and wellness treatments across

we have been using a new brand of cosmetics in our spa: Swiss

many disciplines. Since 2005, the clinic’s Château on the banks of

Perfection. www.swissperfection.com

Lake Geneva near Clarens, Switzerland, has been a veritable haven of superlative quality for those who demand the finest in wellness

Q You say this treatment does not enhance patients’

and anti-ageing therapies. The Château has 24 rooms and suites

appearance.

and is connected to the spa by underground tunnel. The spa centre

A Correct, it stimulates the immune system and slows down its

offers the type of blissful relaxation that only the environment

ageing process, so it has an impact on the inside, not the outside

of a stately home nestled in some of Switzerland’s most idyllic

of the patient but if you feel good and are healthy inside, it shows

countryside could provide. As well as being a renowned relaxation

outside.

centre, Clinique La Prairie offers its customers Thalassomed Therapy and hypnotherapy. The Clinic advocates an emphasis on sophrology, the branch of neurological medicine that studies the human consciousness and its positive effects through practice of specific methodology, with the aim being to harmonise one’s consciousness for the body’s holistic benefit.

Q How do you measure improvements to your patients’ immune system?

A Our scientific committee does it. In 1987, Clinique La Prairie set up a worldwide multi-

disciplinary network of scientists that have since been carrying out fundamental research into CLP Extract. Today, under the leadership and coordination of Professor Ernst Rietschel, former

Clinique La Prairie

and current Chairman of the Leibnitz Centre that groups together thousands of researchers in a large number of institutes, the aim of

Clinique La Prairie

the International CLP Institute is to define CLP Extract scientifically

Ch. de la Prairie

and objectively prove its effects, in particular with respect to the

1815 Clarens-Montreux

mechanisms of ageing. To this end, the Institute works together on

Switzerland

a regular basis with the Swiss Institute on Cancer Research (ISREC),

Fax:

+41(0)21 989 33 33

Email:

info@laprairie.ch

Website: www.laprairie.ch

close by in Lausanne, Switzerland, the Institute of Biology at the University of Freiburg-in-Brisgau, Germany, the Transplantation Immunology unit at Toronto University, Canada and, of course, the Borstel Research Center.

CLINIQUE LA PRAIRIE

Contact

Phone: +41(0)21 989 33 11

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Director of the Borstel Research Center, near Hamburg in Germany,

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Lion in the Sun Situated on the beautiful Kenyan coast, just a stone’s throw from the Indian Ocean, nestled amidst frangipani, bougainvillea and coconut trees, is lion in the sun resort- once the home of Formula One honcho and Italian jetsetter Flavio Briatore. The intimate 16-bedroom hotel set across three acres is just a short flight from Nairobi and is located some 80 miles north of Mombasa on one of Kenya’s most beautiful stretches of coastline.

Lion in the Sun was transformed only two years ago from being Mr. Briatore’s private residence into an exclusive resort of the highest caliber. One of the highlights of any visit here is the acclaimed Thala Spa Henri Chenot, offering a range of aesthetic and thalassotherapy treatments to soothe tired bodies. In collaboration with Henri Chenot, the spa utilizes the renowned “Henri Chenot Method” combining advanced clinical and physiological techniques with the principles of ancient Chinese medicine to unblock energy channels and achieve equilibrium in the human body. The spa will also devise for its guests a special “bio-light” diet-made up of local organic products and rich in vitamins and minerals. Amongst the famous names that have come to detox at the Lion in the Sun’s Thala Spa are Naomi Campbell, Fernando Alonso, Roberto Cavalli, Bono and John Galliano, to name a few. The spa’s weekly detox package is irresistible; comprising a personalized bio-light diet, six massages and six hydrotherapy treatments, six mud therapy treatments and six hydro-jets, it costs Euro-3000 per person. But for those not on the bio-light diet, the Lion in the Sun’s restaurant offers up first-class fare, combining Italian flavours with some local and more exotic ingredients. With coral sand private beach, tennis court and golf and horse-riding available nearby, there is no shortage of things to do here. Downtown in Malindi the locals are known for their friendliness and the same warm welcome can be expected from the 60 staff at the Lion in the Sun, all of whom are devoted to ensuring guests’ happiness during their stay. With its authentic African interiors, arresting physical location and wonderful local flavor, a visit to Malindi and the Lion in the Sun resort will feel like a true escape from the grind of ordinary life. Room rates start at Euro- 330 for double occupancy. After relaxing in the sunshine by one of the four sea-water swimming pools, you can take a leisurely stroll to the retreat’s Park. The beach has a fully serviced pool, cooling tents with luxurious sun beds and personal butler service: perfect ingredients to complete the Lion in the Sun Experience. For more information, please visit: www.lioninthesun.net

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Lion in the sun

private beach located only 300 meters away in the Malindi Marine

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Vision International Vision International (AfghanIstan) is a charity

The new clinic will have the capacity to handle up to 400 outpatients daily and carry out up to 80 cataract and other eye operations, This will gradually reduce the backlog of around

founded by Dr. Howard Harper

14,000 cataract patients in Afghanistan. It will, of course, take some time as we need to train doctors and nurses.’

‘Our work began in 1953 in Pakistan’, says Dr. Harper. ‘We had our first eye clinic at Jungle Dene Murree,

University College London, (premed) and MBBS at West London

mainly operated on cataracts. The next major eye clinic was

Hospital.

established in 1965 in Lashkar Gah, southern Afghanistan and later became the NOOR Combined Eye Hospital. Our clinic, which functioned throughout the war in

Ophthalmology, Kabul. He is a Professor of Ophthalmology at Nangrahar Medical School in Afghanistan.

It then reopened as CURE International in 2005. Vision

Ebenezer Cottage Eridge Green Eridge Road Tunbridge Wells Kent Phone: +44(0)7967 804097

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worked as Founder and first Director of the NOOR Institute of

factions during that war. 2005 when the Taliban was overthrown.

Contact

He is a Fellow of the Royal College of Surgeons, London, a Fellow of the Royal College of Ophthalmologists UK, and has

Afghanistan, was wrecked by the Taliban and other fighting It was rebuilt by Vision International between 2002 and

Vision International (Afghanistan)

Dr. Harper was trained in London at two medical schools,

Pakistan in 1964. This was a short-term eye clinic in which we

Dr. Harper has also worked as Founder and Ophthalmologist at the Vision Eye Clinic in Tashkent, Uzbekistan, the Gilgit Vision Eye Hospital, Pakistan, the Vision Eye Clinic, Ulan

is now building a new day-case eye clinic alongside the old NOOR

Bator, Mongolia. His present position is Founder and Director,

clinic, and is constantly fundraising in order to carry out the works.

Vision Day-case Eye Clinic, Kabul Afghanistan.