Thursday, March 27, 2014

Facelift Vectors: Not all Lifts are the same

As I listen to my patients tell me their stories about their friends, I wonder why they continue to have facelifts that are not favorable.   They complain that their friend looks 'pulled' or 'tight' or just plain weird.  I explain to them that it all depends on the vector of the lift.  That is, the result depends on the direction and magnitude of the lift.   In short, a facelift is about the the vision and technical artistry of the surgeon.  For instance, a patient may request that their facelift look 'natural.'  Well, what does that mean?  Does that mean that the jowl is not completely eliminated?  Or does that mean that the jaw line is tight, neck is clean, but there are no stigmata of a facelift?  To me, that is the most important part of the result - clean jawline, incisions well healed and hidden, and a neck that looks great.

This patient clearly had excess skin and jowls with prominent nasolabial folds and marionette lines.  Without making her look like she had a facelift, she got her jawline cleaned up, neck deepened, and has a fresher look.  This is a good example of what effect proper vectors can have on a person's face.

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Sunday, March 23, 2014

International Education Important in Advancing Rhinoplasty

The concept of being educated in a vacuum of isolation has become less and less of an issue in medicine as information is shared via the world wide web.  However, even today, it is easy for many people to read the same information and interpret it essentially the same way.  Thus, unless there is dialogue and sharing of ideas, it becomes difficult for physicians to find the branch points in the information such that they can take it in a new direction.  As I reflect on my time at the 4th Open Rhinoplasty Course in Bergamo, Italy, I find that I am more likely to take the information from a meeting and apply it than I am when reading a peer reviewed journal.  This was immediately evident by the number of lectures given on the topic of Diced Cartilage and Fascia grafts where I was not the lecturer (neither was Rollin Daniel) and the lecturers were not from the United States.

I found the discussion to be high level, forward thinking, and progressive.  This has caused me to think even more about the fine points of my techniques and results.  We can always find ways to do things better as we simply want to generate the best results possible for our patients.  There is more to come, but for now I am looking forward to more dialogue as we all try to make our specialty better.

Saturday, March 22, 2014

Primary Rhinoplasty Results - Jay Calvert, MD, FACS

If you get it right on the primary rhinoplasty, life is good.  This should be the desire of every patient and surgeon when it comes to getting the best result possible.  For instance, this patient was 25 years old when she decided that her deviated septum and nasal airway obstruction were too much to take.  She also complained about a twisted bridge and dorsal hump. Thus, she come in for a consultation regarding her nasal aesthetics and breathing issues.

These are her results:

Wednesday, March 19, 2014

As I reflect on the professional contacts I have made over the years, I find that my international pals are truly valuable as they provide a different perspective on the health care industry.  Here I am with Chris Moss,  a plastic surgery from Australia.  He and I have become friends over noses and the practice of aesthetic medicine.   He and his wife are on the Real Housewives of Australia and interestingly, they have the same type of issues as my friends from the Real Housewives of Orange County and Real Housewives of Beverly Hills.  I hope to run over and visit him in Melbourne in the next several years, but it sure is a long trip!

For more information, see my website at  
Or feel free to call the office at 310-777-8800

Sunday, March 16, 2014

Rhinoplasty Meeting in Bergamo, Italy

It's been a great experience in Italy with Professor Enrico Robotti and the top notch international faculty he assembled. Seeing old friends and meeting the young surgeons from around the world who want to improve their technique is a real pleasure and keeps me focused on why I do what I do. Its all about the patients and helping them achieve the reaulta they want.

The Rhinoplasty Society of Europe also met on the front end of the Bergamo course.  Truly a great time!

I will look forward to our next time in Bergamo in 2016. 
This was the secondary rhinoplasty patient I operated on in 2012.  She had had a previous rhinoplasty with an over reduced bridge and over rotated tip.  I did a reconstruction using extended spreader grafts, lateral crural strut grafts, a diced cartilage and fascia graft, composite grafts and I columellar strut.  She was very happy with this improvement.  More information on my website:

With Wolfgang Gubish from Stuttgart, Germany.  A true master rhinoplasty surgeon.