ADVICE FROM THE SURGEON
Doctor: I Don’t Like the Way I Look!

– By Julio L. Garcia, MD FACS

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Doctor, I don’t like the way I look. What do I need done?
I think that is the most frequent question I hear from my patients. They have gone through all of the wonderful things in life and are starting to see some changes in their face, but they can’t quite put their finger on it. This is usually the case with what I call “tweeners,” or people who see something happening but are left guessing what they need to have done because the changes are so subtle. When people see large problems such as loose-hanging skin, they can pretty much decide they likely need surgery…but what about the “tweeners?”

One thing I find very educational as I handle these questions and suggest options is to look at pictures of the patient from years ago. I prefer candid shots, as they show the patient in a relaxed pose and are more realistic. (In planned photos, the patient is warned when to smile and in so doing, they all lift up their eyebrows and cheeks to look happy…yet, that is not the way they see themselves since that pose is only held for a minute.) There are times when a plastic surgeon can look at a face and take an educated guess as to what has occurred. We see lines in a certain direction that point to a subconscious attempt to raise something that has fallen, or we see a depression where, normally, there should be a smoother surface. Yet, we cannot always count on that. That is why old photos coupled with strong communication between surgeon and patient prior to surgery is so crucial. With it, the proper option can be chosen together to achieve the desired effect.

Surgery can do wonderful things. For example, it can tighten skin by moving the tissue below its surface into a more youthful position. But surgery performed when something else would have been a better option can leave the person looking different…looking as if “something was done” rather than achieving the rested appearance they actually sought.

In many cases, since one of the early changes of the face is loss of volume (which causes things to look less plump and as if features have fallen), the use of fillers is all that is needed. I know it might sound strange to hear from a surgeon that I might endorse and encourage things besides surgery, but my philosophy is to get the patient to where they want to go with the least possible intervention. We can always do more, but if too much is done right away, it can take years to look better and natural. The options suggested should not be cookie cutter. They must be customized to the patient…to their hopes and desires, as well as what is reasonable and safe.

Fillers such as Restylane, Perlane, Juvederm, Voluma, and Sculptra are great volumizing fillers in my armamentarium of options for the “tweener” who needs volume to achieve their goal. These fillers can also extend the time between facial surgeries by correcting small areas that can make a large difference on the face. If you think you’re a “tweener” and are wondering what is making you look less like “you,” come in for a consultation and explore the options at your disposal. It might surprise you that you don’t need as much as you thought!

Julio L Garcia, MD FACS, is the founder of the Regenerative Medicine Institute of Nevada, which is dedicated to helping patients with adipose-derived cell therapies for the treatment of acute and chronic medical issues. For more information about Dr. Garcia, please visit his websites at www.lvcosmeticsurgery.com and www.rminlasvegas.com, or contact his office by calling 1-888-FACES-89 or (702) 870-0058.

This feature was previously published in The Ridges Magazine, limited distribution to residents of The Ridges, Las Vegas