This is possible – with extensive experience with fat transfer or what is also commonly noted as a fat grafting procedure. Having taken care of literally thousands of patients who have undergone facial fat grafting, we feel this is an outstanding procedure to address some of the volume loss that has occurred. The key to this is to address the portion of volume loss specific to each individual. It is very important not to perform too much fat grafting in the lower part of the face but to primarily address the upper part of the face. The earlobes are somewhat variable in regard to retention and longevity. My typical response to patients is that I don’t know if we are going to see a 10-year result, but we are seeing many years of result with fat transfer. I do believe you lose some result over time and providing that a patient is willing to accept this limitation, it is possible to perform fat transfer to the earlobes.

The type of browlift that I perform now and have for approximately 16 years is the endoscopic approach to brow, forehead and the mid-face. This is essentially performed through a minimally invasive procedure using five small incisions placed behind the hairline. The incisions are approximately one inch long and are hidden very nicely in the hair. We do not cut or remove any of the patient’s hair so the incisions blend right in, in a very short period of time. The procedure is performed with fiber-optics, small incisions and surgical innovation that allow us to do much more through the small incisions. Small incisions also cut down considerably on recovery time. A similar analogy is laparoscopic gall bladder surgery which is performed as an outpatient compared to the one-week hospital stay and large incision that used to be performed in gall bladder removal surgery. Regardless, this addresses the heaviness of the forehead, the temple area, and the hooding that occurs on the outer part of the eyelid and brow region.

In all of our patients who have a consultation regarding Rhinoplasty, we perform computerized imaging. The computerized imaging is software that allows us to alter and change the image which is a wonderful communication tool between the physician and the patient. Using computerized imaging, we are able to demonstrate to the patient what our goal is for surgical outcome and determine if the patient’s expectations are reasonable and realistic. In all patients contemplating Rhinoplasty, our goal is essentially the same, and that is – to leave the patient with a nose that fits their face. This is obviously different with every individual as we have considerations that fit more in male patients vs. female patients. Additionally, there are ethnic considerations as well and it is important to maintain ethnicity as well as a nose that is more appropriate based on the sex and height of the individual. Again, imaging is a wonderful tool to allow us to communicate more effectively with our Rhinoplasty population.

A standard necklift in our hands is considered a minimally invasive procedure. There is a small incision under the chin area that allows us to access the area for cervical liposuction (liposuction o ft he neck). Once this is done the neck bands are tightened and this allows us to approach the remainder of the necklift in a way that gives the neck a much smoother contour of the neck and jawline. The recovery period is about one-two weeks depending on the patient and the results in most patients last between 10-15 years.