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Monthly Archives: September 2011


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Pippa’s (nose) Tip

Pippa's Tip

It is common for patients to ask for a rhinoplasty or nose job to look like a certain celebrity. Even more common is I won’t want a nose like Michael Jackson. The most asked about nose job likeness is now Pippa Middleton. Let’s analyze what makes her nose attractive:

  1. From the front view, the nose has very symmetric sides that arise from the eyebrow and gently sweep down to the ala where the cheek meets the nose.
  2. The dorsum is straight, not scooped – it is strong and doesn’t look done.
  3. There is good “supratop break”. This is a dip behind the tip before the dorsum starts. This isolates and defines the tip.
  4. The top is well-defined with a double point where the nasal cartilage throws off points of light.
  5. The base of the nose is not too wide and not too pinched. As Goldilocks would say – it’s just right.

How do I get Pippa’s tip, you might ask? Modern rhinoplasty techniques, particularly “open” rhinoplasty where sutures and grafts are used to define the nose can help give you the refinement her nose exudes.

More on Rhinoplasty

Steven Davison, MD | Board Certified Plastic Surgeon | Board Certified Facial Plastic Surgeon

FACELIFT – You’re Never Too Old

I’ve recently blogged about facelifts – the types, men and facelifts and today I’ll talk about facelifts and the “age” factor. In Brief:  You’re never too old to have facelift surgery.  There are some conditions – but these apply at every age and for every person having surgery.

Current research has turned up this information and confirms what I’ve always believed and practiced.

  1. If screened properly, people in their 60’s 70’s, 80’s (and a few even older) have facelifts and are at NO GREATER RISK for complications than younger people
  2. The Criteria:  Must be in good general health.
  3. Among annual facelift candidates – 12% are over 65
  4. Good, realistic goals and expectations are a must
  5. Good candidates are looking to remove sagging skin, lines and wrinkles & restore a more youthful – natural appearance
  6. There must be some skin elasticity
  7. A well defined bone structure is important
  8. An individualized plan is critical – “one facelift” does NOT fit all faces as is often touted today.  (See my previous blog on types of Facelifts)

The bottom line is:  seniors around the world are lining up for cosmetic procedures and 12% of those over age 65 are having facelifts.

When checking with my colleagues, I found that plastic/cosmetic surgeons across America are performing more facelifts every year on older adults …and the results are wonderful!

People come to me for facelifts because I’m well qualified, experienced and know how to “match” the right type of facelift to each individual.

OK – been thinking about it?  Come on in (or visit our website)…let’s get to work!

Dr. Steven Davison

Rhytidectomy (Facelift Surgery)

FACELIFT

There is so much information online today…it can get confusing.  Much of it is correct…much of it isn’t.  Facelifts are popular and lot’s of advertising is being done to brand certain kinds as the latest and greatest.   I do lot’s of facelifts in the fall.  So let me give you correct, updated information, to clear up misconceptions and help those of you who have been thinking about having a facelift.

There are six basic facelift techniques – Each has its own specific virtues.

  • Facelift – Traditional way to remove 10 years from an aging face.    Deals  with excessive sagging skin and lost muscle tone.
  • Deep Plane – More powerful technique used for skin with a reduced blood supply and previous damage from smoking & scars etc.
  • MACS – European technique – ideal for middle aged men and women who need only mild to moderate results.
  • S-Lift – Focuses on restoring cheek volume & removing excess jowl skin (addresses lower 2/3 of the face).
  • SMAS – Addresses the deeper layers of skin structure with long lasting results.
  • Revision Facelift – Freshens an old facelift (often correcting disappointing results) & rejuvenates the face & neck.

UNDERSTAND THIS: One facelift is not like the other. Unfortunately, some surgeons do only one procedure and attempt to adjust it to every patient’s needs.  This simply does not work!

HIGHLY ADVERTISED: The “Lifestyle Lift” is highly touted today.  It is designed specifically to tighten the jowls and neck and to reduce frown lines and wrinkles.  This usually means “superficial” tightening and lifting.  Sometimes that’s ok – but not all the time for every patient.

OTHER ???S Is age a factor in having a surgical facelift?  Current studies say NO – not if you are in good overall health.

How Can I Know Which Facelift is Right for Me?  I’m specially trained in all surgical facelift techniques, including reconstructive surgeries.  I do a thorough exam, am highly trained and qualified, have years of experience and I understand the complex facial anatomy.  I can determine what is right for you! Visit my website for more information.

Can a general surgeon do facelift surgery?  Maybe.  But do you want to trust your most precious asset (your face) to someone who may not be qualified?  It is critical that your surgeon has a deep understanding of how to match the right surgery to your specific needs.

I’m also asked:  “Do Men get surgical facelifts too?”  YES – more and more men are getting every type of cosmetic procedure for various reasons (another blog).

THE BOTTOM LINE: There comes a time when surgical Facelift is the only right answer. When that time comes – you have options!  Fall is when men and women get serious about these issues.  Let’s talk more!

Hope this helped clear up some fog!

Helping You Keep Your Best Face Forward!

Dr. Steven Davison

FACELIFTS & MEN

Men today are getting more and more cosmetic procedures done…for various reasons.  Facelift is one of them.  Since facelift surgery is so popular today…with a growing male clientele, I want to encourage the guys with some info.

My last blog covered the six basic techniques used for surgical facelifts.  So, please refer back to that if you have related questions.  Also, see my website for in depth information on each procedure.

Here’s why Men have facelifts today:

  • Want to match their physical appearance with how old they feel.
  • Are looking older than they are…and decide to correct it.   This happens when a dad is asked if his son is his grandson.  ZING!
  • Men want to look “as good” as their wives who are getting things done.
  • They’re going on job interviews  (may have lost a job) and they want to do all they can to “compete.”
  • Aging, injury, trauma, disease have taken a toll “emotionally” and they need to boost their self esteem and self confidence.
  • Pride.  Some men just never want to look their real age.  Always want to look great!
  • Stigma…it’s gone.  It’s OK and men know it.

How Old are these Men? They are of all ages and stages in life.  The critical thing about “age” and facelift surgery, is that the older client should be in overall good health and must expect different results which may take a little longer.  The risk factor is no greater in people over 65 as long as they are healthy with realistic expectations. Men today know that starting in their 40’s/50’s can keep them looking good – always.

If married – what do their wives think? Their wives love it!    A good facelift job needs to match the individual and look “natural” while taking several years off the face.

So come on in and let’s get to work!

Dr. Steven Davison

Labiaplasty—an acceptable cosmetic procedure

Labiaplasty is a plastic surgery of the external (outer) female genitalia.  The predominate reason women seek this operation is increased size of the labia minora (or inner lips). As fashions become more form fitting, hair patterns more revealing and mean of comparison more common, more women are seeking this operation for cosmetic reasons.  Problems with pain, on sitting or in thigh clothes, toilet habits and sexual discomfort are functional reasons patients seek a surgical solution to elongated labia.

The problem may be exacerbated by age or activity (horse or bike riding) and atrophy of the labia majora (outer lips).  Current grading suggests any length more than 5 cm is abnormal by comparison in size with what is considered anatomically normal. The goals of labiaplasty are a minimally invasive way to reduce the enlarged lips while maintaining the sensation, color, texture and adequate opening of the lips. The edges of the labia have a very unique pigmented, corrugated mucosa skin junction that cannot be replicated.

Different techniques exist from amputation of the excess lip, simple wedge excisions and more complex wedge excisions tailored to remove the excess tissue while preserving the edge.  The technique that works the best is one that is tailored to the patient’s own anatomy, yet wedge technique which I use leaves more normal color, appearance and sensation.

The surgery takes about an hour and can be performed under local, sedation or general anesthetic based on patient comfort.  Recovery is about a week of surgical healing with avoiding heavy exercise and sexual activity for two weeks.  Care is minimal involving sitz baths and antibiotic ointment only.  I utilize layers of absorbable sutures which avoid the need for removal and minimize the risk of dehiscence or the wound falling apart which is the most common of this procedure and is a rare complication.

This is one of plastic surgery’s offerings with which patients are undeniably delighted. Large series report 95-98% of patients if happy or would undergo the operation again, a solid testimonial.

The operation is not difficult, yet requires appreciation of genital esthetics, tissue handling and plastic surgery techniques. Seek help from a surgeon with understanding and experience. Ask about techniques they use to preserve mucosa to skin border to maintain texture, color and sensation especially if you have pigmented skin. The surgeon needs to leave at least 1 cm of labial length to avoid retraction and scarring.  I have seen this type  of problem once when serving as an expert witness for another surgeon and it is hard to fix without complex further surgery.

Price is important in all choices but make sure you are comparing the true expenses.  Is this being offered in an office or operating room, is anesthesia included or is it going to require a number of sensitive injections.

In conclusion, this surgery can be combined with other minor procedures to plump up the outer lips or clitoral hooding to remove excess skin from around the clitoris.

Please visit our website for more information.

Dr. Steven Davison

Schedule Your Consultation With Dr. Davison

The initial consultation with your surgeon is critical! It should always be face to face with your surgeon during which time he/she listens closely to your concerns. Dr. Davison believes this time spent with you is critical to both you and to him. It is during the consultation that he comes to fully understand your concerns, evaluates them correctly and is then able to make the recommendations and develop the treatment plan thats right for you. Dr. Davison invests the time to sit down and talk to you face-to-face.

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3301 New Mexico Ave. Suite 236

Washington D.C.