One of my cases today was a young woman who wanted fuller cheeks and lips.+�-� She traveled here for a consultation, some months ago, from across the country.+�-� Unsure of what she needed, she like many pf my patients was looking to me for specific suggestions on how she could be more attractive.+�-� I evaluated her face using my “Palmer Beauty Principles” and showed her that she could benefit from an aesthetic improvement in 2 of the top three facial features.+�-� Her cheeks were relatively flat and her lips were a bit thin.+�-� She agreed and signed up for a day in the Operating Room….she wanted it right away but unfortuneately there were no OR openings for some months.+�-�

+�-�Today was her day and she showed up this morning just as bright, chipper and sweet as could be.+�-� I can’t tell you how nice it is to operate on a person that is sweet, kind and appreciative.+�-� Sometimes patients in this business can be demanding and hard to deal with….the power people with money that are used to always having things exactly their way.+�-� More on this later.+�-� Back to today’s patient.

+�-�I did the Cheek Augmentation first.+�-� I mark the outside of the face, after the patient is under anesthesia….using a purple surgical marking pen to trace the outline of each Cheek Implant as it should sit on top of her cheek bone.+�-� There are several anatomical marks that I have used over the past 16 years that help exact Cheek Implant placement.+�-� I then inject the area with a novacaine-like substance to control the bleeding and numb the area after the procedure.+�-� I use a scalpel to make an incision on the inside of the upper lip close to the gums.+�-� Using scissors, I dissect the tissue until I feel the Cheek Bone.+�-� Dissection continues directly over the Cheek until the space inside is similar but slightly larger than what I have drawn on the outside of the cheek.+�-� Antibiotic solution is placed inside the surgical opening and the Cheek Implant is placed inside the mouth on top of the Cheek.+�-� Once I am satisfied that the Cheek Implant is in the proper position, I close the opening with dissolveable stitches from the inside out.+�-� This prevents the front of the Cheek Implant from slipping downward or poking out into the mouth.+�-� The inside lining (called mucosa) of the mouth (the incision) is closed in a water tight, double layered, running, locking, dissolveable suture.+�-� Say that 5 times really fast!

+�-�Then the same procedure is performed on the opposite Cheek.+�-� I am right handed, so I tend to perform operations from the right side of the OR table and do the right side, of a procedure, followed by the left side.+�-� The incision in the mucosa of the mouth is less than 1 inch long and the dissection goes about 4-6 inches deep…..so I wear a headlight on my head that has a high powered focused beam of light+�-�allowing me to see in deep surgical spaces.+�-� Once the second Cheek is Augmented and the incision is closed, I use reinforced tape, on the skin,+�-�to secure the Cheek Implant.+�-� This first set of tape (steri strips) goes over the entire Cheek and is+�-�removed after 1 week.+�-� At that time, I place steri strips along the top, bottom and leading edge (by the nose) of the Cheek Implant to further secure the Cheek Implant for about 5-7 days.+�-� It’s best to ice the area as much as possible for the first week but really there is not much discomfort, swelling or bruising.

+�-�Once that’s done, I move on to the Lip Augmentation.+�-� I use Alloderm for my Lip Augmentations and I believe that it’s the gold standard for soft, natural fuller lips.+�-� I have had the residents at USC write several pappers about how my experience with Alloderm+�-�stating how great Alloderm is over the past 10 years, or so, that I have been using it for Lip Augmentation.+�-� The Alloderm is rolled and then passed under the mucosa (red portion) of the lips through a small incision in the corner of the mouth.+�-� The incision is closed with dissolveable stitches.+�-� I tell patients that Alloderm Lip Augmenattaion lasts about 7 years and that I think it’s #1 in soft, natural looking lips.

She looked great when I was done…..I was happy and I’m sure she’ll be thrilled!+�-� Just a glimpse at what goes on to make people look good…..and you thought that the beautiful people+�-�were just natural gorgeous, didn’t you?+�-� Guess again!