Q&A with Dr. Rohrich

Q:

Why do some facial procedures look unnatural?

A:

Effective plastic surgery should never look as if someone has had plastic surgery. The first step to avoid this is completing a comprehensive assessment of someone’s face and outlining the most effective plastic surgery options for the individual.

Outcomes are based on the skill and experience of the surgeon. At UT Southwestern Medical Center, we have conducted extensive research on how the face ages and which techniques and procedures will achieve a natural look. Our goal is to help our patients meet their objectives using the latest innovations. All procedures are very highly individualized, with a commitment to patient safety and excellent outcomes.

Q:

What are major considerations in evaluating facial aging?

A:

First of all, not everyone’s face ages the same. For example, one area of our research has discovered that facial fat compartments change at different rates for different people. Additionally, the way someone takes care of his/her skin, as well as diet, the effects of the environment (including the sun), and tobacco can affect the amount of facial fat someone has and promote wrinkles and sagging skin.

Q:

Will combining procedures achieve better results with a face lift?

A:

All procedures should be individualized. There is not one formula for face lifts that will work for everyone. Typically, we combine techniques and treatments, and may include nonsurgical and surgical treatments for facial rejuvenation.

A face lift can make you look younger and fresher, but it should not make you look totally different. It is very important to discuss your expectations with your surgeon.

Q:

All Botox is equal?

A:

No. Not all Botox is the same. Physicians, spas, and others are all offering Botox. However, you get what you pay for – as the company that produces Botox sets a standard price for the product. The discounted versions may be extremely diluted or may not even be Botox.

Q:

Are there nonsurgical options, like fillers and laser treatments, which can replace surgery for facial rejuvenation?

A:

For some patients, nonsurgical options can help rejuvenate their faces – particularly when they are combined properly. These options can delay the signs of aging by smoothing nasolabial folds (laugh lines), lifting the eyebrows, etc. Another benefit is that they have an immediate impact and require very little, if any, downtime. Although effective for some patients – fillers, Botox, and other nonsurgical options are temporary. They do not ultimately replace the long-term impact of surgical procedures.

Q:

Are there creams or serums effective in eliminating dark circles under someone’s eyes?

A:

There are a number of reasons people have dark circles under their eyes. It may be the result of heredity, skin pigmentation, thinning skin, etc. Although it is unlikely that most dark circles can be lightened significantly, there may be options to lighten the discoloration. For example, Retin-A, bleaching creams, lasers, etc., offer positive results for some patients.

Q:

What are considerations regarding breast implants?

A:

First of all, they are safe. Your plastic surgeon will guide you through your options. My experience and research show that, for most patients, breast implants will stay softer longer when placed below the muscle – as well as typically looking more natural.

Q:

What should someone keep in mind when considering nose surgery/rhinoplasty?

A:

Your nose should fit your face. It should not be a carbon copy of a celebrity’s nose.

Rhinoplasty is a highly complex procedure. It is a surgery of millimeters – one millimeter can be the difference in the way someone looks, as well as the how the nose functions after the surgery. It is important to combine delicate surgical skills to address the structure of the nose, as well as focus on the aesthetics.

We can successfully improve issues patients have, such as reducing dorsal humps, changing the tip of the nose, repairing a deviated septum, and improving the overall function such as eliminating breathing difficulties. But, again, this takes skill.

Q:

Is it possible to reduce the amount of scarring that occurs with surgery?

A:

Yes. It depends on the expertise of your surgeon. Key considerations that determine the amount of scarring include where the incision is made and your genetic makeup. In addition, it is important to allow the surgical incision to close and heal properly. For some procedures, we also suggest staying out of the sun, massage therapy, and applying antioxidants such as vitamin E to diminish scarring.

Keep in mind that incisions on the face and neck typically do not leave significant scars, even in patients with darker skin. Scarring is typically more visible on the body, but your surgeon can manage this.

Q:

What type of impact will mixing fillers and other products have on my face? Will it improve results and make them last longer?

A:

Yes. However, it requires skill and experience to understand which products should be combined to produce the most effective results. We know different products have varying levels of effectiveness, depending on where and how they are applied. Also, some products last longer than others. For example, long-lasting fillers should be applied in a deeper fashion. Hyaluronic fillers are effective for surface or more superficial needs. For some patients, a product such as Radiesse can be used in the nasolabial folds, with a hyaluronic acid applied in the commissures – used in combination to reduce laugh lines and reduce wrinkling in the mid-region of the face.

We have extensive experience and research regarding which products work together to achieve the best results. By balancing the appropriate combinations of traditional and new products, we can accomplish great success for patients and create a refreshed look that will last as long as possible.

Q:

What should I look for when considering a plastic surgeon?

A:

Choose wisely. Safety must be a key consideration when considering plastic surgeon. The plastic surgeon you choose will determine how you look and feel long after the procedure.

Anyone with a medical license can say he/she is a plastic surgeon – even if it is not true. It is very important to find out if the doctor has completed training specifically in plastic surgery and is board certified. The American Board of Plastic Surgery is the only medical organization that can certify that a physician is fully trained in plastic surgery of the face and body. It takes six to nine years to complete this training, and then the physician must pass extensive written and oral exams.

Q:

What are key determinants in deciding if a facility is safe for surgical procedures?

Safety should be a key concern as you evaluate the actual facilities where a procedure will be performed. It should be an accredited facility, with support provided by medical professionals. Any surgery should be performed in an accredited medical facility. If it is an outpatient center, the doctors should have admitting privileges to an inpatient facility or hospital, in case a need arises.