1. The Lifestyle Lift and Quicklift franchises don’t offer patients a full range of options for facial rejuvenation. It’s more of a one-operation-fits-all thinking. Cosmetic surgery, though is really one of those things that needs to be intensely customized to each patient. Your face isn’t exactly like anyone elses and your facelift shouldn’t be either.
2. Mini facelifts are procedures with limited results that are suitable only for a limited group of patients. They tend to work if you just barely, sort-of need a facelift. Even then the results can be somewhat subtle and are often short-lived. A basic rule of thumb: If you look in the mirror and think you need a facelift, you probably need a real facelift. I’ve seen far too many patients who’ve spent thousands of dollars on minilifts, Laser treatments, Thermage, and suture lifts only to ultimately end up getting a real facelift. Which is what they needed in the first place.
3. The Times article reports facelift franchise consultants may employ high-pressure sales tactics to get you to sign up for surgery — often before meeting the surgeon. Hard sell does not belong in plastic surgery. If you’re ever in a doctor’s office and feel you are being pushed to get a facelift, leave. No reputable Dallas plastic surgeon I know employs these kind of tactics.
4. The quality of your facelift (or any cosmetic surgery result) ultimately depends on the skill, judgement, and artistry of your plastic surgeon. You only have one face. Choose carefully.

In this post I’ll explain how the procedure works. There are three steps:

Liposuction

This step has two equally important purposes. The first and obvious goal is to collect the fat that I will transfer to your breasts. The second (and often overlooked) purpose is to precisely contour the area being suctioned.  We’re looking not just to enhance the breasts, but to dramatically improve the appearance of each area that’s donating the fat. The fat areas should not be treated as just harvest sites; they should be contoured carefully and precisely.

I typically use the Vaser system for this but may also use micro cannula liposuction depending on your specific needs. If you are a good candidate, I will also use Vaser Hi Def techniques to enhance muscle definition in the treated areas.

Fat Collection

This used to be a really cumbersome process that involved washing, filtering, and centrifuging the fat. It usually required an extra person in the operating room just to perform these tasks.  These steps added a lot of time and cost to the procedure. Also, all this processing increased the risk that the fat would get contaminated or dry out.

Tissu-Trans fat harvest device I now use has made fat collection quicker and more reliable.  The Tissu-Trans connects to the liposuction machine and traps the fat in a sterile bag. The pure fat separates out in the device. It does not need to be processed. Instead, it’s drawn directly into injection syringes from the Tissu-Trans and is ready for use. The fat stays in a sealed system the entire time with minimal air exposure and minimal handling. This protects the delicate fat cells, increasing their survival and improving the outcome.

Fat Injection

Once loaded into syringes, the pure fat is ready for injection. I use a specially designed injection cannula to transfer the fat to the breasts. It’s critical here to use many injections of very small amounts of fat. Big globs of fat won’t survive. Instead, we step by step add little bits of fat throughout the breasts slowly sculpting them up to the desired size and shape. This takes a little longer but improves fat survival and ultimately gives you a better result. All of the fat injections can usually be done through 2 0r 3 tiny puncture incisions. There are virtually no breast scars from this procedure.

The fat transfer breast augmentation is usually done in our Dallas operating room with general anesthesia. Patients go home the same day and can resume usual light daily activities within 24 hours. Return to work is a few days for office jobs.

That means I can now remove the fat from the places you don’t want it…and use it to enlarge your breasts. You get fuller, larger breasts — without any implants — and a leaner figure at the same time.

I’ll discuss how the procedure works in a follow-up post but, for now, let me explain why we now have this fat transfer procedure. Three things have happened recently that have made this a reality:

Better Fat Harvesting Equipment

I now use a Vaser/Tissu-Trans system to suction and collect the fat. Using this technology, I can get more fat and get it more gently. That means we get smoother contouring in the areas we suction and also healthier fat for re-injection. The healthier fat survives better resulting in a bigger, more successful augmentation.

Shorter Surgery Times

These new methods also shorten the fat transfer procedure. The fat collects and processes automatically in the Tissu-Trans device. No longer do we need to wash, filter, and centrifuge the fat. These steps used to add a lot of time and also killed more of the fat cells we needed. I’d estimate that the typical procedure takes about 20% less time now.

And by the way, a shorter procedure is a less expensive procedure. Fat transfer procedures are now much more affordable.

ASPS Approval

The American Society of Plastic Surgeons just released the results of its Fat Grafting Task Force. If you’re so inclined, you can read the actual report. In case you’re not, I’ll summarize it.

The task force reviewed 110 papers on fat grafting.

They found, “Fat grafting may be considered for breast augmentation and correction of defects associated with medical conditions and previous breast surgeries.”

The Task Force found no interference with the detection of breast cancer but did recommend further study of this issue. This is especially good news because potential problems with mammograms was one of the bigger concerns of plastic surgeons regarding this procedure.

“Fat transfer results are dependent on technique and surgeon expertise.” As always, choose a board-certified plastic surgeon and choose him or her carefully. Be sure to find someone with advanced liposuction and fat grafting training, skills, and experience.

I’ll explain more about the actual procedure in the next post. If you have questions or are interested in breast augmentation with your own fat, please call my office at 1-888-800-8300.

As always, I welcome your thoughts and comments on this post.

Juvederm is a clear, smooth gel made out of hyaluronic acid (HA) – a natural substance that adds volume and hydration to your skin.

Where do I use Juvederm?

Juvederm is used to restore or add volume anywhere on the face. It is my favorite product for enhancing and sculpting the lips. It is also terrific for filling in folds, wrinkles and creases.

I have often used it to smooth the crease that runs from beside the nostrils to the corners of the mouth (nasolabial fold) and to hide puffy lower eyelids. Juvederm can be used to enhance the shape of the cheekbones.

Why is Juvederm Better?

Juvederm has all but replaces collagen as a filler. It’s smoother than collagen making it much easier to shape and sculpt with. Lumpiness and irregular contours are much less likely with Juvederm. Juvederm also lasts more than three times as long as collagen. Compared with Restylane, the other HA filler, Juvederm is softer and feels more natural. Most patients who have had both prefer Juvederm and say that it feels softer and more natural. Juvederm is also FDA-approved to last up to one year – about twice as long as Restylane.

How soon will I see results?

You see the results immediately with Juvederm. And the look continues to improve for 1-2 weeks as the Juvederm softens and draws moisture into the area.

How Long is the Recovery?

Most patients have only mild discomfort and downtime is minimal. You might have some mild swelling or firmness that usually resolves in a week or less. You also might bruise though most patients don’t. Bruising is usually mild and can be covered with lipstick or makeup.

How Long does a Juvederm Treatment Take?

Our Juvederm appointments are usually 30 minutes long. The injections usually take about 15 minutes and we add another 15 minutes to allow enough time for the numbing injections to work completely.

Does Juvederm Hurt?

In most cases, not at all. I can numb most areas of the face (lips, cheeks, eyelids, forehead) with local anesthetic nerve blocks. once this is done, you won’t feel the Juvederm injections.

How Many Syringes of Juvederm do I Need?

Most nasolabial folds will typically require two syringes to fully correct. One syringe of Juvederm is sometimes sufficient for mild nasolabial folds.

For lip augmentation, one syringe will sculpt and enhance the lips. The change will be noticeable but subtle. Two syringes will give a more dramatic size increase and enhancement.

As we age, our lips slowly lose volume. Women who have noticed this and want to restore lost volume will usually need two syringes of Juvederm.

See Dr. Schwartz’ Lip Sculpting Results

How to Achieve Natural-Looking Lip Augmentation Results

The lips in the picture (they belong to Lisa Rinna) are the exact opposite of the ideal lip shape. Here are some examples of  natural-looking lip augmentations.

Lip augmentation isn’t just about putting in the right amount of Juvederm. It’s about putting the right amount in the right places.

This 37-year-old Dallas woman had noticed a gradual loss of lip volume over time. To rejuvenate her lips, I used two syringes of Juvederm Ultra hyaluronic acid gel. The first syringe restored the lost volume. I used the second syringe to sculpt the lips into a prettier shape. The photos show the result at one month.

Thank you sooo much! If this isn’t perfection, I don’t know what is!

You gave me exactly what I asked for and I love it.

I am a patient for life.

J  (Dallas, Texas breast augmentation patient)

The Vaser is state of the art for gynecomastia treatment and male chest contouring. Its advanced ultrasound system allows me to remove more fat and breast tissue and to remove it more evenly. The Vaser enables true sculpting of the male chest.