Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Category: Face lift


Agressive Skin Care + Enough Filler = GREAT RESULTS

December 14th, 2011 — 10:25pm

Seattle Plastic Surgeon shows off a GREAT NON-SURGICAL RESULT – take a look at this.

Seattle Plastic Surgeon, Facial filler, skin careTop photo before treatment. After photo is after agressive skin care and HA filler over a nine month period.

I saw this patient recently who I have been treating with aggressive skin care and HA fillers (eg Restylane, Juvederm, Perlane, Prevelle) over about 9 months.  She has been very, very dedicated to her skin care program and I’ve been very, very dedicated to injecting her with filler where she needs it and, as mentioned in a previous blog, using enough to really filler ‘er up. 

And take a look at these photos.  Her skin quality is so much better and the shape of her jaw line and chin is so improved and her wrinkles —- what wrinkles?????  

Fat transfer followed by a deep chemical peel could have achieved this result but no face lift, I repeat, no face lift could have achieved this sort of improvement.

 Yes, she will need continued skin care and will need to come in every year or so for some more filler but remember, this is all with no down time and very, very little pain and suffering. 

 And just remember all of those things we do that also need maintenance – hair, nails, legs, bikini line (ouch),  eyebrows, etc.  Oh yeah, and how about getting your teeth cleaned every 6 months.  No down time but talk about pain and suffering! 

Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues, Dental issues, Face lift, facial fillers, fat injection, jawline, nasolabial folds, Non-invasive, Plastic surgery, Seattle plastic surgery, skin care

Why we mark patients in the upright position!

June 2nd, 2011 — 7:26pm

Lower face in the upright position.Lower face in the supine position.

Lower face in the supine position.

Plastic surgeons always, always, always do our preoperative markings with patients in the upright position.  It doesn’t matter if we’re operating on  a face, a chest or an abdomen.  Most people understand the effect that position has on breasts and bellys but have never really thought about the effect that position has on the face.

Take a look at these photos posted on the Real Self website by a lady with questions about facial surgery.  Look at how much improvement she gets with her jaw line and her nasolabial folds (the creases that run from the nose to the corner of the mouth) when she lies down.  Also look how her square face assumes a more oval shape.  Wild, huh?

These photos also illustrate why we sit patients up during or near completion of a face lift.  A face that looks great supine on the operating room table may need a little tweaking once gravity is added to the equation.

Thanks for reading!

Lisa Lynn Sowder, M.D., Seattle Plastic Surgeon

Face lift, jawline, nasolabial folds, Plastic surgery

Please, no bidding war for a facelift at the school auction!

May 16th, 2011 — 11:34pm


My children’s school had its annual fund raising auction this past weekend. This year was a 60’s theme and we all got to dress up like hippies. It was a blast.

Every year someone inquires about me donating surgery to be auctioned off and I always have to decline. The two national associations I belong to – the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery forbid the donation of surgery to raffles, auctions, wet t-shirt contests, and the like by their members.

When one gives this some thought, it is a very good policy. These events are set up to get participants excited and enthusiastic so they will bid higher or buy more tickets and the winner of the item may never have had an inkling to purchase such a service and in fact may not be a good candidate for a particular service. I would hate to see an unhealthy, overweight, indoor tanning, 2 pack a day smoker in my office expecting a face lift because he or she was the high bidder at the auction. Participation in these events really undermines the usual process of doctor and patient selection. We are allowed to donate non-invasive procedures such as skin care, Botox and filler injections because these have a much broader range of appropriate patients than surgery.

This year I donated our medical skin care system, Obagi Nuderm. It works like a charm for fine lines and uneven pigmentation and is safe for just about everyone. I know the lovely woman who had the high bid this year and I am looking forward to helping her transform her complexion. It’s a win, win, win. She gets great skin, I get a great patient and the school gets a nice chunk of change.

Aging Issues, Face lift, Now that's a little weird, Plastic surgery, Seattle plastic surgery, skin care, sun damage

So, what is a “Lifesytle Lift”?

April 5th, 2011 — 7:28pm

So what is a "Lifestyle Lift"?

Okay, okay. I have had a jillion questions about the “Lifestyle Lift” in the past few weeks. All I can figure is that they are doing some sort of marketing blitz. I don’t watch T.V. so I am a little out of the loop. I am not one of those anti T.V. snobs. It’s just between work, the kids, this blog, my guitar practice, my reading, my working out, my sort of decent social life and my all time favorite thing (sleeping), I don’t have the time.

Here I will tell you everything I know about “Lifestyle Lift”. This information comes from patient reports, the reports from one of our employees who checked it out, and what I know about facelifts (a lot) and what I know about in office operating rooms (a lot). Here goes.

1. A “Lifestyle Lift” is a short scar (usually just in front of the ear) face lift done to improve the lower face and jawline. Additional procedures are necessary to improve the neck, the forehead and/or the eyelids. There appears to be no difference in the technique of a “Lifestyle Lift” compared to other short scar or minimal access facelifts that most plastic surgeons (including me) perform for on some patients.

2. The procedures are done under local anesthesia only.

3. In office operating rooms that do procedures under local anesthesia only (for example “Lifestyle Lift” clinics) do not require any inspection or regulation at the state or national level. They are “under the radar”.

4. Patients are evaluated by non-surgeons. Often the person evaluating the patient has no medical training. They are often “saleswomen” who receive a commission for each patient they schedule. In my opinion, only the operating surgeon can determine if a patient is a good candidate for surgery.

5. The doctors who do the surgery arrive at the “Lifestyle Lift” clinic, meet the day’s patient(s), do the surgery and then return to their home clinic. Their main practice is not at the “Lifesytle Lift” clinic.

6. The doctors who do the surgery at the “Lifestyle Lift” clinic are often not certified by the American Board of Plastic Surgery or any other surgical specialty recognized by the American Board of Medical Specialties (www.abms.org).

7. Follow-up care is often provided my non-doctors.

8. “Lifestyle Lift” has been prosecuted and fined for “astroturfing”, that is providing false online reviews.

9. The Seattle Lifestyle Lift doctors are Ear, Nose and Throat doctors and are not certified by the American Board of Plastic Surgery.

10. Wikipedia has a good entry: http://en.wikipedia.org/wiki/Lifestyle_Lift

Any questions? Shoot me an email at sowder@eplasticsurgeons.net.

Aging Issues, Face lift, patient beware, Plastic surgery, Preoperative care

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