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: Aging Issues

Got Sunscreen?

June 12th, 2018 — 9:47am

Seattle Plastic Surgeon comments on the results of a long running sunscreen use study from Austrailia. 

90% of this ladies skin aging is due to the sun. I hope her grandson uses sunscreen.

90% of this women’s skin aging is due to the sun. I hope her grandson uses sunscreen.

It’s that time of year when I must nag about tanning.  In rainy Seattle it is so tempting to soak up the sun once summer arrives (that is usually about July 5th).  But please, think before you rip off your clothes, don your thong and grab your beach towel.

A good study published by the Annals of Internal Medicine and reported in the Wall Street Journal  has shown that regular use of sunscreen reduces skin aging by 24%.  It had already been shown many times that sun protection prevents most types of skin cancer but now what seemed to be obvious has also got some scientific cred.   Now my nagging has some scientific backing!

I’m certain we are hardwired to love the feel of photons bombarding our skin but way back when we were being hardwired and learning to walk upright, we would die from an abscessed tooth or a ruptured appendix or (if we were lucky) a quick take down by a leopard long before we developed skin cancer or even a bad case of the wrinkles.

Fortunately, sun protection has finally caught up with our longer life spans.  We have really good sun screens and sun block, protective and comfortable clothing and don’t forget about umbrellas, cabanas and the most lovely shade of all, trees.   And lets hear it for staying indoors when the sun is at it’s strongest.  How about a nice glass of ice tea with some fresh mint leaves and a good book.  May I recommend The Storms of Denali by Nicholas O’Connell, or A Visit from the Goon Squad by Jennifer Egan, or I Remember Nothing by the late and great Norah Ephron?

And just to remind you, I nag because I care.  Thanks for reading.  Dr. Lisa Lynn Sowder

I would be honored if you followed me on Instagram @sowdermd and @breastimplantsanity.

Aging Issues, General Health, Skin Cancer, Skin Care, sun damage

Driver’s side skin damage. Check this out!

June 8th, 2017 — 8:12am

Got sunscreen in your glove box?  You should!

 This is an ABC news report written by Serena Marsh and edited for length by me.  This was originally posted in 2012.

Sunny Side Old: Pic Reveals Sun’s Aging Effects

William (Bill) Edward McElligott is two different ages, 66 and 86 yeaars old. 

If you look at McElligott from the right, he looks like any 66-year-old would expect to, but from the left, wrinkles and sagging skin place him far beyond his years. He is a living demonstration of the importance of protecting your skin from the sun.

“It would take me an hour to drive to work and an hour to come home,” McElligott said. “It was a semi route, I’d have six to eight stops. … 6 a.m. to 3 p.m. on the road.”

For almost 30 years, McElligott drove a truck during prime sun hours throughout the city of Chicago delivering milk to stores and gas stations.

“My left arm was always more tan than my right, because a lot of the time I had the window open (since) we didn’t have A.C.,” McElligott said.

The 66-year-old truck driver suffers from unilateral dermatoheliosis or photo-aging, which was caused by repeated, long-term exposure to UVA rays of the sun.

It was 15 years before he noticed any difference between the two sides of his face, but McElligott ignored it, that is until his grandchildren’s questions got the best of him.

Dr. Jennifer Gordon a dermatology resident at UT Southwestern saw McElligott while on a rotation at Northwestern in Chicago and submitted his case study, which was featured in the April edition of the New England Journal of Medicine.

“It was very stark,” Gordon said. “We are used to seeing photo damage, photo aging every day, (but) for it to be so one sided? We were taken aback.”

Gordon explained that since McElligott spent so much time in his car, his left side was exposed to UVA rays that can penetrate glass and cause the majority of photo-aging, unlike UVB rays, which cause sunburns.

“We think its because it (UVA) can penetrate more deeply into the skin than UVB and affect your collagen and elasticity,” she said. “When you destroy those that’s what gives you the aging appearance that we see.”

Dr. Mitchell Chasin, a dermatologist who did not treat McElligott, says it is extremely common to see patients that come in with more damage to their left side than their right.

“Most people are completely unaware and most people who come in to have sun damage treated, they often times will point to their left side saying they see more spots, more wrinkles, more aging, but never put two and two together,” said Chasin.

Chasin says that whenever people are outdoors, even when covered from the sun directly or on a cloudy day, they should be aware they are not safe from the reflected rays of the sun and should wear sunscreen.

“Sun block is the answer, really, for someone 365 days a year, whether it’s cloudy whether it’s sunny, whether someone is outdoors, in the car, or at the beach,” Chasin said. “If someone wants to age as best they can, sun protection is a daily regimen no matter what you are doing. Put sun block on before you leave the house.”

With summer approaching and vacations and road trips, it’s important to make sure your sunblock has protection against both UVA and UVB rays.

Last year the FDA demanded sunscreen manufacturers update their labels to offer protection for both UVA and UVB, as well as to stop the use of misleading claims such as waterproof. The agency recently extended the deadline to December for manufacturers to comply.

For McElligott sunscreen with UVA and UVB protection has become a daily fixture.

“When I’m out in the sun, when I’m going to be driving, I have sunscreen on,” he said. “I always carry it with me.”

Thanks for reading.  And do you have a favorite sunscreen?  Send me an email and let me know.

Dr. Lisa Lynn Sowder

Follow me on Instagram: @sowdermd and @breastimplantsanity


Aging Issues, General Health, Now That's a Little Weird, Skin Care, sun damage

F.D.A. Announces Stricter Rules on Tanning Beds

June 3rd, 2014 — 4:19pm

Seattle Plastic Surgeon is delighted with the new rules regarding the use of tanning beds.  

She just wonders what took so long????????


blog sun damage

Check out this article in the New York Times.  

Thanks for reading and don’t forget your sunscreen this summer.  Dr. Lisa Lynn Sowder


Aging Issues, General Health, Government and Politics, Skin Cancer, sun damage

Statistics on “throwing in the towel.”

October 23rd, 2013 — 10:49am

Seattle Plastic Surgeons shares the latest depressing news about “throwing in the towel”. 

imagesCANBUN41I was paging through one of the many infomercial type “journals” I recieve and came across an interesting statistic from Benenden Health, a healthcare company in the U.K.

They interviewed 2000 men and women and found that, on average, men give up on their appearance and health at age 46 and women give up at age 59.  Maybe that explains why, at my 30th high school reunion a few years ago, the women looked so much better than the men.  The women were still trying!

This study also reports – and this is really, really depressing – that on average, it takes about 26 months after a wedding before the average person said they stopped bothering about their looks.  Yikes,  that’s just over two years out from walking down the aisle!

I sure hope that this survey reflects the culture of the U.K. and not the States.  Throwing in the towel is not good for my business!

Thanks for reading.  Dr. Lisa Lynn Sowder

Aging Issues

This treatment for thinning hair really works.

August 27th, 2013 — 11:23am

Seattle Plastic Surgeon recommends Rogaine for thinning middle age hair.

Does she or doesn't she use Rogaine?   Helen will never tell.

Does she or doesn’t she use Rogaine? Helen will never tell.

About a year ago, I saw a patient about my age (50 something) with really, really gorgeous hair.  And it was all hers – no extentions or weaves.  I commented on her good fortune and she told me that she had been using Rogaine for about 5 years and it had restored the head of hair she remembered having as a young woman.

Soooooo – I gave it a try myself and after one year of pretty consistent use, I have noticed a very nice increase in volume and the thinning patches around my temples have filled in nicely.  Okay, all the new hair is gray  but that’s what a good colorist is for!

So if you are loosing your crowning glory to the magic of middle age, give Rogaine a try.

And by the way, it works better on women than men, probably because we are more consistent.  We’re used to messing with our hair, aren’t we ladies?

Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues

Fertility reality check in the Wall Street Journal

June 5th, 2013 — 2:35pm

Seattle Plastic Surgeon comments on Wall Street Journal article about the realities of fertility.

If you are over 32, your clock is ticking.

If you are over 32, your clock is ticking.

This morning there was an article in the Wall Street Journal about the realities of female fertility and the conflicts that reality can create for the modern woman.  I hope this article gets into circulation among the young and fabulous and indecisive.

I always ask cosmetic breast patients about their child bearing plans and often hear “I haven’t decided yet” and it often comes from women well into their thirties.  I try to educate patients, in the nicest way possible, that it just may be time to decide.

Back in 2001, The American Society for Reproductive Medicine ran a public education campaign urging women not to wait too long to bear children.  I remember very well how this campaign was taken as an attack on the modern woman by many and how Dr. Michael Soules, the society’s president at the time was vilified.  I just shook my head at the push back that resulted from Dr. Soules and his group just  presenting the cold, hard facts of life.  And I knew what a gentle, skilled and kind physician Dr. Soules was.  He was one of my fertility doctors way back then.

I am glad that the Wall Street Journal is shining the light again on this topic.  It’s as if age related infertility is a topic that must never be discussed by the ambitious and well educated and liberated woman.  But it should be.

I’ll end this blog with the words of one of the doctors sited in the article : “There’s never going to be a perfect time.”

Thanks for reading.  Dr. Lisa Lynn Sowder

Aging Issues

“I want to look natural.” Really?

April 25th, 2013 — 11:54am

Seattle Plastic Surgeon riffs on the “natural look”.

Natural look

This is a really, really natural look (except for the tats).

I practice in Seattle and many if not most of my patients come in saying they want a “natural look”.

Simply by making an appointment  with a plastic surgeon tells me that their idea of a natural look and my idea of a natural look may differ a bit.  To me, the lady on the left has a really, really natural look, except for her tats.  And if my patients looked like this lady after surgery, I would not be very busy.  I am not, in any way, dissing this lady.  I rather admire her chutzpah in letting it all hang out.

I try very, very hard to understand exactly what my patients mean by “looking natural” and in most cases what they really mean is that they want it to look like it “could have, just maybe, just possibly, on a really, really good day, occurred in nature”.  Another term I like is “as good for my age as possible”.

So ………… “like it could have occured in nature” and “as good for your age as possible” are two looks that are in my realm of reality and two looks that I strive for in my plastic surgery practice.

Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues, My Plastic Surgery Philosophy

I’m off to the annual meeting of the Northwest Society of Plastic Surgeons

February 15th, 2013 — 4:14pm

Seattle Plastic Surgeon will present “Breast Implant Removal and Breast Lift in the Middle Aged Patient” at the annual meeting of the Northwest Society of Plastic Surgeons.

cc middle aged woman

Implants? I am so over implants!

Tomorrow I am heading off to my favorite meeting to give a talk on the surgical treatment of women who have either physically or mentally “outgrown” their breast implants.  I see a lot of these ladies in my practice and I have been very happy with the results I obtain with doing a breast lift at the same time as implant removal.  This leaves, of course, a smaller breast but the shape is usually very nice and almost all of my patients are pleasantly surprised at the results.

Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues, Breast Implant Removal, Breast Lift

Fillers may reverse skin aging????? WOW.

December 27th, 2012 — 12:17pm

Seattle Plastic Surgeon shares some very interesting research on fillers and skin aging.  Check it out.

Fountain of youth

Could fillers be the Fountain of Youth?

I read with interest today an article from Dermatology Times e news.  To my knowledge, this is the first study looking at the anti-aging effects of off the shelf fillers.  Here it is:

Ann Arbor, Mich. — It may be possible to slow down the skin’s aging process by boosting support of the dermal extracellular matrix, a new study finds.

As the skin ages, the extracellular matrix, which acts as a scaffold for skin cells, becomes fragmented, according to researchers with University of Michigan Medical School, Ann Arbor. Fibroblasts shrink and less collagen is produced causing the support structure to decline, reports.

The researchers found that injecting the space between the skin cells with a filler enhances the structural support of the extracellular matrix.

Investigators injected a dermal filler into the facial skin of 21 volunteers over age 70 during a three month period. Data indicated that the filler stimulated fibroblasts to begin producing more collagen and boosted the support structure of the extracellular matrix. This increased support, the researchers noted, appeared to further stimulate the proliferation of fibroblasts and increase epidermal thickness, according to the abstract. The entire layer of skin grew thicker with more blood vessels, which nourished the cells, according to

“By altering the matrix using an external filler and increasing the internal pressure, we’ve shown that we can essentially trigger a signal for cells to wake up,” a researcher said. “This shows that skin cells in elderly people have the capacity to respond robustly in a very positive way to alterations in the mechanical property of their environment. We still need to know more about how cells sense their environment, but in general it appears we have made a real difference in the structural integrity of skin.”

The findings were published in the October issue of the Journal of Investigative Dermatology.

Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues, Facial Fillers, Now That's Cool, Skin Care

Happy Belated Birthday to the Rolling Stones

July 13th, 2012 — 11:29am

Seattle Plastic Surgeon wishes Happy B-Day to those ageless boys of the Rolling Stones.

It’s hard to believe that the orginal Bad Boys of Rock ‘n’ Roll first went  had their first gig fifty years and one day ago.  Several years ago, Marianne Faithful wrote Memories, Dreams and Reflections about her high times with the band and rumor has it that Keith Richards gave her a call to tell her he didn’t really care what she wrote about him but to be sure to let her readers know how much fun they had.  Further proof that time flies when your having fun.  I haven’t read Marianne’s memoir but I’ve read Keith’s.    It’s a good read, especially about the early days in post WW II England and how he gets that unmistakable sound on his guitar. 

I’m not sure I would call the Stones examples of graceful aging but they have sure made it look much better than the alternative which of course is dying young and leaving a good looking corpse.  One thing they all have in common is that they DID NOT GET FAT.  Not many dudes can fit into their circa 1962 jeans but these dudes can.  Staying lean is obviously not good for the face but  that’s what fillers are for. 

My favorite Stone’s song is Gimme Shelter but Satisfaction is my all time favorite party sing-along song.  It’s so fun to play that opening riff and seeing everyone (well, I guess almost everyone) perk up and start tapping their feet.  What’s your favorite Stone’s song???  Let me know.

Thanks for reading!  Dr. Lisa Lynn Sowder






Aging Issues, Facial Fillers, Obesity

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