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: Facial Rejuvenation

Lifestyle Lift – demise of a plastic surgery franchise

March 4th, 2015 — 7:50pm

Maybe the Franchise Model Just Doesn’t Work for Something as Personal as Plastic Surgery?

I got word yesterday of the closure and pending bankruptcy of “Lifestyle Lift”.   You have to be living in a cave not to recognize this name and their pitch for a “one hour face lift under local anesthesia” and their very pretty spokeswoman, Debby Boone.

Years ago, I was approached by the Seattle Lifestyle Lift with the offer of a part time job which I graciously turned down.  I cannot do a decent facelift in anything under three hours and I seriously doubt that even the speediest of surgeons can do much of anything in just an hour with the patient squirming away with only local anesthesia on board.  Also, I was turned off by their one facelift fits everyone approach.  Facelift, like just about every surgery a plastic surgeon does, is highly individualized.  That’s one of the many things I love about my work.  I never do exactly the same operation twice.  (Well, I take that back.  I did do breast implant surgery on a lovely set of identical twins about ten years ago.)

I just don’t think a franchise is a great business model for surgery in general and plastic surgery in particular.

I will not miss seeing their ads and I am sure Ms. Boone will find another gig.

Thanks for reading!  Dr. Lisa Lynn Sowder

Facial Rejuvenation, Plastic Surgery

Stem Cell Face Lift

April 10th, 2013 — 3:15pm

Seattle Plastic Surgeon discusses the promotion of stem cell face lifts by ethically challenged physicians.

Stem Cell Face Lift

Pssstttt …. I’ve got a Stem Cell Face Lift for sale.

Recently I have had several inquiries about “stem cell face lifts” and whether or not I perform them.  There must be someone out there promoting this as the latest and greatest fountain of youth.   That someone  is probably deceptively promoting him or herself as a plastic surgeon with a magic wand.

A little background on stem cells:  These are little baby cells that can differentiate into almost any adult tissue.  Research on stem cells is one of the hottest areas of biology and with good reason.  Figuring out how to turn on the right genes in a population of stem cells could lead to tissue and organ engineering and amazing advances in the treatment of human disease and injury.

Adult fat tissue has a lot of stem cells.  Cool, huh?  Who would have thought that Mother Nature would pack away these tiny powerhouses of potential in our blubber?  Stem cells can be isolated from fat tissue in the laboratory using very sophisticated equipment .  This equipment  is not something available to physicians working in a clinical setting.   Stem cells are not being isolated from fat and injected into human faces.

So what’s the deal? Fat transfer for facial rejuvenation has been around for 20 + years and is becoming more and more popular as we understand the aging process better and also get better with the very fussy techniques required for successful fat transfer.  I’ve been doing fat transfer for facial rejuvenation for 15 years.  Fat transfer does something that is very obvious:  it plumps up a deflated face and makes it more youthful appearing.  It also does something else that has been observed by those of us who do fat transfer:  it improves the quality of the overlying skin.  And this qualitative improvement is likely the effect of stem cells that come along for the ride with the fat.  So the “stem cell face lift” practitioners are doing fat transfer but are promoting it as something new and unique.   It’s a little like calling a jelly donut a new type of fruit serving.

Check out this article in the New York Times. 

Thanks for reading and if you find a jelly donut that really is a fruit serving, please let me know.  Dr. Lisa Lynn Sowder

Facial Fillers, Facial Rejuvenation, Fat Injection, Uncategorized

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, Facial Fillers, Facial Rejuvenation, Non-invasive, Skin Care

Male brow and eyelid surgery – easy does it!

November 30th, 2011 — 11:16pm
Seattle Plastic Surgeon does male plastic surgery
The masculine brow is low and the lids are full. Just ask James Dean.

Seattle Plastic Surgeon blogs about male facial plastic surgery.

Recently I have done facial plastic surgery on a few dudes and that has gotten me thinking about the difference between male and female plastic surgery. 

With guys undergoing facial surgery, especially around the eyes, less is more.   When one thinks of bad male plastic surgery outcomes, it is often because the area around the eyes was overdone and thus feminized.  That’s not the look most dudes are looking for.

The masculine male brow is low and either horizontal or with just a little itty bitty arch laterally.  And the eyelids are full with a little bit of redundant skin on the upper lids.  The lower lids should also be full but not bulging, with a smooth transition to the cheek.  I often do not remove fat in the lower lids in men, but rather drape it over the lower rim of the eye socket to smooth this area out without making it look hollow. 

I think that operating on guys can be a little tricky because they are more likely to overdue it after surgery and that can result in bleeding, bruising and swelling.  So I always read them the riot act and make sure their family or friends know that hopping on the kite-board or racing off to play Ultimate Frizbee  is not okay until I say so.  

Hey dudes, I’m bossy because I care.  Thanks for reading, Dr. Lisa Lynn Sowder

Facial Rejuvenation, For Men Only, Male Plastic Surgery

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.

Seattle Plastic Surgeon explains why she always marks her patients in the upright postion.

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!  Dr. Lisa Lynn Sowder

Facial Rejuvenation, Nasolabial Folds, Plastic Surgery

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

May 16th, 2011 — 11:34pm

Seattle Plastic Surgeon won’t donate surgery to her children’s school.

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.

Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues, Facial Rejuvenation, Now That's a Little Weird, Plastic Surgery, Skin Care, sun damage

So, what is a “Lifesytle Lift”?

April 5th, 2011 — 7:28pm

So what is a “Lifestyle Lift”?

Seattle Plastic Surgeon Discusses          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. Some of the  doctors who do the surgery at the “Lifestyle Lift” clinic are not certified by the American Board of Plastic Surgery.

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:

Any questions? Shoot me an email at

Aging Issues, Facial Rejuvenation, Patient Beware, Plastic Surgery, Preoperative Care

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