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: Jawline


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, Skin Care

Fill ‘er up for higher patient satisfaction.

November 16th, 2011 — 12:48am
Seattle Plastic Surgeon recommends full tank for HA fillers

Fill ‘er up even if it means saving up some hard earned $$$.

Seattle Plastic Surgeon, Dr. Lisa Lynn Sowder blogs about patient satisfaction with HA fillers such as Restylane, Perlane, Prevelle and Juvederm. 

I’ve been using these fabulous new facial fillers for many years now and have come to really, really love the way they rejuvenate the face without looking fake or tight or overdone. 

Here is one thing I have learned over the years:  patient satisfaction is directly proportional to how full their tank is filled.  The tank is your face and the fuel is the filler

Some patients will get to full with one syringe and some will require a half dozen.  It just depends on how many creases a patient has, how deep the creases are and how much fullness would benefit the patient.   And I am not talking freak show fullenss here.  This is Seattle.  I’m from Spokane.   I don’t do freak show. 

The big issue, of course, is the cost and these magical fillers are pricey.   Many patients are reluctant to spend the money ($2800 for 6 syringes!)  especially considering that these fillers are temporary.  But …….. it has also been my experience that these temporary fillers can often last 18 – 24 months even though they are advertised as lasting 6 months.  And ……….. patient’s who fill ‘er up usually need much less volume for subsequent “maintenance”  injections. 

Fill ‘er up” patients are almost always thrilled and I know they will be back for more.  The patients who settle for just partial correction are rarely impressed and often don’t come back for repeat injections.

So if you need a lot to “fill ‘er up”, save up and let me really do it right!  Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues, Facial Fillers, Jawline, Lip Enhancement and Augmentation, Nasolabial Folds, Non-invasive, 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.

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

Face Lift, Jawline, Nasolabial Folds, Plastic Surgery

What on earth is a liquid face lift??????

May 18th, 2011 — 11:31pm


Liquid Facelift?  Seattle Plastic Surgeon explains.

I’ve already blogged about the “Lifestyle Lift”. See my blog of a couple of months ago, Today I will say a few words about the “Liquid Facelift” which must be getting some buzz lately because I’ve been getting some questions about it. Take a look at my lady here. The before photo on the left shows an old looking jaw line. The after photo on the right shows the jaw line looking more youthful. This was done using HA fillers which come under many brand names such as Restylane, Juvederm, Prevelle, Perlane, etc. I injected some of the deep creases around her mouth and I injected the indented area between her chin and her jowl, the so-called pre-jowl sulcus. This gives the illusion that the jowl has been tightened and pulled up. Even her neck looks a little better and I didn’t do anything to this area! This is a great non-invasive procedure for patients who want some facial rejuvenation without surgery. This is called a “liquid facelift” because the HA filler is sort of a liquid. I think I will rename it the Jelly Facelift because the filler has a consistency of jelly. This particular Jelly Facelift took about 30 minutes and it should last a year or more. Down time is minimal, usually a few days because of swelling and/or bruising. Nice, huh?

Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues, Facial Fillers, Jawline, Nasolabial Folds, Now That's Cool

Too good to be true??? Yes!!!

February 28th, 2011 — 9:21am

Seattle Plastic Surgeon Uncovers Some Really, Really Misleading Before and After Photos.

scan0043I am really on a roll here, or maybe it’s a rampage. It’s too soon to tell. Here is another “before and after” from yet another liposuction gizmo that is supposed to sculpt the fat layer and tighten the skin layer, all without surgery!

Take a close look at these photos. They are pretty impressive, don’t you think? But take a really close look. Mentally drop a straight line down from the point where her nose meets her upper lip. Then take a look at her chin. Her chin (AS IN CHIN BONE) has been moved forward. This ad thus implies that this non-surgical fat sculpting and skin tightening gizmo can actually move a chin and jaw bone. Maybe this lady’s chin and jaw were moved but if so, it was done using an orthognathic surgical procedure and it involved a bone saw and some metal screws and plates. Not exactly non-surgical or minimally invasive. Or maybe the ad folks just used Photoshop. Either way, this ad is more than highly misleading. It is fraudulent.

And again, the wretched thing is that these gizmos are heavily marketed to those without full training in Plastic Surgery. And those wannabe “plastic surgeons” who may be saying, “Wow, what a great result. I must have one of these!” don’t even know what orthognathic surgery is. I sure didn’t know it existed until I did my plastic surgery training.

Orthognatic surgery, by the way, is a field of plastic surgery and maxillofacial surgery which involves moving the bones of the face, usually the upper and/or lower jaw. And it’s not done with a “minimally invasive”, one bazillion dollar, fraudulently advertised gizmo with a “doesn’t know any better” doctor pushing the button.

Ineffective, Jawline, New Technology, Non-invasive, Patient Beware

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