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: Nasolabial Folds


Botox and Facial Filler for the Grinch Who Stole Christmas

December 16th, 2016 — 12:28pm

Seattle Plastic Surgeon knows how to make the Grinch look a little less grinchy.

Botox Restylane Juvederm Seattle

It’s those glabellar frown lines and nasolabial folds that make this Grinch look soooo grinchy.

Take a look at the Grinch.  What is it that makes him look so old and cranky?  It’s his glabellar from lines between his eyes that make him look like he’s having a pretty bad day and it’s his nasolabial folds (those creases that go from the sides of the nose to the corners of the mouth) that make him look a billion years old. All he needs to do to work himself up into a really bad mood is to look in the mirror every morning.  No wonder he has such a bad attitude.

If the Grinch were to come into my office, here is what I would recommend:

His forehead creases would be softened and smoothed out with Botox.  He looks like he needs a pretty large dose, maybe 60 units.  The injection would sting but would be quick and he would see a remarkable improvement within 3 days or so.  Also, he would feel so much more relaxed.  If he wanted to scowl at his poor little dog, he would be unable to!  Smile, yes but scowl, no.  This amount of Botox would set him back $900 and would last at least 3 months.  If he kept coming back for treatment, his dose would likely drop considerably.

His nasolabial folds could be filled in with one of the hyaluronic facial fillers that I inject almost every day of the week.  They are terrific for treating the area around the mouth that is such a problem in some people and is hard to treat with other methods.  Even a full face lift doesn’t help this area very much.  I would use 2 or 3 syringes to get as full of correction as possible.  It’s been my experience that patients who opt for just partial correction (to keep the cost down) are not nearly as satisfied as those who just go for it.  Three syringes of a filler such as Juvederm would set him back about $1600.  Juvederm lasts at least six months and I have many patients who have had nice lasting improvement for up to two years.

Do what about the redemption of his rotten soul?  I’ll leave that up to the transcendent love and forgiveness of Whoville. But he’s got to save his face for me.

Thanks for reading!  Dr. Lisa Lynn Sowder

Botox, Facial Fillers, Nasolabial Folds, Non-invasive

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, 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

Facial Rejuvenation, Nasolabial Folds, Plastic Surgery

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