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

Botox and Facial Filler for the Grinch Who Stole Christmas

November 27th, 2013 — 10:42am

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 $1450.  Juvederm lasts at least six months and I have many patients who have had nice lasting improvement for up to two years.

I hope the Grinch comes into my office this holiday season and leaves those poor Whos in Whoville alone.

Thanks for reading!  Dr. Lisa Lynn Sowder

Botox, Facial Fillers, Nasolabial Folds, Non-invasive

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

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