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: Non-invasive


Continuity of Care – A Great Value!

August 31st, 2017 — 1:55pm

Seattle Plastic Surgeon implores patients not to fall for “Botox on Sale”.

Occasionally I have patients come in for Botox or fillers who have flitted around from doctor to doctor looking for the “best price”.   I hear statements like  “the last Botox didn’t work” , “the Restylane didn’t last”, “I’m not sure what she used but I didn’t like it”, and this is my favorite, “it was on sale but it didn’t last”.

This flitting around in search of a “deal” makes it very hard for a hardworking plastic surgeon (moi, for example) to figure out what, where and how much injectable to inject.  In my practice, we keep very accurate records of all of the above so I can judge what works best for any given patient.   And believe me, every patient is different.

Sometimes I think just because it is “cosmetic”,  patients don’t take these treatments seriously enough.  I cannot imagine anyone shopping around for the “best” price on, say, steroid injections into a bum shoulder or the “best” price for an hour of psychotherapy!

Usually continuity of care provides the best value of all, even if the prices are not bargain basement.  So for injectables, find a good doctor and stick (nice pun, huh?) with him/her.

Thanks for reading and follow me on Instagram @sowdermd and @breastimplantsanity.  Dr. Lisa Lynn Sowder

General Health, Non-invasive, Patient Beware, Plastic Surgery, Skin Care

Happy Valentine’s Day – Pucker Up!

February 14th, 2017 — 7:00am

Seattle Plastic Surgeon loves doing subtle and artful lip augmentation with Hyaluronic Acid fillers. 

Are they real or plumped up with filler? It should be impossible to tell with a nice and artful lip augmentation.

I am always amazed at how much my practice has evolved after being in practice for over 20 years now.  

Back in 1991 when I first hung my shingle, lip enhancement was done with collagen injections or with a procedure where a strip of skin above and below the lip vermilion border was excised and the lips expanded out.  I wasn’t enthusiastic with either procedure.  The collagen was often lumpy and the excision procedure left a scar and sometimes a funny shape. 

Then along came fat transfer and I liked this much better in that it lasted, sometimes for years and years and years, and it looked and felt natural.  But is was unpredictable in that some patients had resorption of the fat over time and needed repeat procedures.  And the recovery from fat transfer is a couple of weeks looking like the love child of Mick Jagger and Angelina Joli. 

Then along came lip implants, Softform Implants, that worked okay in some patients but in others distorted the lips with smiling or puckering.

Then along came HA (hyaluronic acid fillers) and oh happy day.  These fillers make lip augmentation predictable, natural and easy on the patient because down time is in hours or days at most.  The longevity of the fillers varies from filler to filler and from patient to patient but most patients get a good 3 – 6 months.   And a relatively new filler, Volubella lasts a year or more. 

I used to kind of cringe when I would see “lip enhancement” on my schedule.  With the new HA fillers, I love seeing this on my schedule because I know the patient will likely be pleased and that always makes my day.

Thanks for reading!  Dr. Lisa Lynn Sowder

Facial Fillers, Fat Injection, Lip Enhancement and Augmentation, Non-invasive, Plastic Surgery, Uncategorized

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

The Non-surgical Breast Lift – All You Need Is Tape

August 19th, 2014 — 2:46pm

Seattle Plastic Surgeon performs a non-surgical breast lift in the exam room in 72 seconds!

blog breast lift

Non-surgical breast lift on the left. Nice, huh?

Recently I had a lady come in who really, really wanted to know what HER breasts would look like after a breast lift.  Showing her photos of ladies with similar breasts wasn’t quite enough.  She wanted to look in the mirror and see what a perky breast would like on HER chest.  So………………………………..I got out the tape.  Using the tape, I did what I do in surgery.  I raised the nipple, I tightened the breast and in her case I flattened the fatty area near her armpit.  Since the tape covered the nipple, I drew one on with a purple surgical marker.  She looked in the mirror and, except for the purple nipple, really liked what she saw.

Feel free to try this at home if you are thinking about a breast lift but just be aware that sooner or later you will need to remove that tape!  A surgical breast lift will last a whole lot longer!

Thanks for reading!  Dr. Lisa Lynn Sowder

Breast Contouring, Breast Lift, Non-invasive, Now That's Cool

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

The FDA finally catches up with the use of Botox for crows feet.

September 12th, 2013 — 2:29pm

The FDA’s approval of Botox for the treatment of crows feet makes Seattle Plastic Surgeon smile.

Botox is the best treatment for crows feet.

Botox is the best treatment for crows feet.

I’ve been using Botox for the treatment of crows feet (both my patients’ and my own!) for well over ten years.  But I had been using Botox off lable which means that the FDA had not yet approved Botox for this particular area.

Well, finally, the FDA has issued its approval stating that Botox is safe and effective for the temporay treatment of crows feet so now I can begin crowing about what an excellent treatment Botox is.  In fact, Botox is by far the fastest, safest and most effective way to tame these creases that pop up with smiling.

Thanks for reading and keep smiling.  Dr. Lisa Lynn Sowder

Botox, Government and Politics, Non-invasive

Prominent ears – a little tape is worth an operation.

August 30th, 2012 — 1:47pm

Seattle Plastic Surgeon discusses treating prominent ears.

Prominent earsThis week I operated on a young man with prominent ears.  He was starting college out of state in a month and decided to have his prominent ears fixed before heading off. 

His ear deformity was the most common one we plastic surgeons see.  His ears stuck out straight and he lacked a normal fold in his cartilage. 

Otoplasty refers to surgery that reshapes the ear.  In this patient’s case, an incision was made on the back of the ear, the cartilage exposed and stitches placed in the cartilatge to creat a fold.  This folds the ear back closer to the head.  He will be sore and swollen for a few days and in a head band for a week.  After his incisions heal, only his barber will see his scars. 

This young man may have been able to avoid surgery if his ears had been taped when he was a newborn.  Newborn ear cartilage is very flexible and can be molded in the first few weeks on life.  If a baby has ears that stick out and do not have the normal fold, taping them back is often very effective.  

Soooooo………………..if you know a little newborn Dumbo, you may want to consider a little tape.  It could save an operation down the road. 

Thanks for reading!  Dr. Lisa Lynn Sowder

 

Earlobes, General Health, Non-invasive, Now That's Cool

For middle aged dudes with mustaches – looking younger almost instantly.

January 13th, 2012 — 12:12am
Mustache dye job seen by Seattle Plastic Surgeon

No surgery, no pain, and the cost of a few lattes.

Anyone for immediate gratification?  Seattle Plastic Surgeon discovers youth in a bottle for middle aged dudes with mustaches. 

Okay, check this out.

This is a gentleman who came in for a scar revision on his forehead.  When he came in for his post-surgical photos, I was stunned with how much younger he looked.  It took looking at his pre surgical-photos for me to put a finger on what was different.

It was his mustache.  He had dyed it with the help of his girlfriend and honestly, I think it took a good ten years off of him.

I wish I could have attributed his youthful visage to my fabulous surgical skills but could not.  It was his resourceful and clever lady friend and the patient’s openness to this little over the counter tweek.  Good for both of them.

My husband sports nothing but a 5:00 shadow but if he ever grows out his salt and pepper stubble, I know what I will be recommending!

Thanks for reading!  Dr. Lisa Lynn Sowder.

 

Aging Issues, For Men Only, Non-invasive, Now That's Cool

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

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