Cosmetic Surgery Season is Here              


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The holidays are nearing and I look forward to the “crunch time” in cosmetic facial surgery.  I am lucky to have a seasoned practice and we are busy all the time, but there is no doubt that more people have cosmetic surgery in the winter months for obvious reasons.  It is easier to recover as the days are shorter, we spend more time indoors and there is less sun exposure.  Due to this, the end of summer and early fall is an attractive time for patients to have surgery to be at their best for the upcoming holiday season.  There is a slight dip in surgery during the holidays (although some people desire this time for surgery) and then surgery ramps up again for patient who want to be healed by springtime.

The most common surgical procedures we perform are facelift, cosmetic eyelid surgery, cheek and chin implants, brow lift and laser skin resurfacing.  Patients in their 4th decade may present for smaller procedures such as eyelid surgery, laser and facial liposuction.  Patients from their 5th decade on up frequently perform multiple procedures at the same surgery.  These include facelift, eyelid surgery, midface augmentation and skin treatments such as laser or chemical peel.  The smaller surgical procedures have approximately a one week recovery and the larger procedures have approximately a 2 week recovery.


How do we know when it is time?


Obviously, cosmetic surgery is elective and while some people will never embrace it, many people want to look as young as they feel.  Patients in their 30’s are great candidates for skin care, lip plumping and preventive measures such Botox.  Patients in their 40’s may be candidates for Kybella or liposuction for double chin, chemical peels or laser to improve skin and Botox and wrinkle fillers.  Patients in their 50’s on up will notice changes to their lower face and neck and will be candidates for the aforementioned procedures as well as face and neck lift.


What about the “miracle” procedures you see on TV?


Like anything else, cosmetic surgery is subject to trickery, misrepresentation and falsehoods.  If something sounds too good to be true it probably is.  Although we have made many advances in technology there has been no viable replacement for eyelid surgery and facelift surgery.  Any procedure that promises “minimal downtime” will probably have minimal results and minimal longevity.  There is simply no substitute for the safe and effective procedures that have been time tested for decades.  If a doctor offers some “new and amazing” technology, do your homework and check out the procedure and the results of the individual surgeon.  If a doctor can’t show you 50 high quality before and after pictures of results 3 months after surgery, they probably have something to hide or aren’t doing much surgery.  Procedures that truly produce significant results and are long lasting require a longer commitment to recovery.  For a patient in their 50’s, taking two weeks off of work or play is not a bad deal to reduce a half century of aging.  You get what you pay for…………not in money, but in recovery.  Procedures with very short recoveries don’t do much and don’t last long and may need repeated multiple times.  Surgeries with longer recoveries usually produce much more dramatic and longer lasting results.  For patients that simply cannot take time off work, small procedures may be the only options but there is always a trade off in result and longevity.


Is there an easy way out?


Technology has improved and neurotoxins like Botox, fillers like Restylane and Juvederm, fat dissolvers like Kybella, fractional lasers, Pelleve (radiowave skin tightening) can keep aging at bay and improve minor to moderate aging.  As we age, we must bite the bullet and consider surgery.


How do you pick a surgeon?


Choosing the correct cosmetic surgeon is a big choice and fortunately there are many well qualified men and women from numerous specialties that a qualified to perform safe and effective cosmetic surgery.  Some important things to look for include:


  • Find a surgeon that is board certified in his or her specialty.
  • Find a surgeon you like and that is easy to talk to.
  • Find a surgeon that is easy to get a hold of. If it is hard to speak to your surgeon;

You chose the wrong one!

  • Find a surgeon that with a supportive staff that are friendly and compassionate and focus on you.
  • Find a surgeon with a fully accredited surgery center in his or her office. Most cosmetic surgery is no longer performed in the hospital.  Full office accreditation such as the AAAHC, JCAHO or AAAASF means the office and staff have met rigid policies for safety, anesthesia, emergencies, infection control and numerous other important safety factors.
  • Find a surgeon that can show you properly taken and standardized before and after pictures of the procedures you desire. Experienced surgeons should have hundreds or thousands of pictures of their work.
  • Surgeons that publish, teach, and are involved in academics are frequently abreast of the latest techniques and safety measures.


The decision to have cosmetic surgery is multifactorial and patients must consider their health, recovery and budget.  You have to be healthy enough to tolerate surgery and anesthesia, have enough time for a relaxing and healing recovery and be able to afford the procedure(s).  There is usually something for everyone in this mix of health, recovery and budget.


To find out more about facelift and cosmetic facial surgery visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia