Bardia Amirlak, M.D. Answers Questions On: Plastic Surgery

Two areas are currently trending in facial cosmetic surgery that deserve special attention. Firstly, the deep plane face lift restores a more youthful and rested appearance to the aging face and helps create a natural and lasting look that, at times, can be a dramatic change in facial beauty.

Secondly, the modified deep plane upper lip lift – with or without micronized fat injection to the lower lip – is a current trend. This procedure helps create a fuller upper lip and recreate the Cupid’s bow shape of the lip. At the same time, it shortens the upper lip, which improves the facial dynamics (even with well-shaped lips, a long upper lip exaggerates aging). This procedure also reveals more of the incisors, which is a very sensual and attractive look.

These procedures can help patients avoid the need for fillers, which may cause problems in the long term.

Fat injection is a non-implant-based alternative to breast reconstruction or augmentation. We inject the patient’s own fat into the breast area. We have seen great results in patients who’ve tried this method.

Some patients opt against surgery because it has a longer recovery period. However, not all patients can achieve the results they desire using nonsurgical procedures. Surgery may be the best answer for some patients who want to look more youthful. For example, the effects of a face lift are long lasting. A patient can take 10 years off their age, and results last for about 10 to 15 years.

I will evaluate whether a nonsurgical or surgical cosmetic approach will achieve the best results.

There are six different kinds of skin, with “1” being the whitest and “6” the darkest. However, we don’t just consider the color of skin. We also look at ethnic background because there is a lot of variation in skin tones among people of African American, Mediterranean, and Hispanic origin.

Generally, people with darker skin scar worse after surgery, and the scar tends to be more visible. They also tend to have more keloids (raised scars) after surgery.

When considering lasers or chemical peels, they also have to think about how the skin will respond. There could be pronounced color changes in the skin. But it really depends on the skin type.

That patients can get a face lift on their lunch breaks. Patients have to be very careful of these extreme ads that offer results that are too good to be true. In many cases, internet photos have been manipulated to show what they call “miraculous” results. Typically, those results are not long lasting as well.

Patients should do their research before considering any type of cosmetic procedure. The plastic surgeon should be trained in the type of procedure the patient is seeking. And most important, the surgeon should be certified by the American Board of Plastic Surgery.

With breast surgery, it's important to recognize how the breast changes over time, even after cosmetic surgery. The breast can change from pregnancy, gravity, and hormonal changes. These changes will impact the results of your breast surgery. You should not rely only on the post-op results but also consider how results will appear one year and even multiple years after the operation.

One of my patients was a Gulf War veteran whose forearm was caught in a pipe at work and almost torn off. He was flown to UT Southwestern from Longview. However, a significant amount of time had passed between the accident and him arriving at UT Southwestern. His arm was in danger of being amputated.

What was unique was that I had to transfuse blood from his leg to his hand to keep the mangled part “alive” while I was doing the surgery, which took about 14 hours. That kind of “rigged-up” transfusion had never been done before here. We reattached his forearm. The patient is now gaining excellent function of his hand.