plastic surgery The Flawless Facelift AESTHETIC TRENDS HAD THE PRIVILEGE OF INTERVIEWING plastic surgery plastic DR. SAM HAMRA OF DALLAS, TEXAS surgery plastic TO FURTHER UNDERSTAND AND t SHARE HIS PHILOSOPHY REGARDING n TECHNIQUE AND PATIENT CARE at By Cindy L. Vandruff, MBA, Editor in Chief Today’s prevailing facelift surgery trend is to perform small facial rejuvenation procedures In your opinion what are the key independently. While traditional facelift surgery components to a flawless facelift? may seem convenient because it results in minimal DR. HAMRA The key component to a flawless downtime, its weakness is that it fails to address the facelift is the absolute harmonious appearance of aging face as a whole. This can lead to a swept back, the face following the surgery. Every part of the “facelifted” appearance, and a hollow area below aging face should be rejuvenated. The desired the eyes. endpoints are well known and considered youthful. The Composite Facelift, developed by Sam One may also say that a key component is T. Hamra, M.D. (located in Dallas, TX), is an absolutely the absence of signs of surgery. innovative approach to facial rejuvenation that addresses the problems associated with a What percentage of your patients come conventional facelift. Unlike the traditional facelift, from other physicians who require your the Composite Facelift is ideal for restoring facial harmony to the entire face. Dr. Hamra combines assistance to help correct an unfavorable his facelift techniques with a unique cosmetic eyelid outcome? surgery procedure to produce a more youthful DR. HAMRA The percentage of my patients who appearance without the telltale signs of a traditional come to me for a secondary facelift to help correct facelift. an unfavorable is between 50% and 60%. www.aesthetictrends.com | january • february 2010 1 In 1995, I was the first to patient who has aging of the How do you consult your utilize all of the fat of the lower complete face, usually by the age patients to deliver an optimal eyelid, which was called an Arcus of 45, would be a candidate for a result? Marginalis Release and which complete procedure such as the later became the Septal Reset Composite Facelift. Naturally the DR. HAMRA At the time of procedure, an original procedure rate of the progression of aging consultation I examine the published both in 1998 and 2004. varies with every individual. patients, and I show them a 20- or This allowed the tissue of the plastic surgery 30-minute PowerPoint lower eye that covers the fat of the presentation which highlights the lower eyelid to be used and Have you seen a shift in anatomy of aging that they may spread over the orbital bone to particular procedures due to the have and how it compares to the prevent the appearance of hollow down economy and discretionary spending? If so, which many before and after photos of eyes and create a very youthful- other patients I have done. I looking lower eyelid. procedures are your patients The Composite Facelift as requesting now vs. then? think the visual explanation with DR. HAMRA There is no question that with the down The visual explanation of the PowerPoint economy all plastic surgery has presentation has been helpful to explain very been impacted as it is with any luxury item. Adding to that is the clearly to patients what I think they should expect fact that many physicians who are as the optimal result. not plastic surgeons are also doing cosmetic procedures because of the lower income that resulted the PowerPoint presentation has it stands today is a combination of with managed care as well as been helpful to explain very several procedures which are overproduction of doctors in clearly to patients what I think original such as the Septal Reset some major cities. they should expect as the optimal and a procedure called the result. Zygomaticus-Orbicularis Flap published in 1998, which elevates the cheek fat in a vertical Do you have specific direction. procedures that you have created yourself? How do you determine DR. HAMRA There are several what is the best procedure for original procedures that have each of your patients? been originated and published by me. In 1990, I published the DR. HAMRA Each patient, Deep Plane facelift, which was the depending on his or her age, will first time that the fat of the cheek have a varying degree of aging. had been mobilized with the Frequently, a patient who is 38 or facelift tissue. A year later, I 40 years old would simply need Another element is the joined this procedure with the an upper eyelid procedure and ability of large companies to inclusion of the orbicularis oculi perhaps just a cheeklift since the advertise on a national basis for muscle; and this became the jawline and neckline are still very non-invasive procedures such as Composite Facelift. good. On the other hand, a injections and BOTOX®, which 2 january • february 2010 | www.aesthetictrends.com creates a demand for procedures sophisticated, I find that the example, the positions of the for patients who are not really patients I see are very incisions should be well described familiar with what these knowledgeable about plastic in PowerPoint as well as the procedures do. Usually when surgery. It is rare today to find a height of the forehead, the size of patients come to my office, they patient who brings a picture of the earlobes, and all aspects of the are aware from my secretaries or Elizabeth Taylor to the office, facial changes that one would my website or other patients that I which is what is said to have anticipate. happened 30 or 40 years ago. plastic surgery do a complete procedure called a One can easily see from Composite Facelift. The psychology behind the patient’s skin type or age that It is rare that I have a patients who seek plastic surgery certain parts of the face, no matter patient requesting just a small is the same psychology behind what technique is done, may not mini lift. On the other hand, anyone who has self-pride and be optimal due to skin tone or wants to appear as attractive as excessive wrinkling; and this must there are now patients with more knowledge due to the popularity possible. This has been done for be conveyed to the patient so that of plastic surgery and the ability to centuries with makeup and after surgery the shortcomings of gain knowledge with the internet. various clothes and costumes. It is some facelift procedures will be Patients do request injections as only in this day of technology that expected. well as BOTOX® and I do both the same desires of humans to procedures because they are look more attractive and a bit certainly complimentary, although younger can now be fulfilled with How do you feel about they are not a substitute for facelift surgical procedures that deliver the extreme makeover craze, and techniques. impressive results. what would you suggest to other I am convinced that if aesthetic physicians when facelifts could have been interacting with new patients? What are the top three performed 500 years ago, they DR. HAMRA procedures which your patient would have been done because I think the base requests? the desire was there. One has to marketing today, which is remember that in the year 1900 impossible to control, has given DR. HAMRA The primary the average American life span rise to a pre-occupation with procedure is a facelift. I do all plastic surgery which may or may was 48; and today it is well over types of cosmetic surgery; but 70, which means that throughout not be a substitute for patients since I have a facelift practice, the who are unrealistic or may have history, very few patients were same patient population has the aging to the point where they ever different goals. The patient population varies in different parts body changes of natural aging and would have been candidates for childbirth. Therefore, the surgical procedures. of the country and in different abdominalplasty is the second parts of the metropolitan areas. most requested, and various In the suburbs, the breast procedures like breast lifts What do you consider to requests from the younger and breast reductions are a close be “reasonable expectations” for population may be different than third. your patients, and how do you in cities that have older, more convey this during the process of affluent populations. From what I planning a procedure? have seen in the last few years, the How do you approach extreme makeover craze has your patients with the psychology DR. HAMRA This goes back to come and gone with the television behind why patients elect plastic the consultation that I described show Extreme Makeover. One surgery? earlier in which the PowerPoint needs to be on the lookout for the presentation is shown to each unreasonable patient. DR. HAMRA In cities such as patient so that they will know On the other hand, I have Dallas, which is very exactly what to expect. For many patients who have www.aesthetictrends.com | january • february 2010 3 abdominal procedures, patients. They also have different rhinoplasty, breast procedures, views than mine as to the goals About and ultimately the facelift since all and types of facelifts and other the parts of the body, including the techniques. Hopefully most Author surgeons are aware of limitations face, lend themselves to improvement during the normal and in most cases only do aging process. Most women who procedures they are comfortable plastic surgery have undergone childbirth will see doing in settings that dictate the Dr.