The “Special Touch” section of my web site delineates some of the procedures that I especially like and feel that I offer an exceptional level of expertise.

       It is important that you understand that the multiple Plastic Surgery Organizations, of which I am a member, and the American Board of Plastic Surgery, are committed to insuring the public that plastic surgeons present themselves in a realistic manner. I adhere to these guidelines and do not present on-line testimonials or show photos of patients or procedures. I most definitely do give brochures and show photos in my office, under consultation, to insure you know the procedure and its expected result in detail.

       Houston is blessed with several very good plastic surgeons, of which I feel that I am a member. I most definitely feel patients should seek a second opinion, should they desire, after any consultation with a physician. My only request is that you do this with a qualified, board certified plastic surgeon. If there is any question regarding their qualification you should ask to see the certificate of the American Board of Plastic Surgery that we proudly display on our walls.

Please enjoy this section where I list my favorite procedures and my individualized “special touch”.

Botox

       We use Botox for two distinct indications… that of removing, or lessening, facial wrinkles and for select sculpturing of the face – such as elevating the brow. I differ slightly in my approach to Botox utilizations by requiring a two visit method. My fee includes two visits, usually two to three weeks apart. This ensures, in my hands, an optimal effect of the Botox application and is included in a one price structure.

Autogenous Fat Injections (using the patient’s own body fat)

       We prefer the use of the patient’s own tissue for facial filler use. Very small amounts of adipose tissue (fat) is removed, and this, after careful preparation, is injected as a filler under depressions or wrinkles on the patient’s face—such as the upper lip or lateral nasal crease. The use of local vs. general anesthesia is based on the location and amount of tissue fill that I will perform on the patient.

Abdominoplasty

       This procedure is for the correction of excess abdominal wall skin and fat along with tightening of the abdominal wall muscles (rectus abdominus). We perform the procedure through a lower abdominal incision that allows the continued use of high cut (French style) undergarments or swim suits. The use of select liposuction to the posterior back (flank area) allows an excellent enhancement of the waist line and, when combined with the select rectus muscle tightening, a more defined and longer appearing waist. We frequently combine the abdominoplasty procedure with Gyn Procedures (i.e. hysterectomy) or breast procedures.

Liposuction

       We only perform liposuction in the lipo-sculpture venue. I do not perform liposuction for weight loss specifically but limit the technique to the more defined and sculpture aspect of the procedure—defining areas of persistent localized fat deposits that are resistant to diet and exercise. Areas such as the middle or lateral thighs, posterior back and flank areas, as well as the abdominal wall are very responsive to this technique. We do the tumescent technique, with the addition of saline combined with low dose adrenaline (epinephrine), which leads to minimal blood loss and bruising. The post operative pain level is minimal. This is usually an outpatient surgical procedure though some localized areas- such as the submental (under the chin) area can be performed in the office setting, under local anesthesia.

Augmentation Mammoplasty

       Our augmentation mammoplasty procedure utilizes, in over 90% of the time, the FDA approved silicone implants. The submuscular (under the pectoralis muscle and behind the breast tissue) placement of the implant is preferred. My personal preference for the incision location is the periareolar area (at the junction of the normal skin with the pigmented area of the nipple-areolar complex). The incision is fashioned to mimic the actual lines of the pigmented area and when combined with a detailed closure results in excellent scaring compared, in my opinion, to the classic infrmammary (under the breast) or transaxillary (in the armpit region) approaches. During the consultation photos are show depicting the result of this technique.

Mastopexy (breast lift)

       Two approaches are offered… the periareolar approach; that leaves a circular scar around the nipple-areolar complex, or the tailor tack approach; that leaves a ship’s anchor type scar that is around the nipple-areolar complex and a line that goes down to the submammary crease and then horizontal. The technique used will depend on the amount of breast ptosis (drop) present and whether or not the procedure is combined with an augmentation mammoplasty. I find that both procedures offer an excellent result with fully acceptable scars. Again, during consultations, photos are shown showing results and the anticipated scaring.

Rhinoplasty (nose)

       This is one of my favorite procedures and is considered, by most Plastic Surgeons, to be the most difficult to master. I enjoy giving a natural result to the nose while correcting the many defects with which patients present…such as a hump on the top of the nose, a large nasal tip, a wide nose or a nose that drops in a downward tip direction. The approach is either internal, that is confined to incisions only inside the nose, or external, that has internal hidden incisions combined with a small external incision. The selection of the technique will depend on what the patient desires to have changed. Rhinoplasty is an exact and experience demanding procedure but at the same time is a most gratifying one for me… when I see the results combined with a happy patient.

Facelift (rhytidectomy)

       This procedure is the one that prompted me to become a Plastic Surgeon. To alter someone’s entire external face is a challenge and most rewarding experience for the surgeon and the patient.

       My face lifts are natural in their appearance. I strive NOT TO give the results so frequently seen on the faces of some actors and prominent personalities. The natural look is my desired goal… to reverse some of the changes of time but to keep the person the easily recognized individual they are. During consultation various photos are shown and a brochure given to stress my points.

       The most important requirements, in my opinion, in a modern facelift is that of tightening the underlying structures, utilizing the SMAS (superficial musculo aponeurotic system) technique, along with proper removal of excess skin while tightening the facial skin in the appropriate vector of direction….more posterior and upward in a woman and more posterior and horizontal in a man. The skin incision must be carefully placed for minimal visibility in the post operative period.

       Male facelifts are most definitely different than females. It is important that you select a surgeon that knows these differences and can clearly describe them to you.

Blepharoplasty (eye lift)

       I prefer the classic approach to placement of the skin incisions as the thin skin of the eye heals with an almost inperceivable scar. The main concerns with this procedure are again the “natural look”… giving a result with eyes that are not over opened or have had too much periorbital fat removed… leaving a “hollow eyed” appearance.

       Properly performed this procedure will give an excellent result in reversing the aging appearance of the face. It is frequently combined with the facelift and browlift procedures.

Brow Lift

       I use this procedure, frequently with the above two procedures, to correct the drooping appearance of the lateral aspects of the eye brows. Along with this correction I am able to soften the wrinkles (rhytids) in the forehead and between the eye brows… by selectively wreaking the underlying muscles responsible for the wrinkles.

Otoplasty (Protruding Ears, Outstanding Ears)

       I perform this procedure to correct ears that stand out in an unacceptable manner for the patient. This is usually from the failure of development of the contours of the auricular ear cartilage, or over development in some cases, and is corrected by modifying the auricular cartilage by way of an incision behind the ear. This procedure can be performed at any age but we do not usually do this before the patient has attained full size in the ear development…by the first or second grade. My oldest patient is 79, so there is no age limit.

       A fun story regarding this procedure occurred to me several years ago. I had performed an otoplasty on three boys, brothers, back to back in the operating room…aged 10 thought 15. We placed the usual large bulky dressing over both ears at the end of the procedure… the dressing looks like the large, but more exaggerated, Bose Type Ear Phones. A couple of days later, while shopping in the Galleria, I saw in the distance…yep, three big ear dressings, ice skating and having a great time. That is the record for the longest distance from which I have spotted one of my post operative patients. It also demonstrated the durability of my dressings because I saw the boys fall more than once.