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Frank Ware is a patient who has benefitted from Dr. Madorsky’s skills twice! First, with a skin cancer reconstruction of his left cheek, and more recently with a “half facelift” on the right side of his face.

This patient exemplifies why we do what we do, embodying both the skin cancer and cosmetic goals of our practice.

Frank Ware came to the SCARS Center for surgical reconstruction of his left cheek post removal of melanoma. When Dr. Madorsky met Frank to treat his left cheek, he went right to the right side of his face, which has been paralyzed for decades due to a past surgical procedure. Years ago, Frank had an acoustic neuroma tumor in his cranial cavity, and when it was removed, the facial nerve was too involved to be saved. This resulted in facial paralysis. Frank has lived with this over the years, returning to his job as a middle school principal, and adapting to his strained speech and movement.

When Dr. Madorsky met and then examined Frank, he said, “I think we can do something about that.” He thought Frank would be a great candidate for a deep plane frace lift, well, at least half of one.

This brings up a very exciting parallel: The deep plane facelift technique used to correct the right-sided facial paralysis is what has driven development of the specialized flap (SMAS fasciocutaneous Island flap) used for the reconstruction of the melanoma of his left cheek.

In essence, the innovations in facial plastic surgery driven by cosmetic results also inform the methods for reconstruction of an area afflicted with skin cancer.

You glance in the mirror and notice the skin around your eyes looks a bit tired or droopy—maybe it’s time to consider a cosmetic procedure. But which one will help you look more refreshed: a blepharoplasty (eyelid lift) or a brow lift?

While both procedures focus on rejuvenating the eye area, they do so in different ways. Let’s take a closer look.

Blepharoplasty: Eyelid Surgery

Blepharoplasty targets the skin around the eyes and comes in two main types:

While this procedure can improve some dark circles, it won’t affect those caused by pigmentation or fine lines like crow’s feet. However, these issues can be treated with complementary options such as laser resurfacing, Botox, or fillers.

Brow Lift: Forehead Rejuvenation

As the name suggests, a brow lift works on the upper face—specifically the forehead and brows.

During the procedure, small incisions are typically made near the hairline. From there, tissue, skin, and muscle can be lifted to smooth forehead wrinkles, soften frown lines, and elevate drooping eyebrows.

This creates a more youthful, open look around the eyes. However, a brow lift does not remove excess eyelid skin—though it may improve the appearance of upper eyelid puffiness by lifting the brow itself. Surgery usually takes 1–2 hours and is often paired with other cosmetic enhancements like a facelift, blepharoplasty, or skin resurfacing.

Can You Combine These Procedures??

Yes, blepharoplasty and brow lift procedures can absolutely be combined, and in many cases, doing both provides the most balanced, natural-looking rejuvenation of the upper face.

While each procedure addresses specific issues, combining them can offer more comprehensive results. Sometimes what appears to be excess eyelid skin is actually the result of a sagging brow. In these cases, a brow lift alone might reduce the heaviness. But if there’s still extra skin or puffiness on the eyelids, a blepharoplasty may be needed as well.

Benefits of Combining Both Procedures

Dr. Jane Kim, a board-certified oculoplastic surgeon, will assess your facial anatomy and goals to determine which procedures are best for you.

Many people consider rhinoplasty because they want to smooth out a bump on the bridge of their nose or change its overall shape.

 The “Old Way” vs. a “Newer Approach” to Nose Reshaping

Traditional Method: Think of the traditional way like sculpting from the top. To reduce a bump or lower the bridge, surgeons would remove bone and cartilage directly from the top of your nasal bridge. While this can fix the bump, it can sometimes change the natural lines of your nose quite a bit, and there’s a risk it might look a little “done” or unnatural.

Dorsal Preservation Rhinoplasty (The Newer Approach): This is what we’re excited about! “Dorsal” just refers to the bridge of your nose. “Preservation” means we try to keep its natural structure and lines as much as possible.

How it’s Different: Instead of removing bone and cartilage from the top of the bridge, the surgeon makes changes from underneath. Imagine carefully lowering the entire bridge structure from below, rather than chiseling away at the surface. This helps keep the original smooth lines of your nose intact.

The Goal: To give you the results you want (like removing a bump) while respecting and maintaining your nose’s unique, natural appearance.

Why Patients Often Prefer This Preservation Technique

The results with dorsal preservation rhinoplasty tend to make patients happier, which means it’s less likely you’d need a follow-up surgery (revision rhinoplasty). Here’s why:

  1. Keeps Your Nose Looking Naturally Yours: It helps maintain the natural width and smooth contours of your nasal bridge.
  2. Better for Straightening a Crooked Nose: It can lead to improved symmetry if your nose is a bit crooked.
  3. Less Reconstruction Needed: Your surgeon usually needs less cartilage to rebuild or support the nose.

In short, dorsal preservation rhinoplasty is an advanced technique that aims to correct issues like a nasal bump while ensuring your nose still looks like your nose, fitting naturally with your face. It’s about refining, not completely rebuilding, to achieve a look you’ll love.

How do you achieve a more youthful face if you are not ready for or interested in a facelift? Can you get great results without a facelift? We say, “Absolutely.” Short of a facelift, we recommend three effective procedures for a more youthful, refreshed look.

BLEPHAROPLASTY

Blepharoplasty is a surgical procedure that improves the appearance of your eyelids. It helps reduce the look of tired eyes from your lower lids and removes drooping skin from your upper lids. You can focus on just the upper or lower lids, or address both at the same time.

CO2 LASER RESURFACING

CO2 laser treatment aims to improve the appearance of the skin by removing the top layer and stimulating the formation of new skin cells. CO2 Laser Resurfacing is used to tighten the skin and to treat fine lines. It also treats wrinkles, sun-damaged skin, and scarring.

FAT TRANSFER

Facial fat transfer uses a person’s own existing body fat to restore volume to and plump sunken or sagging areas of the face. This procedure is used to treat deep creases on the forehead or between the eyebrows as well as hollow areas under the cheeks and eyes. It can also aid with contouring around the nose, temples, upper lip and the jaw.

Each of these procedures requires confirmation that you are a candidate, as well as some downtime.

This patient had all three of these procedures: lower eyelid surgery with fat grafting and CO2 laser resurfacing of the skin around the eyelids.

When Should You Choose a Facelift?

While we have described some effective procedures for facial rejuvenation, sometimes these methods don’t do the trick.

Maybe you have tried injectables and chemical peels for a while, and they do not provide the long-term results you want. Or perhaps laser or radio frequency treatments just are not achieving what you want.

Whatever the reason, facelift surgery can achieve results that non-surgical results cannot match. Facelift surgery can reposition and lift facial tissues, which is something non-surgical options cannot replicate. It can also remove excess skin, which can roll back the clock on the face by years.

The chin plays a critical role in the balance of facial features. A strong chin can create a greater appearance of strength, symmetry and self-confidence. We offer several options to enhance the size and appearance of your chin.

WHAT IS A CHIN IMPLANT?

Placement of a chin implant, also known as chin augmentation, provides definition for the lower face and balances the facial profile. Chin implants are made of various biocompatible materials and are custom-shaped for a natural looking fit. The results are permanent but can be reversed if desired.

Chin implants are used to correct a weak chin or to balance a strong nose. Patients who undergo chin augmentation love their results!

MALE CHIN AUGMENTATION

Male chin augmentation can redefine a jawline and strengthen the chin, creating facial harmony. A sharp, powerful chin is often considered the cornerstone of masculinity. Chin augmentation is a safe and effective way to restore what has been lost or enhance the current appearance.

CHIN IMPLANT & NECK LIPOSUCTION

Patients with excess fullness beneath the chin often choose to have neck liposuction at the same time as chin implant surgery. While strengthening the chin will help improve jawline definition on its own, removing excess fat from underneath the chin can further improve the appearance of the lower face and neck.

 

NONSURGICAL SOLUTION: INJECTABLES

Augmentation with filler is a great alternative for those who prefer nonsurgical treatment options, or who want to get a glimpse into how a chin augmentation would look.

It has been said that eyes are the gateway to the soul. They are also the center of the face, and can communicate to others how we think and feel.

As we age, loose skin and dark circles under the eyes can make us look tired and fatigued. Fortunately, these issues can be addressed with safe and relatively painless procedures performed by a trained professional. Let us take this opportunity to introduce you to the newest member of our team!

Jane S. Kim, MD is a board-certified and fellowship-trained oculofacial surgeon who specializes in surgical and non-surgical procedures around the eyes, brows, forehead, and mid-face. She has special interests in cosmetic and reconstructive surgery, revision eyelid surgery, and Asian blepharoplasty.

“The key to looking refreshed and rested is choosing the right option for the right patient, whether that is skin care, injectables, surgery, or some combination thereof.”

 

Dr. Kim is committed to patient care. Her expertise lies in both functional and cosmetic surgery of the upper and mid-face, with special attention to the region around the eyes. She also specializes in non-surgical facial rejuvenation, including dermal fillers, neurotoxin injections, laser resurfacing, and chemical peels.

DR. KIM SPECIALIZES IN:

Before and After Images of some patients who have seen Dr. Kim to improve their eyes. If you are interested in meeting with Dr. Kim, please call our office to schedule an appointment.

Dr. Kim’s CONSULTATION FEE will be waived through March 31, 2025.

 

We are pleased to announce that Dr. Madorsky’s article on the interaction between bone and chin implants has been published in Plastic and Reconstructive Surgery Global.

This research provides significant insights into the science of chin augmentation, notably by dispelling the misconception that implants cause bone erosion. The article decodes the complexities of implant-periosteum interaction and offers valuable guidance for improved chin implant procedures.

Background: 

Bone resorption has been imputed to silicone chin implants as the cause of the reported bone changes with chin augmentation. Bone remodeling is complex. Both neo-ossification and bone resorption can occur.

Methods: 

A literature review was performed on bone complications of silicone chin implants and bone remodeling with periosteal manipulation. Available data from plastic surgical and dental literature, alongside a case observation showing neo-ossification 10 years after implantation, were analyzed and used to explain patterns of bone changes around chin implants.

Results: 

Periosteal elevation induces bone formation. Spur-like neo-ossification with silicone chin implants is caused by subperiosteal implant placement. Our case describes such neo-ossification 10 years after silicone chin implantation. The pressure of an implant on bone can cause limited bone resorption. The pressure of an implant trapped under a forming bone shelf can cause significant bone resorption in rare cases.

Conclusions: 

Previously reported mandibular bone resorption ascribed to silicone chin implants has been overwrought. Bone formation is more common with silicone chin augmentation. We propose surgical modifications to limit bone complications of chin implants based on the reviewed literature. Surgical approaches to periosteal elevation and implant insertion and consideration of alternate biomaterials to silicone chin implants may improve outcomes of chin augmentation.

See Full Article Here.

 

If your silicone gel implants are more than two decades old, it’s crucial to meet with a plastic surgeon to assess their condition and explore your options. Dr. Suzanne Quardt, a board-certified plastic surgeon, offers breast revision services to patients in Newport Beach and nearby areas.

The primary concern with older implants is the possibility of leaking or rupturing. It’s important to note that silicone gel implants from over 20 years ago differ significantly from today’s versions. Advances in implant technology have led to thicker outer shells that are more rupture-resistant and the development of more cohesive silicone gel that doesn’t leak as easily. Modern implants, classified as 4th to 6th generation, are vastly improved over older models.

While mammograms are effective for early breast cancer detection, they aren’t very reliable for spotting implant ruptures unless the damage is severe enough to appear on the scan. Instead, watch for changes like hardening of the breast tissue, known as capsular contracture, or noticeable flattening of the breast, which may indicate a ruptured implant. Pain in the breasts warrants an immediate check-up, though many women with ruptured implants experience no discomfort. Silent ruptures, which occur without obvious symptoms, are best detected through MRI, a highly accurate diagnostic tool for this purpose.

If your old implants are saline, replacement is only necessary if issues arise. A saline rupture is harmless as the body absorbs the saline naturally. However, ruptured silicone gel implants can lead to intra-capsular or extra-capsular ruptures. Intra-capsular ruptures contain the silicone within the surrounding scar tissue, while extra-capsular ruptures allow the silicone to escape, potentially reaching the skin or lymph nodes. Immediate removal is recommended for ruptured silicone implants, as advised by manufacturers.

Even without a full rupture, the outer shell of a silicone gel implant may degrade over time, allowing the silicone to leak gradually in a process called silicone bleed. This can cause a capsular contracture, where the tissue around the implant hardens. In some cases, no visible signs of leakage are present, yet the implant may still be compromised.

Many women, for a variety of different reasons, decide to remove their breast implants. One of the biggest concerns is “how will my breasts look after removing my implants?” The volume loss can sometimes create a “caved in” deformity of the upper and central breast after removing the implant. This type of volume loss can NOT be corrected with breast lifts alone.

Dr Suzanne Quardt’s breast reconstruction technique after implant removal, also called explant surgery, offers an innovative and personal approach to addressing a common concern for women undergoing explant surgery.

Her procedure, which she calls the “Q Flap,” enhances the breast’s fullness without using replacement implants by using a patient’s own native breast tissue.

For the appropriate candidate, Dr Quardt has taken her knowledge and training in Breast Reconstructive Surgery to help prevent the explant deformity. Using her intraoperative technique, she performs a rearrangement of the soft tissues of the breasts to create a fuller-looking breast, particularly in the specific area of volume loss after removing the breast implants. By transposing a patient’s own tissues into the void created by the explants, Dr Quardt gives women a much prettier and fuller yet natural-looking breast result after implant removal.

“This is a great procedure for women who want their implants removed but want to maintain fullness in their breasts.”

Suzanne Quardt, MD

Call Us to Schedule a Consultation!
(949) 880-0062

We are thrilled to announce that Dr. Suzanne Quardt, a Board-Certified Plastic Surgeon, has joined our practice!! She recently relocated from the Palm Desert area to Newport Beach, and joined the Appearance Center based on its reputation for outstanding patient care.
 

With extensive training at top institutions, including a surgical residency and two fellowships at USC, and over 20 years of experience, Dr. Quardt is a trusted expert in aesthetic surgery, known for her compassionate approach and exceptional surgical skills.

“I offer a Surgeon’s Hand with a Woman’s Touch.”
Suzanne Quardt, MD

As a female plastic surgeon, wife, and mother, Dr. Quardt has a particular passion for women’s cosmetic concerns. She specializes in breast augmentation, liposuction and tummy tucks, and can help women translate their treatment goals into realistic outcomes.
 

Known for her warm, approachable demeanor, Dr. Quardt makes every patient feel comfortable and empowered throughout their surgical journey. Her commitment to excellence, combined with her deep understanding of the female perspective, has made her a go-to surgeon for women wanting to look and feel their best.