truly is "in the eyes of the beholder" and because it is so subjective and personal, the only one who should influence your decision to have cosmetic surgery is you. If you feel young and vital and someone different looks back at you in the mirror, or if all you focus on is one particular, although perhaps to others objectively minor, flaw then you should not feel guilty or vain about doing something to bring these internal and external images into closer proximity. Cosmetic surgery is designed to achieve a natural- looking harmony of the face while avoiding an "operated on" appearance. Dr. Henderson works with her clients on a case-by-case basis, focusing on highly individualized care to determine what changes work best with their given features. Realistic expectations are important in not only the results one can see but also in realizing that although cosmetic surgery can increase one's self esteem, it should never be expected to change one's life by itself.

time the effects of gravity take their toll on our facial structures leading to downward migration of the soft tissues. This is demonstrated by deepening folds between the nose and mouth, jowls, excess fat under the chin and loose skin with a banded appearance in the neck. Facelift, or rhytidectomy, is performed to reposition the soft tissues and remove the excess skin. Incisions are made around the ears with part of the incision hidden behind the cartilage in front of the ear and a significant portion hidden in natural creases and in the hair. A standard facelift primarily addresses the lower face and neck. An incision is made under the chin if liposuction or treatment of the muscle bands of the neck are indicated. A facelift primarily addresses the jawline and neck with limited benefit to the marionette creases that extend downward from the corners of the mouth and little to no benefit of the nasolabial folds between the nose and mouth and the mid face. Aging changes of the mid face may be improved with mid facelift, cheek implants or fillers while the nasolabial and marionette folds are best treated with fillers. These fillers may include fat, Restylane®, Juvéderm™ , Radiesse™ and ArteFill®. Facelift technique can vary depending on the individual needs between more and less aggressive techniques. Less aggressive techniques often referred to as "minilifts" treat the same area as any other facelift approach but may be done with less risk and under local anesthesia.

Before and after Rhytidectomy case
Patient 1 front view	Patient 1 oblique view
— CLICK ON IMAGES TO ENLARGE —

Patient 1 side view

— CLICK ON IMAGES TO ENLARGE —

to the skin surface from years of sun exposure can present as a dull appearance to the skin, pigmentation spots and textural changes with wrinkling. For less severe cases, conservative treatments such as light chemical peels, microdermabrasion, bleaching creams, spot laser treatments and effective skin care products can freshen the appearance of the skin. For more severe cases, more aggressive approaches are needed to give the desired improvements. CO2 pulsed and Erbium pulsed lasers are available to tighten and smooth the skin through collagen regeneration in the dermis while improving the surface damage. This technique must be chosen in appropriate patients based on skin type and requires approximately 2 weeks of downtime before makeup can be worn. Redness may last for 4 to 6 months or longer and patients are counseled about risks of pigmentation change.

Before and after Laser Resurfacing case
Patient 1 side view	Patient 1 oblique view
— CLICK ON IMAGES TO ENLARGE —