Elle Magazine

'The Producer,' May 2004

Art and science intersect at plastic surgeon David Hidalgo's office on Manhattan's Park Avenue. Eva Chen gets his prescription for eternal youth.

The latest designer handbag may be recognizable from 50 yards, but according to plastic surgeon David Hidalgo, MD, the results of “designer” plastic surgery should be almost invisible. “Skillful surgery doesn't stand out,” he says. “It blends in.” And while the “natural look” might seem oxymoronic in the world of Extreme Makeovers, it's the focus of Hidalgo's career. A former chief of plastic surgery at Memorial Sloan-Kettering Cancer Center in New York City, he invented new reconstructive surgery techniques (which now serve as the benchmark) to help patients look more like their former selves. Currently in private practice (and a clinical professor of surgery at Cornell University), Hidalgo continues to work wonders. “Everyone's different,” he says. “When patients ask me to make them look like someone else, I offer them an alternative—to look like themselves but better.”

How has the field of aesthetic surgery changed?

There's been a shift from overdoing it—third-time face-lifts, whole-body liposuction—to using techniques that are as low-maintenance as possible. My newest procedure removes the tiny, peanut-size muscle between the eyebrows so that wrinkles never form there—like permanent Botox. To save the patient time, money, and stress, I'll perform two procedures—like blepharoplasty [eyelid surgery] and lower-body liposuction—at once. To avoid the obvious breast implant look, I'll use saline breast implants under muscles, instead of above.

What procedure has the most impact?

If it's just a change you're after, a haircut can take care of that. But if you need surgery—if everyone tells you that you look tired even when you've had 10 hours of sleep—blepharoplasty can take years off. When the eyes look young, the whole face is radiant.

Are there any age limits?

I'll occasionally see a woman in her mid-to-late-thirties who asks for a face-lift. But the mid-to-late-forties is both the minimum—and the best—age to have one done. It's before most of the sagging and drooping occurs, so skin is in its best condition. And I've found that a face-lift in your forties can delay the need for any other work.

What can women do to postpone plastic surgery?

People who limit the use of their facial muscles by not smiling or frowning will probably never require surgery. But that's not exactly practical for real life. Not smoking and limiting sun should be common sense by now. If you haven't seen a dermatologist, make an appointment. She will tell you what kind of skin care you should be using, how often to exfoliate, and whether you need chemical peels—all of which keep you looking younger longer.

Which procedures are overhyped?

Women are always looking for the next hot treatment, so often they'll undergo procedures—like Endermologie, thermage, and fat grafting—that have a minimum of scientific research behind them and no proven long-term results.

How can women learn what's best for them?

Not everyone who needs a face-lift will need the same face-lift. Before any procedure, visit at least three surgeons for consultations to get a better idea of what's out there. Sometimes, a touch of Botox or laser resurfacing is all that's necessary.

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Our patient is seen here 6 months after rhinoplasty. The AI transition video shows the elegant nasal contour on the oblique view. One of the many challenges in rhinoplasty is that the nose has to look good on both the front and side views.  Surgical maneuvers that affect one view will also impact the other.  In this case it’s not just removing the bump but also making the nose wider on the front view than it was before, refining the tip, and raising it slightly. There is just a bit of tip swelling at 6 months. This can take another 6 months to resolve completely.  So far she is thrilled and so are we! 

#nose #rhinoplasty #surgery

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Breast augmentation can be accomplished in many ways based on four variables: incision location, implant position above or below muscle, implant type (saline or silicone), and implant size.  The method should be individualized based on anatomy and patient preferences.  While many surgeons prefer one main formula, versatility is important to achieve best results because each patient scenario is unique. Our patient here had one of the most common approaches which is described in the still images at the end of the video. 

#breast #implant #surgery

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Of course it’s never as simple as “just the bump” from a technical point of view. The nose still has to be completely taken apart in these cases.  All of the structural elements within have to be modified so that optimal aesthetics are established on both the front and side views. There were no breathing issues to address in this case, but they commonly co-exist. 

For the surgeons:  A narrow midvault required thin spreader grafts and an SEG was needed to preserve tip position. Subtle lateral crura modification with conservative  cephalic excision and transdomal sutures was performed as well. 

#nose #bump #surgery

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The future is here!  This AI assisted imaging app has gotten quite varied reactions, ranging from “creepy” to amazing!  There is the obvious concern that the results are AI enhanced too. Therefore we will always show the static before and after images at the end to address this concern.  Please comment on what you think about this new tool!

#AI #image #truth

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