image courtesy dreamstime
Memphians reading The Daily Appeal on May 27, 1894, were probably intrigued by a headline, “FACES ALTERED TO SUIT.” A small news item was subheaded, “Nowadays, If Your Nose Isn’t Just Right, You Can Have It Changed.” The article reported, “No idea can be formed of the number of people who rebel at the style of nose, ear, or eyebrow bestowed upon them by nature, and who will leave nothing undone to remedy the defects. Such strides have been made in plastic surgery that displeased mortals may have their features changed, to conform with their peculiar ideas of facial beauty and to make up for nature’s shortcomings.”
Fast forward to the present day, and the notion of patients hoping to improve their appearance is hardly “peculiar,” and any “defects” are no longer confined to the “nose, ear, or eyebrow.” Medical specialists can now transform almost any part of the human body — to improve a patients’ appearance, correct birth defects, and repair the effects of wounds, burns, and other injuries.
In the past, the way we noticed “nature’s shortcomings” was by glancing in a mirror. In recent years, selfies show how the rest of the world sees us, and apps like Zoom allow — if not force — us to compare our visage with other faces staring back through our screens. All too often, that makes us worry: “Hmmm, I don’t look as nice as my co-workers.” Now there are solutions. Today, professionals can:
- Change the size and shape of the nose, ears, and chin with surgery.
- Reduce sagging eyelids with blepharoplasty, surgery that improves a patient’s appearance and vision.
- Reshape the jawline, or a sagging chin, with surgery and implants.
- Tighten sagging skin with precise injections of Botox, and other “neurotoxins” that allow skin to relax.
- Fill wrinkles with injectable dermal fillers, which can “plump up” lips, cheeks, and other features.
- Smooth aged or acne-scarred skin with chemical peels, or gently polish the skin surface.
- Enlarge (with silicone implants) or reduce (with surgery) the size of breasts.
- Remove belly fat with liposuction.
- Tighten the abdomen overall and remove stretch marks after birth with abdominoplasty (also known as a “Mommy Makeover”).
- The most common procedures, perhaps because they are the most visible, remain “nose jobs,” face lifts, and breast augmentation.
Specialists at the Langsdon Clinic in Germantown treat a full range of cosmetic issues, but Dr. Phillip Langsdon, a facial plastic surgeon who opened the practice in 1986, focuses primarily on rhinoplasty. Although some sources claim anywhere from 180,000 to 230,000 “nose jobs” are performed annually in the United States, Langsdon does only one procedure a day.
“There are 156 separate steps involved in a rhinoplasty,” he says. “They are hard and they are complex, and I don’t ever want to rush to finish a patient.”
image courtesy dreamstime
The clinic is a family affair. His wife, Carole, is a nurse practitioner, and his daughter, Dr. Sarah Langsdon, recently joined the staff as a general plastic surgeon, concentrating this year on the face. Another surgeon, Dr. Roberto Lachica, performs cosmetic procedures on other areas.
“There are any number of reasons people get rhinoplasties,” Langsdon says. “They think their nose doesn’t fit their face, or it’s too wide, or it has a hump, or a droopy tip. People come in because their nose is crooked or asymmetrical.”
The process begins with a comprehensive consultation. “Many people are unrealistic,” he says, “and my biggest job is to determine whether they understand what we can — and cannot — do. They’ve seen pictures in magazines and online, but we cannot duplicate another person’s nose.”
With a computer 3D simulation, “I show them what we can do with their particular anatomy,” he says. “Once we determine that we are reading from the same sheet of music, then we help them prepare for the process. We want it to be smooth and easy for them.”
Sometimes, he tells patients he cannot help them, “if what they want is unachievable, or if they don’t need surgery,” he says, “and I think 99 percent of my patients thank me for my honesty.”
In its simplest terms, a basic rhinoplasty involves removing, or rearranging, the cartilage that shapes the nose, using two basic approaches. The “open” procedure involves making a tiny incision in the fleshy area between the nostrils, and working inside the nose from there. With the “closed” procedure, the surgeon operates through the nostrils. Either way, the incision is so small it usually leaves no visible scarring.
Advances in anesthesia make the procedure easier for the patient. “We don’t use gas anesthesia,” he says, preferring intravenous sedation. “When they come out of that, it’s a very pleasant emergence, without the coughing and hacking that comes with other forms.”
Improved surgical techniques, along with new materials that eliminate the cotton-gauze packing pushed inside the nose, reduce the swelling and discomfort. “Eighty percent of the swelling goes away within two weeks,” he says. “The nose may feel a bit puffy, but it won’t look that way to the general public. Over the next few months, the nose gradually gets more defined.”
Langsdon cautions patients about an important aspect of the procedure — the cost. Rhinoplasties can cost close to $10,000 and more, and because it’s considered a cosmetic procedure, it’s not covered by insurance.
He compares it to anyone who buys nice clothing or expensive jewelry. “They are doing something to make you feel good, but they don’t expect insurance to pay for it. Most people understand that.”
image courtesy dreamstime
When Lisa Street founded Glo Medical Aesthetics in Cooper-Young in 2014, she had a specific mission: “The glow that makes people beautiful starts from within. If you are kind to yourself and others and strive to be the best person you can be, that beauty will show on the outside.”
Street employs a complete range of cosmetic procedures to enhance that inner glow. She and her team of medical aestheticians and nurse practitioners do not perform surgery. Instead, they offer medical-grade skin care, injectables, lasers, body contouring, and functional medicine, which looks at ways to improve diet and lifestyle.
image courtesy dreamstime
A patient’s visit begins with a one-hour consultation. “We ask what their concerns are, and what they’d like to change,” she says. “We then come up with a customized, individualized care plan that can be a year long.”
For facial cosmetics, Glo offers treatments like the Hydra Facial, which uses a “fluid vortex” to deep-cleanse the skin, open clogged pores, and improve the appearance of acne, discoloration, and wrinkles. The Glacial Facial uses “controlled cooling” for the same purpose. “These are medical-grade procedures and that’s why they must be done in a professional facility by a licensed provider.”
Street explains that these efforts can dramatically improve the skin’s texture and appearance, “so sometimes patients can wait longer before they need cosmetic surgery, and we work in conjunction with plastic surgeons. It’s better to get your skin in the best condition possible so you will have better results after a facelift, for example. Then we’ll take care of them after the surgery, and that’s a nice combination.”
In the field of medical aesthetics, “the technology keeps getting better and better,” says Street. “we now incorporate regenerative medicine, incorporating platelet-rich plasma like they do in orthopedics to treat joints, and we can stimulate patients to produce their own collagen, so it’s a more natural way to heal.”
Regardless of the treatment plan, she helps patients understand what to expect. “We don’t sugar-coat it. If we use lasers for facials, you may have redness for a short period, or injectables to fill in wrinkles may take a few days to really kick in.”
But the professional results are worth it. “This is not a Mary Kay party,” she says, “where you just swap makeup.”
