Question 1

What is a PDO Thread Lift and how does it work?

Accepted Answer

A PDO thread lift is a minimally invasive, non-surgical procedure that uses tiny, textured PDO threads loaded onto a cannula. These threads are precisely placed into superficial fat pads, where reverse barbs hook onto the tissue to gently lift and reposition it. This creates a lifting 'mesh' that supports the skin, resulting in a refreshed, natural, and more youthful contour.

Question 2

What are the characteristics and benefits of a Deep Plane Facelift?

Accepted Answer

A Deep Plane Facelift is an advanced surgical approach that focuses on lifting the deeper structures of the face, creating natural-looking results that hold up over time. It is an appropriate option for patients in their 40s and can achieve refined contours, a smoother jawline, and an overall refreshed appearance.

Question 3

What anesthesia options are available for procedures at Dr. Zelken's practice?

Accepted Answer

Not all surgical procedures require full general anesthesia. Many in-office treatments are performed under local anesthesia and numbing. For procedures requiring more significant lift and tightening, such as a deep plane face or neck lift, general anesthesia is typically recommended. Platysmaplasty (neck lift) can often be performed awake under local anesthesia.

Question 4

What are the reasons for chin implant revision and how is it performed?

Accepted Answer

Chin implant revision is often sought by patients dissatisfied with previous silicone implants due to issues like fullness under the lip, incorrect positioning (e.g., too high), or a 'clumsy' profile caused by loss of the lip-chin crease. Silicone implants can also cause bony erosion, leaving depressions. During revision, the old implant is removed, and a custom PEEK implant is designed to precisely fit the patient's anatomy, keying into any existing bony 'footprints' to sculpt a more elegant, refined, and harmonious chin.

Question 5

What is a Platysmaplasty (Neck Lift) and what does it achieve?

Accepted Answer

Platysmaplasty, commonly known as a neck lift, is a procedure that tightens the neck muscles and removes excess skin and fat. It is designed to correct sagging in the neck and vertical platysmal bands, resulting in a smoother, more defined jawline.

Question 6

What is the typical recovery and scarring like after Eyelid Surgery (Blepharoplasty)?

Accepted Answer

Mild swelling is expected after eyelid surgery and improves over several weeks. For lower eyelid procedures (transconjunctival blepharoplasty), there is no visible external scar as the incision is hidden inside the eyelid. Stitches are typically removed around 6 to 8 days post-op. Most patients can resume normal daily activities and wear makeup again by about 3 weeks, at which point the surgery is often undetectable to others.

Question 7

How does Dr. Zelken approach facial implant placement for overall facial harmony?

Accepted Answer

Dr. Zelken emphasizes that even the 'right' implant in the wrong place can lead to an unsatisfactory outcome, as a chin implant, for example, must harmonize with the entire jawline and midface. He addresses age-related volume loss in the cheeks and infraorbital rim with custom implants to restore structural volume. His approach involves removing existing implants if necessary and using custom PEEK wraparound jaw, cheek, and infraorbital rim implants, often placed endoscopically, to create a flowing jawline, a lifted midface, and a cohesive facial appearance. Patients may experience some swelling for up to two months, but facial harmony is often evident earlier.

Question 8

What factors contributed to Lindsay Lohan's aesthetic transformation?

Accepted Answer

Dr. Zelken believes Lindsay Lohan's transformation is primarily due to a thoughtful combination of non-surgical treatments, better aesthetic decisions, and natural aging into her features, rather than plastic surgery. Key factors include weight loss leading to a slimmer face, improved filler placement (possibly after previous unflattering filler dissolved), skin resurfacing treatments like CO2 lasers for texture and radiance, and overall healthier habits. He notes there is no evidence of facelift scars or other surgical signs.

Question 9

What specific procedures do you believe contribute to the changes seen in celebrity faces like Lindsay Lohan's?

Accepted Answer

Dr. Zelken believes Lindsay Lohan's transformation is primarily due to a thoughtful combination of non-surgical treatments, better aesthetic decisions, and natural aging into her features, rather than plastic surgery. Key factors include weight loss leading to a slimmer face, improved filler placement (possibly after previous unflattering filler dissolved), skin resurfacing treatments like CO2 lasers for texture and radiance, and overall healthier habits. He notes there is no evidence of facelift scars or other surgical signs.

Question 10

Which common plastic surgery procedures can realistically be performed under local anesthesia or twilight sedation?

Accepted Answer

Not all surgical procedures require full general anesthesia. Many in-office treatments are performed under local anesthesia and numbing. For procedures requiring more significant lift and tightening, such as a deep plane face or neck lift, general anesthesia is typically recommended. Platysmaplasty (neck lift) can often be performed awake under local anesthesia.

Question 11

What is the realistic downtime for upper and lower eyelid surgery, including bruising and swelling?

Accepted Answer

Mild swelling is expected after eyelid surgery and improves over several weeks. For lower eyelid procedures (transconjunctival blepharoplasty), there is no visible external scar as the incision is hidden inside the eyelid. Stitches are typically removed around 6 to 8 days post-op. Most patients can resume normal daily activities and wear makeup again by about 3 weeks, at which point the surgery is often undetectable to others.

Question 12

What factors contribute to an implant being in the 'wrong place,' and how can this be prevented?

Accepted Answer

Dr. Zelken emphasizes that even the 'right' implant in the wrong place can lead to an unsatisfactory outcome, as a chin implant, for example, must harmonize with the entire jawline and midface. He addresses age-related volume loss in the cheeks and infraorbital rim with custom implants to restore structural volume. His approach involves removing existing implants if necessary and using custom PEEK wraparound jaw, cheek, and infraorbital rim implants, often placed endoscopically, to create a flowing jawline, a lifted midface, and a cohesive facial appearance. Patients may experience some swelling for up to two months, but facial harmony is often evident earlier.

Question 13

What are the most common reasons a chin implant might need revision surgery?

Accepted Answer

Chin implant revision is often sought by patients dissatisfied with previous silicone implants due to issues like fullness under the lip, incorrect positioning (e.g., too high), or a 'clumsy' profile caused by loss of the lip-chin crease. Silicone implants can also cause bony erosion, leaving depressions. During revision, the old implant is removed, and a custom PEEK implant is designed to precisely fit the patient's anatomy, keying into any existing bony 'footprints' to sculpt a more elegant, refined, and harmonious chin.

Question 14

What does Dr. Zelken say about what they specialize in?

Accepted Answer

Many of the treatments we perform happen right here in the office.

Question 15

What does Dr. Zelken say about their techniques?

Accepted Answer

My plan is to remove the old implant and design a custom PEEK implant that fits her anatomy and goals with precision. Custom implants allow me to create balance, projection, and harmony. Custom implants allow the surgeon to sculpt an ideal chin, such as a more pointed, elegant, refined, and feminine chin. For those seeking more lift and tightening, we typically recommend a deep plane face or neck lift under general anesthesia. The practice uses custom PEEK wraparound jaw implants for jawline enhancement.

Question 16

What does Dr. Zelken say about consultations?

Accepted Answer

Patients can determine their candidacy for procedures by scheduling a consultation with the practice.

Question 17

What does Dr. Zelken say about their approach?

Accepted Answer

The procedures performed by the practice are designed for efficiency.

Question 18

What does Dr. Zelken say about safety?

Accepted Answer

The procedures performed by the practice are designed for safety. Many in-office treatments performed by the practice utilize local anesthesia and numbing.

Question 19

What does Dr. Zelken say about recovery?

Accepted Answer

The in-office procedures offered by the practice involve minimal downtime.

Dr. Jonathan Zelken, MD

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