Sourced directly from Dr. Nicholas Howland's social posts and replies.
What is the Alma Hybrid Laser and what conditions does Dr. Howland treat with it?
The Alma Hybrid Laser is one of Dr. Howland's preferred state-of-the-art technologies for facial rejuvenation, combining CO2 and 1570nm wavelengths. He considers it to provide the best results short of a full facelift or neck lift, addressing issues like acne scars, age spots, fine lines, and uneven skin texture. The clinic's experts employ specific techniques to ensure safe and effective treatments that deliver visible results.
What is an internal bra (Galiflex/Galiform/Galatea), how does it work, and when does Dr. Howland recommend it?
An internal bra, such as Galiflex, Galiform, or Galatea, is a mesh made of P4HB (poly-4-hydroxybutyrate), a naturally occurring body chemical. The body gradually breaks down this mesh over 18 months, leaving behind a thin layer of scar tissue that is approximately 10 times stronger than natural tissue. This scar tissue helps maintain the breast in its surgically placed position for a longer duration after a lift, reduction, or implant placement, rather than primarily lifting breasts. Dr. Howland frequently uses this product in his practice, considering it an essential tool for certain patients (where he won't perform surgery without it), a beneficial add-on for others, and not necessary for some. It is considered a foreign body with approximately a 1% risk of infection, and is not suitable for every patient.
What is Dr. Howland's approach to combining multiple extensive facial procedures?
Dr. Howland believes that performing multiple extensive facial procedures (such as a full facelift, liposuction, genioplasty, nose hair transplantation, and quad bleph) all at once is too much surgery. He recommends staging these procedures out for patient safety, as combining them would take too long and result in excessive facial swelling.
Is jaw lengthening with wires a permanent solution?
The effect of wires used for jaw lengthening is temporary.
Does Dr. Howland treat Treacher Collins Syndrome?
Dr. Howland believes he can provide effective treatment for Treacher Collins Syndrome and encourages interested individuals to schedule a consultation.
How are cheek implants constructed by Dr. Howland?
Dr. Howland constructs cheek implants using bone grafted from the back of the patient's skull, a procedure that he notes is less severe in experience than it may sound.
How does Dr. Howland correct facial drooping?
Dr. Howland can correct facial drooping by adding fatty deposits for support.
What are the functional benefits of jaw repositioning?
Repositioning the angle of the jaw can have a positive effect on a patient's breathing, eating, and speaking.
What is Dr. Howland's perspective on the safety and research of facial fillers?
Dr. Howland asserts that the medical community has extensive knowledge about fillers, with hundreds of histological studies examining their breakdown, safety, and longevity, which have been accepted and validated.
Why is lymphatic massage crucial after liposuction, according to Dr. Howland?
Dr. Howland considers lymphatic massage an absolutely necessary part of any liposuction procedure, as important as the surgery itself. He notes that plastic surgeons have only recently recognized its full importance. Post-liposuction, patients must have good compression garment compliance and lymphatic massage to help the skin re-adhere to tissue, smooth out fat as it heals, reduce postoperative swelling and bruising by moving fluid into the lymphatic system, and ultimately help patients feel better faster. Without adequate postoperative treatment, even excellent liposuction results can appear lumpy and bumpy.
What are Dr. Howland's recommendations for patients taking GLP-1 medications (e.g., Manjaro, Semaglutide, Ozempic)?
Dr. Howland stresses the importance of taking GLP-1 medications 'the right way.' While these medications reduce food intake and lead to weight loss from fat, bone, and muscle, patients *must* eat protein and lift weights. Failure to do so will result in muscle loss, bone density loss, and predispose patients to conditions like early osteoporosis. He considers it problematic if a healthcare provider does not discuss these critical aspects when prescribing GLP-1s.
What is Dr. Howland's view on the accuracy of plastic surgery portrayals in media like 'Nip/Tuck'?
Dr. Howland notes that series like 'Nip/Tuck' often take dramatic liberties and feature exaggerated procedures, which can misrepresent plastic surgery.