FAQ

What Do You Want to Know
About Working With Us?

FAQs

F
What should I expect the day of my breast augmentation surgery?
Breast surgery should be relatively uneventful. An hour before, you’ll come to our center, where you’ll spend one hour in the holding area with a warmer on your body to make sure they’re comfortable. We’ll then go to the surgical suite. The surgery can take anywhere from one to three hours. You will then spend one hour after the surgery in our recovery suite, and then you can go home. Our patients can typically return to some form of activity within 24 hours. They can start driving as soon as they’re not taking pain medication, which typically is going to be 24 to 48 hours. I’ve had people go back to work as soon as three to four days after their surgeries. Now, full activities, we’re going to restrict for up to three weeks. Full activities include push-ups in the gym, aggressive cardio, your yoga exercises that will let you get into reduced range of motion exercises within the first two weeks.
What is the secret to a great breast surgery outcome?

Breast surgery is the most common operation performed in America. More people have breast surgery than any other type of surgery. At our practice, we do tons of breast surgery related to breast implants, to breast implant with lifts, and lifts alone. We cover the full gamut. We also have a very large population of patients who have had surgery elsewhere that we’re reoperating on to achieve a more aesthetic, balanced result.

The key to achieving good outcomes with breast surgery is, number one, understanding what it is the patient wants. They want to restore their body to a previously lost form from childbirth or weight loss, so we try and enhance an already natural result. Our goal is to make sure the patient understands what they have, and where they want to go. With those criteria, we then select the appropriate operation with the appropriate implant.

What is a mommy makeover? What should I expect from this surgery?
On initial consultation for a “mommy makeover” operation, we’re going to take photographs. We’re going to do a physical examination. Then, we’re going to determine what your lifestyle is and what types of surgeries we could suggest to you for improvement. The recovery is going to depend on the extent of the surgery. If it’s a complete abdominoplasty, you’re going to require 7 to 10 days before you’re going to feel like you like us again. By three weeks, you’re going to start thinking that we’re really pretty good at it. Within three months, we’ll be heroes for you. That really is body surgery in a nutshell. After 10 days, you don’t like us, after three months, you love us.
Could you show me a good example of a mommy makeover?
This case represents one of my favorite scenarios. This lady reached a point after having her babies and reached mid-life — if mid-life can be considered 42 years of age —
and her body had gotten larger than she wanted to be. Through lifestyle changes, including activity and choosing her food a little more selectively, she lost a significant amount of weight, nearly 70 pounds. And she came to us to clean up the mess, if you will, by taking the skin away, tightening the muscles and liposuctioning her hips. She can see we’ve created a body she could never have gotten with all the exercise and dieting in the world. So it’s kind of like the carrot and the stick. She changes her lifestyle, she exercises, chooses her food more carefully, she loses the weight, and then the carrot is us sculpting the body that creates a contour she can be proud of.
How do I choose the best plastic surgeon ?

When it comes to choosing a plastic surgeon, a lot of things come into play, because really, anybody with a license to practice medicine can do plastic surgery. But first and foremost, you want to find out if they’re board-certified. I am personally board-certified in plastic surgery, head and neck surgery with three fellowship trainings in various subspecialties, so that’s actually five different degrees.

That’s all well and good, but what really separates us and our practice from the other plastic surgical practices is the quality that we provide for our clients. I’m fortunate to have been named the top plastic surgeon in Louisville for the last 17 years in a row. I am honored to be invited around the world to speak about plastic surgery and to teach my plastic surgical colleagues things I’ve learned over the last 30 years doing plastic surgery.

How do you combine artistry and science in plastic surgery ?

I’m very fortunate to be an artist, as well as a plastic surgeon. I was born to be an artist, and I found my calling in life when I found plastic surgery. Albert Einstein said the greatest scientists are artists as well. Plastic surgery is 95% art, 5% science. When we’re looking at people’s faces, we’re looking at pictures of them in their youth, and we’re trying to create a shape and a form that recaptures their younger selves, and that’s how we are able to arrive at these artistic expressions.

What is a real board certified plastic surgeon ?
In today’s media, we see plastic surgery everywhere. When choosing a plastic surgeon, you need to be able to differentiate the plastic surgeon from all the other people who call themselves plastic surgeons. The basic bottom line for a plastic surgeon to become board-certified means they have had training in general surgery or neck surgery prior to formal plastic surgery training. Then they pass both written and oral exams from the American Board of Plastic Surgery. This separates them from all the other people who call themselves plastic surgeons who could have had some type of informal training or underwent a weekend seminar.

What is the Dr. O'Daniel difference ? What makes your practice unique ?

Somebody recently asked me, “What is the Dr. O’Daniel difference, because your outcomes seem to be different?” I would say there are three things. Number one’s sheer numbers. We’re doing a tremendous number of these operations and have been for a long time. Thirty years of experience, and we’re doing 140 of these a year, where the average plastic surgeon, according to our national society statistics, a doctor does 10 a year. So that’s one every six weeks, and we’ll do as many as six in some weeks.

The second difference is, we have an artistic approach. I have a lifetime of art and art training and an artistic eye that we’re applying to the outcomes. The third reason that really is pushing us to a level of mastery is the fact I’m teaching these procedures now. I travel the world giving lectures in different countries, which I am absolutely loving at this point in my career. But that requires a different level of expertise. It requires me to deconstruct what I do every day, and then teach to the average plastic surgeon, so they understand and can try to mimic what we’re creating on a daily basis.

Why do patients choose Dr. O'Daniel for revisional plastic surgery ?

Having been in practice now for nearly 25 years, we have patients coming from all over the country seeking our services. Of these patients that come to our practice, one in three are seeking revisions. These patients have less than optimal outcomes, and they’re seeking help. These are particularly challenging cases, and sometimes, there aren’t things that we can do for them. But most often, we can find a solution and a plan.

In particular, we’re seeing facial patients who have the stigmata of previous facelifts, and in addition, I see a significant number of breast deformities. They’ve had previous breast implants and/or breast lifts that we’re correcting. This takes a particularly high level of expertise, planning, and really a unique approach that’s required to give them a more normal appearance with their next surgical procedure.

I’m fortunate to have been in practice for a long time, for the last 25 years. And I have a lot of patients coming from around the country seeking care. Of all of my practice, at least one in three people are seeking revisions. It’s unfortunate that some people have less than optimal outcomes, but when they do run into problems, we’ve reached the point in our career where we’re providing quality care and the expertise that we’re able to correct these deformities.

It’s unfortunate that these events occur, but we’re fortunate to have the skill and the expertise to correct them.

I dont want to look Weird! How do I get a good, natural result ?
What we’re hearing today is that the big fear of getting fillers is that you’ll look odd and unusual, because if it’s done well, by definition, you never see it. You walk into a restaurant, you walk into a drinking establishment, and the first thing you see are the large looks of the huge chipmunk cheeks. The way we avoid those looks is by using artistic touch when we’re doing fillers. Knowing where to put them, how much to put in there, that is the key to avoiding that abnormal look. Once again, we will use your pictures from your youth, as well as your pictures at date throughout the process. We have it on a large computer screen, and we’re referring back and forth to that screen at all times during the placement of fillers.
Why is Dr. O'Daniel so well known for modern facelift surgery ?

I will do anywhere from 120 to 140 face and neck lifts per year, while the average plastic surgeon in America is doing about one every six weeks for a total of 10 to 12 per year. This gives me the ability to get a person into and out of the surgical procedure quickly and make the recovery as quick and painless as possible.

We tell people for the first 48 hours to be really quiet with your wraps and have someone with you. We use little drains that come out in 48 hours. Your sutures are typically out at six to seven days and we will return people back to social life, if you will, at around 10 days. I’ve had people return to their work as soon as early as six days, which is a little on the quick side and taking up to 14 days on the long side. I will let them go back to full physical activity at around four weeks of after surgery. This includes doing your yoga positions with your head down.

Could you show me a good example of a older adult rhinoplasty ?
The rhinoplasty operation, as I mentioned, is our most favorite operation to perform. The nose is particularly interesting because it can start to bother you in your youth, as we saw in the previous case, but it can also continue to bother you throughout your life. I see patients, interestingly, each year, that are in their 60s and even into their 70s who show up for rhinoplasty. When I ask them, “Why now?” They give you a very simple answer, “Because I can.”

This is a great example of a lady who is 66 years of age and she had a rhinoplasty to remove her nasal dorsal bone. She says, “I realize there’s a lot of things that I can do to change my face, but my nose” has always bothered her, and you see her in the after pictures. She’s very happy with this outcome even though it took her 66 years to get it.

Could you show me a good example of a rhinoplasty to balance the nose and face ?
Rhinoplasty is one of my favorite operations. It’s one of the most challenging operations we perform. It’s the ultimate artistic expression for us because it’s a three-dimensional form that projects, and it is one anatomical feature that has a profound impact on people even at a very young age. This is a great example of a teenager that I would typically see who is now coming into adult phase, and the nose is out of proportion with the rest of her face and becomes quite distraught.

Our goals when we’re talking about rhinoplasty is to evaluate the entire face and then create a nose that fits that face. In other words, we want to take the distraction away. We want to bring the attention back to the eyes, the lips, the cheek, the rest of the face without attention to the nose.

What in Dr. O'Daniel's training makes him so well qualified for face, neck and nose surgery ?
My background is an ears, nose, and throat surgery where I’m a board certified surgeon, as well as plastic surgery. In addition, I did three more years of training to do pediatric plastic surgery, which really concentrates on facial anomalies, which include the nose. I did my first rhinoplasty in 1985. Over the last 32 years, I’ve done thousands of rhinoplasties. I choose a technique that’s best for the patient, not the one that’s most comfortable for me. I do closed rhinoplasties. I do open rhinoplasties. We choose the procedure that’s going to give the most ultimate outcome for that patient. At this point in my career, I have performed more rhinoplasties than most of the doctors in this entire region just based on my background.
Could you show me a good example of a young person's rhinoplasty case?

Today, with the social media being so prevalent, Snapchat and Instagram and so many photographs being taken, people are becoming very self-conscious and aware of parts of the face that they’re unhappy with. In particular, the nose can stand out, particularly when they’re smiling. There are certain elements of the nose and the lip that connects, such that when we talk and we’re smiling, the nasal tip moves, and this really is driving people crazy.

We have an operation where we can actually create a beautiful subtle soft nose that’s independent of the lip, and when we create this transition, as you can see in this patient, between the lip and the nose, you can really appreciate that not only does the nose become more beautiful, but the lip becomes more beautiful as well. See the difference when I lift their nose?

What is a revision rhinoplasty? Why do so many choose Dr. O'Daniel?
Three, two, one. Because of the years I’ve been performing this operation I now receive referrals and requests from around the country for treatment of people who have secondary deformities. Because the difficulty of performing a rhinoplasty there are unfortunately a lot of people who end up with less than aesthetic outcomes, and even worse, less than functional outcomes meaning that when we’re revising a nose, we not only want to make it look good but we have to reverse the obstruction that they acquire as a result of that first surgery.
What is functional rhinoplasty and why does it matter?
My training and background in ear, nose and throat surgery becomes a really critical element. But only do I understand the aesthetic sense, as an artist, I also understand the functional component that the nose needs to maintain while acquiring an aesthetic outcome. In other words, we need to make sure it’s still breathes. We keep the nose open, we keep it straight, so that not only do you look good, you feel good.
How can a facelift help to reverse the aging process ?

As we can see from these pictures of Brigitte Bardot, the face changes shape, and as a sculptor we’re always looking at shape and balance. The upper part of her face was nice and wide in her youth and you can see the corners of the mouth are turned up in a very small and a very small and narrow chin, which is the most attractive features in a young face. As she ages, she loses her cheeks. The jowls become fuller, the corners of the mouth turn down, and she does and inverted triangle when you look at her, which gives her a bit of an upset or less than happy look.

As you can see in this example, we have sculpted her face such that we’ve reversed these triangles. We’ve added volume to her cheeks with fat injection, lifted the cheeks with a facelift, and made the lower third narrow with a facelift as well. As you see as I take the triangles away in the next photograph, you can appreciate that that look becomes less of a tired look, more youthful, and it’s certainly a much more pleasant, approachable face.

How do I prepare for my facelift ?

Now, when we’re preparing somebody in the fourth phase once they’ve made a decision to embark on that procedure, we’re going to be sending things in the mail that give you lots of information. This information are very critical that you go over, which will include medications we want you to take and medications we absolutely want you to stay away from.

There are going to be instructions about how to manage your hair, and you’ll also get your post-op instruction so that you can review those before you come to us for your pre-op visit, so we can make sure everything is understood from beginning, during, and through the very end of the procedure and the recovery.

How does the female face age? What can be done to help?

Let’s look at this case. Let me tell you a story about this person. This person has been an fanatic about the outdoors. She loves the beach; she loves the swimming pool; and it’s had an impact on her skin. The environment has impacted her skin by giving her wrinkles and darker spots and more of a bit of a leathery appearance. Her concerns when I start talking to her about shaping her face and repairing her skin is that, “My face was fat when I was young, and I don’t want a fat face. I much prefer a more sculpted face.” When we look at these photographs, we’re using general guidelines.

As you can see in this next slide, as we look at the center picture, there is going to be a more sculpted look that you see in the mid-20s, the mid-30s. Certainly today when we’re shaping a face, non-surgically or surgical, we’re looking at a more stylized look, the look of somebody in their 20s to mid-30s when we have the ideal shape and volume, not that round face of youth that everybody’s afraid. Because most people weren’t happy with their round faces when they’re children.

How do you decide if someone needs a necklift, facelift or both procedures ?

The decision whether we’re going to do a facelift or a neck lift really depends on the state of the tissue between the face and the jaw. If I’m doing just an isolated neck lift, that means I can contour a beautiful neck and do it through very limited incisions, one in the chin which is very small, and the other incisions are hidden behind the ear, in the crease of the ear.
If we’re starting to see the face descending into the neck, under those circumstances, we would potentially recommend a facial rejuvenation procedure, such as a facelift, at which point the incisions are going to go from behind the ear and continue hidden within the front of the ear such that they’re not visible. They hide inside the ear into the hairline, and one can pull their hair back. They can lose their hair, or even someone who wears a very close cropped or even a shaved head can have these incisions hidden.

What should I expect the day of my facial surgery ?

The surgeries are all performed at the local surgery center. A center we started approximately 14 years ago. We’re doing about 14,000 cases a year there, and we have a team that is second to none. You’ll get there about an hour before your surgery, and our team will meet you. We’re going to get all your premedical questionnaires done, we’re going to start an IV, we’re going to get a blanket on you so that we have you warm before surgery happens.

I’ll then come and meet you before surgery, and with your photographs from your youth and what our goals are, I will then mark you before surgery and make sure we’re on the same page for the very last time before we go down the road of surgery. After surgery, you’re going to wake up in the recovery room. Now understand, we don’t use a general anesthetic for our facial procedures. We give you medicine that makes you sleepy. This is a procedure that we have written about and we have essentially popularized around the country for use of IV sedation. As you wake up, it’s a nice, slow, easy recovery without nausea and vomiting, meaning getting sick to your stomach from the anesthesia. Without pain and discomfort, because we put numbing medicine on your face.

After you’re in the recovery room and our post recovery area for about two hours, we’ll then let you go home. We’re going to review the instructions with your caregiver again, and then we’re going to have your phone number, and as always you’ll have my cell phone number. We’ll be talking to you throughout the process for the next 48 hours until you come to the office to get your drain removed.

Why do patients choose Dr. O'Daniel for revisional plastic surgery?

Having been in practice now for nearly 25 years, we have patients coming from all over the country seeking our services. Of these patients that come to our practice, one in three is seeking a revision. These patients have less-than-optimal outcomes, and they’re seeking help. These are particularly challenging cases, and sometimes, there aren’t things we can do for them. But most often, we can find a solution and a plan.

In particular, we’re seeing facial patients who have the stigma of previous facelifts, and in addition, I see a significant number of breast deformities. They’ve had previous breast implants and/or breast lifts that we’re correcting. This takes a particularly high level of expertise, planning and really a unique approach that’s required to give them a more normal appearance with their next surgical procedure.

It’s unfortunate that some people have less-than-optimal outcomes, but when they do run into problems, we’ve reached the point in our career where we’re providing quality care and the expertise that we’re able to correct these deformities.

What is the cost for a facial procedure?
So when you come in for your initial consultation, and we define what is going to give you the best outcome, we’ll then figure out the cost of these procedures. The prices can range anywhere from $500 for Botox to $25,000 for full facial restoration. We individualize these treatments based on what your specific needs are.
How do we decide what facial treatments are right for me ?

So in your initial consultation for face, we’ll have you come to our office and have pictures taken in all the different views at rest as well as with movement. We’ll have you bring in pictures from your youth, which we’ll scan and we’ll put those side by side. Then we’ll start with a simple question, what do you see in the mirror that bothers you? We then work to the photographs to determine what it is that your major concerns are, and then we’ll decide what tools do we have that will best take care of the job that you want done.

After we have the photographs, we are looking at them, we are determining which treatment is best for you, we will describe to you how these treatments are done, we’ll tell you what to expect during the treatment, and we’ll also give you great detail related to the recovery.

How do you create a long and elegant actress style neck ?
So, in the young person, they are absolutely born with tight skin. That’s a given. However, you’ll see plenty young people where the neck remains full. We’re now doing a research project where we’re actually measuring the volume in the neck, and then we’re doing the surgery removing a certain volume to create a 90 degree angle and a more youthful and aesthetically ideal neck, the one that’s long and clean and has a look … that beautiful long actress neck. This does not come from birth, it comes from surgery. Some people are fortunate to have been born with it. We’re fortunate to have found the steps of surgery that create this neck.
How do you evaluate a patient for a necklift ? What are the steps ?
When people come to me and talk particularly about their neck, there are certain steps that we will go through. The age range of patients that I see for neck lifts are anywhere from teenagers to people in their 80s. It’s a very step-wise evaluation. We look at the skin. We look at the muscle. We look at what’s under the muscle, such as the fat and the glands. And then, we make a determination about the mandible. Is the jaw strong enough? Because what we’re trying to create is a strong, angular jaw, particularly in men, and a softer but defined jaw in females. And then, we have to take all these elements of the neck, the skin, the fat, the muscle, and the glands and determine what we’re going to do surgically to create and sculpt the ultimate, ideal neck.
What are the advanced techniques you've pioneered to improve the appearance of the neck ?
I’m currently involved in a world study group looking at advanced techniques to the neck. I’m performing with a group of surgeons in the world, some operations that transform the neck in ways that we’ve not done previously. We’re taking out different layers of fat, we’re manipulating the muscles, we’re sculpting, reducing glands to create a 90 degree angle and a clean neck. Previously, this operation needs steps in the operation were thought to be not capable of being performed. Too dangerous, took too long. We have now pioneered these techniques to the point that we’re trying to teach and bring these techniques to the mainstream, to the rest of plastic surgeons so that more people can benefit from these techniques that we have mastered.
How do you deal with a genetic double chin or droopy neck ?

There’s absolutely no question that neck surgery is where we gained our international reputation. There are things that we’re doing today that are cutting-edge, and we’re really at the very forefront of creating circumstances where neck surgery on all ages of people. Youngest neck lift I’ve done is 19; the oldest I’ve done is 80. The key is the neck has a profound impact on the way we perceive the rest of the body. For instance, you can see in this young lady, she’s 37 years of age, when you look at her you get this sense that she’s overweight, she’s out of shape, but the reality is she was born with a full neck. When you see her before versus the after, it has a profound impact on her entire face. There’s been no other change except her neck.

How does the male face age ? What can be done to help ?

As we can see from these pictures, this gentleman, his 20s, his 30s, and 40s, and comparing it to his 65-year pictures. This gentleman is very attractive in his 20s. You can see that look in his eyes, that youthful look. By the time he’s in his 30s, you can see the enthusiasm as he’s embarking on his career. Then you see him in his 40s. He’s finally made his way into the C Suite. He’s having to seize the ambition and realizing his ambition.

Now at 65, you can see in the bottom picture, he’s now matured. He’s retired, but when he looks in the mirror, he doesn’t look like he has the energy to reap the rewards of all of his hard labors.

He looks at me and asks me, “What can you do to restore the feeling of youth, the look of vitality?” What we’d recommend is we’re going to restore the volume to your face. We’re going to make your neck a little tighter. We’re going to make your eyes a little more awake. But you’re still going to look 66 years of age.

As you can see in this first slide, he’s 20 years of age. He’s 65, and he’s 66. We can see that we’ve not made him look 20, by any stretch of the imagination. But you can definitely tell it’s the same person, the same viable person at a later date.

When we compare him to this picture when he’s in his 30s, you can see the face is a little more angular, a little more sharp, and it’s in the jaw line. I think he looks the same person. I would suggest that he’s even more handsome as he’s aging. This is one of those things that you’re getting better with time.

Now you can see, when we compare him to his pictures from his 40s, this is the point you can see that he certainly doesn’t even look 40. It’s only 25 years difference, but he doesn’t look 40. But he looks more rested. He looks more viable.

When you compare his pictures before and after, he can go back to his corporate retreats with his peers, and they’re going to look at him and tell him, “Wow, retirement has really done well for you.” They’re not going to say, “Wow, what did you do to yourself?”

The goal with all of this is to use these photographs as a guideline to make sure that you don’t look different.

What are my options for improving the appearance of my chin and neck ?
We have two options for enhancing the lower jaw. When we’re looking at the face and the neck, we want to see the balance of the jawline. The person who was born or congenitally having a weak chin, those circumstances we’re going to use an implant, and that’s with a young patient getting a neck lift or rhinoplasty or an older patient who’s undergoing some type of facial aesthetic procedure. However, there is a subset of patients that I see in the aging population where they had a good strong jaw when they were younger, but as they age the chin becomes more weakened and less prominent. In those circumstances, I can actually use their own fat and inject it into a special way and find enhancement of the soft tissues in the neck gives perfectly nice projection of the chin, restoring the youthful shape and projection of the chin with good predictable longevity.
What are the benefits of a male facelift ? How is it different from a woman's facelift ?

The best part of my job is, I get to participate in people’s lives. They bring me these photographs from their youth and we put them on the computer, we compare to where they are today, and they tell me stories about where they came from.

This gentleman was a wrestler before he became a physician. He said it’s his motivation for coming to see me is, he feels like people are treating him different as he’s aging. All day long as a physician, he gets respect and asked questions and is an integral part of the community. At night when he goes to dinner, he feels like people are treating him different. Less respect, he almost feels like he’s embarrassed by the way they treat him.

To help him feel better about what he sees in the mirror, and to give people a different impression of who he really is on the inside, he’s undergone a facelift with fat injection. You can see, this is three years later. We’ve used Scupltra and fillers and Botox to maintain that look, so that he can enjoy every day, showing the person on the outside that he feels like he is on the inside.

What is the secret to a truly great result without looking overdone?

The goals of our treatment, whether it be surgical or nonsurgical, is to create a look that is natural. We hear that all the time. It’s almost a cliché, “I have natural results.” The point I’m trying to make is that when people see the before-and-after pictures of cases we’ve done, they go, “Oh, my goodness. Everybody will notice if I look that much better.”
The reality is we recognize each other based on what we remember of you from the day before. As long as we don’t lose that intrinsic you, that little piece of you that is characteristic, they’ll look at you and say, “Wow, great haircut! You’ve lost weight. What kind of makeup are you using?” They’re not going to say, “Wow, you look great! Who did your facelift?” because that would be the biggest insult that could possibly happen. What we want to hear is, “Wow, you look great!” and your answer is very simple, “Thank you.”

Can getting facial fillers and injections actually make me feel better?
What is really interesting about studying medicine, we’re starting to look at the psychological impact that it has on individuals. For instance, there was a study done looking at Botox and depression, and just the fact that when you get rid of these frown lines on our face, that people who have clinical depression were more likely to respond to treatment than those who did not have Botox. So, think about it in simple terms, you get up in the morning, you look in the mirror, you have the furrowed lines and you go, “Oh, I still feel bad today.” When those lines are gone, it has a positive impact on yourself and the reflection that you’re seeing in the mirror every morning. So, Oprah Winfrey said it best, “It’s confidence in our mind, body and spirit that make us want to chase that new adventure.” We’re here to help you chase your new adventure by giving you confidence in the way you look, which makes you feel better and makes you ready for your next adventure.
Does it hurt? What can be done to stop pain and bruising?
People want to know about the complications and the recovery from fillers. Now when we’re doing the fillers, pain can be an issue. We do lots of things to minimize pain from topical anesthetics to regional blocks. I will use blunt needles. These blunt needles are much less likely to cause pain, and they also give you a better opportunity to avoid bruising. Sometimes we have to use a sharp needle, which can cause bruising, which is the most common problem we see with patients after surgery or injectables. What we’re typically seeing is these bruises go away in a few days and are typically covered with makeup without a problem, when they do occur.
How do I choose the right doctor for fillers and BOTOX?

Over the last 10 years, we have seen an explosion of non-surgical options for our patients. We, as plastic surgeons, are the best situated to provide these non-surgical products because we understand the anatomy of the face, including the muscles, and the arteries and where we should be putting these as sculptors. The difficulty is, for the consumers, they’re going, “What’s the difference between all of these?”

We have Botox, which is a neuromodulator and has become a household name, like Kleenex. That paralyzes muscles, doesn’t take up space. We then have fillers. And when it comes to the fillers, we have 11 different fillers. Now, my goodness, how do we choose which one of these fillers do we use? And then, we’re gonna complicate things with bio-stimulators, meaning we inject the substance and your body makes its own collagen. The critical thing to understand between these different products is they all have a job that they do, and we need to decide what job you need to have done. And that’s where our expertise comes in.

For instance, fillers, they take up a space. They can fill a wrinkle or a dent in the face. We will choose the appropriate filler for the appropriate wrinkle. I may use one filler for a wrinkle that’s fine. And I’ll go to a larger wrinkle and use a totally different filler. The complexity of the choices becomes the entry level that we need to have as practitioners to give you the optimal result.

How do you choose the right fillers for me?
Fillers, neuromodulators and biostimulators, are nothing more than tools, just like knives, lasers, fat injections and surgery. So the tools are what we use as artists to create the optimal picture after a treatment. I will look at your pictures, and what we’re trying to achieve, and then I choose the best tool that will give you the best outcome, depending on what you are willing to go through, as far as time, expense and recovery.
How do you control pain and bruising?
The big concern people have is related to the pain and discomfort. There’s a real needle phobia. We will do everything to alleviate your pain and discomfort by putting a topical anesthetic on, which gives you a numbing affect all parts of your face. We can also do dental blocks, where you feel nothing. The idea that you’re going to suffer through this and put up with the pain is not part of our agenda. Controlling your pain also allows us to control bruising. Understand that when you have pain, your blood pressure goes up. Blood pressure goes up, you increase bruising. However, sometimes bruising occurs despite our best efforts, and it’s a disappointment for all of us. We do have makeup and covers that will help you avoid the signs that you have bruising.
How do you keep a natural look with lip fillers?
The most common complaint I have in my office from people are lips. Everybody is scared to death of the large lips, and there’s a very simple reason we’re seeing so many odd-looking people out there. There’s a ratio of the upper lip to lower lip that was described by the Egyptians. The upper lip should be half the size of the lower lip. What we’re seeing out there are fillers being placed in the lips by people who are not taking this golden ratio into effect. In other words, they’re putting so much filler in the upper lip, it looks like they were stung by a bee. It attracts attention to them, and it’s a very odd look, and that creates fear. If we can train people to stop injecting the upper lip and add it to the lower lip, we can create beautiful lips. Now the last thing to understand about lips, it’s not the filler that creates bad lips, it’s the person that’s holding the syringe of filler that creates the bad lip.
How do you maintain or improve a facelift with fillers?

So when people come to me in consultation, we look at the pictures of where they are. And we’re talking about static time, because remember, life is like a river. When you step in the river and you step out, you don’t step back in the same space, because that water has moved on. And our face is the same way. If we do something to the face today, whether it’s surgical or non-surgical, the aging process, if we’re lucky, will continue to move on.

So there are things that we can do surgically to restore a face, and then we need to think about … how do we maintain what we’ve done? Maintaining our investment, if we will. In those circumstances, we can use non-surgical means such as Sculptra. We can use fillers. We can use Botox, skin care or laser as part of our maintenance program, and vice versa. If someone’s not quite ready for a facelift … they can’t fit it into their schedule. They can’t afford it. It’s too scary. There are small things we can do in preparation for the facelift. In the same vein, we can use neuro-modulators, Botox, fillers, Sculptra, lasers as part of the maintenance program prior to having a facelift.

So the idea is, none of these treatments last forever. There’s nothing that is permanent in life, so we’re trying to treat you at a point in time to make you better today, such that 10 years from now, you’ll still be better than you would’ve been had you done nothing.

How is Dr. O'Daniel pioneering new uses for injectables and fillers?
Currently, one of the more exciting things that we’re doing is using Sculptra away from the face. We’ve got 10, 14 years of using the face. Most recently, I’ve been injecting it into the chest. We make the face look awesome. The neck looks good, but you move into the chest, we see the wrinkles. We see the lines from sleep. We see the sun damage. What we’re finding is by injecting Sculptra into the chest, and then using some type of imaging device, whether it be a laser, which resurfaces the skin, or lasers that get rid of brown spots. We’re restoring the chest so that your dress is open all the way to your bosom, shows good, healthy, clear skin. This is very exciting, the results we’re seeing with this usage of Sculptra.
There are so many options for fillers, how do I choose the best solution?
When you look at the options that you have in front of you for fillers, we have at least 11 in our practice right now, with more coming before the end of the year. The way we choose the filler is to determine what job do you want done. One filler in one line is optimal, where that same filler in another line is less than optimal. So think about it this way. The fillers come in different consistencies, sometimes it’s thick and it’s hard and it’s firm. And that works great when we’re trying to lift the cheeks, because we’re trying to get lift and elevation with a heavy type of tissue. Other times, we’re talking about the fine lip lines around the lips, the lip lines. Under those circumstance, we want to use a liquidy or very thin, very viscous type filler that will then fill that line without leaving those bumps and irregularities. So the choice of the filler is very, very important. And it’s important that we have all these options available to you at any time in our office. It’s not a default, “Well, this is the one I have. So this is the one I’m going to use.”
What is Sculptra, and what can it do?
Sculptra is a very interesting product we have in armamentarium. It is a biostimulator that creates volume and builds structure to lift the face, which we use as a platform for other procedures. I’ve been using Sculptra for the last 13 years. I am been using it since 2010 in a very high volume with a very zealot-like enthusiasm. I use it so much, in fact, that we’re one of the top users in the country. I’ve been invited to the Surgical Advisory Board for the last five years and have been publishing with from around the world on best practices and expanded uses of Sculptra. We find, in our practice, that as a single-modality treatment Sculptra offers us the biggest advances we’ve seen in years, and we’re continue to use it in different uses off the face and as well as the face itself.
What special training does Dr. O'Daniel have?
At this point in my career, nonsurgical sculpting of the face using fillers, Botox-type products like Dysport, neuromodulators and biostimulators, makes up at least half my practice. I’ll do well over 2,000 faces a year with injections sometimes, but that’s about half of my time. Because of the high volume of usage, I’ve now been invited to participate at the surgical advisory board level and writing papers. We’re publishing papers on the use of biostimulators and fillers. This expertise allows us to be on the forefront, the cutting edge, in the use of fillers to optimize nonsurgical treatment of your face. Nonsurgical means you come to the office, you have your treatment, and you are able to return to your normal activities the next day.
Why are some people afraid to get fillers?
For the last five to six years, I’ve been involved in the industry in the advisory boards for fillers. I’ve been involved in surgical education, and so I’m very well aware of the things people are afraid of. When we look at filler, for instance, there are three reasons people don’t have fillers. We’ve identified 20 million women in America who want to have fillers in 2016. Only 2.6 million people had fillers. There are three reasons that they elect not to have treatment. First and foremost is fear, fear of looking different. That is our expertise, is not presenting or creating someone that is different.

The second fear is fear of pain and discomfort. Pain and discomfort can be overcome with using topical agents. We use vibratory sensors, and we use dental blocks for those who have a real aversion to needles and pain and discomfort. Interestingly, the third pain point that prevents people from having treatment is price, and that is a very low percentage of people who avoid treatment as compared to fear of looking different and fear of pain.

Real Patients, Real Results

” Who doesn’t want to look their best? Our bodies are a representation of who we are, what we do, and how we live our lives. Life’s demands can, over time, leave our bodies needing a ‘pick-me-up’ of sorts. When that time comes, my years of experience can help realign inner desires with an outer appearance that instills confidence and pride.”