# Harmon Face Works — Full Site Content > This file contains the full text content of harmonface.com for use by AI assistants and language models. > Harmon Face Works is a premier facial aesthetic and cosmetic surgery practice specializing in > surgical and non-surgical facial rejuvenation. Located in the United States. Generated: 2026-09-16T13:12:34.132Z --- ## Site Pages ### About Us URL: https://www.harmonface.com/about-us ### Meet Dr. Jeffrey Harmon URL: https://www.harmonface.com/about-us/meet-dr-harmon ### Our Practice URL: https://www.harmonface.com/about-us/our-practice ### Testimonials URL: https://www.harmonface.com/about-us/testimonials ### The Harmon Method: A Philosophy of Facial Plastic Surgery URL: https://www.harmonface.com/about-us/the-harmon-method ### Facial Conditions We Treat URL: https://www.harmonface.com/aesthetic-concerns ### Deviated Septum Treatment in Cincinnati URL: https://www.harmonface.com/aesthetic-concerns/deviated-septum ### Dorsal Hump Treatment in Cincinnati URL: https://www.harmonface.com/aesthetic-concerns/dorsal-hump ### Double Chin Treatment in Cincinnati, Harmon Facial Plastic Surgery URL: https://www.harmonface.com/aesthetic-concerns/double-chin ### Droopy Eyelid Treatment in Cincinnati | Harmon Facial Plastic Surgery URL: https://www.harmonface.com/aesthetic-concerns/droopy-eyes ### Duck Lip Treatment in Cincinnati URL: https://www.harmonface.com/aesthetic-concerns/duck-lip ### Eyelid Bags in Cincinnati URL: https://www.harmonface.com/aesthetic-concerns/eyebags ### Facial Skin Tightening in Cincinnati URL: https://www.harmonface.com/aesthetic-concerns/face-skin-tightening ### Hollow Face Treatment in Cincinnati | Harmon Facial Plastic Surgery URL: https://www.harmonface.com/aesthetic-concerns/hollow-face ### What Are Hooded Eyes? URL: https://www.harmonface.com/aesthetic-concerns/hooded-eyes ### Jowls in Cincinnati URL: https://www.harmonface.com/aesthetic-concerns/jowls ### Nasal Valve Collapse Treatment in Cincinnati URL: https://www.harmonface.com/aesthetic-concerns/nasal-valve-collapse ### Protruding Ears Treatment in Cincinnati, Harmon Facial Plastic Surgery URL: https://www.harmonface.com/aesthetic-concerns/protruding-ears ### Turkey Neck URL: https://www.harmonface.com/aesthetic-concerns/turkey-neck ### Weak Chin Treatment in Cincinnati, Harmon Facial Plastic Surgery URL: https://www.harmonface.com/aesthetic-concerns/weak-chin ### Wrinkle Treatment in Cincinnati | Harmon Facial Plastic Surgery URL: https://www.harmonface.com/aesthetic-concerns/wrinkles ### Contact Us URL: https://www.harmonface.com/contact ### Hair URL: https://www.harmonface.com/hair ### Hair Loss Treatment URL: https://www.harmonface.com/hair/hair-loss-treatment ### Hair Restoration URL: https://www.harmonface.com/hair/hair-restoration ### home URL: https://www.harmonface.com/home ### Non-Surgical URL: https://www.harmonface.com/non-surgical ### BOTOX© URL: https://www.harmonface.com/non-surgical/botox ### Fillers URL: https://www.harmonface.com/non-surgical/fillers ### Laser Skin Resurfacing URL: https://www.harmonface.com/non-surgical/laser-resurfacing ### Surgical Procedures URL: https://www.harmonface.com/plastic-surgery ### Blepharoplasty URL: https://www.harmonface.com/plastic-surgery/blepharoplasty ### Brow Lift URL: https://www.harmonface.com/plastic-surgery/brow-lift ### Buccal Fat Removal URL: https://www.harmonface.com/plastic-surgery/buccal-fat-removal ### Chin Implant URL: https://www.harmonface.com/plastic-surgery/chin-implants ### Earlobe Repair URL: https://www.harmonface.com/plastic-surgery/earlobe-repair ### Deep Plane Facelift URL: https://www.harmonface.com/plastic-surgery/facelift/deep-plane-facelift ### Facial Fat Grafting URL: https://www.harmonface.com/plastic-surgery/facial-fat-grafting ### Lip Lift URL: https://www.harmonface.com/plastic-surgery/lip-lift ### Neck Lift URL: https://www.harmonface.com/plastic-surgery/neck-lift ### Neck Liposuction URL: https://www.harmonface.com/plastic-surgery/neck-liposuction ### Rhinoplasty URL: https://www.harmonface.com/plastic-surgery/rhinoplasty ### Scar Revision URL: https://www.harmonface.com/plastic-surgery/scar-revision ### Skin Lesion Removal URL: https://www.harmonface.com/plastic-surgery/skin-lesion-removal ### Skin Cancer Reconstruction URL: https://www.harmonface.com/plastic-surgery/skin-reconstruction ### Privacy Policy URL: https://www.harmonface.com/privacy-policy ### Resources URL: https://www.harmonface.com/resources ### Patient Education & Articles URL: https://www.harmonface.com/resources/peri-operative-instructions ### Sitemap URL: https://www.harmonface.com/sitemap ### Terms of Use URL: https://www.harmonface.com/terms-of-use ### Thank You URL: https://www.harmonface.com/thank-you --- ## Gallery Procedures Before and after photo results are available for the following procedures: - Blepharoplasty — https://www.harmonface.com/gallery/blepharoplasty - Brow Lift — https://www.harmonface.com/gallery/brow-lift - Chin Implants — https://www.harmonface.com/gallery/chin-implants - Deep Plane Facelift — https://www.harmonface.com/gallery/deep-plane-facelift - Fat Grafting — https://www.harmonface.com/gallery/fat-grafting - Fillers — https://www.harmonface.com/gallery/fillers - Hair Restoration — https://www.harmonface.com/gallery/hair-restoration - Laser Resurfacing — https://www.harmonface.com/gallery/laser-resurfacing - Lip Lift — https://www.harmonface.com/gallery/lip-lift - Neck Lift — https://www.harmonface.com/gallery/neck-lift - Revision Surgery — https://www.harmonface.com/gallery/revision-surgery - Rhinoplasty — https://www.harmonface.com/gallery/rhinoplasty --- ## Blog Posts ### How Healing After Facial Plastic Surgery Can Make You Feel & What Helps URL: https://www.harmonface.com/blog/how-the-healing-process-after-facial-plastic-surgery-can-make-us-feel-and-what-to-do-about-it Published: August 21, 2026 Author: Dr. Jeffrey Harmon Categories: General Information I experienced a gentle emotional rollercoaster after rhinoplasty surgery , more like The Barnstormer at Disney World than the TRON Lightcycle/run. I was seventeen and, as most teenagers are, filled with emotion. Every event, however insignificant, seemed like it was the most important thing that could ever happen to me. Would I earn a spot on the top boat in crew? Would the girl I had a crush on say “yes” if I ask her out on a date? Little did I know how life changes with truly important, life-changing events such as becoming a father. I can no longer empathize with the person I was at that time. I do, however, remember the embarrassing trauma – emotional and physical – of running into a glass door at a friend’s house and fracturing my nose. I remember constantly mouth-breathing at crew practice. Rowing was by far the most important thing in my life at the time. As a result, it makes sense why I would choose to undergo facial plastic surgery. The procedure and recovery were uneventful. However, within a few weeks of surgery I felt conflicted about my choice. I remember looking in the mirror and thinking that I like my nose, that it is straighter, and that I could breathe comfortably. But I could tell it was different. How easily would people notice I had surgery? Do I want them to notice I had surgery? Does it look too perfect? If it looks “too perfect,” does it look unnatural? My teenage angst, no different than anyone else’s and not related to any mental health concerns, was temporarily exacerbated. Importantly, these feelings subsided completely. I recovered rather quickly. I could breathe well through my nose. Rowing practice became easier. My nose looked incredible and harmonized with my face. Now I am a facial plastic surgeon telling people about my own experience with facial plastic surgery more than twenty years ago. I often explain to patients that the anticipated trajectory of healing after rhinoplasty and other facial plastic surgery procedures is almost sinusoidal in many cases, with the overall trajectory towards being healed, but with some days that make you feel like you never had surgery – in a good way – and others that remind you that you recently underwent surgery. For example, the nose, eyelids, and/or neck can feel more swollen or less swollen from one day to the next after surgery, with a gradual overall improvement in swelling over weeks and months. Feelings about these experiences can be amplified as the time between follow-up visits increases and in the rare instances of setbacks that are possible during the healing process. I have found these feelings to be most noticeable between approximately one (1) and three (3) months after surgery. It is during this time that patients have just finished frequent follow up with me for, for example, suture removal. It is during this time that they are noticing the changes associated with healing, from swelling to remodeling of the incisions. They may also be reminded of their surgery as the decreased sensation that can be associated with any surgical procedure improves. It is immensely gratifying to care for patients as they heal. I typically see a gradual but significant improvement in their beliefs, attitudes, and behaviors related to the specific area(s) treated as they heal. Many begin carrying themselves with more self-confidence as their perception about the treated area(s) improves. It is for this reason that I believe the feelings I described above are a part of the healing process. But is there evidence for this in medical literature? Unfortunately, the medical literature is sparse and of poor quality regarding this question. This fact cannot be emphasized enough, because it is unclear what firm conclusions can be drawn from the literature available other than in providing hints that may support or contradict beliefs derived from clinical experience. The specific problems with the studies identified are: There are few studies overall. There are few patients in the studies. Body plastic surgery procedures (e.g. reduction mammaplasty, abdominoplasty) are heavily over-represented relative to facial plastic surgery procedures. Moreover, the facial plastic surgery procedures evaluated are almost entirely patients who underwent rhinoplasty, with some patients who underwent blepharoplasty surgery but little-to-no facelift or other similar procedures. Multiple studies mix in some patients who underwent facial plastic surgery procedures with many patients who underwent body plastic surgery procedures. Most studies have no control group to compare the study subjects with. There are very few male subjects in the studies. The follow-up for most studies is short, measured in months rather than years. The following is demonstrated by research studies available on the subject ( 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ): Results demonstrated an overall improvement in the perceived body image of the area(s) treated. This is consistent with my experience. The results on overall self-esteem were variable, with some studies demonstrating improved feelings of self-esteem but an important number of studies demonstrating no improvement. A definition of self-esteem is how one values and perceives themselves. It is usually considered generally, rather than related to specific aspects of the appearance or personality. This differs from self-confidence in that self-confidence suggests certain actions or external behaviors rather than inner self-perception. Someone can act with self-confidence while struggling with self-esteem. No improvement in mental health diagnoses such as depression or anxiety. Facial plastic surgery should never be pursued by a patient for the purpose of treating mental health conditions. The best advice I saw in the literature regarding patient foundations when considering surgery includes ( 1 ): Realistic goals. The understanding that there is no guarantee of a specific or perfect result. The understanding that there is no absolute guarantee of absolute perfect satisfaction. The self-knowledge to feel that they can weather any potential complication, however low the risk. Surgeons can help patients understand realistic goals during the consultation as well as the anticipated recovery after the procedure, especially in the unlikely scenario where there are complications. It is important for patients to try to separate the negative feelings they have about area(s) of the face they would like to address with a procedure from their overall happiness or mental health diagnoses. Other data I found helpful in the literature was ( 9 ): Rushing into a decision is negatively associated with satisfaction with results. External pressure is negatively associated with satisfaction with results. The above two findings make sense intuitively. The decision to proceed with a surgical or non-surgical procedure should be made carefully and in consultation with a qualified medical provider. The decision should also be made for oneself and no one else. It is important for patients to approach facial plastic surgery with clear eyes and self-knowledge. That can take self-work. But what can we do as facial plastic surgeons to help patients through the healing process holistically? After all, understanding people, their strengths and their needs, is very difficult. We facial plastic surgeons do our best to listen to and help people in the ways we know how. I believe it starts by counseling patients pre-operatively that they may experience these feelings post-operatively whenever possible. Normalizing this experience can go a long way in reducing early post-operative anxiety. Also, it is important to explain the anticipated time frame after which these feelings may resolve and previous concerns about their appearance in area(s) treated improve. It is important, as well, to explain that it remains possible that each person is different and that it cannot be guaranteed that these feelings will completely fade or that they will not then focus somewhere else. As expected, there are many other internal and external factors that influence these feelings. Specifically, for those with mental health concerns such as anxiety and/or depression, it is important to establish with a mental health provider and be on effective treatment. Facial plastic surgery should not be expected to treat or improve general mental health conditions or overall self-esteem. Finally, it is important to continue communicating with patients after surgery. This involves being available and present with each patient during their recovery. It also emphasizes the importance of having an at home support system to help with caring for the surgical sites but also emotional support during the first few weeks to months after surgery. References Adamson PA, Chen T. The dangerous dozen--avoiding potential problem patients in cosmetic surgery. Facial Plast Surg Clin North Am. 2008 May;16(2):195-202, vii. Ahmad F, Saleh DB, Khatib M. The Health Benefits of Aesthetic Facial Surgery. Aesthet Surg J. 2025 Aug 9;45(Supplement_2):S47-S51. Ericksen WL, Billick SB. Psychiatric issues in cosmetic plastic surgery. Psychiatr Q. 2012 Sep;83(3):343-52. Garbett KM, Paraskeva N, White P, Lewis-Smith H, Smith H, Anquandah J, Diedrichs PC. The psychosocial outcomes following cosmetic surgery are largely unknown: A systematic review. J Plast Reconstr Aesthet Surg. 2025 May;104:282-297. Imadojemu S, Sarwer DB, Percec I, Sonnad SS, Goldsack JE, Berman M, Sobanko JF. Influence of surgical and minimally invasive facial cosmetic procedures on psychosocial outcomes: a systematic review. JAMA Dermatol. 2013 Nov;149(11):1325-33. Kam O, Na S, La Sala M, Tejeda CI, Koola MM. The Psychological Benefits of Cosmetic Surgery. J Nerv Ment Dis. 2022 Jul 1;210(7):479-485. Kozlowski L. The Psychological Health Benefits of Aesthetic Surgery. Aesthet Surg J. 2025 Aug 9;45(Supplement_2):S62-S65. von Soest T, Kvalem IL, Roald HE, Skolleborg KC. The effects of cosmetic surgery on body image, self-esteem, and psychological problems. J Plast Reconstr Aesthet Surg. 2009 Oct;62(10):1238-44. von Soest T, Kvalem IL, Skolleborg KC, Roald HE. Psychosocial changes after cosmetic surgery: a 5-year follow-up study. Plast Reconstr Surg. 2011 Sep;128(3):765-772. --- ### Face Forward Series: What Makes Someone a Good Candidate for Revision Rhinoplasty? URL: https://www.harmonface.com/blog/face-forward-series-what-makes-someone-good-candidate-revision-rhinoplasty Published: August 10, 2026 Author: Dr. Jeffrey Harmon Categories: General Information What Makes Someone a Good Candidate for Revision Rhinoplasty Surgery and Why? A potentially good candidate for revision rhinoplasty must meet at a minimum the following four (4) criteria: Be fully healed from the previous rhinoplasty , which is at least twelve (12) months, sometimes longer. Have specific, identifiable functional and/or aesthetic concerns about their nose that have a reasonable chance of being addressed with revision surgery. Have realistic expectations about the healing process and what revision rhinoplasty can achieve, which is not necessarily everything primary rhinoplasty can achieve . Be psychologically ready for another rhinoplasty procedure. Revision rhinoplasty can be discussed and planned with Dr. Jeffrey Harmon in Cincinnati, Ohio once the above criteria have been met and there are no other factors that may preclude surgery. What is a Revision Rhinoplasty? A revision rhinoplasty is a surgical procedure in which patients undergo a rhinoplasty nose surgery to correct a feature of the nose they feel has been made worse with surgery or to further improve a feature they feel was inadequately or incompletely treated. It is important to emphasize that just because someone is dissatisfied with the appearance and/or function of their nose after their initial operation does not mean they were "botched." While this term is not definable with any level of precision, Dr. Harmon feels very few patients have truly been botched secondary to the complete lack of skill and/or gross misjudgments of a surgeon. He feels it is more likely that: There is a mismatch between a patient’s aesthetic and/or functional desires and what a surgeon could reasonably achieve. The healing process proceeded unpredictably after surgery. Why is Revision Rhinoplasty Different from Primary Rhinoplasty? Revision rhinoplasty is less predictable intra-operatively and post-operatively due to: Scar tissue – Scar tissue blurs the delineation between tissue planes, making dissection more difficult. Scar tissue results in less robust blood flow to the healing surgical site, making the healing process potentially longer and less predictable. Altered cartilage – Rhinoplasty surgery often involves the removal, reorientation, and suturing of the nasal cartilages. Cartilage grafts are sometimes attached to the nasal tip and/or bridge. The specific alterations to nasal cartilage can affect what is achievable during revision rhinoplasty surgery. The presence of scar tissue and altered cartilage affect each patient variably depending on the extent of the changes made previously. What are the Most Common Reasons People Seek Revision Rhinoplasty Surgery? The reasons patients seek revision surgery are highly variable and deeply personal to everyone. However, the most common reasons communicated to Dr. Harmon include, but are not limited to: Significant nasal tip asymmetry. Overly “pinched” nasal tip. Irregularities at the nasal bridge (dorsum). These irregularities include an inadequately reduced dorsal hump (pollybeak deformity), flattening of the dorsum (open roof deformity), and a collapsed nasal bridge (inverted V deformity). Problems breathing through the nose. The above features can often be improved. There are some features, however, that cannot reasonably be improved with any level of confidence. They include, but are not limited to: Minor asymmetries at the nasal tip and/or bridge. Headaches or other sensory concerns following surgery. Sinus inflammation and/or infection, chronic or recurrent. Dr. Jeffrey Harmon Evaluates Each Patient Thoroughly Prior to Considering Revision Rhinoplasty Surgery in Cincinnati, Ohio Dr. Harmon evaluates each person in consultation based on factors that include, but are not limited to: Anatomy Surgical history Time since previous rhinoplasty surgery Aesthetic goals for surgery Functional goals for surgery Psychological readiness which is largely dependent on an honest self-assessment from the patient There are Situations in Which Revision Rhinoplasty is Not Advisable The situations in which revision rhinoplasty surgery may not be advisable include when: The risk of problems with healing outweighs the potential benefit of revision rhinoplasty. The concerns of a patient are unlikely to be improved with surgery. The patient is not psychologically prepared to undergo rhinoplasty surgery again. Making the decision to advise against surgery is quite difficult. There are no guidelines recommending when to advise for or against revision rhinoplasty surgery. Facial plastic surgeons use their experience and expertise to make their best judgement thoughtfully and honestly. FAQ How long do I need to wait before undergoing revision rhinoplasty surgery? While there is no firm timeline, in most cases patients need to wait at least twelve (12) months from their previous surgery before revision surgery is considered. Can all rhinoplasty results be corrected? No, unfortunately, not all concerns can be addressed with revision rhinoplasty surgery, as previously discussed. Is revision rhinoplasty surgery riskier? Revision rhinoplasty is not necessarily riskier in the hands of a skilled facial plastic surgeon with good judgement. However, it is not always entirely predictable what will be found under the skin during surgery. This can affect what is achievable and how a patient can heal post-operatively. Generally, there is a higher risk of problems with healing after revision rhinoplasty surgery when compared with primary rhinoplasty. How many revision rhinoplasty procedures can I have? There is no specific number a patient is “allowed” to undergo. The decision to proceed with revision rhinoplasty depends on multiple factors, as previously discussed. However, the more rhinoplasty procedures a patient undergoes, the less predictable the results are. --- ### Male Rhinoplasty: Do the Goals and Techniques Differ from Female Rhinoplasty? URL: https://www.harmonface.com/blog/male-rhinoplasty-goals-and-techniques Published: June 26, 2026 Author: Dr. Jeffrey Harmon Categories: Nose Yes, the goals often differ between male rhinoplasty and female rhinoplasty, though the techniques utilized to achieve those goals are the same. What does male rhinoplasty prioritize? It is important to emphasize that there is no one, “male,” form or style of rhinoplasty. This is because there is no rhinoplasty surgery template. However, Dr. Harmon has found men who seek rhinoplasty at Harmon Facial Plastic Surgery in Cincinnati, Ohio often prioritize: Improvements in both the form and function of their nose. Continuity between nasal subunits rather than sharp distinctions between, for example, their nasal bridge and tip. Proportion with their face rather than an overall smaller nose. Men frequently seek rhinoplasty surgery . In fact, Dr. Harmon has written about his experience undergoing rhinoplasty surgery . Dr. Harmon, like many men he has met in consultation, sought both functional and aesthetic improvements in his nose . And he knows, both from his fellowship training and experience as a double board-certified facial plastic surgeon as well as being a patient of one that men tend to seek different results than women with rhinoplasty surgery. Their priorities differ, which is understandable and expected. The priorities of men regarding rhinoplasty surgery include, but are not limited to: A stronger, straighter nasal bridge A well-defined, not necessarily smaller, nasal tip Overall, from Dr. Harmon’s experience, men seek a preservation and even reinforcement of their traditionally “male” features. And, fortunately, the methods available to open the nasal airway and improve breathing often help achieve these aesthetic goals. They certainly did for Dr. Harmon. Does Male Rhinoplasty Require a Distinct Aesthetic Framework? Male rhinoplasty sometimes requires a distinct aesthetic framework. However, this cannot be assumed prior to consultation. Why is a distinct, albeit loose, aesthetic framework sometimes necessary? It is because: A surgeon cannot assume and unnecessarily limit their consideration of how to approach rhinoplasty surgery in men. A surgical plan tailored to an individual, male or female, after a consultation and physical exam will inevitably result in a plan that deviates from any strict conceptual framework. This is normal, natural and expected. That is why it is important to listen closely to each patient’s specific aesthetic goals. However, this does not mean there are generally and genuinely distinct desires between men and women that lends to a loosely held aesthetic framework for each. The reality is that a distinct, rigid aesthetic framework is not required. A framework is not developed and imposed on an individual, distinct from their desires. Rather, the framework arises from an evaluation of the general form of the male nose and from listening to and amalgamating common desires expressed among men seen in consultation. Dr. Harmon has noticed in his practice that men, more often than women: Seek improvements in both the appearance and function of their nose. Often, men first discuss their concerns with nasal breathing in consultation but then transition to discussing nasal aesthetics. This is normal and reasonable. Have functional problems associated with nasal breathing that are often the result of significant prior trauma, typically from playing school sports or from their job. In many – though, not all – cases Dr. Harmon has seen, there is a strong desire among men to avoid a distinctly “female” nasal appearance. For example, men typically do not request aggressive narrowing of their nasal bridge and tip. This is more often requested by women, in Dr. Harmon’s experience. However, there is real debate as to whether there exists distinctly “male” versus “female” nasal aesthetic features. Understanding what most men desire in their nose is simply a matter of listening to them closely. It is not a matter of applying a distinctly “male” template on their nose and forcing it upon them. Frequently Asked Questions About Male Rhinoplasty Is Rhinoplasty Common in Men? Yes, rhinoplasty in men is a very common procedure. According to the American Society of Plastic Surgeons (ASPS) 2024 Plastic Surgery Statistics Report , there were 48,423 reported cosmetic rhinoplasty procedures performed in the United States in 2024. Of those patients, 7,018 were reported to be men, or approximately 14.4% of the total number performed. This is a 2.2% increase compared with the previous year. Importantly, this statistic likely significantly undercounts the total number of rhinoplasty procedures performed on men because: This only counts members of the ASPS, who are largely general plastic surgeons who are often not performing as much rhinoplasty surgery as specialized facial plastic surgeons . This does not count patients who have undergone functional or both functional and cosmetic rhinoplasty surgery. Patients who seek both skew towards male patients, from Dr. Harmon’s experience. Will I Look Like I Have Had Rhinoplasty Surgery? Dr. Harmon’s experience, expertise, and surgical focus minimize the chances that a patient looks unnatural or “operated-on.” However, a patient’s perspective on what exactly looks natural may differ from the surgeon’s perspective. This possible discrepancy can sometimes, though not always, be determined during the consultation process. His surgical method , which reflects his practice’s values , is to treat patients in line with their actual anatomy and to strive for results that elicit a positive emotional response from the patient and others. How Does Recovery from Rhinoplasty Surgery Differ Between Men and Women? Recovery differs for every patient and does not necessarily reflect a difference between men and women. What Is the Most Common Request from Men for Rhinoplasty Surgery? Probably the most common request in rhinoplasty surgery Dr. Harmon receives from men is addressing significant deviation of the nasal bridge, which is typically associated with a dorsal hump and is often secondary to trauma. Why Choose Dr. Jeffrey Harmon for Male Rhinoplasty? Dr. Harmon is a fellowship-trained, double board-certified facial plastic surgeon with extensive experience performing rhinoplasty in men. He has undergone rhinoplasty surgery himself and brings that perspective, alongside his surgical training and expertise, to every consultation. If you are considering rhinoplasty and want to discuss your goals with a specialist, schedule a consultation at Harmon Facial Plastic Surgery in Cincinnati, Ohio. --- ### The Differences Between Treating Skin and Structural Facial Aging URL: https://www.harmonface.com/blog/skin-improvement-versus-structural-facial-aging Published: June 24, 2026 Author: Dr. Jeffrey Harmon Categories: General Information, Aging There can be confusion among some patients in consultation as to whether their aesthetic concerns are related specifically to changes in their skin or something else. That “something else” are the changes that occur to the deeper, multi-layered soft tissue of the face. This blog post seeks to explain the differences between treating the skin and deeper structural aging and to provide some guidance on appropriate sequencing of these procedures with Dr. Jeffrey Harmon in Cincinnati, Ohio. What is the difference between improving aged skin and treating deeper, structural aging? There is a significant difference between treating aged-related changes to the skin and addressing the structural changes to the multiple tissue layers under the skin. The two are often confused, because they can occur at the same time. In fact, it is not uncommon for an individual to present in consultation requesting a facelift to treat their wrinkles. It is important to know that this is a reasonable belief. Unfortunately, a facelift cannot treat facial wrinkles just as a brow lift cannot treat forehead wrinkles, a blepharoplasty cannot treat eyelid wrinkles, a lip lift cannot treat upper lip wrinkles, and a neck lift cannot treat neck wrinkles. To understand the difference between treating the skin surgically or non-surgically and structural, purely surgical lifting is to understand the evolution of facelifting techniques to the most modern form of deep plane facelift surgery . Skin treatment and facelifting are not interchangeable because, while lifting removes excess skin, skin treatments are intended to improve features of the skin surface without removing excess skin. How do I know whether to treat my skin or underlying soft tissue structure? This is largely determined in consultation with Dr. Jeffrey Harmon in Cincinnati, Ohio . He performs a detailed physical exam and listens to each patient’s aesthetic concerns. He also reviews each patient’s medical and facial plastic surgery treatment history to determine what procedures, surgical or non-surgical, they may benefit from. There are situations in which multiple procedures may be beneficial. There are other situations in which no treatment is advisable. Broadly, treatments that can improve the skin itself are mostly non-surgical with two exceptions. Those procedures that can improve the underlying soft tissue structure are entirely surgical. This is important to understand because it is common for individuals to present in consultation with Dr. Harmon and stretch their skin, which hides many deep wrinkles. They request surgery to do this. Unfortunately, surgery to simulate this is simultaneously impractical, unsafe, and distorting to the rest of the face. Table to understand procedures for skin improvement versus structural lifting The following table helps to clarify whether/what may benefit a patient, pending a consultation, thorough physical examination, and review of medical history to make sure there is nothing that would preclude a specific intervention: Condition/Concern Skin Treatment Option(s) Structural Treatment Option(s) Wrinkles CO 2 Laser Resurfacing Nano-fat/PRP Age-Sun Spots (solar lentigines) CO 2 Laser Resurfacing Nano-fat/PRP Scar CO 2 Laser Resurfacing Botox® Scar Revision Nano-fat/PRP Prominent Blood Vessels (telangiectasias) Pulsed Dye Laser (e.g. V-Beam) Droopy Cheeks Facelift Facial Fat Grafting Fillers Hollow Face Facelift Facial Fat Grafting Fillers Droopy Eyelids Blepharoplasty Eyelid Bags Blepharoplasty Facial Fat Grafting Hooded Eyes Brow Lift Jowls Facelift Turkey Neck Neck Lift Facelift Double Chin Neck Lift Neck Liposuction Facelift Hanging Upper Lip Lip Lift Note the difference between the conditions treated with mostly surgery and those treated with primarily non-surgical interventions on the skin. Treating skin conditions as well as underlying structural changes associated with aging can be complementary and part of a single, comprehensive treatment plan for a patient. How does Dr. Harmon sequence skin improvement treatments and structural lifting? The answer is complex and depends on multiple factors, as reflected in his general surgical philosophy . The following are some things that fit his practice pattern, though these are not absolute: CO2 laser resurfacing AFTER facelift, neck lift, and lip lift – Dr. Harmon prefers to perform laser resurfacing procedures on facial skin after surgical procedures such as a facelift, neck lift, and lip lift. It is important to emphasize that this is not based on specific evidence or a clinical practice guideline from an academy of medicine. Instead, this is because, if the laser resurfacing procedure is performed after surgery (approximately 6+ weeks postoperatively) then the incisions themselves can be treated, which may accelerate the healing process . Also, Dr. Harmon does not have to turn the laser power down over the small surface area of the skin-only lift around the ears as he would if the laser was performed during surgery. There are, however, exceptions made. He can perform laser resurfacing during surgery, understanding the above limitations, if it is the patient’s preference. It is also okay for patients to undergo laser skin resurfacing before surgery. However, a patient would need to wait approximately three (3) months after laser resurfacing to undergo facelift surgery. Regenerative medicine procedures IMMEDIATELY BEFORE skin laser resurfacing – The few (i.e. two) procedures Dr. Harmon offers that may fall under the regenerative medicine category, nano-fat and platelet rich plasma (PRP), are performed on the day of laser resurfacing, immediately before the procedure. He does not perform these procedures absent laser resurfacing and/or surgery. This is because one of the most important reasons for using nano-fat and PRP is to help with healing after the procedure. These substances are also placed around incisions after surgery to help the incisions heal, which is another reason to sequence combined nano-fat/PRP/laser resurfacing for after surgery. Botox® or other neuromodulators IMMEDIATELY BEFORE scar revision surgery – These non-surgical treatments are always administered immediately prior to, at the same time as, or by the first post-operative visit after scar revision surgery. The reasoning here is that Dr. Harmon suspects the primary benefit of this treatment is to minimize muscle contraction around the incision that can place tension on it and worsen the appearance of the new incision. Neuromodulators take approximately two (2) weeks to reach maximal effectiveness. He wants the medication to be effective for as long as possible as early as possible after surgery. Why is Dr. Jeffrey Harmon An Expert Both at Treating Skin and Deeper Structural Aging? Dr. Harmon is a fellowship trained, double board-certified facial plastic surgeon who is sought after nationally for his expertise and experience treating signs of aging in the face comprehensively. Dr. Harmon is a fellowship-trained, double board-certified facial plastic surgeon with extensive experience treating both skin and structural facial aging. His approach to comprehensive facial rejuvenation is rooted in understanding how these two categories of aging interact and how to address them in the right sequence for each patient. If you have questions about which treatments may be right for you, schedule a consultation at Harmon Facial Plastic Surgery in Cincinnati, Ohio. Book Your Consultation --- ### Septoplasty versus Rhinoplasty: What is the Difference? URL: https://www.harmonface.com/blog/septoplasty-versus-rhinoplasty-what-is-the-difference Published: June 2, 2026 Author: Dr. Jeffrey Harmon Categories: Nose A general Otolaryngologist (ENT) is usually the first person a patient sees when they have difficulty breathing through their nose in Cincinnati, Ohio. There are multiple causes of nasal obstruction. A deviated nasal septum is one possible cause. Repair of a deviated septum can often improve nasal obstruction. However, the cause of nasal obstruction may involve not only the septum but also the cartilage and bones that give the external shape to the nose. It is in those cases that the patient is usually referred to a sub-specialized, fellowship-trained facial plastic and reconstructive surgeon. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Septoplasty and Rhinoplasty are Not the Same Procedure, Which Matters to Patients Are septoplasty and rhinoplasty the same procedure? No, septoplasty and rhinoplasty are different procedures. However, they are often performed together. Both procedures are performed for the purposes of improving the appearance and/or function of the nose. What distinguishes the procedures and why does this matter to patients? The differences between a septoplasty and rhinoplasty matter to patients because these differences help frame expectations about the anticipated recovery and results from these procedures. A septoplasty is a surgical procedure whereby a portion of the wall — composed of cartilage and bone — sandwiched between the soft tissue composed of mucosa is removed. The purpose of a septoplasty is twofold: Remove a portion of the septum that deviates into one or both nasal cavities and causes obstruction that limits a patient's ability to breathe through their nose. Harvest cartilage and, sometimes, bone to use as a graft when performing rhinoplasty surgery. In contrast, a rhinoplasty is a surgical procedure whereby the shape of the external nose — including, but not limited to, the complexly shaped and oriented cartilage and bone — is altered. The purpose of rhinoplasty surgery is twofold: Improve the appearance of the external nose. Improve the function of the internal nose. In other words, the purpose of rhinoplasty is to make the nose look better and to make patients breathe better through their nose. The Septum is a "Wall" Composed of Cartilage and Bone The septum is a "wall" composed of cartilage and bone that separates the left and right nasal cavities. The septum starts at the front of the nose and ends at the back of the nose into a common opening called the nasopharynx, which sits above and is continuous with the throat. The front of the septum is primarily cartilage. This quadrangular cartilage supports the nasal bridge and tip. The back of the septum is composed of multiple bones that have fused together and which extend from the skull base to what is referred to as the "floor" of the nose. The Severity and Location of Deviation Contributes to the Severity of Nasal Obstruction A septum that causes nasal obstruction is usually deviated or curved from the midline. The deviated portion of the septum can be composed of cartilage, bone, or both. A septal deviation can occur due to trauma, or it can be the result of genetics. A septum can be deviated to one or both sides (i.e., S-shaped septum). The more severe the deviation to one side, the more likely it is to cause nasal obstruction. A septum can be deviated low, towards the nasal floor, or high, towards the nasal bridge. The lower the deviation is in the nose, the more likely it is to cause nasal obstruction. A Septoplasty Procedure Can Improve Nasal Obstruction Secondary to a Deviated Septum A septoplasty utilizes an incision inside the nostril to remove the deviated portion of the septum (cartilage and/or bone). Some cartilage is left behind at the nasal bridge and tip. This cartilage functions as a strut to minimize the risk of deformation of the nasal bridge and/or tip. A Rhinoplasty Can Address More Complex Causes of Nasal Obstruction In contrast, a rhinoplasty involves the manipulation of the complex of cartilage and bone that contributes to the external appearance of the nose. A rhinoplasty can be performed with all of the incisions inside the nostril in some, select cases . However, a rhinoplasty is performed utilizing a small incision at the base of the nose in most cases. The procedure can be performed to improve nasal breathing if these external components are narrowed and contribute to the nasal obstruction. A rhinoplasty can also be performed to improve the appearance of the nose. A Rhinoplasty and Septoplasty Can be Performed Together A septoplasty is often performed with a rhinoplasty not only to improve breathing but also to supply cartilage for grafting for rhinoplasty. Cartilage removed from the septum can be used as a supportive and shaping graft to improve nasal obstruction and/or the appearance of the nose. Double Board-Certified Facial Plastic Surgeon Dr. Jeffrey Harmon is a Specialist in Nose Surgery (Rhinoplasty and Septoplasty) It is very common for both septoplasty and rhinoplasty to be performed together, both to improve nasal aesthetics and function. Whether one or both procedures are performed and for what purpose(s) is determined by each patient's concerns and an evaluation by Dr. Harmon. The procedures are performed together when the cartilage and/or bone removed from the septum is used as a graft, placed in the external nose to open narrow areas that restrict airflow or to adjust the size and/or position of the: Nasal tip Nasal bridge To improve the appearance of the nose. Some patients seek the expertise of Dr. Harmon with concerns about nasal breathing. Others have concerns about the appearance of their nose. And still others are referred from general Otolaryngologists/Ear Nose Throat (ENT) surgeons for one or both of these concerns when they feel a surgeon who has advanced fellowship training specifically in facial plastic and reconstructive surgery is best-suited to treat them. Dr. Harmon sits down in consultation with each patient and listens to their specific concerns and desires. He then performs a detailed physical examination to determine what may be contributing to their concerns. Finally, he develops a personalized plan in collaboration with the patient to address their concerns. Frequently Asked Questions Can septoplasty surgery change the appearance of the nose? No, the purpose of a septoplasty is not to change the appearance of the nose. The area of surgery is located inside the nasal cavity, not externally. However, one risk of septoplasty surgery is that the appearance of the nose changes due to weakening of the structural support to the external nose provided by the septum. It is for this reason that either some of the structure of the septum is preserved, enhanced, and/or replaced during surgery to minimize this risk. Does insurance cover septoplasty? Yes, insurance generally covers septoplasty when the purpose of the procedure is to treat a deviated nasal septum to improve breathing. Will I need both a septoplasty and a rhinoplasty? No, you will not necessarily need both procedures. Dr. Harmon determines whether one or both procedures are most likely to address a patient's concerns through a detailed physical examination. How do I know which procedure I need? A consultation with a physical examination is required to determine the surgical approach. Whether surgery is advisable and which approach is advisable depends on multiple factors including, but not limited to, each patient's medical history, surgical history, and anatomy. What Nasal Breathing Symptoms and Aesthetic Concerns Mean for Patients Dr. Harmon evaluates each patient individually to determine what the anatomy actually requires, not necessarily what a patient assumes they need. This is especially the case for patients who present with difficulty breathing through the nose with or without desired aesthetic changes. It is common, for example, for a patient to arrive in consultation with a request for septoplasty surgery or a referral for septoplasty surgery from a general ENT. The patient may or may not have had imaging (e.g. CT scan) that supports their belief that a septal deviation is causing symptoms they are presenting with. The most important things to understand are what, exactly, their symptoms are and in what context. Are they having trouble breathing from one or both sides of the nose? Has this obstruction been present for many years, months, or only weeks? Is the obstruction constant or does it vary? If it varies, is there a potential cause, for example, changing seasons? Are they using medications administered nasally such as a steroid or oxymetazoline (e.g. Afrin®) that could potentially affect their nasal cavities? All of this information — and more — matters. This is because the nasal cavities are not simply a house with inert walls (i.e. sinus walls, septum) and a roof (nose). The soft tissue mucosa enveloping the nasal cavities consists of multiple layers including a surface that can swell or shrink with infection or allergens and submucosal blood vessels that swell and shrink cyclically throughout the day. There are some conditions that can lead to the perception of nasal obstruction despite largely patent nasal airways, possibly due to alterations in the sensory receptors in the nose that detect airflow and moisture. It is for the above reasons that a detailed history and physical exam is essential, not only because imaging findings do not necessarily reflect the level of actual obstruction but also because there may be other, more important factors at play when evaluating a patient. A patient may, for example, be seeking a septoplasty for headaches and/or chronic or recurrent sinus infections, neither of which should be expected to be treated by a septoplasty in most circumstances. Another patient may have been using intra-nasal oxymetazoline for months or years which has caused chronic swelling of the soft tissue in the nasal cavities and resultant nasal obstruction. Sometimes, for reasons unclear, the level of visible obstruction from the septum on a physical exam may not match a patient's reported symptoms. A patient may describe severe obstruction on one side but have septal deviation to the opposite side. Another patient may have severe septal deviation but report no nasal obstruction. Yet another patient may have nasal obstruction secondary to narrowing of cartilage and/or bone on the nasal bridge or unstable, collapsing nasal cartilage at the tip. Such patients may benefit from rhinoplasty surgery with a septoplasty only to harvest cartilage and place grafts that open these narrowed areas of the nose. Finally, for those patients seeking both functional improvement in nasal breathing and aesthetic improvements in the nose, there are times in which the aesthetic goals of rhinoplasty surgery partially or completely conflict with the maneuvers necessary to improve nasal breathing. For example, many people seek a smaller nasal bridge and a narrowed, more refined nasal tip for aesthetic rhinoplasty surgery. In contrast, treating nasal obstruction at the nasal bridge and/or tip often involves placing a graft to stent the nose open. While such maneuvers tend to have a minimal effect on the external appearance of the nose, they certainly do not narrow it. That does not mean, however, that nasal aesthetics cannot be improved at the same time as nasal breathing. The decision on how to proceed balancing functional and aesthetic surgery on the septum and nose is difficult. Dr. Harmon feels it demands the expertise of a fellowship-trained, double board-certified facial plastic surgeon who is a specialist in caring for the nose. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head and neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us --- ### Artificial Intelligence (AI) Filter Applications and Rhinoplasty: What Your App Cannot Tell You About Real, Achievable Results URL: https://www.harmonface.com/blog/ai-face-filters-rhinoplasty-real-results Published: May 29, 2026 Author: Dr. Jeffrey Harmon Categories: Nose Artificial Intelligence (AI) Filter Applications and Rhinoplasty: What Your App Cannot Tell You About Real, Achievable Results Do AI face filter applications provide realistic rhinoplasty results? No, AI face filter applications generally do not provide realistic rhinoplasty results, in my opinion. However, their popularity is understandable. Furthermore, these photos can sometimes be useful to facilitate counseling during a consultation for rhinoplasty surgery. Artificial intelligence (AI) photo filter applications have become increasingly popular. Altered photos have flooded social media feeds. The presumed intent of these applications is to alter our appearance in photos to achieve a specific aesthetic goal. Sometimes, the goal is to subtly smooth perceived skin imperfections. Other times, the goal is more transformative. For example, many filters create larger eyes and smaller noses on people. I, and likely many other facial plastic surgeons, have seen individuals in consultation who show photos of themselves that have been altered by these applications. The way they are presented in consultation varies widely, from a light suggestion meant to illustrate desires they are verbally communicating for rhinoplasty surgery to a demand for a specific appearance or “look.” AI Filter Application Results are Understandably Desirable, Sometimes Helpful, But Usually Unrealistic I believe that using AI to filter photos is understandable and not entirely different than wearing makeup, staging lighting, and/or positioning during a photo. That is why it is not bothersome to me when someone brings in these photos to help them communicate their aesthetic goals. In fact, the use of these images can be empowering for patients and even assist me during the consultation. However, it is essential to emphasize that the use of AI filter applications to alter the nose often gives a false impression of what can be achieved with rhinoplasty surgery . AI filters too often: Alter the nose in anatomically impossible ways. Alter the nose in ways that are not advisable to try to replicate surgically. This is why pre-operative counseling is so important. It is important to distinguish what is achievable from what is an unrealistic expectation. In a sense, these filtered photos better reveal a patient’s preferences and expectations than they ever could by simply verbally communicating them. In response, I communicate the more important concept of facial harmony and understanding anatomic limitations and natural-appearing, real-world results with rhinoplasty surgery to set appropriate expectations. The Nose is Like a Bridge Draped in a Blanket, Not a Sculpted Piece of Clay The most frequent mismatch between what patients seek and what is achievable is in the overall size of the nose. The size of the nose requested is often much smaller and narrower than what is advisable or even desirable aesthetically in the real world. The best way to understand why an overly narrowed, small nose is often not achievable is to understand nasal anatomy. Rhinoplasty surgery is not like sculpting a nose out of clay or carving it out of stone. A surgeon cannot alter any small portion of the surface area of the nose to a millimeter of precision with any reliability. Nasal anatomy simply does not allow this. A better way to conceptualize the nose is to think of a bridge draped in a huge blanket of varying thickness. The blanket represents the skin and can be thicker or thinner depending on the person. Changes made to the structures underneath thinner skin have more dramatic results but also reveal more imperfections. Conversely, thicker skin better hides imperfections but demonstrates less dramatic results, on average. The “bridge” underneath the skin “blanket” refers to the complexly shaped and oriented cartilage and bone underneath. Each component has its own structural qualities that make it stronger and less deformable in some areas and weaker and more deformable in other areas. The nasal tip also results from an interplay of soft tissue connections to the underlying cartilage framework that places it in tension with itself, like a bridge. Excellent Rhinoplasty Results Harmonize with the Rest of the Face in the Real World Excellent rhinoplasty surgery involves understanding how altering one area not only can result in a redistribution of force to change another area but also how changing one feature of the nose alters the appearance of nearby features. AI filter applications treat the nose more like a piece of clay to be sculpted than a bridge covered in a blanket. Finally, unlike a clay statue, the tissue layers of the nose need to heal after surgery, which can result in less predictable, though usually subtle, changes in the appearance of the nose over time. In summary, an over-reduced nose is not only not advisable from a structural standpoint – potentially leading to an increased risk of problems breathing and eventual collapse over many years – but is often not even possible to achieve. AI filters too often simulate such an “impossible” nose for people. Furthermore, as I have previously written , wide-angle lens cellular phone cameras make the face look wider than it is in proximity, which would make trying to achieve such a small, narrow look even less possible and riskier. Instead, I emphasize working to achieve a result that harmonizes with the face, is structurally sound, and looks good in the real world. Good surgical planning reflects more of the bridge draped in a blanket rather than a block of clay molded precisely to the heart’s desire. Frequently Asked Questions (FAQs) Regarding AI Filter Applications and Rhinoplasty Can I show my surgeon a filtered photo? Yes, a patient is free to show their surgeon a filtered photo if the surgeon is agreeable and it helps the patient explain their aesthetic goals. Please just be sure to make it clear to the surgeon that it is a filtered photo. And please understand that these results are highly likely to be unrealistic. Therefore, expect counseling from the surgeon as to why these results may be unachievable, what may be achievable, and why. Can rhinoplasty give me a smaller nose like my filter? No, while rhinoplasty can give patients a smaller, narrower nasal tip and a narrower nasal bridge, it is unlikely to be like the AI filtered photo(s) for the reasons discussed previously. How do I know what my results will look like? There are programs available that provide two-dimensional (2D) and three-dimensional (3D) simulations of possible results from rhinoplasty surgery. However, both types of programs still treat the nose like a block of clay rather than a bridge draped in a blanket. These simulation programs, while not as reflexively extreme as automated AI filters, should be taken only as a possibility and with a grain of salt. These programs are most useful to show patients how the more “extreme” changes sought can negatively affect facial harmony. AI Filter Applications Can Be a Starting Point but a Consultation with Dr. Harmon is Essential AI filtered images are a starting point for conversation, not a surgical plan. Dr. Harmon utilizes a physical exam rather than the output from an application to determine what is achievable, natural, and harmonious for each patient’s face. Contact the office today if you would like to sit down in conversation to discuss your aesthetic goals for your nose. --- ### Lip Lift Under Local Anesthesia: Precision Surgery Without the Bigger Commitment URL: https://www.harmonface.com/blog/lip-lift-under-local-anesthesia Published: May 20, 2026 Author: Dr. Jeffrey Harmon Categories: Lip For some, the transition from non-surgical procedures such as filler or neuromodulators like Botox® can be intimidating. They may have been primarily cared for at a MedSpa. The thought of undergoing surgery with a facial plastic surgeon may feel like a huge leap. They may associate facial plastic surgery with anesthesia, negatively. They may assume they need to undergo a facelift if they are to address their upper lip. The purpose of this blog post is to reassure patients that a lip lift can be a transformative and rejuvenating surgical procedure for those seeking effective, natural appearing surgical results without the need for a larger procedure requiring sedation or general anesthesia. This blog post is in direct response to MedSpa injectors inquiring into affordable surgical options for their patients. A Lip Lift Has a Much Lower Barrier to Entry Than Other Surgical Procedures A surgical lip lift has a much lower barrier to entry than other facial plastic surgery procedures. However, it is a precision surgical procedure performed by Dr. Jeffrey Harmon, a fellowship trained, double board-certified facial plastic surgeon who is an expert in the lip lift procedure. That is why so many MedSpas refer patients to him. A lip lift addresses multiple aspects of facial aging in the lip that filler and a non-surgical lip flip with Botox® and other similar medications do not. For example, a lip lift treats lengthening of the upper lip, a loss of natural tooth show when the lips are relaxed, thin red upper lips and – specifically with a corner lip lift – a steep drop off of the red lip with involuted skin at its lateral extent. The last feature can give the mouth a less happy, more frowny disposition at rest. The procedure focuses on the upper lip and the surrounding skin. As a result, no sedative medications, including general anesthesia, are required for it. Instead, only local/injectable numbing anesthesia administered by Dr. Harmon is required. This anesthesia lasts for many hours after surgery, making what is already a generally very comfortable procedure remain comfortable long after leaving the office. There is also an option for oral anesthesia administered with a pill that can help patients relax during the procedure as well. Dr. Harmon often notices patients so comfortable that they fall asleep to relaxing background music while he works. The above features of lip lift surgery change the calculus for many patients because of: Improved finances due to a lack of anesthesia fee No need for IV sedation medications for those who fear this type of anesthesia No need for IV sedation medication for those who are medically not a good candidate for this type of anesthesia Even better, expected post-operative bruising and swelling as well as suture removal tend to be limited in severity and time with lip lift surgery. A Consultation is Essential to Determine Candidacy for a Lip Lift The decision about who is a good candidate is complex and depends on a thorough evaluation by Dr. Harmon during a consultation. Factors that help determine candidacy for a lip lift include, but are not limited to: Lip skin length Red upper lip height Visibility of red upper lip from the center out to the most lateral margins of the mouth Amount of tooth show – visible central incisors – when the lips are parted at rest, also known as in repose Dr. Harmon’s approach to lip lift surgery reflects his general surgical philosophy . First, he considers every patient as unique and, therefore, requires a surgical approach tailored to their specific anatomy. For example, a patient may have a long upper lip but requires more conservative surgery due to some already present tooth show. Significant asymmetry in the upper lip demands specific surgical approach changes to improve this. Other patients may benefit from surgery that hides not only at the base of the nose – a subnasal lip lift – but also at the corners of the mouth – a corner lip lift. As important are the aesthetic goals of each patient which Dr. Harmon incorporates into planning every procedure. For patients weighing their options, Dr. Harmon has written in depth on how a lip lift compares to lip filler and whether a non-surgical lip flip is worthwhile. Book a Lip Lift Consultation in Cincinnati Take the first step toward your aesthetic goals with a personalized lip lift consultation in Cincinnati, Ohio. Dr. Harmon will listen to your concerns, answer your questions, and guide you through your options. Schedule your consultation today and discover how expert care can make a difference. Book Your Consultation --- ### Male Facelift vs Female Facelift: Key Differences Explained URL: https://www.harmonface.com/blog/male-vs-female-facelift-surgery-differences Published: May 18, 2026 Author: Dr. Jeffrey Harmon Categories: Face & Neck The differences between facelifts in men and women are few, which surprises many. After all, men and women share facial anatomy. Furthermore, the different anatomic features are a matter of degree rather than of kind when a surgeon encounters them during a procedure. In other words, many men display more traditionally “female” tissue qualities, and many women display more traditionally “male” qualities. Therefore, most of the typical differences encountered in the male versus female facelift are not strictly exclusive. The one difference that is real and significant, however, is the structure of the male versus female hairline and how it factors into surgical planning. This blog post is meant to cut through the often-exaggerated hype present in the broader health and wellness media landscape when it comes to the differences between males and females during facelift surgery. Goals of Female and Male Facial Surgery Both men and women want to preserve and enhance their facial features, not change them. The effects of aging tend to make women look more masculine as well as older. This is why the effects of age-related changes in women tend to look more severe sooner than in men. As a result, women planning to undergo facelift surgery seek a restoration and preservation of the more traditionally female facial aesthetics of their youth. Dr. Harmon feels that the effects of aging are more exaggerated in women compared with men everywhere but the neck, where changes are often much more significant in men relative to women. In fact, changes in the neck (i.e., turkey neck) are commonly the features that prompt men to seek the expertise of Dr. Jeffrey Harmon in Cincinnati, Ohio. Shared Goals in Male Facial Surgery and Female Facelifts In addition to lifting the neck , jawline, and cheeks, men want to avoid the same features that women want to avoid, including: An over-tightened, “pulled” look Stretched or distorted anatomy, especially around the mouth and eyes Highly visible incisions Men simply want to preserve their masculine qualities while restoring some of their more youthful, sculpted angles. Skin Thickness and Vascular Differences in Men Anatomically, men are more likely to demonstrate: Thicker skin More vasculature just beneath the skin, which can lead to more bleeding during surgery and after surgery Tight tissue confluences that need to be released in deep plane facelift surgery , which are thicker and wider However, this is not universally the case. Hairline Differences in Male vs Female Facelift Surgery What is usually the case is that incision visibility tends to be more acutely important to men because they usually wear their hair shorter than women. It is important to note, however, that facial incisions in men tend to heal particularly well and particularly quickly, likely because of the concentration of stem cells in facial hair follicles that women do not have. The differences in where incisions are placed between men and women are in front of the ear. First, men demonstrate more angular, longer sideburns, while women demonstrate a more gently curved temporal hair tuft higher in the temple. The facelift incision simply needs to accommodate this difference. Second, a decision needs to be made whether to carry the incision into the ear canal or in front of it. Taking the incision into the canal, as would be performed in women, hides more of the incision. However, this approach brings facial hair-bearing skin to an area where it did not exist previously. Dr. Harmon prefers to hide the incision in the ear canal unless an older facelift incision already sits in front. This allows the option for laser hair removal in the future, thereby negating the major downside of such an incision. Preserving Masculine Features in a Male Facelift Men, like women, want to look younger while preserving their distinct gender-related features. Other than minor differences in incisions, the reality is that the approach is identical. The best way to prepare is to have the skills and experience to anticipate and address the different range of tissue qualities that can be encountered in men. --- ### Menopause and the Skin: What Estrogen Does for Thickness, Elasticity, and Hydration URL: https://www.harmonface.com/blog/menopause-and-the-skin Published: May 6, 2026 Author: Dr. Jeffrey Harmon Categories: Face & Neck, Aging Patients who come to Harmon Facial Plastic Surgery are frequently concerned about sudden changes to their face after menopause. They feel their facial skin has become thinner, more wrinkled, and sagging within a year or two of experiencing their first symptoms, which are usually hot flashes. The negative effects on someone’s self-image and, therefore, self-confidence with these changes are profound, not the least of which because – at a median age of onset of 51 – women can now expect to live more than one-third of their lifetimes after menopause ( 1 , 2 , 3 ). In effect, they are expected to live decades of their lives post-menopause experiencing a host of difficult symptoms including, but not limited to, degradation of their skin quality. Menopause Symptoms are the Result of a Cessation of Estrogen Production by the Ovaries What changes occur after menopause and why? And could addressing these changes prevent or even reverse the rapid skin aging associated with menopause? Questions about skin health post-menopause are often dismissed by a medical community that: Understandably, is more concerned with other, more medically serious, non-aesthetic symptoms. Questions whether the benefits of treating the underlying cause of menopause outweigh the risks. The primary cause of menopausal symptoms, including skin aging, is a decline and eventual cessation of the production of estrogen by the ovaries ( 4 ). Other factors involved in skin aging include ( 5 ): Genetics Lifestyle (e.g. chronic unprotected sun exposure, smoking history, alcohol history, diet) The primary source of estrogen production in the body after menopause is in the body’s adipose (fat) but at much lower levels ( 6 ). As a result, women live with a significantly reduced level of circulating estrogen after menopause. The typical symptoms patients present to their physician with when they experience menopause are vasomotor i.e. nervous system symptoms such as hot flashes and sleep disturbances ( 7 ). Vasomotor symptoms usually last for approximately four (4) to five (5) years after the onset of menopause. However, there are many other symptoms of menopause that extend far beyond this timeframe. For example, a serious consequence of menopause is a steady reduction in bone mineral density that can lead to osteopenia or even osteoporosis ( 3 ). Both research and the experience of physicians suggest that skin aging is more closely associated with time after menopause than actual chronological age. In other words, a forty-five (45) year old female five (5) years out from the beginning of early-onset menopause may experience more severe skin changes than a fifty-five (55) year old female who has not yet experienced menopause, all else being equal ( 4 ). Key to our understanding of how menopause and the resultant significant reduction in estrogen affects the skin was the discovery that it contains estrogen receptors. Moreover, these receptors are particularly concentrated in the face when compared to skin in other parts of the body ( 6 ). To make matters worse, the concentration of estrogen receptors on the skin steadily declines after menopause, thereby reducing the ability of estrogen to perform its important signaling functions. Menopause Leads to Thinner, Looser, and Dryer Skin The post-menopausal state of estrogen deficiency leads to several rapid, time-dependent changes to the skin that lead to a breakdown in the skin’s “architecture”: The skin thins due to a decrease in the amount of collagen and the development of more disorganized collagen in the skin ( 1 , 2 , 5 , 6 ). The skin becomes less elastic and, therefore, looser due to due to a decrease in the amount of a structural protein in the skin called elastin ( 1 , 3 ). Loss of elasticity due to the loss of elastin is the most difficult thing to restore/improve when treating the skin. The skin becomes dryer due to a reduction in the number of water-loving molecules in the skin called glycosaminoglycans (GAG) (e.g. hyaluronic acid) and a weakening of the skin water barrier due to decrease in the sebum produced in the skin as well as a breakdown in the lipid (fat) content and composition of the skin. Dry skin is the most common skin complaint made by those experiencing menopause ( 2 , 5 ). The skin does not heal as well, in part due to a decrease in the rate and extent of formation of new blood vessels i.e. angiogenesis at injured sites on the body ( 1 , 2 , 6 ). The effect is thinner, looser, less stretchy, more wrinkled, dryer skin that may not heal as well or as quickly. Hormone Replacement Therapy (HRT) as Treatment for the Symptoms of Menopause How can skin changes be treated and/or prevented from occurring? This article will not weigh in on whether a specific treatment for menopause is generally appropriate or not. Specialized physician experts in menopausal health are best qualified to determine the most appropriate treatment for women experiencing menopause. There are complex tradeoffs associated with increasing the levels of estrogen in the body. In addition, aesthetic changes to the skin are probably the least medically important change associated with menopause. As a result, treatment for menopause is not indicated specifically to treat skin symptoms. Hormone Replacement Therapy (HRT) therapy for symptoms of menopause is not the area of expertise of a facial plastic surgeon. Therefore, advice should be sought elsewhere for it. HRT has been used to replace lost estrogen for many decades in post-menopausal women. However, the prevalence of its use has waxed and waned over the decades. For example, the use of HRT decreased dramatically in the early 2000s after concerns about an increased risk of breast cancer with HRT use were expressed by investigators in the 2002 Women’s Health Initiative (WHI) Randomized Controlled Trial. This study led to an FDA Black Box Warning to be placed on HRT. This warning was recently removed due to additional evidence suggesting the potential benefits outweigh the risks when given early enough after the onset of menopause and in appropriately selected patients ( 3 , 8 ). The reported benefit of estrogen replacement on the skin was a serendipitous discovery, like when an ophthalmologist discovered the aesthetic potential of botulinum toxin (e.g. Botox®) while treating eye muscle disorders ( 9 ). This observation led to a series of questions about the effects of estrogen replacement on the skin: Was the observation of a decline in skin quality associated with menopause and an observation of improvement in the skin on HRT associative or causative? In other words, do the estrogen levels in the body directly affect the skin or is there something else? The answer, based on the available research, is that estrogen deprivation likely greatly contributes, along with age, genetics, and lifestyle factors. Can estrogen reverse the effects of skin changes after menopause, or does estrogen simply slow the progression of skin changes ( 2 )? Estrogen is likely better at preventing changes than reversing changes. Also, the effects of smoking and extensive sun exposure may prevent estrogen from being beneficial to the skin in the first place. Does estrogen therapy in HRT need to be systemic (e.g. taken by mouth) or can it be topical, applied directly to the treatment site, thereby avoiding an increase in estrogen levels in the blood? Both are likely effective, though a treatment utilizing estrogen or an estrogen-like compound applied directly to the site of concern that minimizes changes in the blood levels of estrogen would likely be ideal. An FDA-approved treatment does not yet exist. Also, there is concern about what the adverse effects of applying estrogen directly to facial skin could be. What is the most effective dose and time course for treatment with estrogen? It is likely that higher doses for longer are more effective though this is not clear. All these questions have been studied, though no definitive, consensus-driven treatment using estrogen is available for the skin. Until such a treatment is available, there are multiple available treatment options for the aesthetic consequences of menopause that do not involve the use of HRT. This may because studies evaluating the above questions are not in universal agreement about the answers (10) Facial Plastic Surgery Procedures Can Treat Post-Menopause Changes to the Face and Neck There are many surgical and non-surgical treatment options for facial aging. Loose, hanging facial skin is generally associated with drooping of the deeper structures of the face that leads to larger volume shifts in the face. The best approach to address these three dimensional changes to the face is with a deep plane facelift and deep neck lift . It is important to discuss the use of HRT in surgical patients because the use of HRT does increase the risk of a post-operative blood clot, though to a highly variable extent depending on whether estrogen and progesterone are being taken together and whether the medications are taken by mouth or administered transdermal through a patch. Laser resurfacing procedures , including a fractional ablative CO2 laser, can be used to treat fine lines and wrinkles and some of the discoloration (dyschromias) and textural abnormalities of the skin. Laser resurfacing works by removing pigmented cells that cause discoloration and create better organized collagen in the skin. Laser resurfacing is often combined with regenerative medicine treatments such as a mixture of nano-fat and platelet rich plasma (PRP), which are injected into the skin to enhance healing and the effectiveness of the laser by helping to thicken the skin. For more on timing and what to expect, see our related post on facelift prior to menopause. Skincare is Important to Start Prior to the Onset of Menopause Both surgical and non-surgical treatments are available regardless of chronological age. This means that treatments are available earlier in patients experiencing more rapid, early to their skin post-menopause. Skincare, however, should start well before menopause, prior to any changes to the skin that may or may not be improved with HRT. Preventative topical skincare is essential to minimize the effects of skin aging. It starts with sun protection. The most important topical treatment for the skin is sunscreen, preferably a tinted mineral sunscreen with an SPF of 30 or greater. The second most important product is a moisturizer . The third most important product is a retinol or prescription retinoid (tretinoin) in those patients who have skin features that these medications may help address. Dr. Jeffrey Harmon is a Facial Plastic Surgeon and Expert in Treating Facial Aging Post-Menopause Skincare should be started long before menopause. Determining the appropriate surgical and non-surgical treatments for skin aging depends on a thorough consultation with a qualified surgeon who can discuss your aesthetic concerns and create a tailored treatment plan. This is important regardless of whether the patient has been placed HRT therapy or not. Dr. Jeffrey Harmon is a facial plastic surgeon who is fellowship-trained through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and board-certified through both the American Board of Otolaryngology – Head and Neck Surgery (ABO-HNS) and the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). Dr. Harmon is eminently qualified to care for your face as he is an experienced specialist and expert in the surgical and non-surgical care of the face and neck. References Brincat MP, Baron YM, Galea R. Estrogens and the skin. Climacteric. 2005 Jun;8(2):110-23. Shu YY, Maibach HI. Estrogen and skin: therapeutic options. Am J Clin Dermatol. 2011 Oct 1;12(5):297-311. Zouboulis CC, Blume-Peytavi U, Kosmadaki M, Roó E, Vexiau-Robert D, Kerob D, Goldstein SR. Skin, hair and beyond: the impact of menopause. Climacteric. 2022 Oct;25(5):434-442. Reus TL, Brohem CA, Schuck DC, Lorencini M. Revisiting the effects of menopause on the skin: Functional changes, clinical studies, in vitro models and therapeutic alternatives. Mech Ageing Dev. 2020 Jan;185:111193. Viscomi B, Muniz M, Sattler S. Managing Menopausal Skin Changes: A Narrative Review of Skin Quality Changes, Their Aesthetic Impact, and the Actual Role of Hormone Replacement Therapy in Improvement. J Cosmet Dermatol. 2025 Sep;24 Suppl 4(Suppl 4):e70393. Hall G, Phillips TJ. Estrogen and skin: the effects of estrogen, menopause, and hormone replacement therapy on the skin. J Am Acad Dermatol. 2005 Oct;53(4):555-68. Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T. Symptoms of menopause - global prevalence, physiology and implications. Nat Rev Endocrinol. 2018 Apr;14(4):199-215. Roster K, Fleshner L, Karatas TB, Ecanow A, Sayegh A, Farabi B, Marmon S. Menopause and Common Dermatoses: A Systematic Review. Am J Clin Dermatol. 2026 Jan;27(1):67-84. Archer DF. Postmenopausal skin and estrogen. Gynecol Endocrinol. 2012 Oct;28 Suppl 2:2-6. Miller VM, Naftolin F, Asthana S, Black DM, Brinton EA, Budoff MJ, Cedars MI, Dowling NM, Gleason CE, Hodis HN, Jayachandran M, Kantarci K, Lobo RA, Manson JE, Pal L, Santoro NF, Taylor HS, Harman SM. The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned? Menopause. 2019 Sep;26(9):1071-1084. --- ### Facelift Prior to Menopause: Does it Lead to Better, Longer-Lasting Results? URL: https://www.harmonface.com/blog/facelift-prior-to-menopause Published: May 6, 2026 Author: Dr. Jeffrey Harmon Categories: Face & Neck, Aging I try to follow the advice I give to my school-age children. When I explain how flashy, seductive advertising between their favorite shows is designed to capture their attention and encourage them to ask us parents to buy the products on offer, they look at me incredulously. They cannot imagine not taking whatever product is being marketed to them so effectively at face value. I implore them to ignore this advertising. Marketing works, especially when it is couched in a professional manner meant to seem authoritative. I see this method of marketing most frequently in my field of facial plastic surgery with the “What’s Trending” articles by health, beauty, and wellness publications. These articles often quote plastic surgeons and dermatologists who make declarative statements devoid of nuance. One such “trend” advertised is the concept that undergoing a facelift prior to menopause leads to better, longer-lasting results. There is No Rigorous, Quantitative Way to Determine Whether a Facelift Prior to Menopause is Superior to After Menopause Will a facelift prior to menopause lead to better, longer-lasting results? While a reasonable belief, there is no research that suggests an ideal window to undergo facelift surgery and neck lift surgery . There are simply too many other factors that affect age-related changes to the face and neck that are of equal or greater importance. These factors confound any study that could be done; meaning, it would likely be difficult to determine whether menopause itself – the level and length of time of estrogen deprivation – causes a facelift and neck lift result to be worse or last for a shorter period. Furthermore, what exactly could a clinical researcher measure to determine whether a facelift and neck lift are better or last longer? What would these results be compared against? These features are qualities to be judged by other humans, which makes doing rigorous research in facial plastic surgery so difficult . Estrogen Levels Influence the Quality of Facial Skin Estrogen does influence facial skin. A decrease in circulating estrogen is associated with accelerated thinning, laxity, wrinkles, and drying of the skin. Also, decreased estrogen may impair skin healing . However, estrogen levels drop gradually during menopause. As a result, skin changes associated with menopause exist on a spectrum rather than falling off a “cliff” at a specific point in time after menopause. It is likely more important whether a patient is early post-menopause – within approximately ten (10) years – or late menopause. It is also worth considering whether a patient is taking Hormone Replacement Therapy (HRT) or not within that early window. This is because it may be that changes to the skin associated with menopause are not as severe for patients early post-menopause who have maintained their estrogen levels through HRT. Lifestyle Factors are Likely More Influential Than Estrogen Levels on Skin Quality Lifestyle factors are likely a much more important influence on the effectiveness and longevity of a facelift and neck lift. These factors include: Genetics Cumulative unprotected sun exposure Smoking history Alcohol use history Diet Exercise Excess sun exposure and any smoking and/or alcohol use history can adversely affect the quality of the soft tissues of the face. Poor diet and exercise can not only do the same but also lead to excess weight which, when deposited across the face and under the chin, can mask what would otherwise be excellent surgical results. Deeper Tissue Has A Greater Impact Than Skin on Expected Surgical Results The most important thing to understand about facelift surgery and neck lift surgery is that skin quality is not the primary influence on the approach taken or expected results when the most modern, gold-standard surgical approaches are used. This is because with deep plane facelift and neck lift surgery a composite flap that includes not only skin but also fat, muscle, and fascia released from their deeper attachments and secured to the incisions under little-to-no tension. In contrast, older facelift approaches focus primarily on stretching and removing skin. As a result, excellent, natural-appearing results are achievable regardless of the skin’s appearance. The skin changes associated with menopause simply demand consideration of other, complementary procedures to improve the appearance of the skin after surgery, such as: Laser skin resurfacing with nano-fat and platelet rich plasma (PRP) Fillers Neuromodulators like Botox® The Idea of a “Preventative” Facelift and Neck Lift is a Myth Aesthetic medicine too often oversimplifies complex biology and packages it into declarative marketing language. Individual anatomy, regardless of age or menopause status, matters most. Complex three-dimensional changes to the face and neck can precede the skin changes that often accelerate with menopause. However, early prior to these changes is unnecessary. I believe the idea of a “preventative” facelift is a myth. At the same time, I believe that a pre-menopausal facelift is appropriate and beneficial in the right patient when changes in the anatomy, however significant or insignificant, demands it. That determination requires good physical examination during the consultation process. The Best Time to Undergo a Facelift and Neck Lift is Patient-Dependent The best time to undergo a deep plane facelift and deep neck lift is when: There are visible changes – however significant – to the face and neck Healing is optimized by discontinuing alcohol use, avoiding tobacco or nicotine, and treating low estrogen levels if post-menopause but only if indicated to treat other, non-aesthetic symptoms The patient is appropriately motivated for personal reasons as opposed to external pressure The patient has reasonable and appropriate expectations about the results The explanation above does not fit neatly into a piece of marketing material. The answer “it is complex” never does. However, such nuance is increasingly being demanded by the increasingly intelligent, informed public. --- ### Are Lip Fillers Permanent? Here Is What You Need to Know. URL: https://www.harmonface.com/blog/are-lip-fillers-permanent Published: April 28, 2026 Author: Dr. Jeffrey Harmon Categories: Lip Most people can recognize filled lips that look unnatural. Not only can they be obviously large, but also disproportional, with an upper lip as large as or larger than the bottom lip. These lips can also have a translucent quality and/or a “duck-lipped” exaggerated projection. It is reasonable to be concerned about whether the effects of fillers are permanent, especially considering the recent explosion of articles in wellness and beauty media about the potential persistence of hyaluronic acid fillers, which have been considered temporary. This blog post seeks to evaluate the evidence behind more recent concerns about the longevity of hyaluronic acid fillers, summarize the science behind hyaluronic acid fillers broadly, and discuss ways to achieve a long-lasting, more natural-appearing rejuvenation of the lips. Hyaluronic Acid Filler is (1) Chemically Bound and (2) Broken Down Slowly by the Body Hyaluronic acid filler dissolves in the body in much the same way our body’s own, natural hyaluronic acid dissolves . This process simply occurs more slowly because of how the manufactured hyaluronic acid filler products are chemically bound. The differences in chemical bonding explain the different properties, i.e., rheology of these products . Timing likely depends on the: Product Volume injected Depth of injection Location of injection Thicker hyaluronic acid filler products injected at higher volumes more deeply in areas with little movement likely last longer. Are Lip Fillers Permanent? Hyaluronic acid fillers may persist longer than previously believed in some instances. It is important to emphasize that there is a propensity for the media to be an echo chamber, amplifying stories with little context or appropriate analysis that are likely to generate attention. Furthermore, there is also a propensity for plastic surgeons to “ride” this wave of media coverage for their own exposure. I feel the discussion about the longevity of hyaluronic acid filler is one of many examples of this. How the Presence of Lip Filler is Identified. There are two ways that clinicians identify persistent hyaluronic acid filler in the face: Physical exam i.e. actually examining the patient. Imaging (e.g., Magnetic Resonance Imaging [MRI] and Ultrasound [US]) A skilled, experienced clinician who pays attention to the patient generally has a good sense of whether enough filler persists to still cause some fullness where the volume was added. However, especially when most of the filler has dissolved, this can become difficult if not impossible to visualize or even feel. Imaging can provide a more precise answer as to the location and amount of filler that remains in the face. Unfortunately, an MRI, while the best imaging modality to evaluate for the presence of hyaluronic acid filler, is expensive and time-consuming to perform. Ultrasound is much less expensive and easier to perform. However, it is more difficult to distinguish hyaluronic acid filler from surrounding tissue compared with MRI. What Studies Reveal About Lip Filler Life Span My review of the medical literature identified two case reports and one study evaluating the long-term presence of hyaluronic acid filler in the face ( 1 , 2 ). The papers were produced by the same author, which means the breadth of the research is very limited. Also, these studies consist of a limited number of patients in a series without randomization or controls. The studies utilized MRI. One case report identified hyaluronic acid filler in the cheek at 27 months (2 years and 3 months) after treatment without evidence of filler migration . A follow up study looked at 33 patients who received different types of filler at different volumes at least 2 years prior. Every patient was found to have residual filler at least 2 years after their last treatment. 12 of these 33 patients had fillers 5 or more years after their treatment. One patient had evidence of persistent filler 15 years after their last treatment. Why Lip Fillers Typically Do Not Last as Long in the Lips I believe many surgeons would agree that they feel hyaluronic acid filler can persist in the face longer than the reported 6 to 18 months that most manufacturers of hyaluronic acid filler report. This is not based on rigorous research, but our day-to-day experience using the products. I have noticed that hyaluronic acid filler products tend to last longer in areas with little-to-no movement like the cheeks and tear troughs and less time in areas with significant movement like the lips. What the above-referenced studies do suggest is that a more comprehensive, longer-term imaging study – preferably using MRI – would be worthwhile. Also, consideration should be given to being more conservative about the frequency and/or amount of refills or “top offs” administered because the persistence of small amounts of hyaluronic acid filler in the face coupled with too frequent administration of the product may contribute to the “pillow face” phenomenon . Treatment Options Beyond Lip Fillers for Long-Lasting Results An experienced and well-trained physician can evaluate patients based on the bigger picture and offer a range of options, surgical and non-surgical. For example, in many instances, a surgical lip lift can achieve desired results in the lips in a permanent, more-natural appearing manner. It can also facilitate more conservative volumes of filler in the lips geared to enhancing the results of the lip lift rather than being an end to itself . Final Thoughts on Lip Filler Longevity In summary, additional research is essential to confirm what we suspect is true about the rate of dissolution of hyaluronic acid filler in the face. It is equally important to emphasize that there is a disconnect between the sometimes-sensational way the media portrays issues such as this and what we experience as physicians. Healthy curiosity and skepticism, balanced with a calm humility, are in order. Moreover, less consideration of this may need to be given to hyaluronic acid filler products placed in areas with a great deal of movement, where it is noticed to dissolve more quickly, such as in the lips. Finally, hyaluronic acid filler is only one of multiple treatment options to achieve your aesthetic goals for the lip. References Master M, Azizeddin A, Master V. Hyaluronic Acid Filler Longevity in the Mid-face: My review of 33 Magnetic Resonance Imaging Studies. Plast Reconstr Surg Glob Open. 2024 Jul 15;12(7):e5934. Master M, Roberts S. Long-term MRI Follow-up of Hyaluronic Acid Dermal Filler. Plast Reconstr Surg Glob Open. 2022 Apr 13;10(4):e4252. --- ### Caring for the Face Before Surgery URL: https://www.harmonface.com/blog/caring-for-the-face-before-surgery-avoiding-surgery-like-results Published: April 20, 2026 Author: Dr. Jeffrey Harmon Categories: Face & Neck A Philosophy on Avoiding “Surgery-Like” or “Surgery-Lite” Results I see many patients in consultation seeking guidance on which treatments may be beneficial, either to delay the need for cosmetic facial surgery or to make more refined, incremental improvements until the time comes for surgery. It is important to understand that each surgeon has a unique experience and knowledge. Therefore, philosophies on caring for the face before surgery may differ. My philosophy is based on the reality that, while there are many effective treatments that can complement surgical procedures, chasing a “surgery-like” or “surgery-lite” result can often lead to frustration and even make future surgical procedures more difficult. Why “Surgery-Like” or “Surgery-Lite” Results Can Be Misleading For example, I have written extensively about my skepticism of the value of energy-based devices (e.g. ultrasound, radiofrequency) to treat skin laxity in younger individuals who are not yet ready for surgery. I generally advise most patients to hold off on these treatments and, instead, wait until it is time for surgery. Non-Surgical Treatments That Truly Complement Surgery There are two (2) non-surgical treatments that can complement future surgical treatments beautifully: Neuromodulators such as Botox® - This family of medications does what even surgery cannot. These medications can reduce the harsh contractions around the eyes that worsen with age. In fact, neuromodulators are an important component of cosmetic maintenance long-term, even after surgery to address facial aging, such as a deep plane facelift , neck lift , lateral temporal brow lift , and/or eyelid (blepharoplasty) surgery . Skin care – Skin care is essential and more important than the use of Botox® or other neuromodulators. But it does not need to be complex, despite what industry and influencers tell you. The components of a skin care routine often include, in order of importance. Sun protection – A mineral-based, tinted sunscreen of SPF 30 or greater is probably the most important component of any skincare regimen. Excess exposure to the sun increases the risk of skin cancer and accelerates skin aging. Importantly, we are not endorsing sun avoidance. Natural light serves many important purposes, including maintaining our circadian rhythm and helping our skin produce Vitamin D. Go outside but protect yourself from the excesses of the sun. Moisturizers – This is a family of ingredients that, among other things, absorbs water, retains water, and reinforces and repairs the skin barrier, all of which work together to maintain the skin’s moisture. Dry skin can become damaged, which accelerates aging. Retinoid/retinol – Tretinoin is the only Food and Drug Administration (FDA) approved treatment for skin damage from the sun i.e. photoaging. As a result, tretinoin is available by prescription only. A less regulated and less effective alternative is retinol, which can be purchased over-the-counter from many companies. Vitamin C (ascorbic acid) – Another popular ingredient in cosmeceuticals like retinol, Vitamin C has anti-inflammatory properties and photoprotection properties that are inferior – but complementary – to sunscreen. Light-Based Devices That Improve Skin Quality A family of devices worth considering prior to the need for surgery are used to improve the quality of the skin. These devices use light. Some of these devices use a spectrum of light to treat the skin. For example, LED light therapy uses red and near-infrared spectrum light to improve the appearance of the skin. These devices have been shown to be safe at the recommended dosing. As a result, at-home and in-office LED light therapy may be an effective adjunct to your skincare routine, though it should not replace it. Intense Pulsed Light (IPL) is an in-office device that utilizes a broad spectrum of light to treat conditions leading to redness and hyperpigmented (dark) spots on the face. Laser Treatments for Skin Aging Lasers , which are more powerful than LED light therapy and IPL, are diverse group of light-based devices treat skin conditions: Resurfacing lasers (e.g. CO2) – These lasers treat features of aging including fine lines, wrinkles, dark spots, large pores, and textural abnormalities. Vascular lasers – These laser target blood vessels by selectively heating hemoglobin, a component of blood. They are often used to treat abnormal blood vessels that contribute to redness in the face. Devices that utilize light to induce changes to the skin are an externally directed method to improve the appearance of the skin. Regenerative Medicine and the Future of Skin Rejuvenation A new, complementary series of treatments are in development that fall within the regenerative medicine category. These are treatments meant to repair, replace, and/or regenerate human cells. I have written about multiple categories of treatments, including exosomes . And while most of these treatments are not yet “ready for prime time” due to insufficient proof of effectiveness and/or insufficient establishment of their safety, there is one treatment offered at Harmon Facial Plastic Surgery that falls under the category of regenerative medicine, called nano-fat. The treatment involves the isolation of stem cells and cell signaling molecules from a patient’s own fat and the injection of this thin liquid into the deepest layers of the skin of the face. The purpose of nano-fat, unlike structural fat grafting, is not to add volume to the face. Instead, it is to improve the quality and, therefore, the appearance of the face. Early evidence for the effectiveness of nano-fat is promising, and its safety has been demonstrated. There are other promising treatments in the field of regenerative medicine that may be available within the next ten (10) years. Until then, consider nano-fat, which utilizes only the body’s own material. Preparing the Face for Surgery the Right Way In summary, there is no truly effective alternative to surgery when it comes to age-related changes in the face and neck. However, it is important to care for our skin long before surgery becomes necessary. Neuromodulators such as Botox®, effective skin care, LED light therapy, lasers, and regenerative medicine treatments, including nano-fat are all available to prepare for and complement the effects of surgery. --- ### Improving the Extended Deep Plane Facelift by Further Emphasizing a Composite Volume Lift URL: https://www.harmonface.com/blog/improving-extended-deep-plane-facelift Published: April 7, 2026 Author: Dr. Jeffrey Harmon Categories: Face & Neck As I have written about previously , the extended deep plane facelift has gradually become a gold-standard technique in facelift surgery. Importantly, the technique was not developed in isolation. Instead, the extended deep plane facelift is an improvement on deep plane facelift surgery which was, itself, first published over thirty years ago ( 1 ). The evolution of facelift surgery has been one of gradual, iterative improvements in technique in which the strengths of older techniques are preserved and the weaknesses are improved upon. This process has continued with the extended deep plane facelift ( 2 ). Further Emphasizing a Multi-Layered Volume Lift, Further De-Emphasizing a Skin-Only Lift Important improvements have been made to the extended deep plane facelift since the technique was first published approximately fifteen years ago ( 3 ). They have involved a reduction in the amount of subcutaneous dissection at the cheek and on the side of the neck, thereby reducing the amount of skin-only lift. As a result, a larger percentage of the dissection is in the deep plane, which is the connective tissue (e.g., Superficial Musculoaponeurotic System [SMAS]), and muscle (e.g, platysma muscle) that lies immediately deep to the subcutaneous fat. In effect, this approach further emphasizes the volume lift aspect of deep plane surgery. There Are Many Potential Healing Advantages to This Approach The potential advantages of this approach to extended deep plane facelift surgery include ( 2 ): Possible reduction in bruising Possible reduction in swelling Reduction of space in which blood can collect, possibly reducing the risk of and/or severity of a hematoma and/or a seroma Possible reduction in risk of skin color changes Possible improved healing at the incision site The basis for the above is the fact that a significant portion of blood flow to the skin comes from tissue deep to the skin. Therefore, if less skin is dissected, there is likely improved blood flow to the skin after surgery. Moreover, if less skin is dissected, then there is less space for blood and body fluid – called serous fluid – to collect. I have personally seen less swelling, less bruising, and reduced drain output utilizing these modifications to the extended deep plane surgery technique. There Is a Potential Results Advantage to This Approach Less skin dissection means a larger area of deep plane dissection. A larger area of deep plane dissection leads to more volume being lifted. This can provide more natural-appearing results across the cheek and improved results across the neck. First, increased volume immediately in front of the incision can better approach the natural contours of the face in youth. Second, the lift on the side of the neck can capture and lift more volume in the lower, central neck. In contrast, many older facelift techniques that emphasize a skin lift are more likely to result in a pulled, stretched, and/or “windswept” appearance and may have a higher risk of poor healing. This Modified Approach Remains the Extended Deep Plane Facelift Technique It is important to emphasize that these modifications preserve the basic idea of the extended deep plane facelift approach. This approach still extends the deep plane facelift into the neck. The modifications are not revolutionary but are important. They reflect a desire among many individuals to continuously innovate by thinking critically about their technique and evaluating ways in which they can improve results for their patients. References Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990 Jul;86(1):53-61; discussion 62-3. Roskies M, Bray D, Gordon NA, Gualdi A, Nayak LM, Talei B. Limited Delamination Modifications to the Extended Deep Plane Rhytidectomy: An Anatomical Basis for Improved Outcomes. Facial Plast Surg Aesthet Med. 2024 Nov-Dec;26(6):657-664. Jacono AA, Parikh SS. The minimal access deep plane extended vertical facelift. Aesthet Surg J. 2011 Nov;31(8):874-90. --- ### How Dr. Harmon Minimizes Risks and Maximizes the Benefits of Buccal Fat Removal URL: https://www.harmonface.com/blog/buccal-fat-removal-side-effects-what-to-avoid Published: April 7, 2026 Author: Dr. Jeffrey Harmon Categories: Face & Neck Media coverage suggests there is a recent trend among actors presenting with newly hollowed cheeks. While pure speculation, many of these individuals may have undergone surgery to remove their buccal fat. Whether they underwent buccal fat removal surgery or not, they often appear unnatural and gaunt. Buccal Fat Removal Side Effects: Why Some Results Look Hollow The appearance of hollow cheeks is likely due to either: Too much fat being removed. This risk can be mitigated by utilizing a gentle technique that inherently limits what can be removed. This technique also limits the already very low chances of damage to nearby structures (discussed below). Removing fat in individuals who have narrow cheeks already. This risk can be minimized with more careful consultation with the patient and a physical exam. Is Buccal Fat Pad Removal Safe? Understanding the Real Risks Dr. Jeffrey Harmon performs buccal fat removal surgery to reduce fullness in the cheeks of individuals who have a more rounded, cherubic appearance to their face due to the size of their buccal fat. This procedure can be performed without general anesthesia or even IV sedation. Moreover, the procedure is minimally invasive, with small incisions hidden in the mouth. As a result, there is widespread belief that there is effectively no risk to the procedure. But while risks are low, they do exist. Why Surgical Expertise Matters in Preventing Side Effects of Buccal Fat Removal It is important to seek the expertise of a qualified, experienced physician who is a fellowship-trained, double board-certified facial plastic surgeon to perform buccal fat removal surgery. This is because: There are important anatomic structures near the buccal fat. Long-term aesthetic changes to the face associated with age should be considered when performing buccal fat removal surgery. Critical Anatomy Involved in Buccal Fat Removal Surgery The three (3) major anatomic structures located within the space that houses the buccal fat are: Three (3) branches of the maxillary artery – the buccal fat has a very robust blood supply that needs to be accounted for when removing it. This is why some kind of cautery is necessary when performing buccal fat removal surgery. Parotid duct – the parotid duct is a large saliva-producing gland in the cheeks. A duct exits the gland, travelling through the buccal fat for a short distance before diving deeper to open in the inner lining of the cheeks near where the teeth meet when they contact. The opening of the parotid duct into the cheek is marked and avoided during surgery. Buccal branches of the facial nerve – the facial nerve branches from its origin in the face near the bottom of the ear and spreads out across the face and neck. The buccal branches cross the buccal fat close to its outside edge. This means, when the buccal fat is accessed on the deep side from the inner lining of the cheek in the mouth, that the nerve branches sit farther away from the incision. How Dr. Harmon Minimizes Buccal Fat Pad Removal Side Effects Ways to minimize the risk of damaging these structures include: Gentle dissection using a blunt instrument rather than sharp cutting. Marking the approximate path of the parotid duct and its opening into the cheek. Surgery can then be performed above or below this line. Gently easing the buccal fat out of the incision with external pressure and minimal pulling. The fat usually “gives itself” rather than being forced out like a magician pulling scarves from a shirt pocket. Limited bipolar electrocautery to cauterize the rich bed of small blood vessels without spraying electric energy and heat, which can bed achieved using a device that looks like tweezers to limit the focus of energy used to cauterize blood vessels. Buccal Fat Removal Long-Term Side Effects: What Happens Over Time? A common question patients pose is what the long-term effects of buccal fat removal surgery are. There are three (3) schools of thought: The buccal fat tends to increase in size with age. The buccal fat tends to decrease in size with age. The buccal fat remains the same size with age. The explanation tends to elicit laughs, understandably so. It speaks to the fact that we do not really know. It does suggest, however, a conservative approach that still provides natural-appearing results that are noticeable is the best approach. Furthermore, a conservative approach to buccal fat removal could account for any changes in the buccal fat that remains – and some does remain – over time. How Aging and Volume Loss Affect Buccal Fat Removal Results What we know does change is the fat in the more superficial compartments of the face . And it is the relative appearance of the cheeks when the surrounding fat falls and sometimes shrinks that can make the face appear gaunter. Solutions to falling superficial tissue include deep plane facelift surgery . Solutions for loss of superficial volume in the face include fillers and fat grafting . Speak With Dr. Harmon About Buccal Fat Removal Side Effects In summary , buccal fat removal surgery is a safe, effective procedure for patients who have large fat pads in this space contributing to a rounded, cherubic appearance. However, not all people are good candidates. And, for those patients who are good candidates, we do not know for certain what will happen to the remaining buccal fat over many decades. This suggests a gentle approach that does not remove all the fat is warranted, both to minimize the risks to the procedure and to maximize aesthetics. We do know that future procedures may be beneficial to restore the position and volume in more superficial compartments of the face , which could preserve and/or restore the aesthetics of buccal fat removal surgery. --- ### Five (5) Facelift Recovery Mistakes and How to Avoid Them URL: https://www.harmonface.com/blog/facelift-recovery-mistakes-to-avoid Published: April 6, 2026 Author: Dr. Jeffrey Harmon Categories: Face & Neck An optimal recovery from facelift surgery involves caring for both the mind and the body. Moreover, facelift recovery starts before the day of surgery. The following are five facelift recovery mistakes and how to avoid them at Harmon Facial Plastic Surgery in Cincinnati, Ohio. Facelift Recovery Starts Before Surgery Continuing the use of substances that can increase the risk of bleeding during and after surgery – It is important to, for example, discontinue the use of alcohol, supplements, and medications (e.g., NSAIDs like ibuprofen) that can increase the risk of bleeding during surgery and, therefore, impair healing after surgery. Poor nutrition before and after surgery – Optimizing recovery also involves optimizing nutrition before and after surgery to make sure the body is receiving appropriate macro- and micro-nutrients. Harmon Facial Plastic Surgery provides guidance on the general makeup of a diet that can help maximize healing after surgery. Tobacco or nicotine use before and after surgery – It is essential to avoid tobacco and nicotine (e.g., patches, gum, vape) use before and after surgery. The damage to tissue caused by nicotine and other components of cigarettes is significant . In fact, active smoking and/or nicotine use within approximately six (6) weeks of surgery is grounds for rescheduling surgery. Furthermore, it is essential to discontinue use of these products after surgery, preferably forever. Individuals who smoke and/or use nicotine-containing products are at a significantly higher risk of having healing problems, along with associated complications such as infection and abnormal scarring. Patients with a recent history of smoking and/or with a known history of problems healing due to a diagnosed medical problem may benefit from hyperbaric oxygen therapy (HBOT) treatment before and/or after surgery. Avoiding rest and being too active after surgery – There are restrictions on physical activity during the first two (2) weeks after, for example, deep plane facelift and neck lift surgery. These limits include: No lifting greater than 10 – 15 lbs to reduce strain on the surgical sites No bending below the heart (squatting is okay), which is meant to minimize swelling Sleeping with the head elevated (e.g., 2 pillows,) which is also meant to minimize swelling However, it is important to maintain some level of light activity starting one (1) day after surgery. Walking and other similar activities are encouraged. In summary, it is important to maintain balance between remaining active and overextending yourself after surgery. Avoiding the use of recommended garments post-operatively – Two garments are recommended following surgery, both of which are intended to be used day-and-night for the first week, followed by at night only for the second week: Compression socks, which are meant to minimize the risk of a blood clot post-operatively A compression wrap around the head/chin/neck, which is meant to minimize swelling and protect the incisions during the early stages of healing Managing Prolonged Swelling After Facelift Surgery The use of a face and neck garment and some of the activity restrictions above are intended to reduce post-operative swelling. There are two (2) other things that can be considered starting approximately six (6) weeks after surgery in the rare instances of prolonged post-operative swelling: Lymphatic massage – It is recommended to undergo massage by someone specifically certified in lymphatic massage Steroid injections – Considered as a potential option only in those with persistent, firm swelling to accelerate the decrease in swelling and only after a discussion of the potential benefits, risks, and alternatives --- ### From Puffy to Proportional: How to Avoid Pillow Face URL: https://www.harmonface.com/blog/how-to-avoid-pillow-face Published: March 6, 2026 Author: Dr. Jeffrey Harmon Categories: Face & Neck Most have seen it, even if they have struggled to describe what is so often uncanny about it. Commonly referred to as “pillow face,” it is the swollen and distorted appearance of the face due to the placement of too much filler, usually in the wrong location(s). Pillow face consists of: Overfilled, swollen upper cheeks near the junction with the lower eyelids, which can lead to the appearance that the eyes are narrowed and difficult to open. Overfilled, swollen upper lateral cheek, making the face look too wide. Overfilled, swollen lower cheek around the upper lip, which can make the face look aged. All three are important factors. The overall effect is an over-enlarged, upside-down triangle on either side of the face that looks unnatural and distorts the surrounding anatomy. It simultaneously makes patients look older because of the flattening of the ogee curve. The s-shaped ogee curve consists of the convexity extending from the junction of the lower eyelid and cheeks that then transitions to a concavity lower in the cheek near the upper lip from an angled view of the face. Drooping volume in the cheeks with age also flattens the ogee curve. The concern about pillow face is likely one reason for filler fatigue in some patients . Less Likely Potential Causes of Pillow Face Another, less likely explanation for pillow face is related to filler migration . Hyaluronic acid fillers can very rarely migrate into the lower eyelids and upper lip. It is highly unlikely that a significant amount of filler can migrate such that it is noticeable in, for example, the cheek. However, when filler does migrate into the lower eyelids and/or upper lip skin, this can also distort the appearance of the face near the cheek. It is also highly unlikely that an inappropriate product is the cause of pillow face, as the major brands producing hyaluronic acid filler are Food and Drug Administration (FDA) approved for the specific locations in which they are being injected. Pillow Face Filler: Recognizing the Red Flags There are multiple red flags that an injector should recognize that would suggest adding more fillers could cause or worsen pillow face: Importantly, a general recognition of what looks abnormal and/or unnatural. Such an aesthetic eye requires extensive training and experience. When someone requests ever more filler to address minor imperfections and/or asymmetries that they feel are related to previous filler injections. Again, what is too much is largely based on the experience and sound judgment of the injector. The extreme cases are easier to identify but occur less frequently. Obviously, measurable features such as flattening the ogee curve. As a reminder, a high-peaked, well-defined ogee curve is a sign of youth. Too much volume added low in the cheeks near the buccal space is highly likely to flatten this curve. Two (2) Ways to Correct Pillow Face Dissolve the filler in place using the enzyme hyaluronidase. Dr. Harmon prefers Hylenex® because it is modelled after the human form of the enzyme – as opposed to bovine (cow) – which makes it less likely to cause an allergic reaction. He sometimes needs to dissolve filler prior to deep plane facelift surgery because of the potential effects of filler on the appearance of facial anatomy during surgery . Rarely, and only in “extreme” cases, Dr. Harmon asks patients to take a “break” from filler for a period. The distortions associated with pillow face often creep up on individuals because they begin to forget what they looked like prior to treatments. This is because the development of pillow face is usually progressive, occurring over a period of months to years. Choose Dr. Harmon Most patients with pillow face would likely have been better served by undergoing deep plane facelift surgery and a neck lift . These procedures can actually lift fallen volume rather than simply adding more volume, which makes for a more natural, youthful appearance. Then, more conservative volumes can be added using, for example, the patient’s own fat . Alternatively, a lower volume of hyaluronic acid filler can be placed more selectively after surgery. Also, if the decision is made to use fillers, then a staged, gradual injection process is more appropriate in some individuals. In addition, it is important to establish a minimal time to wait between additional injections after aesthetic goals have been reached. Book Your Consultation If you’re concerned about facial volume loss or the appearance of pillow face, a consultation with Dr. Harmon can help you understand your options and determine the safest, most natural approach for your face. --- ### Does a Recent Study Show Surgeons Twice as Likely to Die Than Others? URL: https://www.harmonface.com/blog/study-shows-surgeons-twice-as-likely-to-die Published: December 10, 2025 Author: Dr. Jeffrey Harmon Categories: General Information “Physicians have twice the mortality rate of other physicians!” - anonymous facial plastic surgeon It was a shock to hear this on my first day at the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) conference in Los Angeles. Health and wellness are increasingly common topics at physician conferences. I heard about the importance of appropriate sleep, diet, and exercise frequently. One facial plastic surgeon even wrote a book on an anti-inflammatory diet which he had adhered to for decades. However, the exclamation above is what stuck with me. It refers to a recent article in the Journal of the American Medical Association (JAMA) Surgery that is purported to show that surgeons are twice as likely to die during a given year than other physicians. It certainly frightened me. But was it true? I reviewed the literature to find out. What I found was something much more nuanced but still shocking. Physicians Have an Overall Lower Mortality Rate than the General Population Patel V.R. et al published a paper in JAMA Internal Medicine titled “Mortality Among US Physicians and Other Healthcare Workers” as well as a clinical research letter titled “Mortality Among Surgeons in the United States” in JAMA Surgery ( 1 , 2 ). The team evaluated a newly created public database (National Vital Statistics System) and compared it to census data (US Census Bureau) to estimate mortality (death) rates. They compared groups by profession, income, gender, and ethnicity to look for patterns in the data. They found that physicians had a lower mortality rate than other healthcare workers (e.g. dentists, nurses) and other professionals with similar levels of education and income (e.g. lawyers, engineers, scientists). The survival advantage was even more stark when physicians were compared with individuals considered “middle” or “low” income and who are not in healthcare occupations. Surgeons Have a Higher Rate of Mortality from Cancer than the General Population The JAMA Internal Medicine study demonstrated lower mortality rates among physicians when compared with all other groups. This would seem to contradict the proclamations from my colleague. However, the picture becomes more nuanced with a deeper analysis of the data. Among physicians, surgeons have an approximately 56% - not twice – higher mortality rate than other non-surgeon physicians. Surgeons were more likely than other physicians to die from a motor vehicle collision, hypertension, assault, and cancer. This is significantly higher than other physicians but lower than other groups including non-physician healthcare workers, educated high-income professionals, and others. The picture still seems bright. The most interesting finding from this data was the mortality rate from cancer among surgeons. It was the major outlier. Not only were surgeons found to die from cancer at a higher rate than other non-surgeon physicians, but they were more likely to die from cancer than all other comparison groups, whether individuals with similar education levels and incomes (e.g. lawyers, engineers, scientists) or pooled together with individuals of all professions and income levels. The reason for this is not clear, though it is a major source of concern whose potential causes should be investigated further. There Are Real Limits to the Data Used in These Studies It is very important to note that the data available for these studies was limited by the fact that the database is relatively new. The review of causes of mortality among surgeons was only from 2023 data, while the larger study published in JAMA Internal Medicine consisted of data from 2020 to 2022. A clearer picture of mortality rates and their causes will develop as we gather more years of data. References Patel VR, Liu M, Worsham CM, Stanford FC, Ganguli I, Jena AB. Mortality Among US Physicians and Other Health Care Workers. JAMA Intern Med. 2025 May 1;185(5):563-571. Patel VR, Stearns SA, Liu M, Tsai TC, Jena AB. Mortality Among Surgeons in the United States. JAMA Surg. 2025 Sep 1;160(9):1032-1034. --- ### A Multi-Modal Approach to Addressing Aging Lower Eyelid Skin URL: https://www.harmonface.com/blog/addressing-lower-eyelid-skin Published: November 20, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes The skin of the lower eyelids can exhibit the following features with age: A loose redundancy resulting in bunching near the eyelash line at rest Fine lines and wrinkles extending down to the cheek Hyperpigmentation, which can sometimes be worse in the tear trough region A multi-modal approach to help address the above features should try to both maximize effectiveness and minimize risks. One example of such an approach is: Lower eyelid skin pinch Laser skin resurfacing Nanofat with or without platelet-rich-plasma (PRP) injections It is important to seek a consultation with a fellowship-trained, double board-certified facial plastic surgeon if you have questions about your lower eyelids . The Lower Eyelids are Composed of Multiple Layers of Mostly Thin Tissue It is composed of: Skin Muscles Conjunctiva Fat Connective tissue. It is among the thinnest tissues in the face. The Lower Eyelids Serve Important Functions This part of facial anatomy serves important functions, contributing to: Eyelid closure Tear distribution across the eye The risks of treating this part of the face include, but are not limited to, the following: Scaring Infection Damage to the eye Incomplete eye closure The skin is relatively thin and functionally important. As a result, interventions on the skin of the lower eyelids should be more gentle than on other parts of the face. Therefore, improvements of the skin in this area should be expected to be less dramatic than in other areas of the face. A Multi-Modal Approach Can Increase Effectiveness and Reduce Risks Each of the above procedures can help address aging of the skin in this area through a different mechanism: Lower eyelid skin pinch. Some patients demonstrate redundant skin immediately inferior to the eyelash line. A small amount of this skin is pinched immediately inferior to the lower eyelid eyelash line, extending just past the lateral edge of the eyelid and into a natural fold. The purpose of a skin pinch procedure is to reduce some of the skin bunching that can occur near the eyelash line with rest. Importantly, the muscle controlling the lower eyelid will always contribute to bunching of the tissue in this location when contracting (e.g. speaking, smiling, eyelid closure). Skin resurfacing, which can include lasers, chemical peels, and/or dermabrasion The purpose of these procedures is to ablate a certain depth of skin – usually micrometers – and allow it to heal with the intention of improving the organization of collagen fibers in the skin. Dr. Harmon utilizes a fractional ablative CO2 laser, which delivers laser energy in microcolumns to the skin. Untreated skin is left between these microcolumns. This untreated skin supplies cells and signaling molecules to improve the healing process. Injection of Nanofat and/or PRP. Nanofat involves harvesting fat from the patient’s body, processing it into a thin liquid with components including stem cells, and injecting it immediately under the skin in the lower eyelids. PRP involves drawing blood from the patient and isolating platelets from the blood and injecting them under the skin as well. While neither are Food and Drug Administration (FDA) approved treatments for skin, they both use products from the patient’s own body for treatment. The purpose of injecting one or both of these materials in the skin of the lower eyelids is to help improve skin quality by delivering a concentration of the patient’s own stem cells and signaling molecular to areas of injection. A Consultation With a Fellowship-Trained, Double Board-Certified Facial Plastic Surgeon is Advised A consultation with an experienced, qualified facial plastic surgeon is advised to determine whether patients are candidates for one or more of the above procedures. The procedures can be performed together or separately. And while many patients are satisfied with one laser treatment session, more than one laser treatment may be required for optimal effect. Finally, some patients demonstrate other changes to the lower eyelids such as bags caused by protruding (i.e. pseudo herniated) fat. A full lower blepharoplasty can be performed on these patients who are candidates. --- ### A Museum of Wonder: The Lloyd Library of Cincinnati, Ohio URL: https://www.harmonface.com/blog/explore-the-lloyd-library-with-dr-harmon Published: November 17, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The building is a narrow-windowed, red-brick, monolithic structure on the corner of Plum St. and W. Court St. in downtown Cincinnati. It looks like an abandoned public library from the 1970s. Its appearance is especially stark when contrasted with the distinct, stately Cincinnati City Hall, Isaac M. Wise Temple, and Cathedral Basilica of St. Peter in Chains which are all nearby. However, appearances can be deceiving. This building, the Lloyd Library, is one of the most interesting and largest repositories of pharmaceutical information and old botanical texts in the country with over two hundred thousand books. It is a rare gem and something the city should be proud to showcase. Many say the Lloyd Library is better known outside of Cincinnati, which I can imagine. Its primary use is by those interested in the medicinal properties of plants. Its history harkens back to a fascinating time in which the practice of medicine in the United States was standardizing, professionalizing, and advancing in its understanding of disease and disease treatment. Its history is exemplified both by the library's founder, John Uri Lloyd, and the institution he was most closely associated with, the Eclectic Medical College of Cincinnati (EMI). The library also revealed a couple of interesting stories that were very personal to me, as will be discussed at the end of this post. It is important to note that most of the general history below came from the books John Uri Lloyd: The Great American Eclectic by Michael A. Flannery and A Profile in Alternative Medicine: The Eclectic Medical College of Cincinnati: 1835 – 1942 by John S. Haller. Medical Education was a Free-for-All in the United States in the 19 th Century Medical education was largely a free-for-all in the United States in the 19 th century. There was a great deal of variability in the quality of the medical schools themselves as well as post-education apprenticeships in hospitals. Few medical schools were affiliated with a college or university hospital. There was an overreliance on classroom learning rather than clinical exposure. Medical schools were almost entirely profit-driven, with a board of directors paying dividends to investors. As a result, medical schools were less likely to be mission-driven endeavors with a broader social goal. Furthermore, medical licensing post-apprenticeship was lax and enforced variably by states. This is the historical context in which the EMI was founded. It was also when John Uri Lloyd would begin his teaching and research. Competing Sects of Medicine Arose in Chaos The medical profession was regarded poorly in the 19 th century. The dominant sect then and now, allopathic medicine, derived its legitimacy from its lineage to the historically dominant European models of medicine. Allopathic medical schools graduate physicians with "M.D." after their name. Then and now allopathic physicians dominate staffing at most hospitals, state medical societies, and state board examiners. Despite this, allopathic physicians practiced medicine in a way that was widely considered barbaric. Their "cures" included bloodletting, cupping, and blistering. These brutal treatments extended back to antiquity. Alternative sects arose in response to the dominance of allopathic medicine. Models such as homeopathic medicine and Thomsonism emphasized different methods of diagnosing and treating disease. For example, homeopathic medicine emphasized plant-based therapies and the concept of "like cures like," which is a belief that treatments that induced a symptom such as fever in a healthy individual could treat a fever in an unhealthy individual. Thomsonism encouraged patients to manage their own medical care using home remedies. The eclectics also emphasized plant-based treatments that were gentler on patients and intended to target specific symptoms of disease, though not in the manner of "like cures like." The problem with all these alternative models of medicine is that none focused on diagnosing and treating diseases themselves. Remember, this era of medicine preceded the germ theory of disease. The Eclectic Medical College of Cincinnati (EMI) Is Founded in the 1820s and Grows Rapidly It was in the above context that the EMI and later the Lloyd Library were founded in Cincinnati, Ohio. No longer present, the EMI building was caddy corner to the current location of the Lloyd Library. The EMI originated in New York City, though the school migrated to Columbus and then Cincinnati. It was a disreputable institution in its early years because it was focused on promoting the prescription of "green drugs" developed by a professor that were ineffective. It took Dr. John Milton Scudder, who led the EMI from 1861 – 1894, to improve the EMI's reputation. Dr. Scudder dropped "green drugs." He replaced them with "Specific Medications" developed and produced through a relationship with the pharmaceutical manufacturer H.M. Merrell and Company in Cincinnati. Specific Medications were produced with more consistency in purity and concentration. They were also more effective, though likely not in the same way, for example, ibuprofen improves pain, or an antibiotic eliminates bacteria. The EMI had the largest medical school enrollment in the United States during Dr. Scudder's time as head. It was also during this time, in 1878, that Dr. Scudder hired the pharmacist John Uri Lloyd, the Lloyd Library's namesake, to be the professor of chemistry and pharmacology. John Uri Lloyd was an Academic, Research Pioneer, Businessman, and Popular Author John Lloyd, a native of Northern Kentucky through-and-through, was the most reputable and financially successful professor the EMI ever had. While he was intimately linked to the EMI locally his professional and academic reputation was international and independent of the reputation of the school. To understand John Lloyd is to understand his library. He became one of the most respected professors by students soon after he started teaching. It was with John Lloyd's assistance and that H.M. Merrell and Company would produce Dr. Scudders "Specific Medications." H.M. Merrell and Company would become Lloyd Brothers Pharmacists, Inc. in 1885, owned and managed solely by John and his brothers. This would be the primary source of family wealth. It is remarkable how well each of the Lloyd brothers fit into their roles. John Lloyd was the head of the company as well as the head of research and development. His older brother, Nelson, was the business manager. His younger brother, Curtis, was probably the most interesting. The consummate playboy, he was tasked with traveling the world collecting specimens as well as rare books and texts for what would eventually become the Lloyd Library. I would later learn that these texts included books on the occult, alchemy, and other pseudoscientific endeavors. A shelf in the library displays a hilarious series of two photos of Curtis in what may be, according to the librarian on our tour, one of the first memes ever created, albeit unintentionally. Curtis Loyd died unmarried and without kids. His estate still funds the maintenance of the Lloyd Library to this day as well as research grants to artists and scientists. John Lloyd not only produced the medications eclectic physicians were prescribing, but he also co-authored American Dispensary , which was the eclectic answer to the US Pharmacopeia ( USP ), the primary, allopathic repository of pharmacological information in the United States. John Lloyd's other contributions to pharmacological academic literature were significant as well. Interestingly, elixirs were a craze during this time. Elixirs were mass-produced and marketed mixtures of diluted substances purported to have medical benefits, but which were fraudulent. Little-to-nothing was known of their composition, purity, and concentration. John Lloyd wrote Elixirs: Their History, Formulae, and Methods of Preparation in response to this craze to establish some empirical rigor to the production of these mixtures, which was harming his business and patients. He won the highest award in pharmacology research, the Remington Honor Medical, three times. He advanced research in colloidal chemistry and capillarity in drug development almost 50 years prior to the validation and application of these methods in the production of pharmaceuticals. He discovered a buffered alkaloid called fuller's earth that allowed medications to be functionally preserved and absorbed in the gut, thereby allowing oral administration of some medications. And, late in his career, the significance of his expertise came full circle when he was invited to contribute to the USP itself. His company produced numerous medical patents, the most important of which was a cold sill extractor that allowed for the extraction of compounds from plants without using heat. This was thought to better preserve the structure of plant medicinal compounds. The cold sill extractor was in use in industrial pharmaceutical manufacturing until the 1960s. There is an original cold sill extractor in the library. It is much smaller than I would have expected it to be. John Lloyd was not only a businessman and academician, but also a famous writer. In fact, he used money earned from his fiction writing to fund the purchase of texts for the Lloyd Library. His only novel that remains in print is called Etidorpha . It is a fantasy novel about a man's run-in with a mysterious being and their journey to the center of the earth. I have heard it is not a particularly good book. However, it remains popular with occultists due to its broader themes of hidden worlds filled with secret knowledge. The original illustrator for Etidorpha was the Cincinnatian J. Augustus Knapp. It is worth looking up these drawings as well as others he drew for occultists. They are haunting and mysterious. Some suspect this book, which is filled with anthropomorphic fungi and other strange visuals, indicates that John Lloyd experimented with hallucinogenic plants. Many well-known authors were fans of the Etidorpha , including the famous horror writer H.P. Lovecraft. John Lloyd also wrote a series of popular novels referred to as the Stringtown Series. The Stringtown Series was of the "color stories" genre popular in the United States at the time. They can best be thought of as that era's Young Adult (YA) novels. Color stories were typically set around the Civil War and emphasized regional dialects and made distinct cultural references that were fast disappearing in an industrialized nation. His success led to his recruitment into government and politics. He was a fishing buddy of President Grover Cleveland. He was a vocal proponent of the National Pure Food and Drugs Act, which was passed in 1906 and was the precursor to the Food and Drug Administration (FDA). He was sent by the United States Department of Agriculture (USDA) and the Smithsonian Institue to investigate plant-based medications. He was a member of the grand jury that helped clean up politics after the fall of the famous boss George Cox political machine in Cincinnati. And he was even asked to be the Democratic candidate for mayor of Cincinnati, which he refused. Unlike John Lloyd, the EMI Failed to Evolve With the Times John Lloyd's career thrived despite the gradual decline of the EMI. The EMI, and eclectic medicine generally, disappeared for many reasons, not the least of which was its failure to keep up with the reforms to medical education sweeping North America in the early 20 th century. These reforms were pioneered by a man named Abraham Flexnor. Born in Louisville, Kentucky, Abraham owned a medical school but was not a physician himself. He was commissioned by the Carnegie Foundation at the request of the American Medical Association's Council on Medical Education (CME) to review the state of medical education in the United States and Canada. This was significant because the CME was, and remains, a powerful force in the education of medical students, residents, and physicians to this day. It is also significant because the dominant allopathic medical sect dominated the CME, thereby virtually guaranteeing the demise of the eclectics. The CME was the first to recommend the now-standard 4-year medical school curriculum consisting of 2 years of pre-clinical scientific study followed by 2 years of clinical rotations. The Carnegie Foundation released the Flexnor Report in 1910. The report advocated for more rigorous admissions and graduation standards. For example, most medical schools did not even require an undergraduate education prior to matriculation. It advocated for centralizing medical schools in universities with the model being Johns Hopkins University in Baltimore, Maryland. It advocated for state medical boards to be more selective in who they licensed. Finally, it demanded that medical school professors be hired full time and engaged in scientific research like the German medical training model. My wife and I recently attended the Lloyd Library's exhibit American Medicine at a Crossroads 1820 – 1910 . A glass case held two documents. The first was a map of the United States with all the medical schools marked. The second was a map of the United States with the anticipated number of medical schools after implementation of the Flexner report. The density of dots on the second map was less than half the first. It was astounding. The Flexner Report's implementation through the CME effectively led to the closure of the sectarian medical schools, including the EMI, while preserving the dominant allopathic medical schools, albeit reformed in their traditional methods of treating disease Fara and me at the Lloyd Library for the American Medicine at a Crossroads 1820 – 1910 exhibit It was clear in hindsight that the EMI, and sectarian medicine in general, would not survive the reforms recommended in the Flexnor Report. The EMI did not pursue an affiliation with a university hospital. It did not invest in research facilities for professors and students. It was late in making pre-medical education requirements more rigorous, waiting until 1911 to require a college degree prior to admission. And, despite multiple attempts, the alumni were not forthcoming with donations, presumably because of the stigma associated with being from the eclectic medicine sect. Most alumni wanted to hide this fact and blend in with the broader allopathic medical system. In the end, the EMI would never receive the necessary designation from the CME that would have allowed the institution to receive public funding or even allow their students to gain admission to formal residency training. In fact, the CME considered the EMI functionally "extinct" starting in 1920, 22 years before the closure of the institution. The EMI's last graduating class was 1939. The school closed for good in 1942, when the library and school records were transferred to the Lloyd Library, where they still exist today. The improvements made to medical education by the CME were vast and important. However, I wonder whether something was lost with this process. I wonder whether some wisdom from the eclectic sect of medicine has relevance today. For example, John Lloyd himself argued that the new, more stringent education requirements would likely discourage individuals from pursuing a career as a local family physician in a small town. This is absolutely something we are having difficulty with today. Many are asking whether four years of medical school is necessary, specifically the two pre-clinical years. Furthermore, we may be missing some potential breakthrough medications by not establishing a more robust investigation of potentially therapeutic plant compounds. A short search online of research institutions focused on the medicinal properties of plants identified only The Appalachian Natural Products Research Program at Marshall University in West Virginia as well as programs at the University of Kansas, The Ohio State University, and Emory University. One of the earliest effective chemotherapeutic medications, paclitaxel, was isolated from the Pacific yew tree during government-funded research on therapeutic plant compounds in the 1960s. The Lloyd Library has an instrument on display that was first used to isolate this compound. What potential breakthrough medications could be in our backyard? The Lloyd Library Revealed Two Personally Significant Stories The Lloyd Library contains two personally important pieces of history. First, I discovered that the medication diphenhydramine (Benadryl®) was developed in Cincinnati. This was one of the medications that saved my son's life when he experienced an anaphylactic reaction. I found the second piece of history in a display that felt a bit out-of-place next to the many photos of John Lloyd and his brothers. The glass display included a photo of a man, his admission letter to medical school, and a small note. His last name was Khory, which, according to my Arab friends, is likely of Lebanese origin. I assumed his background made the letter significant as non-whites were unlikely to be admitted to medical school in the 1930s. A note next to the admissions letter explained that this physician founded an allergy practice in Cincinnati ( Cincinnati Allergy & Asthma Center ), that his daughters took it over, and that their sons subsequently took it over. I soon realized that the physician displayed was the grandfather of a person who is not only my son's allergist but also my high school classmate. I reached out to him, sending him a photo of the display. Not only had he never seen this but none of his family knew this display existed. The text exchange between my colleague and I regarding his grandfather's medical school admissions letter The Lloyd Library Evoked a Sense of Wonder in Me The Lloyd Library is a fascinating place. Most museums are, in my opinion. But I wondered why it felt so special despite its undistinguished appearance. I think the answer is because of the sense of wonder the library engendered. The Lloyd Library is filled with an incomprehensible number of exotic plant specimens and old books that reference a now-extinct sect of medicine in addition to other esoteric subjects. I felt like I had come upon an intentionally hidden repository of information. I have experienced this feeling twice before. The first experience occurred fifteen years ago when I was traveling in Paris shortly after college. I had just completed a year teaching at Weil Cornell Medical College in Doha, Qatar. I was ready and open for an adventurous summer before returning to the United States and medical school. I was invited by a friend from Cornell to visit their favorite museum in the city, a pathological specimen collection housed in a medical school. I cannot remember the medical school and, when doing a cursory search, found that at least two of them have shut down since I visited in 2010. The collection of glass jars filled with diseased organs and body parts – including heads – was housed in an old room within the campus. There was no front desk, only an employee available to take money to peruse the collection. It was of obvious interest to me as a soon-to-be medical student. But, as importantly, I felt like I was one of the few people in the world to have discovered this discreet institution. The displays reflected their age. While well-maintained they displayed labels from the 19 th and early 20 th centuries. The specimens contained there must have felt like a repository of esoteric knowledge to those who witnessed it when it first opened. Remember, this museum opened at the same time as the EMI was educating students and John Lloyd was making advances in the field of pharmacology. Those who created this space knew much less than we do now about the diseases these patients suffered from. I felt like I was in the Restricted Section of the Hogwarts Library. A statue at the pathology museum I visited in Paris, France. Notice all the crates stacked around it. This pathology museum was not well-attended. I have sought out similar institutions in the cities I have visited. One such institution is in Los Angeles, California, a city we visit frequently for family. The Museum of Jurassic Technology is part art-installation, part museum, and part cabinet of curiosities. The traditional German name given to a cabinet of curiosities is w underkammen , or house of wonder. These institutions were rooms filled with collections of strange and exotic specimens collected by wealthy patrons who had originally housed them in a private collection. While some of these specimens were real, many were not. In fact, it was often difficult to tell which were real and which were not. They were popular pre-Renaissance and prior to Enlightenment era concepts of empiricism and truth seeking using the human senses that resulted in the transition from these wunderkammen to the modern, public museums we have today that started in the 19 th century. The front entrance to The Museum of Jurassic Technology in Los Angeles, CA The building itself is a non-descript storefront on a busy street in Culver City. The website appears to be a relic of the late nineties and early 2000s, with grainy, incongruous text and little in the way of actual information about the place. The interior is relatively small and filled with winding paths bathed in dim, warm light. Old microphones with a quiet voice on the other end describe the displays, each of with is filled with old documents, machines that may or may not be real, and long, complex histories of people and places that feel legitimate but also like they may be more appropriate for a Ripley's Believe it or Not! I read the Pulitzer finalist book on the museum called Mr. Wilson's Cabinet of Wonder by Lawrence Weschler. He did research on some of the permanent and earlier temporary exhibits, finding much truth – though not complete – even in the stranger family histories described. My two favorite "exhibits" included a detailed history of a little known Russian scientist who developed plans for interplanetary travel in the late 19 th and early 20 th centuries (likely untrue) and a beautiful exhibit on Islamic architecture, the architectural details of which I know are true. The Lloyd Library is an academic institution that does not intend to make any artistic or philosophical statements like the Museum of Jurassic Technology. Furthermore, it is still in use by researchers, unlike the pathology museum I visited in Paris. But, like the pathology museum and the Museum of Jurassic Technology, the Lloyd Library in Cincinnati, Ohio encourages a sense of curiosity and wonder in a way that few museums currently do. I would encourage everyone in the area to visit. References Flannery, Michael A. John Uri Lloyd: The Great American Eclectic. Carbondale: Southern Illinois University Press, 1998. Haller, John S., Jr. A Profile in Alternative Medicine: The Eclectic Medical College of Cincinnati, 1845–1942 . Kent State University Press, 1999. Smith, RJ. "John Uri Lloyd: To Infinity and Beyond." Cincinnati Magazine , April 2015. https://www.cincinnatimagazine.com/citywiseblog/john-uri-lloyd/ Weschler, Lawrence. Mr. Wilson's Cabinet of Wonder . New York: Pantheon Books, 1995 . --- ### Melasma: What is It and How is It Treated? URL: https://www.harmonface.com/blog/melasma-what-is-it-and-treatment-options Published: November 17, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical My wife anticipated she would develop melasma after we found out she was pregnant with our first child. She is of Iranian descent, after all. Her mother also experienced severe cases after her pregnancy with my wife and her brother. Melasma is an unfortunately common consequence of pregnancy for many women, especially those of Latin America, Africa, Middle Eastern, and Asia descent ( 1 ). It is something many women are aware of primarily in the context of pregnancy but otherwise know little about. This blog post is my effort at: Explaining what melasma is Reviewing the potential causes of melasma Summarizing the available treatment options for melasma My intention with this blog post is not to provide direct medical advice nor to serve as an alternative to direct medical advice. Instead, the purpose of this blog post is to give readers a better sense of the conversation to expect when they sit down with a qualified medical provider for a consultation. Melasma Is Caused by Excessive Melanin Deposition in the Skin Melanocytes are the factory that produces melanin, the molecule that gives our skin pigmentation, thereby darkening it ( hyper pigmentation). Melanocytes exist in the top layer of skin, called the epidermis, and the bottom layer of skin, called the dermis. The machinery in the melanin factory is called the melanosome. In summary, melasma is caused by the excessive production of melanin by melanosomes in melanocytes which is quite a tongue-twister ( 2 ). Melasma Has Multiple Potential Causes, Differing Distributions, and Variable Depth There are multiple potential causes of melasma ( 1 , 3 , 4 ) including, but not limited to: Light exposure Genetics Pregnancy Use of oral contraceptives Hormone replacement therapy Sensitivity to a variety of topical medications Furthermore, there are multiple distribution patterns on the face such as the more common centralized and diffuse hyperpigmentation ( 3 ). The depth of melasma differs between individuals as well, including deeper versions that are more difficult to treat ( 3 ). Not only does melasma result in hyperpigmented areas but those areas also exhibit signs of advanced aging as well as redness due to increased blood vessel formation, called neovascularization ( 2 ). Melasma Has a High Recurrence Rate and Often Requires Long-Term Treatment Melasma is a chronic condition that is very difficult to cure and has a high chance of returning regardless of the cause, distribution, depth, and primary treatment. Moreover, there are potential risks and side effects from available treatments that prevent them from being viable long-term i.e. longer than a few months. It is for those reasons that many physicians have a treatment protocol that includes a primary treatment followed by maintenance therapy with potentially less effective but better-tolerated medications. Primary Treatment Is Focused on Stopping Melanocytes From Producing Melanosomes It is helpful to begin the discussion of treatments for melasma with topical therapies, which happen to be the first method used to treat melasma in most instances. It is important to emphasize that, regardless of the treatment, the use of a tinted sunscreen that protects against both visible light and ultraviolet (UV) light, is an essential component not only for the prevention of melasma but also of the initial and maintenance treatment, regardless of other medications used ( 2 , 4 ). There is one medication that is approved by the Food and Drug Administration (FDA) for the treatment of melasma (Tri-Luma® cream). It is a cream applied to the skin consisting of: Hydroquinone A retinoid A corticosteroid Hydroquinone is a skin lightening agent and probably the most studied and frequently used individual medication to treat hyperpigmentation of the skin, including melasma ( 3 , 4 ). In fact, many physicians start by treating melasma with hydroquinone only. It works by stopping the creation of melanin in melanosomes by blocking a specific enzyme in the melanosome. Tretinoin is itself an FDA-approved treatment for photoaging, which is the premature aging of the skin secondary to exposure to ultraviolet (UV) rays from the sun. As a result, it is frequently used to treat and prevent the development of fine lines, wrinkles, and other features of photoaging. I was treated with tretinoin as a teenager for fine "bumps" on my cheeks like those many people develop on the backs of their arms, called keratosis pilaris. Tretinoin works synergistically with hydroquinone, preventing its breakdown and allowing it to work deeper in the skin ( 1 ). It also reduces the production of the enzyme that creates melanin and accelerates the turnover of surface pigment in the epidermis ( 4 ). A mild-potency corticosteroid i.e. steroid is added to reduce the amount of redness, peeling, and itching that are side effects of both hydroquinone and tretinoin ( 1 ). It is not used as a treatment for melasma alone. The problem with the above "triple therapy" is that it is generally not used for prolonged periods of time due to the risk of long-term complications from the three medications, especially the hydroquinone and corticosteroid. Again, it is important to emphasize that there are many ways to treat melasma with topical medications other than with "triple therapy." For example, I have dermatology colleagues who alternate hydroquinone and tretinoin as individual therapies to reduce the potential for the development of side effects from these medications. Though "triple therapy" has been shown in studies to be more effective that any single medication or combination of the two medications above, there may be good reasons to avoid it. For example, patient intolerance of one or more medications or a desire to minimize the risk of complications from the use of these medications may prevent its use ( 1 ). An example of a rare complication from the long-term use of hydroquinone is called exogenous ochronosis, which is the paradoxical formation of blue grey "bumps" on the skin in the area(s) treated ( 4 ). Though not FDA-approved for the purposes of treating melasma, there has been a great deal of research on the use of tranexamic acid (TXA) for its treatment, especially melasma located in the dermis, or deeper layer of skin ( 1 , 5 ). While it is generally not the first treatment used for melasma, many consider it a secondary option for appropriately selected patients when the first-line therapies do not adequately treat the condition ( 4 , 5 ). TXA is FDA-approved to reduce blood loss during surgery when administered intravenously (IV) and menstruation when administered by mouth (orally). The mechanism whereby it treats melasma is not clear ( 1 ). TXA has been administered: Orally Topically Injection directly into the hyperpigmented skin The most used form of TXA is oral ( 1 , 5 ). Potential side effects of the oral use of TXA include nausea, vomiting, diarrhea, an increased risk of blood clot, an allergic reaction, damage to color vision, and kidney damage. That is why this treatment is typically only considered if the initial treatment failed and only for those patients who undergo a detailed screening to make sure, for example, they do not have a baseline blood clotting disorder and/or color blindness ( 5 ). There are many other treatments under investigation. Substances studied include: Thiamidol Pycnogenol and others ( 4 ). Chemical peels, especially glycolic acid, have been used as an adjunct to topical medications with some limited benefit simply by removing the pigmented skin itself ( 4 ). The multitude of lasers studied for the treatment of melasma often result in rapid recurrence of melasma, especially after sun exposure ( 4 ). These treatments will not be discussed at length here for sake of simplicity as their evidence base is shallow. They would likely be considered only as an adjunct to other topical medications or as an alternative if all other treatments fail. Maintenance Therapy Is Often Considered After the Initial Treatment Course Is Complete As stated previously, a tinted sunscreen to protect from not only from visible light but also from UV light – both UVA and UVB – is a mainstay of maintenance therapy after the initial treatment is complete. Other than sunscreen, the concept behind maintenance therapy is that the treatments can be administered long-term with a decreased potential for side effects or complications from the medications. Importantly, maintenance therapy tends to be less effective than the initial therapy. Possible options include the continued use of tretinoin only as well as cosmeceuticals such as Vitamin C (ascorbic acid) and/or E. But while there is a known mechanism whereby Vitamin C and/or Vitamin E could reduce the activity of the enzyme that makes melanin, their effect on the treatment of melasma does not have strong evidence. They may more rightly be considered as simply an enhanced photoprotective regimen ( 1 ). The Treatment of Melasma Is Complex and Usually Frustrating and Requires Close Observation by a Qualified Medical Professional In summary, the treatment of melasma is often complex and frustrating. The Cochrane Library, a world-renowned Danish organization that produces studies referencing only the highest quality studies available, labeled the treatment of melasma as "unsatisfactory" because available therapies are often incomplete, complicated by side effects, and melasma has a high likelihood of recurring ( 3 ). That is why it is essential to be evaluated and treated by a qualified medical provider, usually a dermatologist. These professionals can follow patients long-term, responding to their specific skin type, their specific type of melasma. They can have a long discussion about the potential benefits, risks, and alternatives to any treatment option. References Mahajan VK, Patil A, Blicharz L, Kassir M, Konnikov N, Gold MH, Goldman MP, Galadari H, Goldust M. Medical therapies for melasma. J Cosmet Dermatol. 2022 Sep;21(9):3707-3728. Artzi O, Horovitz T, Bar-Ilan E, Shehadeh W, Koren A, Zusmanovitch L, Mehrabi JN, Salameh F, Isman Nelkenbaum G, Zur E, Sprecher E, Mashiah J. The pathogenesis of melasma and implications for treatment. J Cosmet Dermatol. 2021 Nov;20(11):3432-3445. Rajaratnam R, Halpern J, Salim A, Emmett C. Interventions for melasma. Cochrane Database Syst Rev. 2010 Jul 7;(7):CD003583. Gan C, Rodrigues M. An Update on New and Existing Treatments for the Management of Melasma. Am J Clin Dermatol. 2024 Sep;25(5):717-733. doi: 10.1007/s40257-024-00863-2. Epub 2024 Jun 19. Konisky H, Balazic E, Jaller JA, Khanna U, Kobets K. Tranexamic acid in melasma: A focused review on drug administration routes. J Cosmet Dermatol. 2023 Apr;22(4):1197-1206. --- ### LED Light Masks for Facial Rejuvenation: An Explainer URL: https://www.harmonface.com/blog/led-light-masks-for-facial-rejuvenation-explained Published: November 13, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical There are countless “best of” lists of LED light therapy masks intended for facial skin rejuvenation. These devices have become popular online. They are advertised as helping to: Treat aging skin (photoaging) Prevent photoaging Treat acne This blog post will discuss: The theory behind this treatment modality, called photobiomodulation (PBM) Evidence for the effectiveness of PBM Evidence for the safety of PBM Possible reasons why these products have proliferated LED Light Masks for Facial Rejuvenation Utilize Red and Near Infrared Light These masks contain LED lights which are directed onto facial skin. They project different colors of light, each of which compose a narrow range of wavelengths (in nm): Red (approximately 630 – 680 nm) Near infrared (approximately 750 – 1200 nm) Red and near infrared red light penetrate the skin deeper than other colors. Devices utilizing these wavelengths are intended to treat and prevent photoaging. Red LED Light Masks are Based on the Concept of Photobiomodulation The mechanism of action of red and near infrared light masks is referred to as photobiomodulation (PBM). Formerly known as Low Level Light Therapy (LLLT), PBM refers to using light to induce therapeutic changes in tissue. In this case, the tissue treated is skin. LED Light Masks are Not Lasers Lasers are also used for therapeutic purposes on the skin. However, lasers are more likely to be used in a clinical setting such as a physician’s office because they are more powerful. Unlike PBM, lasers are: Of a single wavelength Coherent (in phase) Collimated (in a parallel beam) Lasers are able heat or ablate (destroy) the skin. PBM products do not ( 1 ). The advantages of PBM over lasers include: Less expense, especially because LED lights have become inexpensive Home administration A larger surface area of treatment PBM devices are also much less regulated by the Food and Drug Administration (FDA) when compared with lasers. For example, manufacturers of PBM face masks can apply for FDA clearance without having to undergo the rigorous testing to prove safety and effectiveness that lasers require ( 2 , 3 ). The above advantages are probably why products have proliferated. Photobiomodulation is Thought to Help Cells Produce More Energy The exact mechanism(s) by which PBM works is not entirely known. It is thought to be related to the activity of an enzyme that is targeted by the light delivered through these masks. The enzyme is called cytochrome c oxidase (CCO). COO is present in mitochondria, which are the energy generating machines of the body. Mitochondria create adenosine triphosphate (ATP), which is the primary energy delivery vehicle for the body. Red and near infrared light, in targeting COO, are thought to increase the production of ATP, thereby increasing cellular energy and activity. The result is improved collagen deposition and increased clearance of cells and molecules that can be harmful to the skin ( 4 ). Evidence Shows Photobiomodulation Can Be Effective in Facial Rejuvenation The available evidence for the effects of PBM on facial rejuvenation shows benefit, though the studies have multiple limitations. A systematic review and meta-analysis, which included the best studies I could find, found PBM can significantly reduce wrinkles and fine lines in treated patients ( 5 ). However, the weaknesses of this data include: Limited data on humans Studies with humans have relatively few participants Significant conflicts of interest related to industry funding of these studies Current Evidence Suggests Products are Safe if Used as Intended A single blinded, randomized controlled trial was conducted to determine safe dosing of PBM on multiple skin types. This study showed PBM to be safe for skin of all types up to levels higher than the usual amount delivered from devices sold directly to consumers ( 6 ). Furthermore, a systematic review found no evidence that PBM causes dysplastic (pre-cancerous) changes in human cells ( 7 ). LED Light Masks are Promising but Caution is Necessary In conclusion, LED light masks (PBM) are a promising method to help address photoaging at home, safely, and with minimal risk of side effects. However, the overall effectiveness of these devices is likely limited and should be considered only as part of a multi-modal approach to skin care. Also, one should keep in mind the reason these devices have proliferated is not necessarily because they are so much more effective than other treatments, but because they are less regulated and considered safer than other modes of facial rejuvenation. References: Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring. Semin Cutan Med Surg. 2013 Mar;32(1):41-52. Sun Y, Lan CE. Commentary on: Photobiomodulation: The Clinical Applications of Low Level Light Therapy. Aesthet Surg J. 2021 May 18;41(6):739-740. Glass GE. Photobiomodulation: The Clinical Applications of Low-Level Light Therapy. Aesthet Surg J. 2021 May 18;41(6):723-738. Hamblin MR. Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation. Photochem Photobiol. 2018 Mar;94(2):199-212. Ngoc LTN, Moon JY, Lee YC. Utilization of light-emitting diodes for skin therapy: Systematic review and meta-analysis. Photodermatol Photoimmunol Photomed. 2023 Jul;39(4):303-317. Jagdeo J, Nguyen JK, Ho D, Wang EB, Austin E, Mamalis A, Kaur R, Kraeva E, Schulman JM, Li CS, Hwang ST, Wun T, Maverakis E, Isseroff RR. Safety of light emitting diode-red light on human skin: Two randomized controlled trials. J Biophotonics. 2020 Mar;13(3):e201960014. Glass GE. Photobiomodulation: A Systematic Review of the Oncologic Safety of Low-Level Light Therapy for Aesthetic Skin Rejuvenation. Aesthet Surg J. 2023 Apr 10;43(5):NP357-NP371. --- ### Filler Fatigue: Reasons Why People May Experience It URL: https://www.harmonface.com/blog/filler-fatigue Published: November 11, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Trends in facial plastic surgery can be fickle. The pendulum can swing towards or against almost any surgical or non-surgical procedure. Examples include: Toward or away from buccal fat removal surgery Follicular Unit Extraction (FUE) versus follicular strip (FUT) hair restoration surgery A third example is the recent reported shift away from hyaluronic acid filler, also referred to as filler fatigue . There may be multiple reasons why. Some May Feel Filler Is Being Overused Two reasons may be related to differences in aesthetic goals between the patient and the injector, or that the injector has no other available treatment. Patients may feel that fillers are recommended too frequently as a treatment for their aesthetic concerns when it may not be the best option. One example is patients who have received hyaluronic acid filler to their jawline to address jowls and other age-related changes. The problem with this is that it can worsen the appearance of the lower face by making it appear wider and more bottom-heavy, especially in women. (See: When Is Jawline Filler Not Aesthetically Appropriate? ) Other patients may feel they received too much filler, though in an aesthetically appropriate location. This may be because too much was injected initially or that they had received injections too frequently. This may occur in the lips, tear troughs , or other locations. Some May Tire of the Products Themselves Some patients express frustration with needing to return for more filler after it dissolves. It may be that individuals who have received filler for a long time are growing tired of having to return to replace it. They may also learn about longer-lasting options such as facial fat grafting . Hyaluronic acid fillers have been Food and Drug Administration (FDA) approved for just over twenty (20) years. However, the range of products within this category has proliferated over the past few years. It is likely that only recently patients have received fillers long enough to grow tired of them. Patients are also learning more about the risks associated with fillers. Though low, these risks have been present since fillers were first used and are discussed with patients during the consultation process, and are included in the signed consent form. More information on the potential benefits and risks of fillers can be found on our fillers procedure page . Finally, patients are concerned that some filler may last longer than the manufacturers of these medications anticipated. It is not clear, however, whether this would ultimately affect aesthetics unless the individual was not satisfied with the treatment in the first place. Check out our blog post on the hyaluronic acid dermal filler products for more information on the different physical qualities of hyaluronic acid fillers. How to Avoid Filler Fatigue: Better Candidates, Better Injectors In summary, there may be user-specific reasons and medication-specific reasons for reported filler fatigue. This is inevitably more likely because the industry has pushed more individuals to inject and more individuals to receive fillers. The pendulum may swing back if only the best-qualified providers inject a better-selected patient cohort. If you’re looking to avoid burnout with injectables, you should consider: Working with a qualified physician injector and discussing a long‑term plan rather than single‑session goals Choosing more conservative dosing and appropriate intervals between treatments Considering alternative options for adding volume (e.g., fat grafting ) Dissolving hyaluronic acid filler before treating again, when indicated Contact Us Questions about treatment planning or concerns about filler and how to avoid filler fatigue? Please contact our Cincinnati office , and our team will be happy to help. --- ### Facelifts: An Evolution From Traditional to Contemporary Techniques URL: https://www.harmonface.com/blog/history-of-facelifts Published: November 11, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck, History The history of facelifts is greater than one hundred years. Many facelift techniques have been developed. Some techniques have become widely adopted. Other techniques have fallen out of favor and been forgotten. Those procedures that have endured reflect improvements in our understanding of facial anatomy. History of Facelift Surgery: Overall Trends The overall trend has been: An increase in the depth of the lift, i.e., deep plane facelift surgery An expansion of the area lifted from the face to the lateral neck, i.e., extended deep plane facelift The Earliest Techniques Involved the Excision of Ellipses of Skin Some of the earliest facial surgery techniques involved removing ellipses of skin from the hairline and pulling the remaining skin, thereby hiding the incisions in the hairline. These techniques were quick to perform and were often performed under local anesthesia only. The problems with them were significant, however. The problems were related to the significant tension placed on the skin closure, including: Distortions of the facial anatomy, including, but not limited to, the mouth Increased risk of abnormal scarring Increased risk of infection Skin is more likely to heal poorly when placed under a lot of tension. Results are more likely to appear unnatural as well. The Peri-Auricular Incision Revolutionized Facelifting The area where the skin was lifted gradually expanded across the face and neck. By the mid-twentieth century, a long incision hidden around the ears gave surgeons greater access to lift the skin off the face and neck. In fact, this peri-auricular incision is very similar to the most common incision performed for these procedures today. Sutures were often placed through the deep tissue around the jowls to lift them. There was little understanding of the makeup of this deep tissue. The skin was pulled tight, secured to the peri-auricular incision, and skin was removed. This approach risked not only poor healing at the incision sites (e.g., infection, abnormal scarring, ischemia, and necrosis of the skin) but also stretching the skin too much in an abnormal direction. This can lead to a pulled or windswept look. Furthermore, when skin is placed under significant tension, it risks stretching out worse than prior to surgery due to a feature called biological creep. The Discovery and Characterization of the SMAS Layer Improved Results Surgeons then began to understand the importance of the deeper tissues in the face, specifically the platysmal muscle and the Superficial Musculoaponeurotic System (SMAS)( 1 ), and how their weakening and sagging contribute to age-related changes in the face. This led to the development of a broad category of facelift surgery called the SMASectomy. Skin is still lifted widely and pulled tight like older approaches. However, now an incision is made through the SMAS, and stitches are used to pull on this layer to lift the jowls. This improved the effectiveness and longevity of the procedure. However, important problems with this approach remained: The skin is still treated the same way as the previously described procedures, with all of its potential problems and limitations Because there is no SMAS layer in the upper cheeks, a mid-face cheek lift cannot be accomplished with this technique. It is because the SMASectomy approach cannot lift cheek fat that one sometimes sees individuals who are over-filled with facial fat grafting procedures to make up for this limitation. Deep Plane Surgery Helps Address Many of the Problems with the Above Traditional Approaches to Facelifts The above realizations lead to the development of deep plane facelift surgery , with the differences as discussed in a previous blog post. Deep plane facelift surgery and its improvements have, over its approximately 35-year history in the medical literature, become the gold-standard approach to facelift surgery ( 2 ). Conclusion To learn more about contemporary techniques or whether an extended deep plane approach is appropriate for your goals, please contact our office . References Whitney, Z. B., Jain, M., & Zito, P. M. (2024, January 30). Anatomy, skin, superficial musculoaponeurotic system (SMAS) fascia. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Barrett, D. M., Casanueva, F. J., & Wang, T. D. (2016). Evolution of the rhytidectomy. World journal of otorhinolaryngology - head and neck surgery, 2(1), 38–44. https://doi.org/10.1016/j.wjorl.2015.12.001 --- ### Artificial Intelligence and Aesthetic Ideals: Why Facial Harmony is Key URL: https://www.harmonface.com/blog/facial-symmetry-and-artificial-intelligence Published: November 4, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The desire for facial symmetry is understandable. Improved symmetry is possible with many facial plastic surgery procedures , especially when the asymmetry is significant. However, perfect symmetry is impossible and, frankly, undesirable. Instead, facial harmony is the north star facial plastic surgeons work towards to create natural-appearing results. Perfect Facial Symmetry Is Impossible and Undesirable Significant asymmetry in the brows, eyelids, neck, and other areas of the face develop in many patients. The range of procedures offered by facial plastic surgeons can improve significant asymmetries. However, the smaller the asymmetries, the more difficult they are to improve. Unfortunately, some patients are bothered greatly by smaller asymmetries while others are not bothered at all by significant asymmetries. A natural-appearing face has some asymmetry, however minor. This becomes apparent when utilizing programs to project a mirror image of one side of the face on the other. It is important for facial plastic surgeons to counsel patients on this fact as well as the limits in addressing small asymmetries inherent in any facial plastic surgeon procedure. AI Powered Programs Evaluating Facial Asymmetry Can be Counterproductive There exist AI powered programs that perform evaluations of the face for facial symmetry. These programs can be useful when, for example, there is significant asymmetry in facial bones and a custom-made implant is developed with the assistance of imaging and the AI program. However, my concern is that with some patients there will be a disconnect between the grade of asymmetry visible on the surface and the available treatment options. Furthermore, a focus on facial symmetry may distract from what, in my opinion, is the most important goal of facial plastic surgery: improved facial harmony. Facial Harmony Is a Broader and More Inclusive Concept Than Facial Symmetry Facial harmony is the idea that the changes made to the face through facial plastic surgery create a more youthful appearance by improving the agreement of the area(s) treated with the whole of the face. Smaller, less significant asymmetries are natural and desired as long as the appearance each area of the face balances with the remaining areas in location and proportion. Facial harmony is a difficult concept to define on a procedure-by-procedure basis. It is also difficult to distinguish from facial asymmetry. That is where the art of facial plastic surgery factors in. Examples of differences between facial harmony and facial symmetry are: An almost perfectly symmetric nose that is, nevertheless, too narrow or sloped for a larger, more rounded face versus an appropriately sized and shaped nose with some asymmetries An almost perfectly symmetric upper lip that is too long and pendulous for the face versus a shorter, fuller upper lip with some minor asymmetries in the shape of the vermillion border, the border between the red lip and the skin of the upper lip Facial harmony is a broader and more inclusive concept than facial symmetry. And, while improved facial symmetry can be one goal of a facial plastic surgery procedure, facial harmony is the north star. --- ### Hyperbaric Oxygen Therapy (HBOT) for Post-Operative Healing in Facial Plastic Surgery: An Explainer URL: https://www.harmonface.com/blog/hyperbaric-oxygen-therapy-post-operative-healing Published: November 3, 2025 Author: Dr. Jeffrey Harmon Categories: General Information, Non-Surgical Picture a suspended animation capsule on a spaceship headed for a distant star. You have likely seen many iterations of this on film. The actor is frozen in a large cylinder, visible through a large glass window and surrounded by thick metal tubes and what appear to be rivets everywhere. This is not dissimilar to what you would witness at a hyperbaric oxygen therapy (HBOT) clinic. HBOT has been available for decades, though it has more recently become popular among plastic surgeons and their patients for the purposes of improving healing post-operatively. And, unlike that suspended animation chamber of your imagination, patients are fully awake during HBOT treatment. In fact, they are usually watching television and can call "outside" through what appears to be an old-fashioned, black landline phone one would expect to see at the desk of an FBI agent. It is a fascinating process to witness. How does HBOT work? Is it effective? I hope this blog post can answer these questions and more. The purpose of this blog post is to explain what HBOT is, what it is used for in facial plastic surgery, and to discuss the evidence for its safety and effectiveness. What Is HBOT? Hyperbaric oxygen therapy involves placing a patient in a pressurized chamber filled with pure oxygen. It is an environment in which patients are breathing pressurized pure oxygen which increases the oxygen content of blood plasma, thereby increasing the delivery of oxygen to tissues through the bloodstream. HBOT is also believed to result in selective constriction/narrowing of blood vessels in healthy tissue versus unhealthy tissue, thereby shunting more highly oxygenated tissue to areas that need it. The theory behind HBOT is that increased oxygen delivery to tissues improves the healing process, especially for those wounds that are healing poorly due to patient-specific factors ( 1 ). These factors can include: A weak immune system (e.g. diabetes mellitus, treatment with chemotherapy) A post-operative/treatment reduction in blood flow to tissue (e.g. excess skin tension after a facelift , blockage of a vessel with hyaluronic acid filler ) Plastic surgeons reason that if HBOT can help with tissue that is healing poorly it can accelerate the healing process for otherwise healthy individuals recovering normally from surgical procedures. What Is HBOT Used for in Facial Plastic Surgery? HBOT is currently being used in both reconstructive (e.g. skin cancer reconstruction ) and cosmetic (e.g. facelift) facial plastic surgery. The Undersea & Hyperbaric Medical Society has a list of fifteen (15) indications for which they approve the use of HOBT. Those related to facial plastic surgery are: Compromised flaps and grafts Arterial inefficiencies: Central Retinal Artery Occlusion The Tenth European Consensus Conference on Hyperbaric Medicine agrees with the above indications ( 2 ). As a result, HBOT is used for surgical and non-surgical cosmetic procedures in facial plastic surgery such as ( 3 ): Poor healing of facial skin after facelift surgery due to a reduction in blood flow to that skin ( 1 ) Blockage of blood vessels after hyaluronic acid filler procedures leading to a reduction in blood flow to skin or other tissue (e.g. eyes) those blood vessels supply Some otherwise healthy patients who are healing appropriately also elect to undergo HBOT in the hopes of accelerating the healing process. Is HBOT safe? HBOT is generally considered safe when treatment is performed by appropriately trained and experienced professionals in appropriately selected patients. It is not without side effects and risks, however. For example, it is common for patients to experience lightheadedness or fatigue after treatment for a short period of time. Risks of HBOT are low but include, and are not limited to: Temporary nearsightedness (transient myopia) Damage to the ears (middle ear barotrauma) Oxygen toxicity seizure, though available research on cosmetic procedures has reported no cases of oxygen toxicity, possibly due to the shorter treatment regimens and lower pressures associated with cosmetic procedures ( 4 ) There are some conditions for which a patient should not undergo HBOT, including, but not limited to: Epilepsy Pregnancy Heart failure Pneumothorax (lung collapse) Claustrophobia Patients taking certain medications (e.g. chemotherapeutic agents) Is HBOT effective? There is good research supporting the effectiveness of HBOT for chronic wounds that are healing poorly. There is more limited evidence supporting its use soon after surgery in acutely healing tissue ( 5 ). Therefore, it is not clear that HBOT can save skin and other tissues when there is evidence of significant damage due to inadequate oxygenation. However, the theory behind the effectiveness of HBOT in this scenario is sound and anecdotal reports from facial plastic surgeons suggest HBOT can be successful for both surgical and non-surgical procedures. For example, there are many case reports of the successful use of HBOT to combat the loss of oxygenation to facial tissue due to the unintentional blockage of blood vessels with hyaluronic acid filler. Moreover, it is considered a relatively safe procedure in appropriately selected patients. As a result, many facial plastic surgeons would argue that HBOT should be considered a treatment option if they have concerns about the health of tissue on the face soon after a procedure. Unfortunately, there is simply insufficient evidence for a facial plastic surgeon to strongly recommend pre-operative or post-operative HBOT for cosmetic surgery in otherwise healthy patients healing appropriately unless the patient wants to try everything possible to maximize their healing potential. For example, the largest study examining otherwise healthy plastic surgery patients undergoing HBOT peri-operatively was on patients who underwent a "tummy tuck" procedure and no facial plastic surgery procedures ( 3 , 4 ). There may never be a large-scale, high-quality study (e.g. randomized-controlled trial) looking at treatment with HBOT for complications related to a loss of blood flow to tissue after surgical and non-surgical procedures in cosmetic surgery because these complications are so rare. In fact, we may be dependent on evidence for the effectiveness of HBOT on improving healing in compromised reconstructive flaps instead, for which there are multiple case reports and reasonable evidence for its effectiveness ( 6 ). Conclusion In short, hyperbaric oxygen therapy can be an appropriate treatment for many patients who demonstrate problems healing soon after surgery due to inadequate oxygenation of their tissues. It is dependent on the judgement of the surgeon as to whether this is occurring. Similarly, HBOT is one treatment option among many for those patients demonstrating insufficient blood flow to tissues after injectables procedures. Whether it accelerates the healing process for healthy patients healing normally is less clear. References Tamaki A, Silverman DA, Ozer E. The Role of Hyperbaric Oxygen in Head and Neck Reconstruction and Facial Cosmetic Surgery. Facial Plast Surg. 2020 Dec;36(6):753-759. Parnis J, Magrin AMF, Hassan H. The role, safety, and efficacy of hyperbaric oxygen therapy in aesthetic practice-An evidence-based review. J Cosmet Dermatol. 2024 Jun;23(6):1940-1955. Fisher SM, Sherif RD, Borab ZM, Ganesh Kumar N, Rohrich RJ. Hyperbaric Oxygen Therapy in Aesthetic Medicine and Anti-Aging: A Systematic Review. Aesthetic Plast Surg. 2024 Dec 28. Mortada H, González JE, Husseiny YM, Al Jabbar I, Sultan F, Alrobaiea S, Neel OF. Efficacy of Hyperbaric Oxygen Therapy as an Adjunct in Aesthetic Surgery: A Systematic Review and Meta-analysis of Postoperative Outcomes and Complications. Aesthetic Plast Surg. 2025 Feb 26. Dauwe PB, Pulikkottil BJ, Lavery L, Stuzin JM, Rohrich RJ. Does hyperbaric oxygen therapy work in facilitating acute wound healing: a systematic review. Plast Reconstr Surg. 2014 Feb;133(2):208e-215e. Francis A, Baynosa RC. Hyperbaric Oxygen Therapy for the Compromised Graft or Flap. Adv Wound Care (New Rochelle). 2017 Jan 1;6(1):23-32. --- ### Dr. Jeffrey Harmon Is a Castle Connolly 2025 Top Doctor! URL: https://www.harmonface.com/blog/castle-connolly-top-doctor-2025-dr-harmon Published: October 29, 2025 Author: Dr. Jeffrey Harmon Categories: General Information I was pleasantly surprised to wake up one morning and find a congratulatory email from Castle Connolly in my inbox. I had been designated a Castle Connolly Top Doctor for 2025. I had no idea who nominated me. It certainly was not something I was actively pursuing. I am, however, honored by this recognition. Such recognition cannot be purchased. I feel it reflects our values of honesty and excellence in patient care at Harmon Facial Plastic Surgery . Castle Connolly Has Its Own (Proprietary) Evaluation Process According to the Castle Connolly website, the process to be designated a top doctor is as follows: A physician is nominated for the designation by their physician peers. A physician-led research team evaluates each nominee on a range of qualifications. The designation is not permanent; rather, the assessment of the physician is ongoing. The factors evaluated include: Education – I was educated at Cornell University as an undergraduate and The University of Cincinnati College of Medicine for medical school. Medical training – I completed residency training in Otolaryngology – Head and Neck Surgery at the University of Cincinnati Medical Center and fellowship training in Facial Plastic and Reconstructive Surgery with Andrew Jacono in New York City . Qualifications – I am double board-certified through the American Board of Otolaryngology – Head and Neck Surgery and the American Board of Facial Plastic and Reconstructive Surgery . Professional reputation Disciplinary history Castle Connolly reports that the designation of top doctor is given to only 7% of physicians in the United States. But while this designation is an honor, it is important to emphasize that such designations should not be the sole – or even top – criteria for evaluating a facial plastic surgeon. In addition to such designations, meaningful qualifications to look at for a facial plastic surgeon include: Patient testimonials Online reviews Before and after images Physician values and philosophy, which can be found on their website Physician personality, which patients should have a strong sense of after an in-person consultation with that physician --- ### Hypochlorous Acid (HOCl) as a Skin Cleanser in Cosmetic Facial Plastic Surgery: An Explainer URL: https://www.harmonface.com/blog/hypochlorous-acid-skin-cleanser Published: October 7, 2025 Author: Dr. Jeffrey Harmon Categories: General Information, Non-Surgical "That smells great, like pool water!" I hear this frequently during my injectables treatment sessions with my patients. This is because I use hypochlorous acid (HOCl) to clean the skin prior to placement of neuromodulators (e.g. Botox ® ) and hyaluronic acid filler. Widely used as a disinfectant in pools – hence, the strangely pleasant smell –, HOCl has more recently been formulated as a gentle antiseptic agent for the skin. HOCl is gaining a lot of attention among facial plastic surgeons and the media due to its many advantages and few disadvantages compared with other antiseptic agents. It certainly has become a valuable addition to my practice over the years, as will be explained below. But is it at risk of becoming another Windex® as referenced in the movie My Big Fat Greek Wedding , where the father figure recommends its use for everything, regardless of its actual effectiveness? What Is HOCl and What is it Used for? HOCl is a naturally occurring substance produced by immunological cells when fighting bacterial infections in the body. It damages the cell membranes of bacteria, causing their death. HOCl also has anti-inflammatory properties, which align with the production of HOCl by our immune system in response to a bacterial infection. The HOCl used in medicine is a clear liquid that is poured on or sprayed on intact skin, an incision, and/or an open wound for the purpose of reducing the number of bacteria on tissue, thereby preventing and/or helping to treat an infection. A reduced bacterial burden in a wound can also accelerate the healing process. There are multiple producers of HOCl for medical use. One example is Puracyn® Plus, which is the product I use most frequently. HOCl is used as an antiseptic (i.e. bacteria killer) prior to, during, and/or after surgical and non-surgical procedures in facial plastic surgery . It is also used on chronic non-healing wounds in other areas of the body, particularly in patients with conditions such as diabetes who are more likely to suffer from such wounds. Is HOCl Safe? HOCl has been demonstrated to be safe in particularly sensitive areas in animal models, including the eyes ( 1 ). As stated above, HOCl has been used safely on less sensitive human tissue (e.g. skin) for years, including by me. Is HOCl Effective? HOCl is a naturally occurring substance but requires specific conditions to remain stable and effective. In fact, HOCl only became a viable product for widespread use in medicine when a gentler concentration could be stabilized at a specific pH and mass-produced. In vitro (i.e. cell culture) studies demonstrate significant, quick (within a few minutes) effectiveness again many bacteria, including those that are resistant to some antibiotics ( 1 ) How Does HOCl Compare With Other Similar Products? An ideal disinfectant works quickly against a wide range of bacteria without causing damage to surrounding normal cells, thereby allowing healing to progress. Importantly, HOCl compares favorably with other similar products, especially when it comes to how quickly it works and how gentle it is on healthy tissue. It is important to note, however, that research on HOCl is limited by the fact that most studies are not randomized controlled trials (RCTs). Instead, they largely consist of studies carried out in vitro (i.e. cell culture) and on animals. Those that do involve humans typically include only a very small number of patients. There is no "best" treatment protocol for disinfection of the skin before a procedure or of a surgical site after a procure. There are multiple products available other than HOCl, including: Isopropyl alcohol Chlorhexidine gluconate Povidone-iodine Each antiseptic has advantages and disadvantages. The advantages of HOCl are that it is: Non-irritating Anti-inflammatory Quick acting Broad spectrum, meaning, it can treat many different "families" of bacteria Able to break up biofilms, which are "communities" of bacteria that band together and build defensive structures to block the immune system and antibiotics from killing them ( 2 ) Chlorhexidine gluconate and povidone-iodine, in contrast with HOCl, are harsher on tissue. As a result, HOCl may be a superior option for treating open wounds and surgical incisions. The disadvantages of HOCl are: That there is an important question about the effectiveness of HOCl products over time due to the specific conditions under which stabilized HOCl must be produced That it is, frankly, not as effective in killing bacteria as some antiseptics, including chlorhexidine gluconate ( 3 ) Chlorhexidine gluconate has been shown to be more effective than other agents in reducing the overall burden of bacteria on the skin ( 3 ). As a result, it may be a superior option for treating intact skin prior to surgery when compared with HOCl. In summary, HOCl is an excellent option for treating skin prior to minor procedures involving needles such as injectables. It is also an excellent option for treating incisions and open wounds after surgery. Other products, however, are likely superior as a agent to "prepare" the skin immediately prior to surgery. References Wang L, Bassiri M, Najafi R, Najafi K, Yang J, Khosrovi B, Hwong W, Barati E, Belisle B, Celeri C, Robson MC. Hypochlorous acid as a potential wound care agent: part I. Stabilized hypochlorous acid: a component of the inorganic armamentarium of innate immunity. J Burns Wounds. 2007 Apr 11;6:e5. Day A, Alkhalil A, Carney BC, Hoffman HN, Moffatt LT, Shupp JW. Disruption of Biofilms and Neutralization of Bacteria Using Hypochlorous Acid Solution: An In Vivo and In Vitro Evaluation. Adv Skin Wound Care. 2017 Dec;30(12):543-551. Tran AQ, Topilow N, Rong A, Persad PJ, Lee MC, Lee JH, Anagnostopoulos AG, Lee WW. Comparison of Skin Antiseptic Agents and the Role of 0.01% Hypochlorous Acid. Aesthet Surg J. 2021 Sep 14;41(10):1170-1175. --- ### Artificial Intelligence in Facial Plastic Surgery URL: https://www.harmonface.com/blog/artificial-intelligence-in-facial-plastic-surgery Published: October 1, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Artificial intelligence (AI) seems to be portrayed in the media in one of two ways: AI is portrayed as a solution to almost all the world’s problems, or AI is portrayed as the source of destruction of the world What if it is neither of the above? What if it is slowly transformative but only in select, specific tasks (e.g. drug discovery)? What if AI provides only a marginal improvement in the administrative efficiency of individuals? And what if this improvement in administrative efficiency distracts us from the hard work of making real reforms in the way we organize our businesses, including in healthcare? Artificial intelligence Has Marginally Improved My Administrative Efficiency AI has been only of marginal benefit to me. For example, I currently use AI only to produce templates for school and work excuses as well as to help write appeals when an insurance company denies coverage for a procedure. The time savings are small for my staff and myself . I Can Imagine a Time When the Administrative Role for Artificial Intelligence Expands I can imagine AI improving the administrative efficiency of the following: Scheduling patients Transcribing consultations and post-operative visit notes Scheduling business meetings Transcribing business meetings Companies that produce AI products that automate the above need to navigate healthcare privacy laws to be adopted widely by physicians. There Are Two Areas of Concern Over the Use of Artificial Intelligence There are two areas of concern with the use of AI in the field of facial plastic surgery : Future AI-powered programs that analyze the face and recommend surgical and non-surgical treatments. There are multiple reasons why AI is likely to be a poor judge of aesthetics, not the least of which is the bias of the information being fed into the AI models. Another reason AI is likely to be a poor judge of aesthetics is that each person has their own personal aesthetic and associated concerns beyond a “model” cosmetic patient. Also, it would be difficult to imagine a scenario in which an AI-powered program could reasonably understand the possibilities and limitations of any facial plastic surgery procedure on an individual’s face. As a result, such future programs run a real risk of establishing unreasonable expectations for patients and/or potentially pushing them towards a procedure for something that does not bother them. Furthermore, it would likely be an expensive piece of software and/or hardware for salespeople to foist onto providers. One area where many people feel AI shows promise is as a background general assistant, completing tasks that require navigating multiple programs and websites (e.g. booking a vacation). One scenario in which AI would potentially be helpful for the administrative staff in an office is in managing health insurance billing and insurance claims denials. Unfortunately, healthcare privacy laws would seem likely to create too much friction to make this a practical reality for providers in the near term. In the medium-to-long term, AI may make a kludgy bureaucracy easier to navigate. However, this runs the risk of an administrative arms race where everything becomes increasingly complicated to manage on both sides of, for example, insurance billing. Instead, it would seem to make more sense to pursue reform of the systems themselves such that AI is not necessary. --- ### The Science of Humidifiers for Dry Winter Skin URL: https://www.harmonface.com/blog/humidifiers-for-dry-skin Published: September 30, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Cold winter air retains less moisture than warm air. This, in addition to the use of air conditioners, can result in very dry air indoors. Dry air can damage the skin barrier, leading to a loss of moisture from the skin. Signs of dry skin include: Cracks/fissures Roughness Humidifiers can help with signs of dry skin . Humidifiers Can Help Maintain Optimal Humidity Levels An optimal humidity level for the skin is approximately 40% to 60%. If humidity levels are too low, there is a risk of damage to the skin barrier. If humidity levels are too high the risk of mold and mildew in a home increases, thereby increasing the risk of respiratory illnesses. The use of a humidifier can help maintain humidity levels within an optimal range. In fact, some humidifiers have monitors that track the humidity of the air, turning on and off automatically within this range. Humidifiers can also be an adjunct to topical skincare products that add and/or retain moisture. There Are Two Categories of Humidifiers Broadly, there are two types of humidifiers: Cold air, which is room temperature water that is brought into the air using either ultrasonic vibrations or an evaporative wick Warm air, in which water is boiled, and warm steam is released into the air The most appropriate device depends on multiple factors. For example, warm air humidifiers can get hot and burn skin. As a result, they may not be appropriate for homes with small children. Also, warm air humidifiers may have an increased risk of harboring bacteria and fungi, though both warm and cold air humidifiers can harbor bacteria and fungi if not cleaned properly. There are many ways to clean these devices. It is recommended to review the manufacturers for their recommended cleaning regimen. For example, distilled white vinegar and boiling water are two commonly used products for cleaning these devices. --- ### The Winter K-Beauty Trend of “Slugging”: What Is It? Could I Benefit from It? URL: https://www.harmonface.com/blog/slugging-k-beauty-trend Published: September 29, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Popularized on social media, skin “slugging” is a K-Beaty trend of moisturizing the skin during dry winter months. Slugging involves the use of a thick emollient applied to the face at night. An emollient (e.g. petrolatum) is an occlusive ingredient that holds moisture on the skin. The thicker the emollient, the more effective it is. However, thicker emollients tend to look and feel greasy on the face, which is why these emollients are applied to the face at night. Examples of petrolatum-containing emollients include Aquaphor® and Vaseline®. Slugging may not be suitable for all skin types including, but not limited to: Individuals with acne or acne-prone skin Individuals with oil-occluded pores Applying thick emollients to the above skin types may make these conditions worse. It is also important to note that emollients are not typically used in isolation; rather, thick emollients enhance the effects of humectants such as glycerin and hyaluronic acid. Humectants are substances that draw in moisture. Emollients are added over humectants in dry environments in order to prevent the diffusion of moisture from the skin to the dryer air. See the previous blog post Dry Skin and Moisturizers: An Explainer for more information. --- ### Creating Your Support System: Essential Help You Will Need After Surgery URL: https://www.harmonface.com/blog/support-system-after-surgery Published: September 24, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Support is essential when undergoing any surgical procedure . Support can come from family and friends. Support can be both emotional and physical. Children, siblings, and partners can be especially helpful during the initial recovery period. Friends can be helpful during the weeks and months of healing following the initial recovery. Loved Ones Are Welcome to the Consultation I find it helpful for patients to bring their support in for the consultation. Whether it is a husband, wife, partner, child, or best friend, these individuals can ask questions the patient may have forgotten or not thought to ask. I have found that these individuals can sometimes clarify thoughts and the aesthetic concerns of a patient. They may also have an opinion on how the consultation went. Physical Support Is Essential for Twenty-Four (24) Hours After Surgery Patients are required to have a caregiver with them for the first approximately twenty-four (24) hours after surgery as they recover from the anesthesia medications . This time requires someone to provide physical support, as patients are most likely going to relax during this period. Support is not necessarily required after twenty-four (24) hours. However, these individuals can be helpful even after this time. For example, they can help the patient wash their face and hair. They can apply ointments to the incisions , some of which are tucked behind the ears and are, therefore, difficult to see. Emotional Support Is Essential for the Days and Weeks of Healing Finally, a support group can be hugely beneficial during the first weeks and months of recovery when the patient is not visiting the office as frequently. For example, the first one (1) to three (3) months of recovery can be the most challenging mentally. Patients are healing and improving every day. However, the process often feels like it slows. There are also fewer steps indicating progression such as suture removal, etc. As a result, it can be a sensitive time when it is important to seek the support of loved ones. --- ### Maskne: What Is It? How Do I Prevent It? URL: https://www.harmonface.com/blog/how-to-prevent-maskne Published: September 22, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Maskne is a term referring to symptoms experienced while wearing masks that started to trend at the height of the COVID-19 pandemic when masks were worn more frequently and for longer periods by the public. Symptoms of maskne include: Redness Irritation Itching Acne breakouts These symptoms can be present on the skin from hours to days after wearing a mask. There Are Multiple Causes of Maskne There are multiple causes of maskne: An allergic contact dermatitis from an adhesive on the mask. I experienced this. I develop redness, swelling, and tenderness for about 24 – 48 hours after using surgical face masks with an adhesive over my nose and cheeks. Instead, I use surgical masks with foam pads over my nose and cheeks. My symptoms have not recurred. Heat and humidity in the mask. The heat and humidity generated when breathing in a mask can exacerbate acne. Masks Are Very Important There are many situations in which wearing a mask is essential, including in: The operating room to reduce the risk of contaminating the surgical site Crowded areas to reduce the transmission of respiratory illnesses Strategies to Reduce the Risk of Maskne Maskne is unlikely to be a problem for most people. However, those who wear masks frequently, those who wear masks for long periods of time, and/or those with underlying inflammatory skin conditions (e.g. acne) may be more susceptible. Strategies to reduce the risk of maskne include: Keeping your face clean with a gentle face cleanser Taking breaks with a mask but only when safe and appropriate Changing your mask regularly Avoiding masks with adhesives, if sensitive --- ### Dr. Jeffrey Harmon Named a Top Doc by Cincinnati Magazine in 2025 URL: https://www.harmonface.com/blog/cincinnati-magazine-top-doc-2025 Published: September 4, 2025 Author: Dr. Jeffrey Harmon Categories: General Information We at Harmon Facial Plastic Surgery are thrilled to announce that Dr. Harmon was honored as a Cincinnati Magazine Top Doctor in 2025. This designation is the result of voting by peer physicians. We feel it reflects our work to provide the highest level of care to our patients. It also reflects the positive relationship we have with physicians in our community. We have demonstrated time and again that we are a practice that our peers can confidently refer patients to for their facial plastic surgery needs. 2025 — What a Year! We have exciting developments in 2025, including: A new website has been our largest long-term project. In development for months, the website has involved a great deal of writing, designing, photographing, and filming. Our goal with the new website is to present more of the practice online, to give prospective patients a sense of what an experience at Harmon Facial Plastic Surgery is like from consultation to treatment to follow-up. Visit our homepage here: harmonface.com . Educational events for patients and other providers. As he has written about previously, Dr. Harmon loves to teach. He is seizing these opportunities to not only teach other providers but also to provide some guidance to potential patients on their aesthetic journey. Explore recent articles and updates on our blog . “As we continue to grow this year, we remain committed to the values on which we founded our practice—building something our children will be proud of and working tirelessly to provide the very best care for our patients." - Dr. Jeffrey Harmon Give Us a Call Have questions or want to connect with our team? Please contact our office and we’ll be happy to help. --- ### Rhinoplasty Cost in Ohio: What Patients Should Know URL: https://www.harmonface.com/blog/rhinoplasty-cost-ohio Published: August 29, 2025 Author: Dr. Jeffrey Harmon Categories: Nose As previously discussed , patients seek rhinoplasty surgery for aesthetic and/or functional reasons. They often ask: "how much does rhinoplasty cost?" The answer may differ depending on the scenario: Cosmetic-only rhinoplasty, where the focus surgery is on addressing aesthetic concerns about the nose Functional-only rhinoplasty, where the focus of surgery is on addressing difficulty breathing through the nose Rhinoplasty with both cosmetic and functional components Please note that patients should expect additional costs associated with, for example, prescription medications, over-the-counter medications, and preoperative medical clearance and testing performed/ordered by a primary care provider. Cosmetic-Only Surgery Expenses: What Is Included in the Cost of Rhinoplasty A surgical quote is provided before surgery when a rhinoplasty is entirely for cosmetic purposes. The charges include: Surgeon’s fee Anesthesia fee Facility fee The anesthesia fee and facility fee can differ depending on the location of the surgery (e.g. hospital versus office-based surgery suite). Payment for the procedure is made before surgery. Additional details are available for review in the quote. Functional-Only Surgery Expenses and Insurance Coverage Rhinoplasty for improvement in nasal breathing may or may not be covered by a patient’s health insurance plan, depending on multiple factors. One example of a scenario where a health insurer may not cover a functional rhinoplasty is if the initial procedure performed on the nose that led to the difficulty breathing was itself performed for cosmetic purposes. If the patient’s health insurance does cover this procedure, the surgeon, facility, and anesthesia group usually each bill the health insurance company directly. The total out-of-pocket costs depend on the details of the insurance coverage and could vary depending on multiple factors, including, but not limited to, the patient’s deductible. The process may also differ if the surgeon, facility, and/or anesthesia group are considered out-of-network by the patient’s health insurer. For general context on typical fees and coverage, see overviews from the American Society of Plastic Surgeons and the American Academy of Facial Plastic and Reconstructive Surgery. Why Combined Cosmetic and Functional Procedures Affect Costs Both scenarios above apply when the procedure involves both a cosmetic and functional component. First, the patient would be presented with a quote for the cosmetic component of the procedure. And, if the surgeon, anesthesia group, and facility are considered in-network by the patient’s health insurer, the respective individuals generally bill the patient’s health insurer directly for the functional component of the procedure, with the same caveats as discussed above (e.g. out-of-network providers/facilities). This is not an uncommon scenario that can influence the overall cost of rhinoplasty in Ohio, depending on plan details and case complexity. --- ### A History of Facial Plastic Surgery URL: https://www.harmonface.com/blog/a-history-of-facial-plastic-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: History This information is adapted from a presentation given to physician groups and a series of videos available online. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Source: Martin, Paula J. Suzanne Noel: Cosmetic Surgery, Feminism and Beauty in Early Twentieth-Century France . Burlington, Vermont: Ashgate, 2014. Print. Timeline The history of facial plastic surgery is a story of heroes and charlatans who navigated a nascent subspecialty developing shortly after the invention of anesthetic agents. While its true origins are ancient, its modern origins begin in the late 19th and early 20th century, immediately before World War I. The best way to understand the modern history of facial plastic surgery is to visualize a timeline extending from a “pre-war” period through World War I, an “inter-war” period, World War II, and the immediate “post-war” period. This timeline is the skeleton on which the history can be fleshed out. Advancements in cosmetic facial plastic surgery developed gradually over this period. World War I and World War II were punctuation marks during which the reconstructive side of facial plastic surgery made great, rapid advancements because the war wounded were surviving increasingly severe facial trauma. The field of facial plastic surgery became medicalized – crystalized into its own coherent field of medicine with its own philosophies and techniques – from the pre-war period to World War II. Facial plastic surgery professionalized – formed a governing body, formal inclusion and exclusion criteria, and a formal delineation of the boundaries of the practice of the field – during World War II and the post-war period. The history below was gathered from reading the referenced books and combining this information into a story of a field of medicine I am proud to be a member of. The individuals discussed here are only a small fraction of those practicing facial plastic surgery at the time. Their stories simply exemplify the evolution of the field in a coherent way. Early History - Reconstructive Surgery The earliest facial plastic surgery procedures were developed to repair the nose . The Italian physician Gaspare Tagliacozzi wrote the first textbook on plastic surgery in the Western world in 1597. Called The Surgery of Defects by Implantations , the book includes instructions on a procedure used to reconstruct the nose of patients who contracted syphilis, which destroys the supporting cartilage of the nose. It was a tortuous procedure requiring multiple operations over the course of 3 to 5 months. The procedure utilized skin from the inner arm and forced patients into an uncomfortable, contorted position during the entire reconstructive period. The caste of potters on the Indian subcontinent developed a much more elegant technique hundreds of years prior to reconstruct the noses of individuals who had theirs removed as punishment for crimes utilizing tissue from the forehead. This technique remained unknown in the West until the early 20th century. Joseph Constantine Carpue, a British army officer, introduced the technique to the West in 1914 and published An Account of Two Successful Operations for Restoring a Lost Nose from the Integuments of the Forehead in 1916. World War I and II would accelerate advancements on the above techniques by necessity. Source: Meikle, Murrary C. Reconstructing Faces: The Art and Wartime Surgery of Gillies, Pickerill, McIndoe & Mowlem . Otago University Press, 2013. Print. World War I - Reconstructive Surgery There was a rapid innovation in the field of reconstructive facial plastic surgery during World War I when approximately 15% of the soldiers who survived trench warfare experienced facial injuries. Ernest Hemmingway wrote eloquently about these survivors: There were other people too who lived in the quarter and came to the Lilas, and some wore Croix de Guerre ribbons in their lapels and others also had the yellow and green of the Medaille Militaire , and I watched how well they were overcoming the handicap of the loss of limbs and saw the quality of their artificial eyes and the degree of skill with which their faces had been reconstructed. There was always an almost iridescent shiny cast about the considerably reconstructed face, rather like that of a well packed ski run, and we respected these clients more than we did the savants or the professors. World War I made heroes out of many surgeons, including the New Zealand-born Ear, Nose and Throat (ENT) surgeon Harold Gillies. Initially stationed in France, he returned to England, where he attended medical school, to Cambridge Hospital in Aldershot then to Queen’s Hospital in Sidcup, Kent when Aldershot was of insufficient size to care for the number of wounded. The hospital at Sidcup was founded specifically for those with facial injuries. In fact, it is considered the birthplace of modern reconstructive plastic surgery. Approximately 8000 maxillofacial procedures were performed during its busiest period from 1917 to 1921. The wards housing the most gruesomely injured soldiers were called the “chamber of horrors” by other patients. Mirrors were banned at the hospital during this time. Harold Gillies wrote Plastic Surgery of the Face in 1920 based on this wartime experience. His book describes multiple innovations including the tubed pedicle, which allowed him to transfer skin from one area of the face to another. However, he also made poor recommendations in his textbook. For example, Harold Gillies insisted on the value of the use of bovine (cow) cartilage for nasal reconstruction despite the discovery of transplant immunity. Source: Meikle, Murrary C. Reconstructing Faces: The Art and Wartime Surgery of Gillies, Pickerill, McIndoe & Mowlem . Otago University Press, 2013. Print. World War II - Reconstructive Surgery The need for plastic surgeons during World War II surged beyond the needs of even World War I. Unfortunately, the total number of plastic surgeons in the United Kingdom during World War II was only 4, including Harold Gillies. As a result, a plastic surgery hospital was built for each of them. Dr. Gillies settled in Rooksdown House during World War II where he founded The Plastic and Jaw Unit in 1941. They become very busy after the battle and evacuation at Dunkirk. Dr. Gillies was training a few new surgeons at a time during this period, mostly Americans and mostly informally. This is because there were no formal plastic surgery residencies at the time. Harold Gillies would not found the British Association for Plastic Surgeons until 1946. His influence on future generations would be immense, however, as exemplified by the Brazilian plastic surgeon Ivo Pitanguy, whose life will be discussed later. Harold Gillies was a practical joker. He would disguise himself to potential applicant physicians and chat with them in the hall prior to their scheduled interview as described by one of those applicants: At the outbreak of the Second World War a plastic and jaw unit was established by Sir Harold Gillies at Rooksdown House, Basingstoke. In 1954 I applied for a post in plastic surgery. The subsequent interview was held at the hospital, a strange looking building which had been the private block of Park Prewett Hospital. On inquiry at the porter’s office, I was directed by an elderly gentleman to wait in the main hall along with the other candidates. Being last in line for interview I was left in glorious isolation until joined by the porter who proceeded to make conversation. His opening gambit was to inquire how much fishing I had done in Ireland, to which I replied in the negative. As to other sporting activities, I admitted that there were none at that particular time. There followed a few desultory questions about my surgical activities, which I thought were none of his business. Returning to the question of sport, he expressed further curiosity regarding my sporting interests in the past. Feeling slightly irritated and intimidated by the old man’s persistence I announced that I had been a member of the Irish Olympic rowing team, which competed at Henley in 1948. He was most interested in this information and casually mentioned that he had rowed for Cambridge in the Boat Race. It emerged that he had also played golf for England and that painting and fishing were his main interests apart, of course, plastic surgery. Shortly afterwards I was called in to see the medical superintendents who, after a few perfunctory remarks, told me that Sir Harold Gillies had interviewed me in the hall and that my application was satisfactory. During the ensuing three years at Rooksdown House, Sir Harold made no reference to our unconventional interview. A second hospital – Queen Victoria Hospital – was assigned to Harold Gillies’ younger cousin, Archibald McIndoe. Dr. McIndoe started working with Harold Gillies prior to World War II in the United Kingdom. Dr. Gillies facilitated his advancement, even relinquishing his role as a consultant physician for the Royal Air Force for him in 1938. Interestingly, Archibald McIndoe maintained his civilian status while working with the military to eliminate rank and other military formalities among the hospital staff to boost and maintain morale. He changed the color scheme of the hospital to brighter colors, believing the appearance of the hospital could affect the emotional health of patients. He even encouraged the local population to visit the hospital and the patients, which was very unusual at the time. His appreciative burn patients – those individuals whose burns were so severe they required surgical treatment – formed the “Guinea Pig Club” and met annually after World War II to toast the plastic surgeon who treated them. Dr. McIndoe would also teach and influence Ivo Pitanguy. Source: Martin, Paula J. Suzanne Noel: Cosmetic Surgery, Feminism and Beauty in Early Twentieth-Century France . Burlington, Vermont: Ashgate, 2014. Print. Cosmetic Surgery It is important to note that most plastic surgeons practiced both reconstructive and cosmetic surgery during this period. In fact, Harold Gillies developed a robust cosmetic surgery practice after World War II, partially because he could not otherwise retire comfortably. Archibald McIndoe also developed a busy cosmetic surgery practice, becoming known for his “McIndoe Nose” which distinguished those patients who underwent rhinoplasty surgery with him. Cosmetic plastic surgery was widely considered a “lesser” specialty and was ridiculed for focusing on largely healthy patients. The level of scorn directed toward the physicians who practiced cosmetic plastic surgery varied depending on their level of self-promotion as well as their level of engagement with the lay public. Facial plastic surgery in the late 19th and early 20th century was most often employed to “pass” in public, to blend in rather than stand out. This had both positive and negative connotations and may also have contributed to the fact that many of the plastic surgeons performing cosmetic surgery at the time were considered charlatans. John Orlando Roe, an ENT surgeon from Rochester, became known as the father of cosmetic rhinoplasty, publishing papers on modifying the nasal tip and bridge in the late 19th and early 20th century. He initially became known for treating collapsed nasal bridges, called a saddle nose deformity, in patients who contracted syphilis. There were severe legal restrictions in the United States to advertising as a physician at the time. He was considered one of the more noble cosmetic facial plastic surgeons because he did not advertise and was not ostentatious. The German plastic surgeon Jacque Joseph was a European contemporary of John Orlando Roe. Like Dr. Roe, Jacque Joseph espoused the psychological benefits of cosmetic plastic surgery. Dr. Joseph was initially allowed to operate only at Jewish hospitals due to the antisemitism prevalent in Germany during this time. In fact, Jacque Joseph maintained dueling scars on his face to better “pass” in German society and avoid this. He even had requests from others to create “dueling scars” on their face to better “pass” themselves. However, even the Jewish hospitals eventually banned him from operating because he was performing cosmetic plastic surgery. Professional opinions about him changed when World War I broke out and his expertise was required to treat the war-wounded. He was recruited to work as the Director of Facial Plastic Surgery at Charite Hospital in Berlin during the war. He transitioned to private practice after World War I to refocus on cosmetic plastic surgery. His innovations included techniques to reshape nasal bones during rhinoplasty (osteotomies). He also performed facelifts and body plastic surgery. He became internationally renowned, drawing even Americans to visit him. He was reportedly very secretive, having his nurse keep his instruments under towels to prevent visitors from copying his designs. His great contribution to the medical literature was the textbook Rhinoplasty and Other Facial Plastic Surgery published in 1931. This textbook was the first to include photos of post-operative patients smiling after their recovery. Another great European facial plastic surgeon of the early 20th century was the French physician Suzanne Noel. Born in 1878, she came of age in La Belle Epoque when the women’s rights were improving in France, which likely influenced her drive. She married Henry Pertat, a dermatologist 9 years her senior, at age 18. He was able to start a dermatology practice with family money. French law at the time dictated that women needed permission from their husband to attend medical school. Laws even required husbands to be informed of where their wives were going and the “general spirit” of any conversation they had with others outside of the house. Fortunately for the world, Henry encouraged Suzanne to pursue medicine. Suzanne passed the externat to function as an extern at Paris Hospital in 1908 at age 30, the same year she gave birth to her daughter Jacqueline. After 2 years as an extern and earning high marks in her testing she started a 4-year internship as a resident physician. She worked in the public hospitals in the morning and at her husband Henry’s dermatology practice in the afternoons. Her two most influential teachers during her internship were Hippolyte Morestin and Jean-Louis Brocq. Hippolyte Morestin was a French surgeon who became famous during World War I. He was especially concerned with reconstructive surgery and the concealment of scars. He taught Suzanne to be decisive and to take risks in the operating room. The Spanish flu would kill Dr. Morestin in 1919, a tragedy that would befall her daughter in 1922. Jean-Louis Brocq was a dermatologist who first exposed Suzanne to cosmetic plastic surgery. She developed an interest in cosmetic plastic surgery after being visited by the famous actress Sarah Bernhardt, who had undergone a brow lift by the plastic surgeon Charles Conrad Miller in Chicago. She felt she could have done a superior job. Dr. Brocq allowed her to perform cosmetic surgery procedures on volunteer patients during her internship. Suzanne ran her husband’s dermatology practice when he left for the front lines during World War I. Unfortunately, he suffered from chlorine gas exposure while testing gas masks, which permanently disabled him. He was forced home from the front lines in 1918 where he died from respiratory failure. Suzanne married Andre Noel, her medical school classmate and close friend, in 1919. Like her first husband, Andre pursued dermatology. In fact, Andre took over Henry’s dermatology practice after he died. This is partially because, at the time, a woman could only practice medicine under a male physician’s license. Suzanne could run the dermatology practice but was not allowed. Suzanne gave her medical school thesis – a device that used air pressure to spray jets of medication impregnated water on the skin of patients – to Andre so he could run the dermatology clinic. The couple would later commercialize and sell the device. Andre became depressed after Jacqueline’s death and committed suicide in 1924. Left with a dermatology practice she could not run because she never submitted a thesis (women could practice independently with a license now), Dr. Noel quickly wrote a thesis on the topic of the big toe, partially to slight the leadership at the University of Paris for previously restricting her practice of medicine. She would acquire her medical license in 1925, allowing her to run the dermatology clinic. Her cosmetic surgery practice quickly became popular, which allowed her to pay off the enormous debts Andre had accumulated during his depression. She operated out of her apartment in Paris near the Hotel George V, because cosmetic plastic surgeons were generally not allowed to operate in hospitals in France at the time. She eventually outgrew her apartment, moving her private practice to the prestigious Clinique des Bleuets . She also promoted the practice of cosmetic plastic surgery around Europe, advocating the psychological benefits of plastic surgery like Dr. Roe and Dr. Joseph. She travelled to Germany to advocate for the founding of a Department of Social Cosmetics at the Institute for Dermatology at the University of Berlin. Berlin was one of the few places in the world where cosmetic surgery was considered acceptable as a form of “mental hygiene.” This was during the time that Jacque Joseph was becoming famous for his rhinoplasty techniques while practicing in Berlin. Dr. Noel published Aesthetic Surgery and its Social Significance in 1926. This textbook was immensely popular, being translated into other language and further establishing her reputation. Her contributions to the field of plastic surgery were numerous. They included the pioneering use of long, elliptical incisions along the hairlines during face lifting operations. She invented the craniometer, a device which allowed her to measure facial dimensions more precisely. She improved on a now-common approach to lower eyelid surgery and the facelift. Probably most importantly, she successfully combined local anesthetics with epinephrine to reduce bleeding and improve patient comfort during surgery, a generally accepted practice today. She also took a more patient-centered approach to practice and teaching. She was one of the first surgeons to include actual photos of the steps of her operations in her textbook. She discussed surgical options and expected results with her patients. She allowed her patients to decide between local and general anesthesia. She was obsessed with concealing the effects of surgery, going so far as to formulate tinctures matching various hair colors to dye the bandages she placed on patient’s hairlines. She also provided tea and lunch to her patients after surgery. It was for her accomplishments that she was awarded The Order of the Legion of Honor in 1931, a rarity for women in France. In contrast with Drs. Roe, Joseph, and Noel, Joseph Sheehan was considerably showier and more ostentatious. He was born in Dublin, Ireland in 1885 and emigrated to the United States. Relegated to poverty after the death of his father, he managed to gain admittance to Yale Medical School and trained with Harold Gillies at Sidcup during World War I. He returned to the United States and practiced in New York City. He became enmeshed in bad press after inviting a New York Times reporter back to his office after a lecture he was asked to give to the New York City Police Department. The reporter described the extravagance of his office rather than the lecture he was being interviewed about. He also attracted considerable controversy because he was a supporter of the Spanish dictator Francisco Franco, helping to organize hospitals and train surgeons in Franco’s army. Joseph Sheehan was deeply connected to the concept of the use plastic surgery to “pass” in society. Convicted criminals sought out facial plastic surgery in the early 20th century to escape detection by authorities. Dr. Sheehan was giving a lecture to the New York City Police Department about what could and could not be accomplished with plastic surgery at the time so that the police force could better detect individuals attempting to evade them. This panic is what led to European and American criminal authorities to tattoo convicted criminals. One of the most famous examples of a criminal undergoing facial plastic surgery to evade the police was John Dillinger, the leader of the Dillinger Gang which robbed banks and police stations during the Great Depression. John Dillinger was arrested and killed in 1935 along with the plastic surgeon who performed a rhinoplasty and facelift on him to conceal his identity. Even J. Edgar Hoover became involved, warning plastic surgeons of the risks in aiding criminals. A more modern example is the drug trafficker Richie Ramos who underwent rhinoplasty, liposuction, and excision of gunshot scars from his face to evade the police. He and his plastic surgeon, Dr. Jose Castillo, were arrested in 1997 for obstruction of justice. There was not only a concern in the early 20th century that criminals would undergo facial plastic surgery to conceal their identity. Some also theorized that one could change criminality by changing the appearance of criminals. In fact, some prisons offered to pay plastic surgeons to operate on jailed criminals. One example was a pilot project at San Quentin in 1927 examining the rehabilitative effects of facial plastic surgery which was initiated by the convicts themselves. As expected, this project would prove unsuccessful. Source: Simons, Robert L. Coming of Age: A Twenty-Fifth Anniversary History of the American Academy of Facial Plastic and Reconstructive Surgery . New York, New York: Thieme Medical Publishers, Inc., 1989. Print. Professionalization The professionalization of the field of facial plastic surgery followed World War II. The founders of the field remained marginalized from professional circles. As a result, they were forced to develop some the earliest standardized training programs of any subspeciality. And even within the field of facial plastic surgery there was conflict between those who felt the emphasis should be on reconstructive versus cosmetic surgery. That distinction is best exemplified by two individuals, Maurice Cottle and Irving Goldman. Both individuals were taught by Samuel Fomon. Samuel Fomon was not a surgeon but an anatomy teacher who nevertheless was operating. He compiled all known work on facial plastic surgery and taught it at a time when general plastic surgeons were excluding ENT/facial plastic surgeons from this knowledge. He gained this knowledge while traveling abroad, specifically to Germany where he visited Jacque Joseph. He confirmed Jacque Joseph’s penchant for secrecy. He even paid Dr. Joseph’s nurse to see his instruments, sketched the designs and returned to the United States to re-create these instruments for use during his course. He initially established the Fomon Course in the 1940s in Manhattan General Hospital, one of the few places where formal instruction in facial plastic surgery was available. Students would pay an “assistant’s fee” to operate on the patients. Samuel Fomon’s wife, who was a physician, assembled his textbook and functioned as the in-house artist who double-checked his work. He was initially ostracized from universities in the United States until Dr. George Coates of Philadelphia, a well-respected ENT and editor of A rchives of Otolaryngology , started to encourage the University of Pennsylvania residents to attend his course. This endorsement, as well as the endorsement of the course by the chairman of the Department of Otolaryngology at the University of Iowa, Dr. Dean Leirle, legitimized the course in the eyes of other universities. Maurice Cottle and Irving Goldman both attended the Fomon Course. Maurice Cottle emphasized the importance of functional rhinoplasty over cosmetic rhinoplasty. He later created his own course on rhinoplasty. He was obsessive, reportedly dedicating an entire decade of courses to individual components of the nasal anatomy, starting with the septum and ending with the bony pyramid in the fourth decade of his course. He was reportedly a difficult teacher, but fair. In fact, he was as difficult on the chairmen of otolaryngology departments as he was on new trainees. He also always made sure that the nurses, janitors, electrician, carpenters, and anyone else who assisted in putting on the course received a gift of appreciation. He became known for his sayings, or “Cottle-isms” including “never do in nasal surgery something that you cannot undo” and “the best operation is one we don’t have to do…we are second best.” In contrast, Irving Goldman emphasized the cosmetic approach to rhinoplasty. Born in 1898 in New York City, he was initially trained as an ENT but then developed an interest in cosmetic rhinoplasty. Like other facial plastic surgeons at the time, he was excluded from the establishment by general plastic surgeons. It took time but he eventually established himself at Mt. Sinai Hospital in New York City. He was initially not allowed to perform cosmetic rhinoplasty surgery at the hospital; that is, until he performed the procedure on two of the daughters of the chief of medicine there. He eventually performed many of the revision rhinoplasty procedures of the general plastic surgeons who initially excluded him. He started a course emphasizing the aesthetic aspects of rhinoplasty in 1950. The Goldman course became the longest running course in rhinoplasty. Dr. Goldman would eventually become the first president of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Source: Holzer, John. Plastic Surgery Obsession: Brazil’s Dr Ivo Pitanguy Triggered it All . Houston, TX: Alto Press, 2011. Print. Ivo Pitanguy The Brazilian surgeon Ivo Pitanguy was a product of the development and professionalization of the field of plastic surgery. He was a pioneer in reconstructive and cosmetic facial plastic surgery, importantly outside of the traditional centers of Europe and the United States. Dr. Pitanguy’s origins were modest, but his training was top notch. He started as a general surgery resident largely working out of an ambulance in the favelas of Rio de Janeiro. He won a scholarship to study reconstructive plastic surgery under John Longacre in Cincinnati at Bethesda Hospital in 1948. He then travelled to the United Kingdom to study under Harold Gillies and Archibald McIndoe under a British Council Scholarship. Dr. Gillies encouraged him to teach and perform research while McIndoe encourage him to perform cosmetic plastic surgery. The reporter Joan Kron reported in her book Lift: Wanting, Fearing, and Having a Face-Lift , that "once, while [Pitanguy was] watching Gillies do a facelift...Gillies said something inspirational: 'If I didn't think this had value, I wouldn't do it." He returned to Rio de Janeiro in 1952 where he started a burn unit to treat the direst patients. It was at this hospital that he mobilized his team to treat hundreds of patients who were severely burned during the Niteroi Circus Fire, the worst indoor fire disaster ever. He was a workaholic, practicing on cadavers at night. Interestingly, he was reportedly never mugged when walking the streets of Rio de Janeiro at night because the formaldehyde left him with the “smell of death.” It was at this institution that he developed a training program for plastic surgery based on the American residency system for training new physicians. Dr. Pitanguy not only taught residents but also proselytized plastic surgery to other specialties. This differed greatly from other plastic surgeons like Jacque Joseph who hid their techniques. He followed up the founding of his clinic with the founding of the world’s first plastic surgery hospital called Clinica Ivo Pitanguy in Rio de Janeiro in 1963. This hospital provided a luxurious experience for patients. It was through this hospital that Rio de Janeiro became a center for plastic surgery. The city was popular with jet setting royalty and movie stars at the time. Ivo Pitanguy’s reputation spread from there. He was also a scholar. His contributions to the medical literature were immense. He published Aesthetic Surgery of the Head and Body in 1981, which is considered a classic textbook. He identified the Pitanguy Ligament in the nose, which is an important structure when performing rhinoplasty. He also identified Pitanguy’s line, which follows a branch of the facial nerve up the forehead and is an important marker for head and neck surgery. One of the most fascinating things about Ivo Pitanguy was his personality. His skills and work ethic were legendary. He was ambidextrous and could operate equally well with his right and left hands. He would routinely operate 12 hours daily then go immediately to a black-tie event in the evening. He assembled an excellent team to facilitate this productivity. He was also very sociable and warm, another unusual trait for surgeons at the time. He spoke 6 languages fluently. His patients included movie stars such as Brigitte Bardot, Frank Sinatra, and Michael Jackson, whose scalp he repaired after it was burned while filming a Pepsi commercial. He treated royalty including empress Farah Diba of Iran. He also treated political royalty including Jackie Onassis and Rosalynn Carter. He was also unusually open with the press. This was partially facilitated by the fact that there were fewer legal and cultural restrictions against self-promotion in Brazil compared with the United States and Europe. An article in Time magazine in 1967 helped spread his fame internationally among non-surgeons. One of his patients wrote a book titled The Beautiful People’s Beauty Book in 1971, which was the first public glimpse inside the world of plastic surgery. He earned the respect and, unfortunately, jealousy of many plastic surgeons because of his skills and fame. For example, many European countries recruited him to operate but subsequently withdrew his privileges because of his popularity. Joan Kron explained that "it would take years for the medical establishment to accept the fact that publicity and charlatanism didn't necessarily go hand in hand." In the end, Ivo Pitanguy had the last laugh. The institutions he built, the physicians he trained, and his contributions to the medical literature are inalienable. His life inspired Vinciciu de Moraes, the writer of the song “The Girl from Ipanema” to coin the new Portuguese verb Pitanguizar , which means to create beauty. According to Joan Kron, who had an opportunity to spend time with Dr. Pitanguy before he passed, he explained that his goal was "to give age a dignified expression, a frame the spirit can inhabit" while being "adamant that surgeons - or anyone else, for that matter - should not impose their vision on the patient." Conclusion Harold Gillies, Archibald McIndoe, John Orlando Roe, Jacque Joseph, Suzanne Noel, Joseph Sheehan, Maurice Cottle, Irving Goldman, and Ivo Pitanguy stood on the shoulders of giants. Now giants themselves, newer generations of facial plastic surgeons are advancing on their discoveries and innovations. Among the major lessons about the lives of these individuals is that the reconstructive and cosmetic side of facial plastic surgery are both important and essential. Each area of focus informs the other. A second major lesson is the importance of being inclusive. Suzanne Noel, Jacque Joseph, and Ivo Pitanguy were all discriminated against in some way, but they persevered and contributed immeasurably to the field of facial plastic surgery. Future advances will depend on identifying and supporting talented surgeons regardless of their background. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References Gilman, Sander L. Making the Body Beautiful: A Cultural History of Aesthetic Surgery . Princeton, New Jersey: Princeton University Press, 1999. Print. Haiken, Elizabeth. Venus Envy: A History of Cosmetic Surgery . Baltimore, Maryland: The Johns Hopkins University Press, 1997. Print. Holzer, John. Plastic Surgery Obsession: Brazil’s Dr Ivo Pitanguy Triggered it All . Houston, TX: Alto Press, 2011. Print. Martin, Paula J. Suzanne Noel: Cosmetic Surgery, Feminism and Beauty in Early Twentieth-Century France . Burlington, Vermont: Ashgate, 2014. Print. Meikle, Murrary C. Reconstructing Faces: The Art and Wartime Surgery of Gillies, Pickerill, McIndoe & Mowlem . Otago University Press, 2013. Print. Mendelson, Bryan. In Your Face: The hidden history of plastic surgery and why looks matter . Richmond, Virginia: Hardie Grant Books, 2013. Print. Simons, Robert L. Coming of Age: A Twenty-Fifth Anniversary History of the American Academy of Facial Plastic and Reconstructive Surgery . New York, New York: Thieme Medical Publishers, Inc., 1989. Print. --- ### 4 Benefits of the Extended Deep Plane Facelift URL: https://www.harmonface.com/blog/4-benefits-of-the-extended-deep-plane-facelift Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Dr. Jeffrey Harmon Learn More About Our Deep Plane Facelift Schedule a Consultation The most natural, longest-lasting approach to a facelift is the deep plane facelift . The extended deep plane facelift offers a variety of benefits that other facelift procedures simply cannot provide. Keep reading to learn more, and schedule a consultation at Harmon Facial Plastic Surgery in Cincinnati. Restores the Natural Position and Volume of Drooping Cheeks Unlike other facelift techniques, the extended deep plane facelift restores and enhances natural volume to the cheeks. This reduces or eliminates the need to place additional volume in the cheeks with fat or filler. Restores the Natural Definition, Length, and Volume of the Jawline Unlike other facelift techniques, the extended deep plane facelift redefines the entire length of the jawline and restores youthful volume to the corner of the jaw. Tension-Free Lift One important difference between the extended deep plane facelift and older approaches is that the extended deep plane facelift releases multiple tension points and lifts both the skin and muscle layers of the face at the most natural anatomic angle, neither too vertical nor too horizontal. This allows a much more natural result and prevents the "pulled" appearance that can sometimes occur with other approaches. Improved Healing The tension-free approach to the extended deep plane facelift significantly improves skin healing and reduces the appearance of incisions when compared with older approaches to face lifting. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Schedule a Consultation If you are interested in the benefits of an extended deep plane facelift, schedule a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Reach out today to schedule . Contact Us --- ### Perioral Mounds: What are They and Why are They So Difficult to Treat? URL: https://www.harmonface.com/blog/perioral-mounds-what-are-they-and-why-are-they-so-difficult-to-treat Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Perioral rejuvenation – or plastic surgery of and around the mouth – is a popular topic in Cincinnati, Ohio. The perioral area includes not only the lips but also the skin and other soft tissue immediately surrounding the lips. The perioral mounds are a subunit of this anatomy that are relevant to facelift surgery . The characteristics and location of the perioral mounds make them very difficult to treat. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Perioral Mounds are Adjacent to, but Distinct From, the Jowls The perioral mounds (see image above) have been described as an area that sits between the lower edge of the cheek fat compartments and the fat compartments that form the jowls. The perioral mounds can become fuller and droopier with age ( 1, 2 ). Perioral mounds are confused by many with the jowls, which themselves are confused with buccal fat . Jowls are the fat and other soft tissue of the superficial lower cheek that hangs over the bony jawline with aging. Stuzin et al describe jowl fat as “fluffy, thick fat” which is “situated between the masseter ligaments and the mandibular ligaments overlying the facial portion of the platysma” muscle ( 3 ). In contrast, the fat located in the perioral mound is very thin with poorly defined borders. Perioral mounds are a distinct anatomic feature of the face. The fat in perioral mounds overlies soft tissue called the SMAS layer, which is superior to and continuous with the platysma muscle ( 1, 2 ). The SMAS and platysma muscle are treated during deep plane facelift surgery, which is why this approach to facelift surgery can be so effective in treating the jowls in a long-lasting and natural appearing way. However, facelift procedures of any kind do not effectively treat age-related changes at the perioral mounds ( 1, 2 ). This may be because multiple muscles that move the mouth meet at the perioral mounds. As a result, dissection does not proceed that close to the mouth. In addition, the area around the perioral mounds contracts actively with speech and emotive facial expressions, creating a crease that is often confused with the perioral rhytids/wrinkles that are typically best treated with a resurfacing procedure such as a laser, chemical peel, or dermabrasion. Such resurfacing procedures are also poorly effective at treating the skin at the perioral mounds. There are Two Treatment Options That Have Been Discussed for Perioral Mounds There is little research published on the treatment of the perioral mounds. Two studies describe the use of a small cannula to perform a limited liposuction of the site manually ( 1, 2 ). The problem with this approach is the fact that the fat in this location is very thin and close to the surface of the skin. As a result, Gu et al report “overaggressive liposuction of the perioral mound region may result in skin hyperpigmentation, unnatural facial expressions, depression, and even skin necrosis” ( 2 ). Depression or unevenness of the area from liposuction is one of the most concerning and logical risks of this technique. Also, while liposuction can reduce fat, it does not improve loose or hanging soft tissue, including the SMAS layer, which may develop with age. A second treatment described is the use of energy-based devices to melt fat and tighten skin at this site. The energy-based devices include, but are not limited to, devices that utilize radiofrequency energy to heat the tissue deep to the skin. A search of the medical literature found no article describing this technique and demonstrating its effectiveness. One should be extremely cautious at this time when pursuing treatment of the perioral mounds due to the potential risks of liposuction and the lack of published effectiveness research for energy-based devices. More safe and effective treatment options may become available in the future, however, as newer techniques and technologies become available. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati, Ohio. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us References Sullivan PK, Hoy EA, Mehan V, Singer DP. An anatomical evaluation and surgical approach to the perioral mound in facial rejuvenation. Plast Reconstr Surg. 2010 Oct;126(4):1333-1340. Gu Y, Yang M, Li J, Sun J, Lv Q, Qi Y, Han X, Qi Z, Ma GE. Efficacy and Safety of Perioral Mound Region Liposuction-A Novel Concept to Improve Perioral Mound Fullness. Aesthet Surg J. 2023 Apr 10;43(5):527-534. Stuzin JM, Rohrich RJ, Dayan E. The Facial Fat Compartments Revisited: Clinical Relevance to Subcutaneous Dissection and Facial Deflation in Face Lifting. Plast Reconstr Surg. 2019 Nov;144(5):1070-1078. --- ### How Do Brow Lift Procedures Differ? URL: https://www.harmonface.com/blog/how-do-brow-lift-procedures-differ Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes There are a range of approaches to lifting the eyebrows, the best of which depends on the specific anatomy of a patient as well as their aesthetic goals. While the list below is not comprehensive, it highlights two important approaches to the brow lift as well as the considerations that go into choosing which is the most appropriate approach. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. A Lateral Temporal Brow Lift Naturally Addresses the Most Common Age-Related Concern Patients Have About Drooping Brows The lateral temporal brow lift , also referred to as an endoscopic brow lift, can address the most common concerns about the eyebrows. Most individuals express concern about age-related drooping of the lateral eyebrows over their eyes. This can result in “hooding” or an overhang of skin and fat over the lateral eyes. As a result, the eyebrow can develop an exaggerated curve where the lateralmost portion of the eyebrow curves down around the eye rather can canting upward laterally. The lateral temporal brow lift lifts the lateral brow up and out in a tension-free manner, which is key to a natural, long-lasting result. Only two incisions placed behind the hairline are required. The lateral temporal lift can lift the medial brow up to approximately 3 mm as well. If more than approximately 3 mm of medial brow lift is required, the medial brows can be lifted more with only two additional small incisions hidden in the hair. The lateral temporal lift results in no removal of skin or hair follicles, an enormous benefit associated with the procedure. A Pretrichial or Trichophytic Brow Lift May Be a Good Option for Revision Procedures and Those with a High Hairline Seeking to Lower It Another approach to the brow lift involves a longer incision extending across the hairline. The incision can be placed slightly into the hairline (trichophytic) or along the hairline (pretrichial). A pretrichial or trichophytic brow lift may be the best approach for those individuals who are not only seeking a brow lift but who also have a very high hairline, such as men with receding hairlines or women with a high forehead. This technique can lower the hairline and improve the appearance of the forehead. This technique is also potentially a good option for revision procedures in which a previous lift was too aggressive, resulting in a “surprised” appearance to the eyes. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about drooping eyebrows. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us References Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthet Surg J . 2013 Aug 1;33(6):769-82. Jacono A. Extended Deep Plane Facelift and Other Adjunctive Procedures for Rejuvenation of the Upper, Middle and Lower Face. Quality Medical Publishing Inc. Lee H, Quatela VC. Endoscopic Browplasty. Facial Plast Surg . 2018 Apr;34(2):139-144. Sykes JM, Riedler KL, Cotofana S, Palhazi P. Superficial and Deep Facial Anatomy and Its Implications for Rhytidectomy. Facial Plast Surg Clin North Am . 2020 Aug;28(3):243-251. --- ### Youthful Neck Anatomy and Neck Lift Surgery URL: https://www.harmonface.com/blog/youthful-neck-anatomy-and-neck-lift-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck The neck is a common area patients seek improvements in with surgery. Signs of aging in the neck are the result of loosening muscle and skin and sometimes the accumulation of fat. The medical literature recognizes youthful contours and angles to the neck and jawline which surgeons can strive for. However, all patients are not born with these features. In fact, there probably is no true “ideal” neck which every patient possesses in youth. There are many approaches to a neck lift. My approach is through a deep plane neck lift in the central neck in addition to a deep plane lift of the sides of the neck through the extended deep plane facelift . I feel this approach can provide the most comprehensive and longest-lasting improvements in the appearance of the neck. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. It is important to have a discussion with your surgeon about what can and cannot be accomplished with surgery to treat age-related changes to the neck. Tight Muscle and Skin Tight platysma muscle and skin contribute to a youthful-appearing neck. The platysma muscle is a long, thin muscle that wraps around the front and sides of the neck. It is weakest at the center. Most age-related changes to the platysma muscle occur when the center of the muscle weakens. This results in a separation of the muscle fibers from the center of the neck resulting in banding. Banding appears as thick, ropy folds in the center of the neck that can be more limited to the upper part of the neck or extend down low in the neck. The skin follows the loosening of the platysma muscle. Sharp Angle between the Jawline and Neck The angle between the more horizontal jawline and the more vertical neck is called the cervicomental angle. An aesthetically “ideal” angle is acute, with the soft tissue under the jawline tucked up between the jaw bones and the skin and platysma muscle tight against the neck. Age results in a blunting of the cervicomental angle, regardless of where it started. This can be due to loosening of the platysma muscle resulting in banding, the accumulation of fat deep to and superficial to this muscle, and loosening skin. The horizontal location of the soft tissue – whether it is tucked up under the jawline or rests below it – is dependent on the patient’s natural anatomy. Some individuals may have more soft tissue that sits below the jawline from an early age. Visible Thyroid Notch The thyroid notch is a small depression above the cartilage, called the thyroid cartilage, and below the cervicomental angle. It is less visible in women versus men because men have a more prominent thyroid cartilage. The thyroid notch reflects the tight attachment of the soft tissue of the neck just below the cervicomental angle. Loosening of skin and muscle in the neck due to aging reduces the appearance of the thyroid notch. Tightening of the muscle and skin can improve the appearance of it. Every Neck is Different Every individual is born with different neck features. Some individuals were born with a sharp cervicomental angle and little soft tissue hanging below the jawline. Others were born with a blunter cervicomental angle and, therefore, a more poorly defined neck. A blunted cervicomental angle can be due to the location of a bone, called the hyoid bone, which sits above the thyroid cartilage. When the hyoid bone sits up and back in the neck a sharper cervicomental angle is possible. However, some individuals are born with a hyoid that sits down and forward, creating a naturally more blunted cervicomental angle. All the deeper muscles of the neck radiate from this bone, which is what sets the cervicomental angle in the first place. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! CONTACT US --- ### Why People Seek Revision Nose Surgery and the Expected Recovery URL: https://www.harmonface.com/blog/why-people-seek-revision-nose-surgery-and-the-expected-recovery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Nose Revision, or secondary, nose surgery (rhinoplasty) is a technically challenging procedure, largely because the previous surgery usually alters the nasal anatomy in unpredictable ways that require creativity and skill to address and correct. There are many reasons why a patient would desire to undergo revision rhinoplasty. In most cases, however, the recovery from a secondary nose surgery is longer and less predictable than with the first surgery. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have difficulty breathing through your nose and/or concerns about the appearance of your nose after a previous nose surgery. Some Patients Experience New Difficulties Breathing After Their First Procedure There are multiple reasons why a patient may experience new difficulties breathing after nose surgery. Rarely, some patients experience abnormally aggressive scarring in the tissue deep to the skin of their nose that can weaken the support structures of the nose and even cause them to collapse. Abnormal scarring can be due to infection, autoimmune disorders, and/or other medical conditions that make abnormal healing more likely. New difficulty breathing is more likely when too much cartilage is weakened or removed during the first surgery. It is also more likely when the nasal bones are too aggressively manipulated during surgery. Revision nose surgery seeks to re-support and reinforce weakened cartilage and bone in a way that preserves or restores the cosmetic appearance of the nose. Other Patients Experience Persistent or New Concerns About the Appearance of Their Nose More often it is persistent or new cosmetic concerns about their nose that bring patients in for revision nose surgery. Abnormal healing may not result in difficulty breathing through the nose but may result in cosmetic abnormalities they would like corrected. Those abnormalities may be due to weakening and collapse of the cartilage and/or bone in the nose after the first surgery. Potential problems include a collapse of the bridge of the nose or the nostrils and a more significant asymmetry of the nasal bridge and/or nasal tip. Other abnormalities are due to poorly planned surgery resulting in an over projected nasal tip after removal of a large hump on the nasal bridge or a nasal tip that is overly rotated up or overly pinched after surgery. Correction of the above problems often requires reinforcement and realignment of cartilage with cartilage grafts and/or realignment of the nasal bones. Expect a Slightly Longer and Less Predictable Recovery after the Second Procedure Undergoing a revision nose surgery to correct problems associated with the first is a very rewarding procedure that can provide immeasurable benefits to patients. However, it is important to counsel patients that the expected swelling after surgery can be greater and take longer to resolve than after the first surgery. This is because the blood supply and lymphatic drainage system is not as robust after the first surgery, which is normal and expected. It is also for this reason that it is essential that all patients be counseled that the healing process overall can be less predictable with revision nose surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your nose. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Why People Seek Revision Facelifts and Why Deep Plane Facelift Surgery is the Best Approach URL: https://www.harmonface.com/blog/why-people-seek-revision-facelifts-and-why-deep-plane-facelift-surgery-is-the-best-approach Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck There are many reasons individuals seek revision , or secondary, facelifts. Regardless of the reason, deep plane facelift surgery including the extended deep plane facelift is usually the superior approach. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Some Individuals Were Happy with Their Previous Facelift But it is Time for a Secondary Procedure No facelift technique stops the aging process. As a result, the age-related changes in the face that were treated with a facelift progress, usually over a period of years. Patients who undergo older facelift techniques tend to notice a recurrence of loose skin, muscle, and fat more quickly (i.e., many years earlier) than those who undergo deep plane facelift surgery. Many individuals loved their results from their first facelift but would like a secondary procedure to lift what has fallen again. Other Individuals are Concerned About Incomplete Treatment of the Signs of Facial Aging or Poor Cosmetic Results Some individuals feel their facelift results did not adequately treat the signs of facial aging that concerned them. Inadequate treatment of the neck with a facelift can result in persistent, severe, hanging skin and muscle. The neck can be better addressed specifically with the extended deep plane facelift . Facelift techniques that are not deep plane techniques do not lift the cheeks, which can make the face appear unnatural when the jawline is partially addressed but the cheeks are not. Many surgeons add large volumes of fat to the face to mask the lack of a cheek lift. However, as previously discussed , this can distort the natural appearance of the cheeks by leaving the drooping volume in an unnatural position while adding more volume where the natural volume should be located. Other individuals experience poor cosmetic results making their face appear distorted and unnatural. Individuals who undergo facelift techniques that are not deep plane are at a significantly increased risk of multiple abnormalities. First, they are at an increased risk of poor healing and abnormal scarring at the incision sites due to the presence of significant tension on the skin. Second, they are at an increased risk of a pixie ear deformity, which is the adherence of the earlobe to the side of the face, which then stretches out down the side of the face as the incisions heal. Third, they are at an increased risk of appearing “windswept” or abnormally stretched horizontally, which can result in an unnatural purse string appearance with tethering at the jawline and a widened mouth. Deep Plane Facelift Surgery is the Best Facelift Technique to Address the Signs of Facial Aging Comprehensively in a Revision Procedure Please see the following blog post to understand why the extended deep plane facelift – and deep plane facelift surgery generally – is the best technique to address the signs of facial aging comprehensively and naturally in individuals who have previously undergone a facelift. There is a great deal of scarring of the tissue deep to the skin after any facelift procedure. As a result, the blood supply to the skin is weaker than prior to surgery. Deep plane facelift surgery is a superior approach to a secondary facelift because it preserves thicker, healthier tissue when lifted and more of the surgical work occurs in areas of the face that are previous untouched, and therefore, safer to navigate. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Why Our Hair Turns Gray with Age URL: https://www.harmonface.com/blog/why-our-hair-turns-gray-with-age Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Hair The cells that impart color to the hair, called melanocytes, are the same cells that impart pigmentation to the skin. The melanocytes located in hair follicles are more sensitive to the aging process than those in the skin. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Melanocytes in the Skin and Hair Follicle are Related but Behave Differently Melanocytes in the skin and hair follicle are related to each other but behave differently where they reside. For example, melanocytes associated with hair follicles function with the hair cycle; that is, when the hair is in its growth stage, called anagen, it is producing the melanin that pigments the hair. However, when the hair is dormant (i.e., telogen phase) melanin is not produced. Melanin is always produced by melanocytes in normal skin. The Number of Melanocytes in the Hair Follicles Decreases with Age When melanocytes are lost in the hair follicle there is less melanin produced and less pigment in the hair. This is what leads to graying of the hair. This process tends to occur in the scalp earlier than in the beard and in body hair in men. The average age of hair graying depends on an individual’s gender, race, and family history. For example, Caucasians tend to start graying the earliest, in their mid-30s. The cause of early graying is not yet clear, though it may have something to due with the production of inflammatory free radicals in the body, like what causes skin changes associated with aging, chronic sun exposure, and tobacco use . Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your hair. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us References Blume-Peytavi U, Tosti A, Whiting DA, Trueb R, eds. Hair Growth and Disorders . Springer Publishing; 2008. --- ### Which Bags are Treated by Lower Eyelid (Blepharoplasty) Surgery? URL: https://www.harmonface.com/blog/which-bags-are-treated-by-lower-eyelid-blepharoplasty-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes There are two different bags that can develop in the lower eyelid/cheek region which people request treatment for. These are (1) lower eyelid bags created by fat that has started to prolapse out against the eyelid and (2) festoons, also known as malar bags, which are pockets of swelling located at the eyelid/cheek interface below the lower eyelid bags. Each requires different surgical approaches to treat. The treatment for one does not treat the other. As always, an in-person consultation with a qualified medical professional is essential prior to considering facial plastic surgery. It is important to determine whether the area of concern is related to lower eyelid bags or festoons/malar bags. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Lower Eyelid Bags are Caused by Pseudo Herniated Fat and Can be Treated with Lower Eyelid Surgery (Blepharoplasty) Lower eyelid surgery (blepharoplasty) can treat multiple aspects of age-related changes to the eye. Though redundant lower eyelid skin and loose or “blousy” muscle can be improved with lower blepharoplasty, the primary reason lower eyelid surgery is performed is to treat lower eyelid bags. These bags can leave a heavy, tired appearance in the eyes that makes the face appear significantly older. These bags are caused by fat in the lower eyelids – which is normally held in place by a “wall” called the septum – pushing the septum forward such that the fat hangs over the tear trough and cheeks. Festoons are Also Known as Malar Bags and Can Be Treated with Direct Excision We are not certain what causes festoons, the watery swelling around the lower end of the lower eyelids at and around the junction with the cheek. The swelling demonstrates characteristic slightly translucent skin with occasional redness. Individuals can have both lower eyelid bags and festoons at the same time. The most common approach to treating festoons, especially severe festoons, is by directly excising them along with the skin. This does, however, leave a potentially obvious scar at the junction between the lower eyelid and cheek. There can also be prolonged swelling of this site after surgery, presumably due to the same process that causes the festoons themselves. It is Important to Distinguish Between Pseudo Herniated Fat and Festoons/Malar Bags to Determine the Most Appropriate Surgical Treatment The approach to lower eyelid surgery (blepharoplasty) at Harmon Facial Plastic Surgery is through fat preservation, where the fat in the lower eyelid is preserved and simply reoriented to a more anatomic region where youthful volume can be preserved and the transition from the lower eyelid to the cheeks smoothed. This contrasts with older approaches that simply remove the lower eyelid fat and/or add fat transferred from other parts of the body to the lower eyelids. It is important to counsel patients that lower eyelid surgery (blepharoplasty), even fat preservation lower eyelid surgery (blepharoplasty), does not treat festoons/malar bags. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### Where Does the Cartilage Used to Graft the Nose Come From? URL: https://www.harmonface.com/blog/where-does-the-cartilage-used-to-graft-the-nose-come-from Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Nose The nose is composed of multiple, matching, complexly shaped cartilage pieces and bone. The use of additional cartilage is often required to achieve specific functional or aesthetic goals during nose surgery (rhinoplasty) . For example, cartilage can be used to open and strengthen the valves of the nose to improve nasal breathing. It can also be used to change the contours of the nose to achieve a specific aesthetic result. There are four different sources of cartilage used in nose surgery (rhinoplasty) to achieve the functional and aesthetic goals of the operation. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Nasal Septum The nasal septum, located inside the nose, is the “wall” that separates the left from the right nasal cavity. It is composed of cartilage and bone. The bone is sometimes used for grafting. However, it is usually the cartilage only that is used for grafting. The nasal septal cartilage is an ideal source for most needs during nose surgery (rhinoplasty). It is relatively straight and strong. The thickness is usually ideal. There is typically enough that can be removed to accomplish the functional or aesthetic goals of grafting. Except in select circumstances, nasal septal cartilage is usually the first cartilage used during nose surgery (rhinoplasty). There are cases when this cartilage is not available or ideal. For example, patients with severe injuries to their nose may have septal cartilage that is crushed and severely scarred. Other patients may have undergone a septoplasty or nose surgery (rhinoplasty) previously and have inadequate cartilage available. The options below are typically used when this is the case. Ear The ears include a large piece of cartilage with complex folds. There are subunits to the cartilage in the ear, also known as the auricle. The area harvested is called the concha, which is the bowl-shaped area closest to the opening of the ear canal. This area contains cartilage that closely matches the size and shape of the nostrils. Removal of a portion of the concha is also less likely to result in deformities to the ear compared with other areas. Conchal cartilage is also not always ideal for use. It is not as strong as other cartilage sources. As a result, it is less useful when strong structural support of the nose is required. There is less cartilage available from a single ear when compared with a previously untouched septum. And this cartilage can become hard and brittle with advanced age, limiting its usefulness in some individuals. Rib The rib is an ideal source of cartilage for many reasons. First, it can be strong like septal cartilage. Second, abundant cartilage can be harvested. This makes it particularly useful for large grafts such as those meant to increase the height of the nasal bridge. Third, its shape allows additional flexibility in carving the exact shape and size graft required. This graft can be very useful for revision nose surgery (rhinoplasty) when extensive grafting is required and there is no longer septal cartilage to use. The rib cartilage is harvested through an incision below the breast. Many patients prefer to avoid the additional procedure below the breast and its associated recovery and incision. Another option for rib is donor rib cartilage that is processed and tested to ensure its safe, effective use. The Most Appropriate Source of Cartilage Depends on Multiple Factors Some patients do not require cartilage grafting. For those who do, the most appropriate cartilage source depends on the size and shape of the graft required, the patient’s medical and surgical history, and their personal preferences. The plan for cartilage harvesting is discussed with the patient pre-operatively. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your nose. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### When Should I Consider Undergoing Facial Plastic Surgery Procedures Prior to a Wedding? URL: https://www.harmonface.com/blog/when-should-i-consider-undergoing-facial-plastic-surgery-procedures-prior-to-a-wedding Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information There are many wonderful options for facial rejuvenation prior to a wedding. And whether you are the bride, groom or, more commonly, the mother or father of the bride or groom, it is important to know what procedures are commonly sought and how long before such an event one should consider undergoing these procedures. Seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether any of these procedures may be able to address your concerns and desires. Six Months to One Year Prior to the Wedding Day The extended deep plane facelift and neck lift are frequently considered prior to a wedding, usually from the mother or father of the bride or groom. These procedures are among the most effective at restoring some of the youthful features of the face and neck. It is recommended to allow at least six months but preferably twelve months prior to the wedding to the wedding date to undergo these procedures to allow enough time to heal. Three to Six Months Prior to the Wedding Day Many individuals desire a refresh of their eyes prior to a wedding. They are concerned about redundant upper eyelid skin, drooping eyebrows, and lower eyelid bags . They would like their eyes to appear more “open” and youthful. The lateral temporal brow lift can address eyebrow drooping and eyelid surgery (blepharoplasty) can address redundant upper eyelid skin and lower eyelid bags. All three procedures complement each other. It is recommended to allow at least three months but preferably six months prior to the wedding date to undergo a lateral temporal brow lift and/or eyelid surgery (blepharoplasty). Like eyebrow and eyelid surgery, allow at least three months but preferably six months prior to the wedding date to undergo laser resurfacing of the face. Laser resurfacing can treat wrinkles, age spots, and sunspots as well as mismatched and uneven skin texture. It is very important to avoid prolonged exposure to the sun for the first three months after the procedure, which is often difficult on the wedding day. Two to Four Weeks Prior to the Wedding Day Botox® is one of the most common procedures requested by the wedding party. It is recommended to allow at least two weeks prior the event for the effects of the treatment to reach their maximal effect. It is preferable to receive this treatment at least four weeks prior to the wedding in case additional Botox® needs to be added to achieve an ideal result. Like Botox®, allow at least two weeks but preferably four weeks prior to the wedding date to have hyaluronic acid filler placed. The Above Time Frames are Recommendations and Not Guarantees of Results The above time frames listed are a best approximation of the anticipated recovery from each procedure. Every patient is different and may heal at a different rate. Therefore, the above time frames listed do not guarantee full recovery prior to the wedding day. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about age-related changes in the face and/or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### When Is Jawline Filler Not Aesthetically Appropriate? URL: https://www.harmonface.com/blog/when-is-jawline-filler-not-aesthetically-appropriate Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Hyaluronic acid filler is commonly placed in the jawline to mask age-related changes to the jawline, including drooping jowls and loosening skin and muscle. However, placing hyaluronic acid filler in this location is not a replacement for a facelift and can sometimes masculinize the face and/or accentuate the appearance of the jowls. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. A Hyaluronic Acid Filler Product for the Jawline was Recently FDA-Approved The hyaluronic acid filler product by Juvederm©, Volux XC, has recently been FDA-approved for use in the jawline. However, there are multiple products from companies including Restylane©, Juvederm©, and others, that demonstrate properties that may make it appropriate for use in the jawline. These products may be appropriate for individuals with a weak, receded jawline, most often in men. Only a Small Cohort of Female Patients Could Potentially Benefit from Jawline Filler Generally, only a small cohort of female patients demonstrate a weakness in the jawline severe enough to benefit from placement of filler in this location. The problem with adding volume along the jawline in women with drooping jowls and a loss of definition of the jawline is that it risks masculinizing the face and making the jowls appear heavier than they are. In contrast, the chin is a commonly recessed area for which filler can often be an appropriate treatment option for men and women. Only a Facelift Can Directly Address Jowls A facelift and neck lift are the best treatment options for loose and drooping soft tissue - including skin, muscle, and fat pads - along the jawline. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### When is it Unwise to Narrow the Nasal Tip? URL: https://www.harmonface.com/blog/when-is-it-unwise-to-narrow-the-nasal-tip Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Nose Cosmetic nose surgery (rhinoplasty) is one of the most common procedures I perform. Patients who have never undergone nose surgery often request a “smaller” nasal tip. A more refined tip can be delivered with specialized techniques that also preserve the strength and structure of the tip of the nose in most instances. However, sometimes what individuals perceive as a large or “bulbous” nasal tip is something else entirely. Instead, it is a problem that requires a more complex technique to deliver on their aesthetic goals. It is important to ground an understanding of why this is sometimes the case by reviewing the anatomy of the nasal tip. The nasal tip is formed primarily by paired cartilages, called lower lateral cartilages, and their ligamentous attachments to each other as well as surrounding cartilage and soft tissue (see image below). The lower lateral cartilages pair up and align at the center. This area of the cartilage is called the medial crura or columella. The cartilages then separate, curving out over the nostrils. This section is called the lateral crura. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Source: Modification of Image from Çakır B, Küçüker İ, Aksakal İA, Sağır HÖ. Auto-Rim Flap Technique for Lateral Crura Caudal Excess Treatment. Aesthet Surg J. 2017 Jan;37(1):24-32. The lateral crura are sometimes angled too vertically (see image below). The lateral crura can collapse when they are angled too vertically, resulting in a concave rather than a convex curve. The lateral crura are considered too vertically positioned. The nasal tip appears large not because it is but because the lateral crura are “pinched.” It becomes clearer when comparing the tip of the nose to the middle third of the nose. If the tip is approximately the width of the middle of the nose it is unlikely to be too large. It is important to recognize this deformity because performing the standard suite of tip narrowing techniques on such a nose will not improve it and may, in fact, make it worse. Instead of trying to reduce the size and therefore strength of the nasal tip, this section of the cartilage needs to be strengthened and reoriented to provide the more refined shape the individual is seeking. This can be performed using cartilage taken from the septum inside the nose. The modifications I often recommend in these instances can require extensive counseling, because some patients are understandably confused when they present to my office believing they have a large nasal tip. This is a circumstance that requires a detailed exam to identify and treat correctly Source: Mohebbi A, Azizi A, Tabatabaiee S. Repositioned lateral crural flap technique for cephalic malposition in rhinoplasty. Plast Surg (Oakv). 2015 Fall;23(3):183-8. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References Çakır B, Küçüker İ, Aksakal İA, Sağır HÖ. Auto-Rim Flap Technique for Lateral Crura Caudal Excess Treatment. Aesthet Surg J. 2017 Jan;37(1):24-32. Mohebbi A, Azizi A, Tabatabaiee S. Repositioned lateral crural flap technique for cephalic malposition in rhinoplasty. Plast Surg (Oakv). 2015 Fall;23(3):183-8. --- ### What was the “Harper’s Bazaar Hassle?” URL: https://www.harmonface.com/blog/what-was-the-harpers-bazaar-hassle Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: History The promotion of aesthetic plastic surgery in the United States increased dramatically after the second world war when surgeons who gained experience reconstructing the war wounded saw a sudden drop in patients. This development paralleled the greater professionalization – the act of increasing training for and/or the qualifications required to enter - of the field of plastic surgery. However, one of the problems associated with the early advertising of plastic surgery services in the 1940s and 1950s was that these promotional efforts did not extend to the head and neck surgery trained facial plastic surgeons who were highly qualified to perform aesthetic facial plastic surgery procedures. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Facial Plastic Surgeons Could Not be Listed in the Yellow Pages Facial plastic surgeons even had difficulty getting their names listed in the Yellow Pages, which was one of the most important ways for prospective patients to find plastic surgeons at the time. The American Medical Association (AMA) specialty code designations that telephone companies adhered to when listing physicians in the Yellow Pages did not allow a physician to declare their sub-specialty practice or to change their specialty practice after they were listed. This prevented a head and neck surgeon from, for example, declaring a subspecialty of facial plastic surgery or changing their specialty to facial plastic surgery, which effectively excluded them from advertising. It took an anti-trust complaint filed by the Federal Trade Commission against the AMA in the 1970s – which allowed physicians to generally advertise and market – to allow facial plastic surgeons to appropriately designate themselves in the Yellow Pages. Photo Source: Simons, Robert L. Coming of Age: A Twenty-Fifth Anniversary History of the American Academy of Facial Plastic and Reconstructive Surgery . New York, New York: Thieme Medical Publishers, Inc., 1989. Print. Facial Plastic Surgeons were Professionally Excluded Head and neck surgery trained facial plastic surgeons were not allowed to evaluate the credentials of facial plastic surgeons for hospital privileges and plastic surgeons often refused to do so. Plastic surgery medical societies who agreed to allow head and neck surgeons to present papers were often criticized. Attempts were made to stop seminars on facial plastic surgery taught by head and neck surgeons. Companies were threatened with economic sanctions for agreeing to sell surgical equipment to head and neck surgeons. Plastic surgeons even obstructed the teaching of facial plastic surgery to head and neck surgery residents. These restrictions lead head and neck surgery residency programs to develop some of the earliest formalized and best organized teaching curricula for facial plastic surgery. For more information on this please see this previous blog post on the history of facial plastic surgery. A Harper’s Bazaar Article Led to the American Academy of Facial Plastic and Reconstructive Surgery An article was published under the heading “The Wish to be Beautiful” by the plastic surgeon Geri Trotta in Harper’s Bazaar in 1960. Readers were asked to write to the secretary of the American Board of Plastic Surgery in St. Louis for a list of qualified surgeons. Those qualified surgeons did not include facial plastic surgeons. Harper’s Bazaar was, and remains, a popular and widely read beauty and fashion magazine. As a result, this article captured the attention of the public. Called the “Harper’s Bazaar Hassle,” this article was a strong impetus for the formation of the American Academy of Facial Plastic and Reconstructive Surgery – of whom I am a fellowship-trained member – in 1964. This Level of Conflict no Longer Exists between Specialties The contributions of both facial plastic surgeons and plastic surgeons to the field of plastic surgery has been immense. For example, it was the plastic surgeon Sam Hamra who developed and first published on deep plane facelift surgery, which my fellowship director, the facial plastic surgeon Andrew Jacono, advanced with his extended deep plane facelift technique . Each specialty has valuable skills and lessons to teach the other. That exchange in the literature and at conferences is essential to advancing the field of aesthetic plastic surgery. The above history simply highlights the early challenges facial plastic surgeons faced to gain the professional respect and acknowledgement they deserved. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us References Simons, Robert L. Coming of Age: A Twenty-Fifth Anniversary History of the American Academy of Facial Plastic and Reconstructive Surgery . New York, New York: Thieme Medical Publishers, Inc., 1989. Print. Featured photo of June 1960 cover of Bazaar credit: EphemeraForever.com via Pinterest --- ### What to Expect from a Consultation with Dr. Jeffrey Harmon URL: https://www.harmonface.com/blog/what-to-expect-from-a-consultation-with-dr-jeffrey-harmon Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Patients can expect a detailed and honest conversation with Dr. Harmon during their consultation at Harmon Facial Plastic Surgery in Cincinnati, Ohio. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Expect a Detailed Conversation About Your Concerns and Aesthetic Goals with Dr. Harmon Dr. Harmon feels that the focus of a consultation should be on establishing a strong physician-patient relationship. As a result, he brings patients to his office and conducts the entire consultation himself. Expect a detailed discussion about your concerns and aesthetic goals. Dr. Harmon prefers to listen to what concerns you rather than tell you what he thinks should concern you. Expect an Honest Conversation About the Available Treatments, their Benefits, and their Potential Risks Dr. Harmon performs the gold standard surgical techniques in aesthetic facial plastic surgery including the extended deep plane facelift and fat perseveration eyelid surgery (blepharoplasty) . He also adheres to the most up-to-date evidence in the medical literature when making recommendations, whether surgical or non-surgical. As a specialist in facial plastic surgery, he can confidently determine whether a surgical or non-surgical treatment would best address your concerns and aesthetic goals. He also believes it is important to communicate not only the benefits of any procedure but also the potential risks – however small – to patients himself. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### What Qualities Distinguish Hyaluronic Acid Dermal Filler Products? URL: https://www.harmonface.com/blog/what-qualities-distinguish-hyaluronic-acid-dermal-filler-products Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Hyaluronic acid dermal fillers can address specific concerns about flatness or poor volume in your face , including your temples, cheeks, tear troughs, lips , chin, and/or jawline. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether dermal fillers are appropriate for your concerns. Different Hyaluronic Acid Dermal Filler Products Deform and Change Under Stress Differently The study of how a material – in this case, hyaluronic acid dermal filler – deforms and changes under mechanical stress is called rheology (1). Hyaluronic acid is produced in the body in massive quantities but is soon dissolved. In contrast, hyaluronic acid dermal filler products are produced in a laboratory, outside of the human body, with particles of a controlled size, concentration, and extent of crosslinking. Crosslinking is a chemical process that binds these hyaluronic acid particles. It is these qualities that are used to produce dermal filler products with features that are optimized for placement in specific areas of the face to achieve a cosmetic goal. Extent of Crosslinking and Concentration of Hyaluronic Acid Determines Rheology More extensive crosslinking results in a stiffer dermal filler. It also prolongs the effect of the product. A higher gel concentration also results in a stiffer gel. Different products include hyaluronic acid at different concentrations and different levels of crosslinking to produce a desired effect. Rheology Describes Useful Hyaluronic Acid Dermal Filler Qualities The stiffness of a dermal filler , or its ability to return to its original shape when acted on by forces, is called the G’. The higher the G’, the stiffer the gel. Each hyaluronic acid product takes a different approach to reach a specific G’, with some products focusing more on the extent of the crosslinking while others focusing more on the concentration of hyaluronic acid particles in the gel. For example, softer hyaluronic acid fillers such as Restylane Silk© are often used more superficially or in areas with thinner tissue overlying it, such as the tear troughs, due to its lower G’. In contrast, Restylane Lyft© has a high stiffness, or G’. As a result, it is generally placed deeper and in areas requiring a more pronounced, stable lift, such as the cheeks or temples. The extent of crosslinking and concentration of hyaluronic acid gels also determine the product’s cohesivity, which determines whether a product maintains projection or falls apart with pressure, such as massage. A less cohesive product is more malleable and can be massaged in place more easily. Restylane products have the lowest cohesivity of the different brands of hyaluronic acid fillers (2). Trust your face to a facial plastic surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about flatness or poor volume in your face, including your temples, cheeks, tear troughs, lips, chin, and/or jawline. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more ! Contact Us References 1. Heitmiller K, Ring C, Saedi N. Rheologic properties of soft tissue fillers and implications for clinical use. J Cosmet Dermatol. 2021 Jan;20(1):28-34. 2. Sundaram H, Rohrich RJ, Liew S, Sattler G, Talarico S, Trévidic P, Molliard SG. Cohesivity of Hyaluronic Acid Fillers: Development and Clinical Implications of a Novel Assay, Pilot Validation with a Five-Point Grading Scale, and Evaluation of Six U.S. Food and Drug Administration-Approved Fillers. Plast Reconstr Surg. 2015 Oct;136(4):678-686. --- ### What Pre-Operative Testing Is Required at Harmon Facial Plastic Surgery? URL: https://www.harmonface.com/blog/what-pre-operative-testing-is-required-at-harmon-facial-plastic-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Pre-operative testing and medical clearance from a Primary Care Provider (PCP) are key to maximizing the safety of any surgical procedure in which oral or IV anesthesia medications are being used at Harmon Facial Plastic Surgery in Cincinnati. The testing and medical clearance are reviewed by Dr. Harmon and the physician anesthesiologist prior to the surgery date. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Testing Required Depends on Multiple Factors The extent of pre-operative testing depends on each patient’s past medical history as well as the type of anesthesia they will receive. More testing is required prior to a longer surgical procedure in which IV sedation will be used compared with a procedure in which only local anesthesia is used. Every Patient Receiving IV Anesthesia Needs Medical Clearance from Their PCP It is essential that any patient undergoing IV sedation is evaluated by their PCP to assess their cardiovascular risk prior to undergoing surgery. The PCP reviews their past medical history, reviews current medical problems, completes a physical exam, and reviews the testing listed below to conclude whether they are cleared for surgery. Most Patients Need an Electrocardiogram (ECG) Most patients need an ECG to rule out any previously undiagnosed abnormal heart rhythms or changes consistent with coronary artery disease (CAD) that would place them at increased risk while undergoing anesthesia. Most Patients Need a Chest Xray (CXR) Most patients need a CXR prior to surgery to rule out any obvious changes that could make oxygenating difficult while undergoing anesthesia. Most Patients Need Laboratory Work The laboratory testing most patients need includes a Basic Metabolic Panel (BMP) to evaluate electrolytes as well as a Complete Blood Count (CBC) to evaluate the levels of various components of the blood. Pregnancy Testing is Required for Most Individuals Pre-Operatively Harmon Facial Plastic Surgery has a pre-operative pregnancy testing policy that requires pregnancy testing – unless refused – for females of child-bearing age the morning of surgery who have not undergone a hysterectomy or removal of their ovaries and fallopian tubes (salpingo-oophorectomy). Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### What Medical Conditions Leading to Hair Loss Would Not be Appropriate for Hair Restoration Surgery? URL: https://www.harmonface.com/blog/what-medical-conditions-leading-to-hair-loss-would-not-be-appropriate-for-hair-restoration-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Hair Hair restoration surgery , which includes follicular strip (FUS) and follicular unit extraction (FUE) procedures, is an excellent option to treat the most common cause of hair loss in men and women, called androgenic alopecia. The pattern of hair loss in men and women with androgenic alopecia differs, though the cause is similar. Here at Harmon Facial Plastic Surgery in Cincinnati, Ohio both FUS and FUE hair restoration surgery is performed for both men and women with concerns about hair loss. However, there are multiple causes of hair loss for which hair restoration surgery would not be a good treatment option. The examples below are not all-inclusive but present a wide range of potential diagnoses. It is essential that any individual for whom you have a concern about any of these diagnoses should be evaluated by a dermatologist prior to considering hair restoration surgery. Seek a fellowship-trained , double board-certified facial plastic surgeon if you have concerns about your hair and feel hair restoration treatments may be a good option. Inflammatory Causes to Hair Loss Would Not be Appropriate for Hair Restoration Surgery Two types of inflammatory causes to hair loss will be discussed below. They are distinguished by the fact that one family of diseases causes scarring of the scalp while the other does not. The family of diseases that fall under cicatricial, or scarring, alopecia result in hair loss due to permanent destruction of the hair follicle. Examination of the scalp demonstrates a complete loss of hair follicles as well as scar tissue. The cause is inflammation caused by one or more types of inflammatory cells. One example is called lichen planopilaris. It is more common in women and most commonly develops in your 40s and 50s. Patients typically experience an intensely itchy scalp associated with hair shedding. It typically affects the central scalp. When you look closely at the hair on the scalp you see scaling and redness at the base of the hairs at the location of the follicles. A second example is called frontal fibrosing alopecia. It was first discovered in post-menopausal women who were experiencing recession of their frontal hairline and temples. Unlike lichen planopilaris, itching is typically not associated with this disease. The skin where the hair is lost appears smooth and shiny, though the edge of the hairline that remains demonstrates inflammatory changes. Eyebrow hair is typically lost as well. A third example is central centrifugal cicatricial alopecia. This disease affects primarily adult females of African descent. The hair loss pattern typically starts in the center of the scalp and spreads radially, leaving just a few scattered hairs in its wake. The affected skin is smooth and soft. There are other inflammatory processes that result in hair loss without scarring of the scalp skin. One example is the autoimmune condition called alopecia areata. Unlike the above conditions, alopecia areata demonstrates waxing and waning - rather than progressive - symptoms and is reversible. It affects men and women equally and in a wide age range. Alopecia areata appears as small, well-defined patches without other symptoms that can expand or contract in size. A telltale sign of this disease on exam is the demonstration of what are called “exclamation mark” hairs, which appear to expand in width from base to tip. The patient’s nails also sometimes develop an abnormal texture. Whether the inflammatory cause of hair loss is scarring or not, neither are generally appropriate for hair restoration surgery. These conditions should be evaluated and treated by a dermatologist. Infectious Causes to Hair Loss Would Not be Appropriate for Hair Restoration Surgery There are multiple infections that can cause hair loss. Though less common now, syphilis is one example of an infection that can cause hair loss. A more common infectious cause is tinea capitis, also known as ringworm. Tinea capitis is a fungal infection of the scalp than results in scaly, swollen, draining skin with associated hair loss. As expected, the exam usually strongly suggests an infection. These individuals are not good candidates for hair restoration surgery. Instead, they should be treated promptly by a physician specialized in the treatment of such infections. Hair Loss Related to Mental Health Would Not be Appropriate for Hair Restoration Surgery There is an impulse disorder in the family of conditions related to obsessive compulsive disorder called trichotillomania where patients chronically pull hair from their scalp. These individuals sometimes present to hair restoration surgeons concerned about hair loss. The symptoms typically start in late childhood but can persist into adulthood. Among the signs to look out for are hair loss that demonstrates a bizarre geometric pattern as well as evidence of recent bleeding from the scalp with hair removal. These patients are best evaluated and treated by a mental health professional for their symptoms. Hair restoration surgery is not appropriate for these individuals. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us References Blume-Peytavi U, Tosti A, Whiting DA, Trueb R, eds. Hair Growth and Disorders . Springer Publishing; 2008. --- ### What Makes a Facial Plastic Surgeon Qualified to Care for Your Face? URL: https://www.harmonface.com/blog/what-makes-a-facial-plastic-surgeon-qualified-to-care-for-your-face Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information It is a common misconception that all plastic surgeons have the same background and surgical training. The number and complexity of plastic surgery procedures had increased and the required depth of knowledge and skills to master a specific anatomic area has increased. The route a facial plastic surgeon takes begins with a five (5) year residency in head and neck surgery. That training includes an extensive volume of cosmetic and reconstructive plastic surgery focused solely on the face, neck, nose, eyes, and hair. Head and neck surgery training also includes head and neck cancer removal, restoration of facial nerve function, sinus surgery, larynx (voicebox) surgery, and airway surgery. A wide range of skills are developed by training in these disparate surgery types on the head and neck anatomy. A head and neck surgery resident then enters an additional year of training in fellowship focused exclusively on facial plastic and reconstructive surgery through the American Academy of Facial Plastic and Reconstruction Surgery (AAFPRS). It is during this year that our clinical and surgical skills amalgamate and crystallize. The whole process takes 6 years, after which we start as an employed physician in a hospital or private practice or start our own practice. This focused, specialized training is why the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) says “trust your face to a facial plastic surgeon.” It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### What is/are the Best Method(s) Used by Plastic Surgeons to Reduce the Risks of Bleeding in Facelift and Neck Lift Surgery? URL: https://www.harmonface.com/blog/what-isare-the-best-methods-used-by-plastic-surgeons-to-reduce-the-risks-of-bleeding-in-facelift-and-neck-lift-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Almost every surgical procedure in every surgical subspecialty has post-operative bleeding as a risk. This includes facial plastic surgery procedures. And while the risk of bleeding – also known as a hematoma – is low, it is something surgeons work hard to further reduce the risk of, especially with neck lift surgery and facelift surgery. The interventions discussed in this blog post include the use compression dressings, the placement of drains, hemostatic (Auersvald) netting, tissue glues (e.g., Tisseel©, Artiss©, and Platelet-Rich-Plasma [PRP]), and Tranexamic Acid (TXA). Current research does NOT indicate which intervention or combination of interventions is best to reduce the risk of bleeding. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Meticulous Surgical Technique Meticulous surgical technique that minimizes bleeding and addresses the source(s) of bleeding carefully and while minimizing the effects to surrounding tissue is likely the best method for reducing the risk of bleeding after surgery. Blood Pressure Control The major risk factor for bleeding is significantly elevated blood pressure. That is why optimal blood pressure control prior to surgery and maintenance of adequate blood pressure control can reduce the risk of bleeding. It is possible for an individual’s blood pressure to be higher than normal before surgery due to anxiety about the procedure. This typically dissipates as the patient relaxes and they receive anesthesia medications. Blood pressure post-operatively is typically affected by pain, nausea, and vomiting, which is why tailoring the pain control regimen and nausea control regimen can decrease the risk of bleeding in some individuals. However, our experience at Harmon Facial Plastic Surgery has been that extended deep plane facelift surgery generally does not cause significant pain and the anesthesia administered generally does not cause significant nausea when compared with other approaches. Compression Dressings Tight dressings around the face and neck have been used historically as a compression dressing meant to reduce the risk of bleeding. However, the use of this needs to be balanced against the risk of constricting the skin too much such that the skin loses adequate blood flow from compression. We at Harmon Facial Plastic Surgery do not use tight compression dressings after surgery for this reason. Drains Drains have also historically been used to reduce bleeding and bruising after surgery. And while this has not been definitively proven in the literature, the mechanism makes sense – as evidenced by the fact that fluid collecting in the drains is not collecting in the body. The drains generally remain in for a very short period. That is why we place drains post-operatively in all patients . Their upkeep is straightforward and simple. They generally cause little discomfort. Hemostatic Netting Hemostatic, or Auersvald, netting involves the placement of stitches/sutures in areas where skin has been lifted for 48 to 72 hours to temporarily secure the skin against the deeper tissue until it has had some time to heal. Patients with a history of significantly elevated blood pressure and/or individuals for whom more bleeding than usual is encountered in surgery may be a better candidate for such an intervention than others. This technique makes sense, but like all the interventions discussed, more research is required to determine whether it is one of the best approaches. Tissue Glues Tissue glues are products made with the patient’s own blood or that are procured from a company that serve to seal blood vessels and tissue layers to each other during surgery. Products made by the body include Platelet-Rich-Plasma (PRP) and other similar concentrations of blood components that are “activated” to form an adhesive gel. Those products procured by companies include, but are not limited to, Tisseel© and Artiss© fibrin sealants. It is important to note that tissue sealants procured from companies are made from blood products from other humans, similar to the use of cadaveric rib cartilage for nose (rhinoplasty) surgery . A 2016 meta-analysis evaluating the effectiveness of fibrin tissue sealant (e.g. Tisseel©, Artiss©, and PRP) demonstrated a statistically significant rate of reduction of hematoma for Artiss© only. Furthermore, the study demonstrated a statistically significant rate of reduction of hematoma for patient undergoing older, often less effective and less natural appearing methods of facelifting but not for deep-plane facelift surgery ( 1 ). Of note, Dr. Harmon utilizes the extended deep plane facelift approach . One may consider the use of tissue sealants on a case-by-case basis when one suspects an individual who may be at a higher-than-normal risk of bleeding after surgery. Tranexamic Acid (TXA) The origins of the use of TXA are in orthopedic, cardiac, and trauma literature. Relatively little has been published in the aesthetic surgery literature regarding the use of TXA to prevent bleeding. TXA has been given intravenously (IV), included in injected local anesthesia mixtures injected into the surgical site, and applied topically to the surgical site during surgery. The evidence is currently not clear whether there is one safest, most effective approach to the use of TXA. And, as with all medications, the potential benefits, risks, and alternatives need to be considered with the use of the medication to reduce bleeding. A review of the evidence demonstrates the current data shows an improvement in the intra-operative bleeding, operating time, and drain output, but no statistically significant difference in the rate of bleeding after surgery ( 2 ). It must also be noted that injecting or applying TXA topically is a United States Food and Drug Administration (FDA) off-label use of the medication. There is No Method or Combination of Methods that is Considered the Definitive Treatment to Reduce Bleeding and Bleeding Can Occur Regardless of How the Patient is Optimized Research remains non-specific as to which intervention or combination of interventions is best to reduce the already relatively low risk of bleeding during and after surgery. The Laryngoscope , one of the premier publications in the field of head and neck surgery, commonly publishes articles called “Best Practices” where contributors review the available literature to conclude about a common clinical question. Kleinberge A. and Spiegel J., in their article “What is the Best Method for Minimizing the Risk of Hematoma Formation After Rhytidectomy [Facelift]?” determined that “the current literature does not definitively support one particular method for reliably preventing post-operative hematoma after rhytidectomy” and “there is no replacement for meticulous surgical technique and adequate intraoperative hemostasis” ( 3 ). Larger, better designed studies are required to elucidate this. However, it is important to ask whether your surgeon has engaged with the medical literature and comes to their decisions about intra-operative and post-operative care in a thoughtful manner, weighing the potential risks and benefits of any and all of the above interventions. In the end, there is currently not one perfect method or methods. Each of the above methods could be implemented and the low risk of bleeding would remain. Seek someone who you trust understands how to evaluate and respond if something such as a bleed does occur. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us References Giordano S, Koskivuo I, Suominen E, Veräjänkorva E. Tissue sealants may reduce haematoma and complications in face-lifts: A meta-analysis of comparative studies. J Plast Reconstr Aesthet Surg. 2017 Mar;70(3):297-306. Soltany A, Alhallak N, Al Aissami M. Tranexamic acid in rhytidectomy: a scoping review. Ann Med Surg (Lond). 2023 Sep 1;85(10):4964-4968. Kleinberger AJ, Spiegel JH. What is the best method for minimizing the risk of hematoma formation after rhytidectomy? Laryngoscope. 2015 Mar;125(3):534-6. --- ### What is the Difference between the Hyaluronic Acid Found in the Body, Applied to the Skin, and Injected as Filler? URL: https://www.harmonface.com/blog/what-is-the-difference-between-the-hyaluronic-acid-found-in-the-body-applied-to-the-skin-and-injected-as-filler Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical The differences between hyaluronic acid naturally present in the body, that is applied to the skin in skincare products, and that is injected as filler (e.g., Restylane©) is whether the hyaluronic acid is formulated in the body or the lab and whether the hyaluronic acid is cross-linked or not. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Hyaluronic Acid is Naturally Present in the Body Turned Over Quickly Hyaluronic acid is produced extensively in the body. It is broken down by natural enzymes in the body within 24 to 36 hours of being produced. Hyaluronic acid retains water well. It also acts as a shock absorber within the support matrix for skin cells. Hyaluronic Acid Applied to the Skin Needs to be Absorbed to be Effective Hyaluronic acid is excellent at retaining moisture. The term for this is a humectant. In fact, hyaluronic acid can retain 1,000 times its weight in water. That is why it is included in many skin moisturizers on the market. However, the lab-formulated hyaluronic acid molecules need to be small enough to be absorbed by the skin to be effective. Many products are ineffective because they are not small enough to be absorbed. Topical hyaluronic acid that is not completely absorbed by the skin will draw moisture out of the skin to itself. This will dry the skin. As a result, hyaluronic acid is probably best used in a humid environment so that moisture moves towards rather than away from the skin. Hyaluronic Acid Filler Injected Under the Skin is Stabilized by Cross-Linking Hyaluronic acid filler, which include Restylane© products, is composed of hyaluronic acid molecules produced in a laboratory which are cross-linked so that they develop certain properties useful for aesthetic purposes but also remain present without being dissolved by the body’s natural enzymes as quickly. These products can last in the body for six months or longer; that is, unless a medication called hyaluronidase is injected where it is located. Hyaluronidase is a lab-produced enzyme that can speed up the dissolution of cross-linked hyaluronic acid filler. This filler needs to be injected under the skin because the size of the cross-linked molecules prevents skin from absorbing it. And, because hyaluronic acid filler absorbs water, swelling immediately after injection of hyaluronic acid filler is expected. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us Reference Baumann L. Cosmeceuticals and Cosmetic Ingredients. McGraw-Hill Education; 2015. --- ### What is the Difference Between a Functional and a Cosmetic Rhinoplasty? URL: https://www.harmonface.com/blog/what-is-the-difference-between-a-functional-and-a-cosmetic-rhinoplasty Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Nose The difference(s) between a functional and a cosmetic rhinoplasty is(are) of philosophy and goals, not necessarily of specific surgical maneuvers. A functional rhinoplasty is focused on improving nasal breathing by widening or strengthening the opening of one or both nasal cavities. A cosmetic rhinoplasty may be like a functional rhinoplasty but may also involve maneuvers that narrow or reduce the size of the nose. Most patients desire both functional and cosmetic improvement, demanding a mixed philosophy which informs the surgical approach. Overall, it is important to work towards a natural appearing result that fits each patient’s unique facial features when performing a functional rhinoplasty, cosmetic rhinoplasty, or a rhinoplasty that incorporates both functional and cosmetic goals. An in-person consultation is always necessary to evaluate the nose to determine the most appropriate approach. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Some Maneuvers are Primarily Cosmetic Maneuvers that may be more cosmetic than functional include: Dorsal hump (bump) reduction, which is meant to reduce the height of the nasal bridge Dorsal onlay graft, which is meant to increase the height of the nasal bridge Nasal tip cartilage suturing (stitching), which is meant to narrow the nasal tip Nasal tip grafting (e.g., columellar strut graft, caudal septal extension graft), which is meant to control the projection and rotation (i.e., upturn) of the nasal tip Lateral crural trim, which is meant to decrease the “fullness” of the nasal tip Lateral and medial osteotomies, which are meant to narrow the nasal bridge The above maneuvers change the height of the nasal bridge, the size and shape of the nasal tip, and the projection and/or rotation of the nasal tip. One or more of these maneuvers may be an appropriate approach to achieve a patient’s cosmetic goals. However, this list is not comprehensive, as there are many other maneuvers available to surgeons. Maneuvers that Widen and/or Strengthen Can be Functional and Cosmetic Maneuvers that open a collapsed area of the nose or strengthen the opening of one or both nasal cavities can improve restricted nasal breathing as well as the appearance of the nose. Maneuvers that may be functional as well as cosmetic include: Spreader grafts that widen the nasal bridge and open up the interior of the nasal cavity Lateral crural grafts that open and strength the valve that keeps the opening of the nose stable Grafts that straighten and strengthen the nasal septum While most osteotomies are intended to narrow the nasal bridge, they can be used to return a previously fractured nose to a more symmetric position, thereby opening a previously narrowed nasal cavity. All functional rhinoplasty procedures should seek to at least preserve and, when possible, enhance the cosmesis of the nose. The focus of functional rhinoplasty, however, should be on improving air flow through the nose. There may be instances in which the cosmesis of the nose is sacrificed when function of the nose is by far the most valued goal of a patient. Facial Plastic Surgeons Have an Eye Towards Long-Term Results A facial plastic surgeon has an aesthetic eye regardless of the primary goals of a rhinoplasty. As a result, there is not a purely functional or cosmetic procedure. Instead, each procedure is tailored to the individual patient based on a detailed discussion of their aesthetic and functional goals. A facial plastic surgeon’s aesthetic eye should be aimed towards the future such that the best, most natural appearing, long-term result that is possible is achieved, not necessarily the most trendy result immediately after surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### What is the Difference Between a Deep Plane Facelift and an Extended Deep Plane Facelift? URL: https://www.harmonface.com/blog/what-is-the-difference-between-a-deep-plane-facelift-and-an-extended-deep-plane-facelift Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck The core of any facial plastic surgeon’s skills come from their training in fellowship, which follows their residency training. The premier body for fellowship training in facial plastic surgery is the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Established surgeons learn from their colleagues by visiting them in the operating room and by engaging with them through medical literature and at meetings. True advancements in surgical techniques are more likely to be published in reputable journals than kept within the surgeon’s operating room. Moreover, these advancements usually improve upon previous innovations in an iterative process where the wisdom of a surgeon’s colleagues is built upon. Those surgeons who advanced early facelift techniques (e.g., Suzanne Noel ) set the stage for improvements based on an evaluation of the strengths and weaknesses of those techniques and an improved understanding of the anatomy of the face and neck. No truly innovative technique ignores history. The deep plane facelift as developed by the plastic surgeon Dr. Sam Hamra (1, 2, 3, 4, 5) was a combination of the advancements made by previously developed techniques, specifically the SMASectomy facelift, and new understandings of facial anatomy. The extended deep plane facelift , a technique developed by my AAFPRS fellowship director Dr. Andrew Jacono, advanced upon the deep plane facelift technique as developed by Dr. Sam Hamra (6, 7, 8, 9). This blog post seeks to explain the differences between the deep plane facelift and extended deep plane facelift. As a result, this blog post will explain why these techniques were such an incredible improvement on previous facelift techniques. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Deep Plane Facelift Does Not Address the Side of the Neck The most significant difference between the deep plane facelift and the extended deep plane facelift is that the deep plane facelift does not address the side of the neck in a deep plane. In contrast, the extended deep plane facelift “extends” the deep plane facelift technique into the side of the neck (6, 7, 8, 9). This involves the release of tension points called cervical retaining ligaments that restrict the ability to tighten the muscle around the neck surgically unless released, much like the two important ligaments in the face and jawline released during deep plane facelift surgery. The Extended Deep Plane Facelift Can Speed Up Recovery One relatively minor difference between the two techniques as described in the literature makes a potentially large difference on the length of recovery. The initial description of deep plane facelift involved lifting the eye muscle itself. This can sometimes result in more prolonged swelling around the eyes and increases the risk of temporary weakness in the eye muscle at this location. In contrast, the extended deep plane facelift goes over the muscle, preserving its continuity, thereby decreasing the risk of prolonged swelling and temporary muscle weakness around the eyes. Dr. Harmon is One of the Few Surgeons in the World Fellowship Trained in the Extended Deep Plane Facelift by Dr. Andrew Jacono The extended deep plane facelift requires extensive training to perform. Dr. Harmon is one of the few surgeons in the world – and the only surgeon in the Cincinnati, OH area – trained in the extended deep plane facelift by its creator, Dr. Andrew Jacono. As a result, he is uniquely qualified to perform this technique both for a first facelift and for a secondary/revision facelift on patients who have undergone a facelift with other, older techniques in the past. As always, an in-person consultation is important to understand whether the extended deep plane facelift is appropriate for an individual. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us References Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990 Jul;86(1):53-61 Hamra ST. Composite rhytidectomy. Plast Reconstr Surg. 1992 Jul;90(1):1-13. Hamra ST. Composite rhytidectomy and the nasolabial fold. Clin Plast Surg. 1995 Apr;22(2):313-24. Hamra ST. Composite rhytidectomy. Finesse and refinements in technique. Clin Plast Surg. 1997 Apr;24(2):337-46. Hamra ST. Building the Composite Face Lift: A Personal Odyssey. Plast Reconstr Surg. 2016 Jul;138(1):85-96. Jacono AA. Face-Lift Surgical Techniques. Facial Plast Surg Clin North Am. 2020 Aug;28(3):xv-xvi. Jacono AA. A Novel Volumizing Extended Deep-Plane Facelift: Using Composite Flap Shifts to Volumize the Midface and Jawline. Facial Plast Surg Clin North Am. 2020 Aug;28(3):331-368. Jacono AA, Alemi AS, Harmon JJ, Ahmedli N. The Effect of a Novel Platysma Hammock Flap During Extended Deep Plane Facelift on the Signs of Aging in the Neck. Aesthet Surg J. 2022 Aug 1;42(8):845-857. Jacono A, Bryant LM. Extended Deep Plane Facelift: Incorporating Facial Retaining Ligament Release and Composite Flap Shifts to Maximize Midface, Jawline and Neck Rejuvenation. Clin Plast Surg. 2018 Oct;45(4):527-554. --- ### What is the Best Way to Treat Lower Eyelid Bags? URL: https://www.harmonface.com/blog/what-is-the-best-way-to-treat-lower-eyelid-bags Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes Lower eyelid surgery (blepharoplasty) that preserves fat is superior to procedures that strictly remove and sometimes move fat from other areas of the body. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Eyelid Aging is Complex Multiple changes occur as the lower eyelids age, each aspect of which requires careful analysis and tailored treatment. Fat present in the lower eyelids pushes against the septum, or “wall” holding that fat back, resulting in eyelid bags. This is called fat pseudoherniation. There are two ways to address eyelid bags. Fat Removal Only is Insufficient and Counterproductive One, older, approach is reductive. This approach removes a portion of the fat in all three (3) fat compartments of the lower eyelid. The problem with removing fat from all three compartments is that this can leave an individual with a hollowed appearance which can accelerate the aging process. Fat Grafting Can be Good in Specific Cases The tear trough is a crease at the interface between the lower eyelid and cheek. The tear trough deepens as lower eyelid bags worsen and the cheeks droop. Known as fat grafting, fat from other areas of the body is often placed in the tear trough after fat from the lower eyelid is removed in overly reductive lower eyelid surgery. Fat grafting can work well for individuals who have previously undergone a reductive lower eyelid surgery (blepharoplasty) elsewhere. However, it is generally not the best approach to smooth out the bags and tear troughs in the lower eyelids if no surgery has previously been performed. Fat Preservation and Transposition is a Superior Approach Instead, the approach at Harmon Facial Plastic Surgery is to perform a fat transposition. This approach utilizes a significant portion of the fat present in the lower eyelids and repositions it into the tear trough rather than removing it entirely. The benefits of this approach are multiple. First, this fat more predictably keeps its volume because it still has its own blood supply, unlike fat transferred from other parts of the body. Second, it better smooths out the transition from the lower eyelid to the tear troughs and cheek, restoring youthful contours and significantly reducing the risk of appearing hollowed and aged. A more technically difficult approach, fat transposition can provide a more natural result than fat removal and grafting for those individuals who are undergoing lower eyelid surgery (blepharoplasty) for the first time. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### What is Okay and What to Avoid After Botox® URL: https://www.harmonface.com/blog/what-is-okay-and-what-to-avoid-after-botox Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical The following blog post is a quick summary of the few things that are okay and need to be avoided after treatment of the face with Botox® . It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Avoid Massaging Your Face and Exercise for a Day It is best to avoid massaging your face or exercising for one to two days after treatment. This reduces the risk of the medication diffusing to areas of the face where it was not originally placed. It is Okay to Wash Your Face and Apply Makeup Afterwards However, it is okay to wash your face and apply makeup after treatment. It is normal to have small red dots in a few areas of the face where the medication is administered. And while the skin is gently cleaned before and after treatment these red dots often persist until washed with soap and water at home. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### What is Lymphatic Massage and What Can it Do After Facelift and Neck Lift Surgery? URL: https://www.harmonface.com/blog/what-is-lymphatic-massage-and-what-can-it-do-after-facelift-and-neck-lift-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Dr. Jeffrey Harmon and Dr. Ricci Hoover Lymphatic massage, otherwise known as Manual Lymphatic Drainage (MLD), is increasingly being employed to accelerate the recovery of cosmetic surgery patients, including those who have undergone facelift and neck lift surgery. Starting approximately 4 – 6 weeks after surgery, the goal of MLD therapy is to accelerate the resolution of any remaining post-operative swelling. This is based on the concept, albeit with limited evidence supporting it (1), that a significant contributor to post-operative swelling is the fact that the lymphatic drainage system needs time to heal after surgery. After all, swelling is expected after any surgery in the head and neck. Furthermore, swelling is expected to improve and resolve over a period of weeks to months after facelift and neck lift surgery, regardless of the intervention. MLD is believed to improve the flow of lymphatic fluid away from the treatment site(s) while the body is healing. We at Harmon Facial Plastic Surgery have found this to be one of multiple effective treatment options for normal post-operative swelling in our patients. It is important to have a consultation with your surgeon prior to considering any treatment, including MLD. It is also important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Research on the Effectiveness of MLD is Incomplete and Reported Good Results Real but Anecdotal Almost all the literature on MLD therapy has been on therapy as one component of multi-modality treatment for swollen arms after a mastectomy for breast cancer. A systematic review of the literature including randomized controlled trials (RCTs) utilizing MLD therapy as well as a Cochrane Library review of RCTs concluded that MLD is safe in the treatment of lymphedema after mastectomy. The effectiveness of the therapy was mixed in the studies, partially due to the lack of standardization of methods and outcome measurements (2, 3). The benefits of this therapy in cosmetic surgery are anecdotal and, therefore, will require quality studies to determine its effectiveness definitively. However, the reported benefits from patients and surgeons are such that it is an area of therapy worth exploring, especially because it is a gentle, safe therapy when performed by a trained and certified therapist. It is Important to Have a Trained, Certified Lymphedema Specialist Perform MLD It is important that a trained, certified lymphedema therapist perform MLD therapy. A certified lymphedema physical therapist (CLT) is someone who has earned their doctorate in physical therapy and has gone on to become certified in MLD. The certification is a ten-day, twelve hour per day course that includes education on the anatomy and physiology of the lymphatic system as well as the various sequences of manual treatments for lymphatic drainage. MLD Consists of Gentle Hand Movements Over the Face and Neck MLD consists of gentle hand movements over the face and neck. There are four major methods of MLD, including the Volder, Foldi, Casey-Smith, and Leduc methods. Each method involves slightly different hand movements. The physiological mechanism of treatment with these methods is poorly studied and, therefore, poorly understood. However, as previously explained, each of these methods has long been implemented in the context of multi-modality therapy for post-mastectomy patients with arm swelling. There are four total hand strokes and techniques that are used to affect the lymphatic system: stationary circles, pump technique, rotary technique, and scoop technique. A combination of strokes is used in different areas of the body. They can all be used during one treatment session if the practitioner sees fit. However, the primary method used in the head and neck is stationary circles. The average number of therapy sessions is three to four. The CLT may then teach patients how to perform a modified version of this therapy at their home. Patients usually feel relaxed during each MLD therapy session. It is normal to feel a cold sensation or tingling where MLD is performed. Patients may also feel tired after treatment. There are Instances in Which MLD is Not Appropriate MLD is not appropriate for patients with acute infections, untreated or incompletely treated cancer, cardiac problems including, but not limited to, arrhythmias, or poorly controlled hyperthyroidism. MLD is One Component of Multi-Modality Therapy for Expected Post-Operative Swelling It is also important that MLD be only one component of multi-modality therapy to treat normal or abnormal post-operative swelling. One important component of multi-modality therapy is time, as the swelling is secondary to a typically normal healing process that simply requires time to resolve in most cases. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation for Facial Plastic Surgery with Dr. Jeffrey Harmon Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us Request a Consultation for MLD with Dr. Ricci Hoover at Elevate Physical Therapy Request a consultation with Ricci Hoover, PT, DPT, CLT at Elevate Physical Therapy in Blue Ash, Ohio if have questions about MLD, including whether it may be appropriate for you. Email: @elevatepelvicpt Instagram: ricci@elevatepelvicpt.com References Meade RA, Teotia SS, Griffeth LK, Barton FE. Facelift and patterns of lymphatic drainage. Aesthet Surg J. 2012 Jan;32(1):39-45. Thompson B, Gaitatzis K, Janse de Jonge X, Blackwell R, Koelmeyer LA. Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature. J Cancer Surviv . 2021 Apr;15(2):244-258. Ezzo J, Manheimer E, McNeely ML, Howell DM, Weiss R, Johansson KI, Bao T, Bily L, Tuppo CM, Williams AF, Karadibak D. Manual lymphatic drainage for lymphedema following breast cancer treatment. Cochrane Database Syst Rev. 2015 May 21 --- ### What is Hemostatic Netting and Why Would It Be Used During Facelift and Neck Lift Surgery? URL: https://www.harmonface.com/blog/what-is-hemostatic-netting-and-why-would-it-be-used-during-facelift-and-neck-lift-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck You may have seen images or videos of hemostatic netting online: these images or videos are often extreme and unusual examples of patients who have just undergone a facelift and neck lift who have loops of dark suture quilted across their face and neck. Though they capture people’s attention, they are not necessarily good representations of the hemostatic netting technique. The images and videos distract from the reason(s) why surgeons consider using the technique. This blog post seeks to clarify what hemostatic netting is, why it is sometimes used, and where it is typically placed. While evidence of its effectiveness is more limited in the medical literature, the articles that have been published and anecdotal evidence both suggest that hemostatic netting can be effective in reducing the risk of bleeding post-operatively in certain clinical situations. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. A consultation with a well-qualified surgeon will allow you to determine if the following approach is appropriate for you, because this technique may not be appropriate for every patient. Hemostatic (Auersvald) Netting is a Technique Used in Facelift and Neck Lift Surgery A hemostatic net is a technique used in facelift and neck lift surgery. The technique was first described approximately 10 years ago by Brazilian plastic surgeons with the last name Auersvald, hence the nickname for the technique (1). A hemostatic net involves the placement of temporary stitches through the skin and deeper tissue in the face and/or neck after facelift and/or neck lift surgery. A Hemostatic Net is Intended to Reduce the Risk Associated with Bleeding After Surgery The purpose of a hemostatic net is to further reduce the low risk associated with bleeding after facelift and neck lift surgery. This is in addition to the placement of temporary drains . Hemostatic netting reduces the amount of space in which blood could hypothetically accumulate. There is some evidence in the literature demonstrating its effectiveness (1,2). However, there are no official guidelines discussing the appropriate clinical situations in which to use this technique; rather, it is the surgeon’s clinical judgement weighing the potential risks and benefits of the technique that determines to which individuals it is recommended. For example, a patient with high blood pressure may benefit more from the placement of hemostatic netting than others though the final decision to place a hemostatic net depends on multiple factors unique to each individual patient. A Hemostatic Net is Loose and Not Permanent It is important to note that these stitches do not remain permanently or even for an extended period. They are removed completely in 48 to 72 hours after surgery along with the drains. It is also important to note that these stitches are not tight. This minimizes discomfort and allows good blood flow to the surrounding skin. A Hemostatic Net is Less Important in the Face After Deep Plane Facelift Surgery One of the benefits of deep plane facelift surgery is that much less skin is lifted off the deeper tissue of the face during surgery. As a result, the connection between the skin and the deeper tissue and, therefore, the blood supply to the skin, remains intact over a larger surface of the face when compared with other, older facelift techniques . As a result, the potential benefit of hemostatic netting in the face with deep plane facelift surgery is less. Instead, hemostatic netting is typically placed only in the area under the chin and in the neck, usually around drains. The dressings placed around the head and neck usually cover them well. This makes the technique much less visible and dramatic appearing than internet images and videos would otherwise suggest. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us References Auersvald A, Auersvald LA. Hemostatic net in rhytidoplasty: an efficient and safe method for preventing hematoma in 405 consecutive patients. Aesthetic Plast Surg. 2014 Feb;38(1):1-9. Janssen TJ, Maheshwari K, Sivadasan A, Waterhouse N. Hemostatic Net in Facelift Surgery: A 5-Year Single-Surgeon Experience. Aesthet Surg J. 2023 Apr 11:sjad097. --- ### What is Glamour And How Does It Relate to Facial Plastic Surgery? URL: https://www.harmonface.com/blog/what-is-glamour-and-how-does-it-relate-to-facial-plastic-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: History I never bought into the supposed glamour of plastic surgery despite the abundance of advertising to that effect. Rather, I feel glamour is more often intended to be associated with plastic surgeons themselves in advertising. Virginia Postrel, a cultural writer, argues in her wonderful book The Power of Glamour that glamour “offers the implicit promise of a life devoid of mediocrity” and is “an illusion known to be false but felt to be true.” Facial plastic surgery is, by definition, not an illusion. It does not provide escape but can facilitate engagement with the world on your own terms and with confidence. Ms. Postrel also states that, unlike luxury, glamour is not something money can buy. That is not the case with facial plastic surgery. But there is one quote from Ms. Postrel’s book about the concept of glamour that I do think defines a great deal of plastic surgery marketing: “bring out the best, conceal the worst, and leave something to the imagination.” The scenes of a plastic surgeon standing next to a private jet in a suit or driving a luxury car with aviators on is meant to glamorize the life of the plastic surgeon, not the client. However, this life, as Virginia Postrel states, is “an illusion known to be false but felt to be true.” The truth is, we as plastic surgeons spend our 20s and early 30s working very hard for long hours in order to gain the experience and skills to safely and effectively take care of patients. Many of us have families with children. We deal with the exact same challenges and experience the exact same joys as our patients. We simply have the education and training to provide them a specialized service that few people can offer. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### What is Filler Migration? URL: https://www.harmonface.com/blog/what-is-filler-migration Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Filler migration involves the movement of injected filler (e.g., hyaluronic acid filler) away from the location in which it was initially injected. This is a very rare occurrence in skilled, experienced hands. There are various reasons why filler migration may occur. All are based on conjecture. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon who has extensive experience with injectable procedures to minimize the risk of filler migration. Filler Migration Can Occur Anywhere but is More Noticeable in Specific Locations Filler migration can occur anywhere. However, it tends to be noticed more in specific locations such as the lips and the tear troughs. Physical Signs of Filler Migration The sign of filler migration is new volume in an area where it was not previously injected with filler. The changed contours can distort or eliminate the natural transition points from one anatomic region to another. It is important to note, however, that swelling is normal after the injection of hyaluronic acid filler. Furthermore, this swelling can develop outside the area injected. Swelling tends to resolve after a few days but up to approximately two weeks. It rarely lasts longer than two weeks. The Product Used, Total Volume Injected, and the Depth of Injection All Likely Affect the Risk of Migration Too much product injected too superficially may be the primary reasons why filler migration occurs, though this is not proven in the medical literature. Furthermore, there is no “threshold” volume in one location over which filler migration is likely to occur. However, it stands to reason that the more mobile superficial tissue planes can push filler in locations it was not initially injected. This becomes more likely the more volume is added. Every patient is different and, therefore, can tolerate a specific volume before being overdone. It is important, however, to avoid layering too much filler, especially different products, prior to the previously injected filler dissolving adequately. This can result in the gradual accumulation of too much filler that then migrates. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face when you have concerns about your face. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### What is Ear Pinning (Otoplasty) Surgery and Could I Benefit From It? URL: https://www.harmonface.com/blog/what-is-ear-pinning-otoplasty-surgery-and-could-i-benefit-from-it Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Ear pinning (otoplasty) surgery can address specific concerns about excessive projection of the ears in children and adults. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether ear pinning (otoplasty) surgery is appropriate for your concerns. Some Individuals are Bothered by Protruding Ears Both men and women have protruding ears, which make the face look wider than it is. Protruding ears are usually treated in childhood. Adults with untreated protruding ears often seek the care of a fellowship-trained facial plastic surgeon for correction. Ear Pinning (Otoplasty) Can Improve Protruding Ears with Hidden Incisions There are multiple approaches to treating protruding ears. The most appropriate approach depends on the patient’s unique anatomy. Protruding ears are often caused by excess ear (auricular) cartilage near the opening of the ear canal. The surgical procedure correcting this anatomy involves the setback and possible reduction of the cartilage depending on the severity of the ear protrusion. The incisions are hidden in the natural deep crease behind the ears. Sutures (stitches) are removed 7 – 10 days after surgery. Ear Pinning (Otoplasty) Can be Performed Under Local Anesthesia Regardless of the approach to treating protruding ears, the surgical procedure can be performed under local anesthesia in the nationally accredited surgery suite here at Harmon Facial Plastic Surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about age-related changes to your face and/or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### What is a Lower Eyelid Skin Pinch and What Can It Do for Me? URL: https://www.harmonface.com/blog/what-is-a-lower-eyelid-skin-pinch-and-what-can-it-do-for-me Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes Lower eyelid surgery (blepharoplasty) can treat heavy bags, loose muscle, and redundant/folded over skin. Each of these features can cause the eyes to look tired and aged. The procedure can be tailored to treat any or all these features, depending on what concerns the patient. For example, some demonstrate changes in their skin only. These individuals may benefit from a minimally invasive lower eyelid skin pinch . This procedure has been available for decades but has recently become popularized on social media, including TikTok. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Overall Effect of the Lower Eyelid Skin Pinch is a Smoother Lower Eyelid The procedure involves the “pinching” of excess skin immediately below the eyelashes – no eyelashes are cut during the procedure – that is carefully removed such that the incision hides below the eyelash line and into a natural wrinkle (crow’s feet). In effect, this procedure allows the skin of the lower eyelid to be lifted like a facelift, creating a smoother lower eyelid. This 50-year-old patient demonstrated only redundant lower eyelid skin. She was an excellent candidate for a lower eyelid skin pinch. The Lower Eyelid Skin Pinch Can be Performed Painlessly Under Local Anesthesia The lower eyelid skin pinch is often performed with other procedures when a patient is receiving IV sedation. However, it can also be performed painlessly under local anesthesia, especially if it is being performed as a singular procedure. Stiches (sutures) are removed only five (5) days after surgery. Candidates for a Lower Eyelid Skin Pinch are Often but Not Always Younger Patients who may benefit from a lower eyelid skin pinch tend to be younger than those who typically seek lower eyelid surgery (blepharoplasty), with many patients in their early 40s. However, patients of any age may benefit from the procedure if they demonstrate signs of aging in the lower eyelids that are limited to the skin. Moreover, undergoing a lower eyelid skin pinch does not prevent you from having lower eyelid bags treated in the future if they develop. Laser Resurfacing is a Less Effective Alternative to the Lower Eyelid Skin Pinch Resurfacing procedures of the skin , which include lasers, chemical peels, and dermabrasion, can treat fine- and medium-depth wrinkles in the skin of the lower eyelids. These are wonderful procedures that can produce excellent results in the right patient. However, none of these procedures can tighten the skin in the lower eyelid to the extent that a lower eyelid skin pinch can. It is important to have a detailed discussion with your surgeon about the differences between these non-surgical procedures and a surgical option such as the lower eyelid skin pinch. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### What Facial Plastic Surgery Procedures Do Men Frequently Seek? URL: https://www.harmonface.com/blog/what-facial-plastic-surgery-procedures-do-men-frequently-seek Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Men frequently seek a wide range of surgical and non-surgical facial plastic surgery procedures. This list is not all-inclusive but does highlight commonly requested procedures. Seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether any of these procedures may be able to address your concerns and desires. Non-Surgical Procedures Sought Include Botox®, Hyaluronic Acid Fillers, and Platelet-Rich-Plasma (PRP) Botox® can be immensely beneficial to men as well as women. Professionals including physicians, some of whom are attending special events such as weddings, seek Botox® to smooth out coarse wrinkles while preserving their masculine facial features. Men often seek treatment of their forehead, frown lines, and crow’s feet, which are usually much coarser than in women. The procedure does not differ between men and women. However, men sometimes require higher doses to achieve their aesthetic goals due to the size of their facial muscles. Men also seek hyaluronic acid fillers , sometimes in areas rarely placed in women. For example, many men are bothered by a weak chin and jawline but are not ready for an implant. A strong, sturdy hyaluronic acid filler can be placed in these locations for non-surgical enhancement. Hyaluronic acid fillers are also used to straighten a dorsal hump in a procedure called a non-surgical, or liquid, rhinoplasty. PRP can be an excellent treatment option for hair loss in men who are younger with mild-to-moderate hair loss and who are not yet candidates, or not yet ready, for hair restoration surgery. PRP involves drawing a patient’s own blood and concentrating the platelet component of the blood. These platelets release signaling molecules when injected around hair follicles that can restart the growth of dormant, or miniaturized, hair and sometimes even increase hair width. Surgical Procedures Sought Include Nose Surgery, Eyelid Surgery, Jawline Implants, Hair Restoration Surgery, and Facelift Surgery Nose surgery (rhinoplasty) is sought by men from their 20s to their 70s. Surgical considerations usually differ between men and women. Like women, men often seek a straighter nasal bridge, a narrower nasal tip, and a reduction of their nasal hump/bump. However, unlike women, the dorsal hump is generally softened or, at most, completely straightened. This is because a concave nasal bridge can sometimes feminize the nose. This can also occur when the nose is overly narrowed. A detailed discussion needs to be had between the surgeon and the patient regarding their aesthetic goals and how best to achieve those goals while preserving the masculine appearance of the nose. Like women, men develop age-related changes to their eyes – namely, redundant upper eyelid skin and lower eyelid bags – than can make them appear tired, sad, and/or angry. Eyelid surgery (blepharoplasty) can treat these changes comprehensively and naturally. Some men seek a more permanent solution to their poorly projected, weak jawline and chins. Usually made of silicone, chin and jawline implants come in multiple shapes and sizes. They can also be carved to perfect their size and contour, matching the patient’s aesthetic goals as closely as possible. A chin implant is generally placed through a small incision under the chin. Jawline implants are generally placed through a small incision in the mouth. Men are the primary, though not exclusive, hair restoration surgery patients. Patients are usually in their mid-thirties or older with moderate-to-severe hair loss and have tried medications or PRP but found them incompletely effective. Hair restoration surgery encompasses two categories of procedures, called follicular strip harvesting (FUT) or follicular unit extraction (FUE), each of which has advantages for certain patients. Medications and PRP are usually used as complementary treatments. And more than one hair restoration surgery procedure is usually required to achieve a patient’s aesthetic goal. Finally, men, like women, experience the same age-related changes to their face and neck. Men experience drooping cheeks, jowling, and scalloping of the jawline into the neck. Men also develop loose skin and muscle in the neck, which is often described as a “turkey gobbler” neck. As a result, men can also benefit from the extended deep plane facelift and neck lift . Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about age-related changes in your face and neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### What Cosmetic Treatments for the Face are Currently Available in South Korea but Not Widely Available the United States? URL: https://www.harmonface.com/blog/what-cosmetic-treatments-for-the-face-are-currently-available-in-south-korea-but-not-widely-available-the-united-states Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Following my previous post on the development of facial plastic surgery in South Korea , this blog post includes a list of cosmetic treatments for the face that are available in South Korea but not the United States (US). It is important to note that not all of the treatments listed below have been evaluated, much less approved, by the Food and Drug Administration (FDA). That is, to the best of my knowledge, why the medications and devices are not yet widely available in the US. I will do my best to update this list as I identify additional treatments as well as any additional publications that weigh in on the actual safety and effectiveness of these treatments. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Rejuran® (PRM-001 Polynucleotide Product [Pharmaresearch Products, Inc., Seoul, South Korea]) I first learned about this product while reading Flawless: Lessons in Looks and Culture from the K-Beauty Capital by the National Public Radio (NPR) reporter Elise Hu. She mentioned the use of a product derived from salmon gonads (seriously) that South Koreans inject in their face at cosmetic clinics, ostensibly for the purposes of improving the appearance of the skin. Additional research revealed that this product, called Rejuran®, is available not only in South Korea but also now in Europe and Australia. It is an injectable like hyaluronic acid fillers but rather than using cross-linked hyaluronic acid to add volume to the face, fish gonadal polynucleotides are injected to increase the production of collagen and elastin in the skin, both of which are important to maintain the smooth and supple qualities of youthful skin. Polynucleotides are simply a string of signaling molecules which DNA and RNA is composed of. I am skeptical that a chain of these molecules from fish can somehow induce signaling in another species ( i.e., humans) to achieve cosmetic results. Interestingly, the only study I found in the literature on this product was a phase III trial of Rejuran® conducted in South Korea in 2014 that was retracted from the medical literature two years after its publication ( 1 ). That, to me, is a red flag regarding its actual safety and effectiveness. Additional studies should help determine whether this product is worth evaluation by the FDA. Local Dynamic Micro-ultrasound (LDM) or Micro-Massage or Dual Frequency Ultrasound Termed Local Dynamic Micro-Ultrasound, Local Dynamic Micro-Massage (LDM), or Dual-Frequency Ultrasound, this treatment consists of an ultrasound device (probe) that alternates between two very high frequencies when applied to the surface of the skin. The device is being promoted as a technique to improve skin surface quality, with mechanisms of action which are unclear but may include changes in the inflammatory cascade that affect skin surface quality. My review of the literature identified studies that found improvements in bruising and swelling after rhinoplasty and improvements in redness in patients with rosacea and acne with the use of LDM ( 2 , 3 ). However, as is common with facial plastic surgery studies, the methodology included largely subjective physical assessments by surgeons and patient satisfaction scores to determine their results. Moreover, papers I found that published on the effects of dual frequency ultrasound on wound healing had no comparison group from which to determine whether this treatment accelerated the healing process. This somewhat limits the value of the research itself. Moreover, while I was able to identify the above studies reporting the effects of the device on bruising, swelling, redness, and wound healing, I found no patient studies evaluating the aesthetic qualities of the skin as would be used in a cosmetic practice. Skin Botox® Skin Botox® is exactly as it sounds. The technique involves the use of botulinum toxin injections with products including, but not limited to, Botox® more superficially in the skin. It is argued that, when injected superficially to the facial muscle, botulinum toxin decreases pore size without affecting the muscle. This is considered an FDA off-label use of the medication in the United States, which is sometimes mixed with diluted hyaluronic acid filler and injected in the superficial surface of the skin. I would imagine it to be extremely challenging to place Botox® or other similar products precisely in the skin such that it is unlikely to diffuse to the underlying musculature which, if affected, could adversely affect facial movements including, but not limited to, smiling. Certainly, an appropriate dilution of the medication(s) and a needle that controls the depth of injection may make such a treatment consistently safe. Otherwise, it would seem a challenging thing to perform safely consistently, regardless of considerations of effectiveness. In my opinion, additional research is required. Ionophoresis/Sonophoresis Devices One of the more difficult problems with administering medications trans-dermally, or through the skin, is that it is difficult to get many products to actually be absorbed through the skin barrier. Instead, many products simply sit on the surface of the skin. The ability to move medications across this barrier precisely, efficiently, and safely would have potentially profound implications. And, if a device was found to be clinically safe and effective, the question then becomes whether the products administered are clinically safe and effective. The concepts of ionophoresis and sonophoresis have been around for many years. Iontophoresis involves the use of an electrical current through the skin to facilitate the transfer of products ( 4 ). Sonophoresis involves the use of sound waves through the skin to accomplish this ( 5 ). Both iontophoresis and sonophoresis techniques are intended to temporarily increased the permeability of skin in the specific area treated. The Environ Ionzyme® DF Machine is the device I found to be most commonly associated with the use of iontophoresis and sonophoresis to facilitate the transfer of medications and other products through the skin to achieve a clinical and/or aesthetic goal. My review of available information suggests the advertised products used with this device are often vitamins, including Vitamin A. I could not find definitive information as to whether the Environ Ionzyme® DF Machine specifically is FDA approved. Moreover, it does not appear to be widely available in the United States (US). I will be following the development and availability of ionophoresis/sonophoresis devices in the US. Air Dissection Filler Technique The air dissection filler technique utilizes pressurized air delivered into the skin using a special needle and device for the purposes of delivering products such as hyaluronic acid filler. One argument made for this technique is that hyaluronic acid filler can be delivered more evenly in the same tissue plane because the resistance to injecting into the specific tissue plane in which air is placed is reduced. Most of the before and after photos I have seen have demonstrated improvements in severely depressed scars. It is also argued that this technique can reduce the rare complications associated with intra-vascular injection of hyaluronic acid filler. However, I have found no study demonstrating this. I find the air dissection technique intriguing, especially for severely depressed acne scarring. I am looking forward to the opportunity to evaluate a device if and when it becomes FDA approved and available in the US. Trust Your Face to a Double Board-Certified Facial Plastic Surgeon It is important to seek a fellowship-trained, double board-certified specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us References Notice of Retraction: Pak CS, et al. A Phase III, Randomized, Double-Blind, Matched-Pairs, Active-Controlled Clinical Trial and Preclinical Animal Study to Compare the Durability, Efficacy and Safety between Polynucleotide Filler and Hyaluronic Acid Filler in the Correction of Crow's Feet: A New Concept of Regenerative Filler. J Korean Med Sci 2014; 29(Suppl 3): S201-S209. J Korean Med Sci. 2016 Feb;31(2):330. Ahn TH, Lee JS, Kim SY, Lee SB, Kim W, Kruglik I, Yi KH. Application of dual-frequency ultrasound for reduction of perilesional edema and ecchymosis after rhinoseptoplasty. J Cosmet Dermatol. 2024 Mar;23(3):830-838. Kim YJ, Moon IJ, Lee HW, Won CH, Chang SE, Lee MW, Choi JH, Lee WJ. The Efficacy and Safety of Dual-Frequency Ultrasound for Improving Skin Hydration and Erythema in Patients with Rosacea and Acne. J Clin Med. 2021 Feb 18;10(4):834. Roustit M, Blaise S, Cracowski JL. Trials and tribulations of skin iontophoresis in therapeutics. Br J Clin Pharmacol. 2014 Jan;77(1):63-71. Rao R, Nanda S. Sonophoresis: recent advancements and future trends. J Pharm Pharmacol. 2009 Jun;61(6):689-705. --- ### What Concerns Can Be Addressed with Nose Surgery? URL: https://www.harmonface.com/blog/what-concerns-can-be-addressed-with-nose-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Nose Nose surgery (rhinoplasty) can address multiple concerns about the nasal bridge (dorsum) and nasal tip. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Nasal Hump Composed of a variable combination of cartilage and bone, a hump on the nose can make other features of the nose appear small and the length short. The treatment of a nasal hump is not a one-size-fits-all approach. It is important to consider each patient’s aesthetic goals, gender, and ethnic background when developing a surgical plan. Some individuals may benefit from – and desire – the creation of a gentle concavity to their nose. In contrast, over aggressive reduction of a nasal hump in a male patient can make their nose appear more feminine. Instead, the nasal hump tends to be softened or straightened. It is also important to be respectful of the beautiful features of a nose that communicate the ethnic background of an individual. For example, individuals of Arab, Iranian, or Turkish background may request only a subtle reduction in their nasal hump. Wide Nasal Bridge A wide nasal bridge often needs to be narrowed when a large nasal hump is reduced to reduce the risk of long-term complications. It is also important to consider the width of the nasal bridge when a large, bulbous nasal tip is narrowed. The nasal bridge may appear wider than the tip if it is not narrowed with the tip, thereby breaking an aesthetically ideal curve from the eyebrow to the nasal tip. Bulbous Nasal Tip Narrowing and refining a bulbous nasal tip, like addressing a drooping tip, is among the most technically difficult portions of nose surgery (rhinoplasty). This is due to the complexity of the paired cartilages that contribute to the shape of the nasal tip. Refinement of the nasal tip usually employs some combination of suturing and reorientation of the cartilages, sometimes with removal of a small amount of the cartilage. Drooping Nasal Tip Lifting a drooping nasal tip naturally is technically difficult because the complex nasal tip cartilages need to be reoriented and secured to the septum – the wall separating each nasal cavity - symmetrically. Moreover, the projection of the nasal tip can change as a result of lifting a drooping a nasal tip, which needs to be accounted for when securing the final position of the nasal tip. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your nose. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Trapezius Botox® i.e., “Trap Tox” or “Barbie Tox”: Is it Safe and Effective? URL: https://www.harmonface.com/blog/trapezius-botox-ie-trap-tox-or-barbie-tox-is-it-safe-and-effective Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical The treatment of the trapezius muscle with Botox® or similar medications has become a trending topic on social media, including Tik Tok. Commonly referred to as “Trap Tox” or “Barbie Tox,” this FDA off-label treatment has primarily aesthetic goals with reported potential secondary functional benefits. In fact, treatment of the trapezius muscle with Botox® or similar medications has been popular in Soth Korea for many years. Please see an earlier blog post The Right to Beauty and the Development of Plastic Surgery in Brazil and South Korea for more information. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Trapezius Muscle Extends Over the Neck, Shoulders, and Back The trapezius muscle is a pair of triangular muscles that fan over the neck, back, and shoulders. The muscle contributes to balance of the head and stability of the shoulder girdle. This muscle commonly tenses up, leading to neck and shoulder discomfort. It tapers from the neck to the shoulder, the height of which can make the neck appear shorter or longer, depending on its size. The Purpose of the Procedure is to Relieve Shoulder Stress and Make the Neck Appear Longer Botox® or similar medications is injected into the trapezius muscle on either side of the neck with the goal of weakening this limited area of the muscle around the neck. The purpose of this treatment is to reduce the fullness of this muscle around the neck, thereby making the neck appear longer. This purported effect is the reason the procedure is among the most popular aesthetic procedures performed in South Korea. Another reported benefit of this procedure is a reduction of muscle tension around the neck. Placement of Botox® or Similar Medications in the Trapezius Muscle Has Important Safety Considerations There are important safety considerations with placement of Botox® or similar medications in the trapezius muscle. First, the treatment is FDA off-label. As a result, its safety and effectiveness has not yet been officially established. Second, the trapezius muscle has important functions in stabilizing the neck and shoulders that could be affected by treatment of this muscle. Facial plastic surgeons encounter the trapezius muscle frequently in our head and neck surgery residency training when treating cancer. There is a nerve called the accessory nerve that supplies the signals for the trapezius muscle to move. This nerve and the trapezius muscle can sometimes be involved with head and neck cancer. The nerve and parts of the muscle near the neck need to be removed in these instances. A resultant non-functional trapezius muscle can lead to debilitating neck and shoulder dysfunction as well as shoulder pain. While the goal is to weaken only a small portion of the trapezius muscle near the neck to limit the potential functional sequelae of treatment, placement of Botox® or similar medications in the trapezius muscle does carry the above risk. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### What Can a Liquid Rhinoplasty Achieve? URL: https://www.harmonface.com/blog/what-can-a-liquid-rhinoplasty-achieve Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Commonly referred to as a “non-surgical rhinoplasty” or a “liquid rhinoplasty,” hyaluronic acid filler such as Restylane© products are often placed in the nose to achieve an aesthetic goal. However, this procedure is not appropriate for everyone and has specific limitations that people should be aware of. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. This 24-year-old came to Dr. Harmon with a desire smooth the bump on her nasal bridge in a natural way and without surgery. Hyaluronic acid filler was added to the bridge of her nose above the bump in order to accomplish this. Placing Filler in the Nose Always Adds, Never Subtracts Placing filler in the deep tissue of the nose is always additive by definition and never a reductive procedure. This limits what can be accomplished when compared with nose surgery (rhinoplasty) , which can be customized to address a wide variety of major and minor aesthetic concerns. The Treatment is Temporary Placing filler is also temporary. Hyaluronic acid filler typically lasts approximately 1 to 1.5 years, though it can last for less or more time in some instances. As a result, this procedure requires ongoing maintenance treatments to maintain the same effect. The Treatment is a FDA Off-Label Use of Hyaluronic Acid Filler It is important to note that treatment of the nose with hyaluronic acid filler is an FDA off-label use of these products. However, hyaluronic acid filler has been used in the nose for many years by well-trained, experienced, qualified medical professionals. Little-to-No Downtime It is, however, an in-office non-surgical procedure with little-to-no downtime and no required anesthesia. Those are major benefits. A Liquid Rhinoplasty Can Effectively Address Two Concerns About the Nose Hyaluronic acid filler can be effective in improving a large, peaked nasal bridge by adding volume to the top of the bridge, thereby softening the curve of the nose. Filler can also be effective in creating the appearance of a lifted nasal tip in some individuals. However, a history of previous nose surgery (rhinoplasty) may preclude the placement of filler in the nasal tip due to concerns about the blood supply to the nasal tip after surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### What are the Different Types of Anesthesia Administered During Surgery? URL: https://www.harmonface.com/blog/what-are-the-different-types-of-anesthesia-administered-during-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The purpose of anesthesia is to reduce the discomfort associated with surgery and to keep the patient safe while allowing the surgeon to complete the operation. The types and depth of anesthesia patients can undergo fall on a spectrum. As a facial plastic surgeon, I am not an authority on anesthesiology. However, I work closely with anesthesiologists in the operating room. I have cared for patients who have received each of the below types of anesthesia. The descriptions below are simply basic summaries to better educate patients. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Local Anesthesia Almost all procedures, regardless of the other anesthesia agents given (see below), involve the use of local anesthesia. The purpose of local anesthesia is to reduce or eliminate the local pain associated with the procedure itself. There are two families of anesthesia agents with multiple medication within these families. Some are shorter acting (e.g., one to two hours) and others are longer acting (e.g., six to eight hours). Short acting and long-acting agents are often mixed to provide the ideal time frame and depth of anesthesia. Other medications are also sometimes added to the mixture. Epinephrine is frequently added to the local anesthesia mixture. This medication can reduce the amount of bleeding during surgery by constricting the blood vessels in the area injected. Epinephrine also increases the effectiveness of the local anesthesia and can increase the safe amount of local anesthesia which is allowed to be injected. Sodium bicarbonate, which can reduce the pain associated with the initial injection, is sometimes added to local anesthesia as well. Local anesthesia can numb an area in two ways. First, the anesthesia can numb the area injected. Second, anesthesia injected around a larger nerve that supplies sensation to an entire region of the body can numb that entire region, despite no actual medication reaching the periphery of the area numbed. It is important to note that local anesthesia not only affects nerves that control sensation but also nerves that control movement. As a result, local anesthesia can cause temporary weakness in the muscle(s) in the area(s) injected. Oral Sedation Some patients prefer and could benefit from oral sedation in addition to local anesthesia. These patients may be undergoing procedures such as hair restoration surgery , upper eyelid surgery (blepharoplasty) , lip lift , and/or buccal fat removal . These patients may not require being completely asleep but would prefer something to relax. The typical medication given is a benzodiazepine such as Valium. These patients have their vital signs monitored during the entirety of the procedure. It is important to note that any patient who receives oral anesthesia such as a benzodiazepine needs a caregiver for 12 – 24 hours after surgery. These patients cannot drive themselves home after surgery because of the oral medication. Intravenous (IV) Sedation The term “IV Sedation” simply refers to anesthesia in which the patient is given one or more medications to reduce their level of consciousness to make the surgical procedure comfortable for the patient and to allow the surgeon the ability to operate more comfortably. The term also refers to the fact that the patient is breathing on their own and, therefore, does not require a breathing tube (intubation). There is a wide range in the depth of sedation patients can undergo. Some patients undergo very light sedation where they are awake and able to speak comfortably. Others undergo sedation where they are sleepier. There are many different medications that can be administered intravenously to achieve this sedation. This sedation is performed by a board-certified and licensed anesthesiologist. The anesthesiologist is the expert in administering this anesthesia as well as monitoring of the patient. Intubation Some patients benefit from deeper sedation requiring a breathing tube (intubation). The breathing tube protects the airway and is used with an anesthesia machine, which breathes for the patient. There are two techniques for administering this type of anesthesia. The first technique uses medications administered only intravenously (IV). The second technique uses anesthesia gases that the patient breathes through the breathing tube in addition to medications administered IV. The Most Appropriate Technique Depends on the Patient, the Procedure, the Surgeon, and the Anesthesiologist The anesthesia plan is developed in consultation between the surgeon and the anesthesiologist. It is dependent on multiple factors, including the surgical procedure, the estimated time of anesthesia, and the medical history of the patient. We at Harmon Facial Plastic Surgery have a Quad A accredited surgery suite at our office where we perform many of our procedures. We utilize the expertise of board-certified, licensed, anesthesia physicians for our procedures requiring IV sedation at Harmon Facial Plastic Surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### What are Common Areas to Receive Fat Augmentation in the Face? URL: https://www.harmonface.com/blog/what-are-common-areas-to-receive-fat-augmentation-in-the-face Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Some individuals lose volume (i.e., fat) in their face as they age. Other individuals are born with poor volume and/or poor projection of their facial bones. Both individuals may benefit from fat augmentation. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Fat Augmentation is a More Permanent Alternative to Dermal Filler for the Face Fat augmentation involves the transfer of fat cells from other areas of the body (e.g., thigh, abdomen) to the face in areas with poor volume. The fat cells are carefully distributed evenly and at an appropriate depth to increase the volume of the target area. There are two areas of the face that are commonly augmented with fat. Temples The temples can hollow with age. Fat transfer to this location can restore some of that volume, in effect balancing out the volume in the lateral eyebrows. That is why fat augmentation of the temples can serve as a nice complement to the lateral temporal brow lift procedure. It is important to place the fat at the proper depth to maximize how smooth the contour of this volume is. It is a bit like adding a thick, viscous liquid to a balloon. The lining of the balloon stretches but tends to remain smooth because the liquid is distributed under the surface area of what is thick balloon material more evenly. In contrast, placement of the fat more superficially is more likely to lead to contour irregularities. Cheeks Some lose significant volume in their cheeks with age. A midface (i.e., cheek) lift through the extended deep plane facelift may be inadequate to re-approximate the youthful heart-shaped appearance to the face in those select circumstances. It is important to understand that the cheek is composed of multiple subzones, each of which volume can be lost in variably. Therefore, it is important to consider all subzones when adding volume, whether with fat or hyaluronic acid filler . Fat Augmentation is Generally a Poor Replacement for a Cheek Lift Fat augmentation can sometimes be a useful adjunct to but is generally a poor replacement for a cheek lift with the extended deep plane facelift. Augmenting the cheeks with large volumes of fat to mask drooping cheek fat can make the face appear overly rounded and unnatural, because the drooping cheek fat remains in an area that typically has a lower volume in youth. High volume fat augmentation also increases the risk of contour irregularities and asymmetries. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about volume loss in the face. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Treatment Options for a Weak Chin URL: https://www.harmonface.com/blog/treatment-options-for-a-weak-chin Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck A weak, or recessed, chin can be concerning to men and women, not only because this feature can make the face appear smaller than it is, but it can also make the nose appear larger and more projected than it is. There are surgical and non-surgical options to treat a weak chin. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Non-Surgical Treatment Options Include Hyaluronic Acid Filler While a weak, recessed chin is usually best address with an implant, hyaluronic acid filler can address concerns requiring a more subtle result. Filler can also serve as a temporary treatment to help determine whether placement of an implant could achieve the desired aesthetic result. Filler is also less expensive than an implant and results in little-to-no downtime after treatment. Hyaluronic acid filler can be placed deep along the bone and/or more superficially to firm up the skin. A firmer, more structural product such as Restylane© Lyft is a good option to project a weak chin. Surgical Treatment Options Include a Contoured Chin Implant A more permanent option involves the placement of an implant , usually silicone. There are many shapes and sizes of chin implants available. These implants can also be carved to achieve the ideal projection and width to the chin. Implants are usually placed over the periosteum of the chin – which is the fascial covering of the bone – with tapered wings placed in pockets under the peri-ostium on either side. Silicone implants can be removed and replaced if desired. The combination of chin implant and liposuction under the jawline can be a powerful combination for those individuals with excess fat under the chin. The following is just such an example of a patient: Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### What Can Botox® Treatment of the Corner of the Jawline (Masseter Muscles) Achieve? URL: https://www.harmonface.com/blog/what-can-botox-treatment-of-the-corner-of-the-jawline-masseter-muscles-achieve Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Patients have increasingly sought treatment of the corner of the jawline with products such as Botox® for cosmetic and functional purposes. The muscles treated are called the masseter muscles. This blog post seeks to clarify what the masseter muscles are, what cosmetic and/or functional concerns they can contribute to, and how treatment with products such as Botox® may benefit these cosmetic and/or functional concerns. My expertise as an aesthetic facial plastic surgeon is in addressing cosmetic concerns with the masseter muscles. Any functional improvements are wonderful potential secondary benefits. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck to determine whether treatment of your jawline with Botox® is right for you. The Masseter Muscles Are for Chewing The masseter muscles are large, strong muscles that sit on either side of the back corner of the jawline. They are one of multiple muscles that contribute to chewing. Tension in this muscle can contribute to jaw pain as well as teeth grinding at night, also known as bruxism. Large masseter muscles can contribute to fullness in the back of the jawline, resulting in the appearance of a wide jawline, which can be an aesthetic concern, especially in women. Treatment of the Masseter Muscles with Botox® Can Benefit a Patient Aesthetically Products such as Botox® are injected into the lower part of the masseter muscles, which attaches at the back and bottom corner of the jawline. Botox® is injected into the deep muscle to be effective while still preserving strong chewing function. The purpose of this treatment is to reduce the size of the masseter muscle by reducing its strong contraction. The overall aesthetic effect that can be achieved is a reduction in the width of the jawline. Treatment of the Masseter Muscles with Botox® Can Benefit a Patient Functionally Products such as Botox® are frequently placed in the same location in the masseter muscles to treat tightness in the jaw as well as bruxism. Patients seeking treatment of enlarged masseter muscles often mention the above concerns as well. And, while the primary purpose of placing Botox® in the masseter muscles at Harmon Facial Plastic surgery is for aesthetic purposes, any potential functional benefit is welcomed. Patient often return to clinic excited because their jaw symptoms improve after treatment. Treatment of the Masseter Muscles with Botox® is Safe and Effective but an FDA Off-Label Use It is important to note that injection of the masseter muscles with Botox® or other similar products is an FDA off-label use of these medications. However, there are multiple locations in which these medications have been used FDA off-label for many years safely and effectively. For example, Botox® was FDA approved for use in the forehead in 2017 but had been used safely and effectively in this location for many years prior to its approval. It is important to have a conversation about this with your facial plastic surgeon. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### Three Procedures to Address the Signs of an Aging Face Comprehensively URL: https://www.harmonface.com/blog/three-procedures-to-address-the-signs-of-an-aging-face-comprehensively Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck People generally know their body better than anyone else, including their physician. However, people do not always have the medical language to explain what they see when they look in a mirror. For example, you may have heard and understand the term “jowling” but do not quite feel like that fully explains what you see. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. As explained in a previous blog post ( 4 Benefits of the Extended Deep Plane Facelift ), the extended deep plane facelift can address multiple signs of aging of the lower two-thirds of the face as well as the neck in a manner that other facelift approaches cannot. However, the upper one-third of the face and the upper lip also undergo age-related changes, which no facelift approach can address. The lateral temporal lift and lip lift are complementary procedures to the extended deep plane facelift and neck lift. The red portion of the upper lip thins and loses definition. The skin between the red portion of the upper lip and the base of the nose lengthens. The lip lift can address these changes. The sides of the brow droop, hanging over the edge of the eyes. The lateral temporal lift can address these changes. In summary, the extended deep plane facelift, neck lift, lateral temporal lift, and lip lift can address the signs of facial aging comprehensively. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Things I Have Learned About Aging Well URL: https://www.harmonface.com/blog/things-i-have-learned-about-aging-well Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information This blog post is adapted from multiple sources (references below) and summarizes some things I have learned over the years about aging well that I have tried to incorporate into my life. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Aging Well Means Maintaining Function Fara and I had an opportunity to give a talk on aging well at a country club. It was very gratifying to impart whatever wisdom I could to interested individuals. The World Health Organization (WHO) defines healthy aging as the process of developing and maintaining functional ability with age. Genetics, the environment, and human behavior all contribute to healthy aging. Healthy aging is distinct from changes to our appearance which can occur with age. Functional decline may or may not parallel the development of an aged appearance. For example, there are many high-performance athletes, such as triathletes, who maintain high functional abilities into their old age but whose faces appear older due to factors that will be discussed. Lessons from the "Blue Zones" Have Been a Helpful Guide “Blue zones” as defined by the author of The Blue Zones: 9 Lessons for Living Longer from the People Who’ve Lived the Longest, Dan Buettner, are areas of the world where the number of people living into old age is much higher than average. The communities identified are in Japan, Costa Rica, Italy, Greece, and Southern California. The author and his colleagues visited these communities and distilled the qualities that they believe are likely contributing to their longevity into 9 “lessons” for others to follow. A Culture of Physical Activity is Essential The behavioral traits identified in these blue zones include a culture of physical activity. However, this is not simply regular exercise, though both aerobic and strength training are recommended. The individuals in these communities live in a built environment where exercise is easy and performed passively and physical activity is required to perform activities of daily living. This includes walking to school, the market, and friends’ homes. I completed fellowship training in facial plastic surgery in New York City. My wife, son, and I lived in Queens during this time. The community we lived in was composed of medium-height buildings spaced close together. The nearby parks were beautiful, safe, and child friendly. Our friends lived within walking distance. All our necessities were within walking distance. I traveled to work on the subway system, which required walking a few blocks each day. The fact that we lived in a small apartment seemed less important because we could live our lives in the city. It was easy to maintain our physical health while enjoying our lives. A short commute was invaluable, because I worked very long hours and would otherwise been unable to see my wife and son before they went to bed if I had a long commute by car. The walkability of the community we lived in improved our quality of life greatly. In contrast, my time teaching in Doha, Qatar for Weill Cornell Medical College in Qatar provided a very different lifestyle. I lived in downtown Doha in a high-rise apartment. The university was located a 30-minute drive away on the outskirts of the city in the desert. Temperatures reached the 100s to 110s daily, even at night. As a result, outdoor activities were severely limited during the day. We lived inside air-conditioned buildings all day, albeit very nice ones. I scheduled time to work out in my building’s gym to maintain my physical health. But it was not easy. Work was time-consuming and I wanted to take as much time to explore a part of the world I previously knew so little about. One consideration I would add to a culture of physical activity is optimizing ergonomics. A surgeon spends most of their day standing or sitting in somewhat contorted positions. The potential for this to put strain on the shoulders, back, and hips is significant. It is important to maintain an exercise regimen that keeps a strengthened core and to constantly focus on proper body positioning when operating. After all, we owe it to our patients and ourselves to maintain peak physical health to optimize our surgical outcomes. To that end, I practice pilates to maintain my core strength. Strong Social Support Contributes to Aging Well Some of my family and me at the Trains and Traditions Exhibit at the Krohn Conservatory in Cincinnati, Ohio. Another behavioral trait identified was a strong social structure. This includes strong family connections, friendships, and support from their community groups. When my wife and I returned to Cincinnati from New York City we realized how much we missed being near family. Our son, Babak, suddenly had his grandparents nearby. It was very helpful for us as we established Harmon Facial Plastic Surgery. The relationship Babak has built with his grandparents has meant so much to Fara and me. I believe it has help developed Babak’s emotional intelligence and happiness. I hope our soon-to-be-born daughter, Roya, will have a similar experience. Good Nutrition is Whole and Balanced A third behavioral trait relates to their cultures of food and nutrition. I would like to reference this blog post on nutrition written by the dietician Tirzah Thompson who presented at our office in the past. Individuals in blue zone communities eat a well-rounded diet of whole foods, avoiding processed foods. They eat to contentedness only while maintaining adequate calories for nutrition. The information provided by Tirzah Thompson and the blue zone communities does not account for individuals with micronutrient deficiencies due to disease and/or food allergies and intolerances. Any diet should account for these differences and be culturally appropriate/sensitive. I have really enjoyed learning about Persian food and the culture surrounding it from my wife and her family. Persian food is complex and beautiful, consisting of stews filled with unusual spices. It takes hours to prepare but is well worth the wait. The wisdom gained from years of trial and error is evident in the combination of ingredients and the care with which it is prepared. My favorite dish is called ghormeh sabzi which consists of a mixed of herbs including parsley, cilantro, scallions, and fenugreek as well as kidney beans, beef and a special dried lime commonly used in the region in teas and to impart additional flavor to a stew. The stew is over fluffy long-grain rice tossed with butter and saffron. The taste is slightly citrusy and bitter, and the aroma is unlike anything I have previous experienced. That is the case with most Persian dishes. Persian cooking, like cooking from all over the world, contains generations of embedded wisdom that make eating a well-rounded diet easy and the experience enjoyable. Adequate Sleep Can be Difficult but is Necessary An area unmentioned in the blue zones studies was the importance of sleep. The American Academy of Sleep Medicine recommends 7 or more hours of sleep per night regularly. The academy allows 9 hours of sleep per night for individuals who are recovering from an illness or who have been deprived of sleep. I understand that 7 hours of sleep per night regularly can be more difficult at different times in our lives. For example, our sleep can be limited when caring for young children and/or our elderly relatives whose functional capacity is limited. Our jobs can also limit our sleep. I have certainly felt this way during residency and fellowship training and when our son was just born and waking regularly to feed. I have learned that life is a long, beautiful journey. We cannot always be perfect to ourselves or for our loved ones. The Skin Ages Functional decline may or may not parallel age-related changes to appearance, including of the skin. The changes related to skin aging develop due to both external and internal factors. The internal factors are genetic and a relatively minor contributor to skin aging. Most age-related changes to the skin are due to external factors, none more so than cumulative sun exposure. Other external factors include smoking, excessive alcohol intake, poor nutrition, and pollution. These external factors contribute to skin aging by accelerating a chemical reaction in the skin that leads to a breakdown of its components. There are three components of skin whose changes contribute to aging. The first is collagen, which is the skin scaffold. The second is elastin, which imparts elasticity to the skin. The third are glycosaminoglycans (GAGs), of which hyaluronic acid is an example, which increases skin hydration and plumpness. Aged skin appears more fragile, thin, wrinkled, dry, rough, sallow, and with poor light reflection and pigmented spots. Necessary but not sufficient, good skin care can both treat and decrease the effects of aging on the skin. A good skin care routine is simple and includes agents that are pro-collagen, antioxidant/anti-inflammatory, and photoprotective. Topical Retinoids are Pro-Collagen Retinoids, which include retinols, are derivatives of Vitamin A that can be applied to the skin. Topical retinoids are pro-collagen, meaning they increase the production of youthful collagen and reduce the breakdown of collagen. Retinoids, a prescription medication, are the only FDA-approved treatment for photoaging. Retinols, a precursor molecule that is converted to retinoids in the body, are not FDA-approved; rather, they are a cosmeceutical. Retinols do not require a prescription. While not FDA-approved, there is extensive evidence for their effectiveness as well. Retinoids and retinols are unique among skin care products in that there is evidence both that they can reverse and prevent some of the signs of skin aging. Retinoids do have some side effects and may not be appropriate for all individuals or all skin types. A consultation with a dermatologist or plastic surgeon is recommended prior to considering the use of retinoids of any kind. Topical Vitamin C is Anti-Inflammatory and Photoprotective The most important topical antioxidant/anti-inflammatory product – the product with the most evidence for its effectiveness – is ascorbic acid, also known as Vitamin C. Vitamin C is an important component of collagen. There is strong evidence for its effectiveness as a topical antioxidant, which reduces the frequency of the previously described chemical reaction on the skin. It is also photoprotective, reducing the effects of ultra-violet rays from the sun. The problem with Vitamin C is that it requires a specific formulation to be adequately absorbed by the skin. It is also exquisitely sensitive to light and air, necessitating special packaging. Other ingredients are often added to Vitamin C that preserve the function and even potentiate its effects, including tocopherol (Vitamin E), ferulic acid, and pycnogenol. These ingredients, including topical Vitamin C, are all cosmeceuticals which are not FDA-approved to treat photoaging. All necessary precautions should be taken when using these ingredients as they may not be appropriate for all individuals or all skin types. A consultation with a dermatologist or plastic surgeon is recommended prior to considering the use of these treatments. Sunscreen is Photoprotective The best photoprotective product for the skin is sunscreen. The best sunscreen to use is a mineral-based sunscreen, such as one that includes zinc oxide. Chemical-based sunscreens rarely provide as strong and complete protection. Recommendations include a mineral-based sunscreen of at least an SPF of 30 or greater. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about age-related changes to your face and/or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References Baumann, L. (2014). Cosmeceuticals and Cosmetic Ingredients (1st ed.). McGraw Hill/Medical. Buettner, D. (2012). The Blue Zones: 9 Lessons for Living Longer from the People Who’ve Lived the Longest (2nd ed.). National Geographic. --- ### The Right to Beauty and the Development of Plastic Surgery in Brazil and South Korea URL: https://www.harmonface.com/blog/the-right-to-beauty-and-the-development-of-plastic-surgery-in-brazil-and-south-korea Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: History A rendering of Homa, the mythological Persian bird that never stops flying, caught my eye. The line to pick up boarding passes and drop off checked luggage for Iran Air was a train of luxury shopping bags, headscarves, and nasal casts. I had landed in Dubai International Airport, which contained a fascinating mix of people from all over the world. It was my first trip to the city, a 30-minute flight from Doha, Qatar where I was based working as a teacher at Weil Cornell Medical College. It was the only flight I have experienced where we started the descent at almost the exact moment we reached cruising altitude. I have long been fascinated with Iranian culture and history. It may be because my uncle through marriage is Iranian. But despite this fact, my exposure to Iranian culture was shallow. I remember my uncle’s mother visiting them in Lexington, Kentucky in the nineties. From Ahvaz, Iran, she was a very short woman in a headscarf who would spend all day stirring a pot of rice and the evenings smoking hookah under a tent in their backyard. I do not remember eating her rice, or any Persian food for that matter. Iranian culture seemed mentally so comfortable I never processed the differences from American culture. It also seemed physically inaccessible. I would be unable to travel to Iran during my time in Doha because it is potentially dangerous to travel there as an American. I understood why many Iranians – especially women – would travel to Dubai to shop and drink. I was curious, however, as to why so many women had casts on their nose. I correctly assumed they had undergone rhinoplasty surgery . Still, the sheer number as a percent of passengers boarding flights with Iran Air was shocking. I would later learn that Iran is a world capital for facial plastic surgery, specifically rhinoplasty. I would then learn from my wife, who is Iranian American, that rhinoplasty is an incredibly common procedure undergone by Iranians in the United States as well. We in the United States naturally have a Western-focused view of plastic surgery, assuming the high quality of our trained surgeons, the advanced technology we possess, and our collective wealth – thereby allowing many to afford plastic surgery procedures – would place the United States and Europe in an echelon above the rest of the world. That certainly was the case for a period. However, the history of plastic surgery long precedes the founding of the United States and the Western European nation-states. More recently, centers for plastic surgery outside of the United States and Western Europe have developed. Americans have influenced these centers. They, in turn, will influence us. The essay below seeks to provide some information on and context to two of these global centers, Brazil and South Korea. I would have liked to provide more information about the development of plastic surgery in Iran. However, the English-language literature available is limited. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Brazil “Oh it’s part of daily life now. It’s easier, safer – techniques have improved. And everyone’s doing it. My secretary is having plástica because something is bothering her. This is cool. I have the flu so I take medicine. I have a falling breast, so I have plástica. To feel better, to work better, to be in a better mood.” – Brazilian plastic surgery patient quoted from the book Pretty Modern: Beauty, Sex, and Plastic Surgery in Brazil by Alexander Edmonds Many international visitors visited my fellowship director Andrew Jacono in New York City while I was training with him through the American Academy of Facial Plastic and Reconstructive Surgery. By far the best represented nationality was Brazil. We would routinely have anywhere between one and five Brazilians visiting for a day-or-two to ask questions of a widely regarded master of facial plastic surgery. In turn, I learned a great deal about how these surgeons practiced. For example, I learned that most practice in the relatively wealthy southeastern area of the country where the cities of Sao Paolo and Rio de Janeiro are located. I also learned that Brazilian national pride as a “melting pot” of individuals of African and European descent deeply influences the aesthetic norms there. We exchanged ideas and techniques. We showed them some of the most advanced techniques in facial plastic surgery. But we also learned from them. It was a window into what is a robust academic and cultural center for plastic surgery. The International Society for Aesthetic Plastic Surgery (ISAPS) statistics on practice patterns around the world in 2020 identified 1.3 million plastic surgery procedures performed in Brazil in 2020, compared with 1.5 million performed in the United States. That makes the per capita rate of plastic surgery in Brazil (1 procedure per 163 individuals) higher than that of the United States (1 procedure per 220 individuals). The most popular surgical procedures performed in Brazil in 2020 were, in order, liposuction, breast augmentation, eyelid surgery, abdominoplasty (“tummy tuck”), and breast lift. The most popular surgical procedures performed in the United States in 2020 matched those in Brazil. Most attribute the foundation of plastic surgery in Brazil to one man, Ivo Pitanguy. Dr. Pitanguy, the world-famous plastic surgeon from Brazil , argued for the “right to beauty” for all, rich and poor, through plastic surgery. Furthermore, he argued that plastic surgery is a vehicle for social and economic advancement as well as a way of improving overall health. Dr. Pitanguy is lionized for his role in the professional organization and cultural spread of plastic surgery in Brazil. My sister-in-law, a pediatric ophthalmologist, is from Brazil. One of the first questions she asked me when I told her I am a facial plastic surgeon was whether I knew who Ivo Pitanguy is. Not only did I know who Ivo Pitanguy is, I use one of his anatomical markers to identify the approximate course of a branch of the facial nerve when I perform an extended deep plane facelift . But while Dr. Pitanguy planted the seed, no individual is solely responsible for the flowering of popularity of plastic surgery in Brazil. As Alexander Edmonds explains in Pretty Modern: Beauty, Sex, and Plastic Surgery in Brazil , not only the medical community but also the media and national government contributed. For example, the democratically elected president of Brazil in the 1950s was a supporter of Ivo Pitanguy and his mission. This mission gained broad public support after Dr. Pitanguy and his residents treated hundreds of children after a terrible indoor circus fire broke out in Rio de Janeiro. As a result, the president helped fund the establishment of the first teaching hospital for plastic surgery at Santa Casa, an old Catholic charity hospital in the city. The Unified Health System (UHS) was established in Brazil in 1988, shortly after the end of the military dictatorship and shortly before the first democratic elections in many decades. The UHS expanded the public health system but did not nationalize all hospitals and providers. It did, however, improve funding for residency programs, including in plastic surgery. This provided new monetary support for the program Ivo Pitanguy started at Santa Casa, which has treated over 44,000 patients and trained almost 450 physicians from its opening to the early 2000s. Aesthetic and reconstructive surgery procedures are offered at a significant discount in the public hospitals, where resident and attending plastic surgeons care for and operate on patients. This has greatly expanded the access of plastic surgery to the public. One major reason aesthetic plastic surgery procedures are effectively subsidized in Brazil is because the distinction between reconstructive and aesthetic plastic surgery is blurred in Brazil, largely due to the influence of Dr. Pitanguy. As a result, plastic surgery residents gain extensive experience, which they utilize both in the public hospitals and private clinics, which is where most plastic surgery performed in Brazil. And while the healthcare system has fewer resources than that of the United States, Canada, and Europe, foreign physicians visit Brazil to train and observe in droves. This has improved the reputation of plastic surgery in Brazil internationally. The media in Brazil also contributes to the popularity of plastic surgery. One dominant media conglomerate, Globo , promotes plastic surgery and celebrates the television and movie stars who are more open – and often celebratory – about the plastic surgery they have undergone. Popular telenovelas as well as magazines such as Plastica & Beleza and Plastica & Corpo that focus on plastic surgery are read widely. This reflects the high value Brazilian society places on individual beauty and health. South Korea “This [Korea] is indeed a plastic surgeon’s paradise.” – Dr. David Ralph Millard quoted from the book Reconstructing Bodies: Biomedicine, Health, and Nation-Building in South Korea Since 1945 by John Dimoia Commonly referred to as the “Republic of Plastic Surgery,” South Korea is home to the largest number of cosmetic plastic surgery procedures performed and the largest number of cosmetic plastic surgeons per capita in the world. Most South Korean plastic surgery patients are female, which reflects a strict cultural expectation that women maintain a youthful appearance when in public life. Possibly because of this cultural expectation, South Koreans begin undergoing cosmetic plastic surgery at a relatively young age. A Gallup Korea poll from 2015 found that one-third of women ages 19 to 29 have undergone plastic surgery in South Korea. According to the NPR reporter Elise Hu in her book Flawless: Lessons in Looks and Culture from the K-Beauty Capital , high school graduates are commonly given gift certificates for cosmetic surgery by their parents and grandparents. The three most common procedures chosen by patients are double eyelid (blepharoplasty) surgery followed by rhinoplasty then jaw contouring surgery, otherwise known as V-line surgery. More specifically, the New Yorker reporter Patricia Marx describes the Bagel Girl look, short for “baby-faced and glamorous,” as being popular among South Koreans as of 2015. In addition to V-line surgery, double eyelid surgery with epicanthoplasty (will be discussed below), and rhinoplasty, fat grafting to the lower eyelids is considered to contribute to this look. Regardless of the name given to this look, the history of cosmetic plastic surgery in South Korea and possibly the future of cosmetic plastic surgery worldwide can be found in the three most common cosmetic plastic surgery procedures pursued. The origin story of cosmetic plastic surgery in South Korean, according to most Western authors, begins with an American named David Ralph Millard. Dr. Millard was the plastic surgeon for the United States Marines in South Korea. He trained with the famous plastic surgeon Dr. Harold Gillies during World War II. He remained in South Korea after the armistice in 1953 and continued to practice as a plastic surgeon, performing both cosmetic and reconstructive surgery on American troops and South Koreans. The two procedures he performed most frequently on South Korean patients were double eyelid surgery – which created an extra fold in the upper eyelids – and rhinoplasty meant to increase the projection of the nose. Patients included South Korean sex workers trying to better attract American troops and South Korean women who married Americans and felt plastic surgery would ease their transition to life in the United States. Like Ivo Pitanguy, Dr. Millard believed he was empowering those he treated by transforming their character. He also believed he was a pioneer in the techniques he utilized. The professor John P. DiMoia argues against this origin story in his book Reconstructing Bodies: Biomedicine, Health, and Nation-Building in South Korea Since 1945 . Mr. Dimoia writes that the story of Dr. Millard, while important, is incomplete. For example, the technique Dr. Millard employed for double eyelid surgery was only one of over thirty techniques developed since the late 1800s. In fact, according to Elise Hu, the first reported double eyelid surgery in the literature was published by the Japanese ophthalmologist and surgeon Kotaro Mikamo in 1896. South Korean surgeons more often cited the techniques of Japanese plastic surgeons from the late 1800s to the 1920s in their publications and teaching, because Japan was a regional center for plastic surgery at the time. The professionalization of the field of plastic surgery started with the foundation of the Department of Plastic Surgery at Yonsei University in 1961. Residents were taught starting in 1964. However, it was not until 1973 that plastic surgery was officially recognized as a subspeciality in South Korea. Private plastic surgery clinics providing cosmetic services would start to predominate reconstructive surgery programs in the 1980s and 1990s after healthcare reforms largely nationalized the healthcare system. Physician-reported difficulties getting paid by the South Korean government for medical services pushed plastic surgeons to break from large hospitals and establish their own private cosmetic plastic surgery clinics in the Gagnam district in Seoul. Another impetus for the movement of plastic surgeons to cosmetic procedures was the fact that the government supported the development of the industry (like Brazil), starting by temporarily subsidizing cosmetic surgery after the financial crisis of the late 1990s. According to Elise Hu, in addition to creating tax breaks for cosmetic plastic surgery domestically, the South Korean government started the Korea Culture and Content Agency to promote popular Korean culture worldwide, referred to as Hallyu, which includes cosmetic plastic surgery. As a result of the government’s effort, the number of medical tourism patients increased almost tenfold, from 60,000 in 2009 to almost 500,000 in 2019. Most tourists come from China, which accounts for 40% of all plastic surgery procedures in South Korea. Japan, the United States, Thailand, and Vietnam round out the top visitor countries. This medical tourism has spread the influence of South Korean aesthetic plastic surgery procedures and aesthetics around the world, including the United States. For example, I once met a Caucasian patient from the United States who had travelled to South Korea for V-line surgery. This individual explained that they desired a narrower, more refined jawline. They were very satisfied with their results. However, they were told by the South Korean surgeon that they would likely require a facelift earlier than normal due to the procedure. This individual returned to the United States and sought a facelift within a few years of undergoing V-line surgery. The geographic center of plastic surgery in South Korea, called the Improvement Quarter/Beauty Belt/Plastic Surgery Street in the Apgujeong and Sinsa wards of the Gagnam district, is significantly smaller than that of Brazil. The “Beverly Hills of Seoul” got its start as a “new money” neighborhood on the outskirts of Seoul in the 1980s where land was less expensive than in the city center. It is home to over four hundred plastic surgery clinics per square mile and over seven hundred clinics total as of 2007. This concentration of surgeons and the number of cosmetic plastic surgery procedures performed in South Korea has resulted in a great deal of innovation in the field, which patients around the world are only just starting to benefit from. For example, an additional focus of South Korean surgical innovation from the 1960s to the present has involved not simply the creation of double eyelids but also the removal of an extra fold of skin in the medial eye near the nose that is present in some South Koreans, called the epicanthal fold. Mr. Dimoia and Ms. Hu argue that there is a misconception that double eyelid surgery and epicanthoplasty surgery were meant to make South Koreans look more Western. In fact, double eyelid surgery and the epicanthoplasty reflect an independently developed, regional Asian aesthetic norm. Moreover, innovations in scar concealment reflect a greater desire on the part of South Koreans to minimize the appearance of scars compared with Americans. As a result, the overall trend in eyelid surgery has shifted from what Dr. Millard described as a desire for “round eyes” to “big eyes,” which encompasses a wider variety of procedures, including epicanthoplasty. In contrast, there is also a concern about having a “big face,” which is why V-line surgery – an invasive surgery that involves a reduction in the width of the jawline – has become so popular in South Korea. And while South Korean aesthetic norms may have been influenced by American surgeons like Dr. Millard, additional influences range from regional colleagues in countries such as Japan and local South Korean culture, similar in process to the unique aesthetic norms that have developed in Brazil. In fact, the V-line surgery is a distinctly Korean creation that reflects a focus on facial proportions such that men and women seek a narrowing jawline that forms a V shape. According to Ms. Hu, an “ideal” face in Korea has big eyes (see above), a pointy nose with a raised nasal bridge, and a V-shaped jawline. This is consistent with the most chosen cosmetic plastic surgery procedures in South Korea. Interestingly, the more “traditional,” unaltered Korean face – more circular, with smaller eyes, round cheeks, and wider noses – is now associated with the standard look of North Koreans. The differences in aesthetic norms between South Korea and the United States have led to confusion as highlighted by the author S. Heijin Lee in the essay “Beauty Between Empires” in the book Fashion and Beauty in the Time of Asia. A GIF was widely circulated in the United States of what was believed to be a fast scroll of all the candidates for the 2013 Miss South Korea competition. What was striking to people was how similar the faces of the contestants looked. Online commenters considered this a reflection of the sameness of the appearance of South Koreans and heaped scorn on the country for promoting this. The GIF was a photoshopped fake. That people, specifically Americans, would not immediately assume the GIF to be a fake was thought to be indicative of a misunderstanding of Asian diversity and conceptions of beauty. Like in Brazil, the increasing popularity of plastic surgery reflects the increased wealth and democratization of the country, which accelerated in the 1980s. The body was considered a way to elevate one’s status in society to gain economic and social advantages. Patricia Marx traveled to South Korea in 2015 to learn about why South Korea has become a capital of plastic surgery. She reports that there is a great deal of competition for jobs in South Korea, especially since the Asian financial crisis of the late 1990s. Many men and women in South Korea feel plastic surgery can improve their competitiveness for jobs. This sentiment is reflected in common terms used in South Korean ads for plastic surgery such as “self-management,” “self-development,” and “self-investment.” Competition for jobs is so intense, in fact, that an industry of “face readers” has sprouted in South Korean where one can pay for a non-physician to examine your face and make recommendations for changes with plastic surgery. Surgeons in the United States Exchanges Ideas and Innovations Among Themselves and International Colleagues W. David Marx argues in the book Status and Culture: How Our Desire for Social Rank Creates Taste, Identity, Art, Fashion, and Constant Change that humans seek to maximize and stabilize status and that human culture reflects status hierarchies. Even concepts considered separate from culture, such as the idea of beauty, get swept up into it. This theory is consistent with the association of plastic surgery with the wealthy and famous in Brazil as well as the promotion of plastic surgery by the South Korea government through K-Pop groups and Hallyu more broadly. As Mr. Marx argues, media promotion results in taste congruence among individuals across the socioeconomic divide. This process has likely accelerated with the development of social media and online culture. For example, Ms. Hu notes “present-day social media already places a new pressure on everyone to remain forever photogenic, forever young, forever fit and thin, forever wrinkle free.” Further, she writes “the technological gaze keeps feeding us an ever-evolving, ever narrowing beauty ideal.” Increasing wealth and democracy in the context of a free market have allowed Brazilians and South Koreans to acquire the means to purchase plastic surgery, historically a marker of high status. I believe Mr. Marx’s theory is partially descriptive and Ms. Hu are correct, but their arguments are incomplete because they ignore the free agency of empowered individuals to make decisions based on their own, personal desires and values. The internationalization of media and development of a global culture has sped the exchange of ideas between countries and the relative influence of plastic surgeons from across the world, however. To what extent these individual choices are influenced by popular local and global culture remains a question. This is especially acute in a society like South Korea’s that is more communal than the United States and Brazil, a culture in which Elise Hu states: “A Korean woman who gets plastic surgery to fit in in this way is not looking good just for herself. She is showing respect for others in the community. She is also signifying where she fits – or might fit – in the class hierarchy, such that beauty work or body modification can help a lower-class woman ‘pass’ as a middle- or even upper-class person.” The development of Brazil and South Korea as major centers for plastic surgery has benefited the world on net. Just as American surgeons have learned from Europeans and vice versa, the more centers for innovation that develop the higher the likelihood safer and more effective techniques and technology will be developed through the increasingly global exchange of ideas. We as plastic surgeons do, however, need to be cognizant of how internet culture pressures some individuals to pursue procedures to their detriment. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us References DiMoia J. Reconstructing Bodies: Biomedicine, Health, and Nation-Building in South Korea Since 1945 . Redwood City, CA, Stanford University Press, 2013. Edmonds A. Pretty Modern: Beauty, Sex, and Plastic Surgery in Brazil . Durham, NC, Duke University Press, 2010. Hu E. Flawless: Lessons in Looks and Culture from the K-Beauty Capital. Dutton, 2023. Jarrin AE. The Rise of the Cosmetic Nation: Plastic Governmentality and Hybrid Medical Practices in Brazil. Medical Anthropology: Cross-Cultural Studies in Health and Illness . 2012; 31(3): 213 – 228. Lee SH. “Beauty Between Empires: Global Feminisms, Plastic Surgery, and the Trouble with Self-Esteem.” Fashion and Beauty in the Time of Asia , edited by Lee SH, Moon CH, and Nguyen Tu TL, New York University Press, 2019, 69 – 102. Marx P. “About Face: Why is South Korea the world’s plastic surgery capital?” New Yorker , 16 March 2015. Marx WD. Status and Culture: How Our Desire for Social Rank Creates Taste, Identity, Art, Fashion, and Constant Change . New York, Viking, 2022. This blog post is for educational purposes only. It is essential that you have a consultation with your medical provider prior to considering any treatment. This will allow you the opportunity to discuss any potential benefits, risks, and alternatives to the treatment. --- ### The Potential Value of Preventative Physical Therapy for Surgeons URL: https://www.harmonface.com/blog/the-potential-value-of-preventative-physical-therapy-for-surgeons Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information “Do you want the bed up?” I heard these words frequently from the circulating nurse and anesthesiologist in the operating room during residency. I heard them rarely, not surprisingly, from my attending physician. It was an expression of concern for my back and neck because I looked so unnatural and uncomfortable operating as a new resident. I almost always replied that I would like the bed raised. However, I initially felt awkward asking. I was usually taller than the attending surgeon and staff. I knew they would need to adjust to accommodate me. It took time, but I grew increasingly comfortable and assertive requesting ergonomic adjustments that were less stressful on my neck and back. I have been interested in the topic since. The following blog post is a summary of what I have learned from research, experience, and conversation with professionals. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Surgery is Physically Demanding Work Head and neck surgery is physically demanding, often because of the variety of positioning required to perform the multitude of procedures. Facial plastic surgery, the subspecialty I was fellowship-trained – and am double board-certified - in, requires standing and sitting, the back and neck flexed at multiple angles, throughout a single procedure. Endoscopic sinus surgery involves often-uncomfortable positioning of the arms at an angle to the trunk to be able to see the monitor, which shows the sinus anatomy the instruments are navigating. These instruments can be heavy as well, resulting in additional strain. Surgery of the larynx, otherwise known as the “voice box,” requires the use of microsurgical instruments and precise movements on a fulcrum from the end of the long instrument to the wrist. Head and neck cancer surgery involves hours-long procedures with the head often weighed down by a headlight and a microscope attached to glasses, called loupes. As a result, the risk of developing work-related musculoskeletal disorders is high. In fact, work-related musculoskeletal disorders may be as prevalent among surgeons as some industrial tradesmen, including masons and electricians. A review of the literature ( 1 ) demonstrates a twelve-month prevalence of pain in the following locations in surgeons and interventional physicians: ● Neck – 60% ● Shoulder – 52% ● Back – 49% ● Upper Extremity – 39% Regarding head and neck surgery, between 47.4% and 97% of have reported musculoskeletal symptoms in the literature, with back and neck pain being the most frequently cited locations ( 2 ). Similar numbers are found among facial plastic surgeons specifically ( 3 , 4 ). Pain tends to begin early in residency and persists, likely because there is not only little training but little understanding of good ergonomics in residency programs. As a result, 23% to 84% of head and neck surgeons report seeking medical treatment, which includes physical therapy, medications, massage, and/or acupuncture ( 2 ). Unfortunately, 2.4% to 28% report requiring surgery, 16% require time away from work, and 2% are forced to stop work or retire early due to work-related musculoskeletal disorders ( 5 ). A recent survey amount members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) confirmed the above findings, with 67.8% of respondents reporting a work-related musculoskeletal disorder necessitating treatment, physical therapy, or a modification of practice patterns ( 6 ). Work-related musculoskeletal disorders are a prevalent and severe problem among surgeons and interventional physicians resulting in significant morbidity and lost time. What can be done to prevent and treat it? The following information is what I have learned from my conversations with Physical Therapists (PTs) who I know and who I have been treated by for the purpose of preventing musculoskeletal injury. While I want to emphasize that I am not a trained, licensed physical therapist – and, therefore, the following information should be considered educational only – I do believe prevention is the optimal approach to the above problems in surgery and would advise any surgeon with musculoskeletal problems or who has concerns they will develop them to consider evaluation by a licensed, qualified PT. Physical Therapists Explain Why Physical Therapy Can be Beneficial for Surgeon Musculoskeletal Health Between 85.7% and 93.6% of head and neck surgeons have reported improvements in musculoskeletal symptoms with physical therapy ( 2 ). Physical therapists can be utilized both preventatively and therapeutically. According to my physical therapy colleagues, the initial evaluation includes: Identifying areas of muscle and joint restriction Assessing strength and endurance in sustained positioning or with repetitive movements. The body is accustomed to taking the path of least resistance, which often results in pressure on the joints. This can be a source of injury and pain, because joints are not able to tolerate static load over time in the same way our muscle can. Therefore, the most important thing for physician surgeons to develop is improved positional awareness to choose positions with the least strain. It is for that reason that I started Reformer Pilates, both to strengthen muscles that stabilize my spine, but also to strengthen and activate those muscles I was instructed I will need to position myself in the least stressful way possible. Physical Therapists Explain Why Movement During Surgery is Important for Surgeon Musculoskeletal Health Some physical therapists will argue that no single position should be considered necessarily “bad” or “good.” Positioning depends on the individual and the work demands on them. However, the general problem comes from maintaining one position for too long. Neck and trunk flexion as well as flexion and abduction of the shoulders create higher force and increased muscle strain. This positioning is common during surgery. To that extent, “micropauses” of 20 seconds or more – or short breaks in general – are advised by some physical therapists to reduce joint and muscle strain. Physical Therapists Argue Strategic Movement Before, Between and After Surgery is Important for Surgeon Musculoskeletal Health Some physical therapists will argue that what we do before, between, and after surgery is important as well. For example, building muscle strength and flexibility beyond the range of motion of the activity performed – in this instance, surgery – is important to reduce the risk of injury. In fact, many professional athletes adhere to this strategy in basketball and other sports. Other Common Preventative Strategies May be Less Helpful The feedback I have received from physical therapists is that biofeedback devices – those devices that are often worn on the back and send signals with changes in posture – are generally not effective absent other interventions as described above. One colleague explained that, while biofeedback devices can be used for training, they are less effective with daily use, primarily because they can take attention away from the task at hand (i.e., surgery). However, every individual needs to make the decision for themselves whether the above is indeed true for them. I was very interested in the feedback I received on postural chairs; chairs meant to force improvement in posture. I have colleagues who use these chairs during surgery. I was informed that, while postural chairs can be good to provide breaks for your body, they should not be a primary intervention. These chairs can reduce the usage of muscles whose strength is important to maintain good posture and, therefore, protect your musculoskeletal system. Again, however, the use of postural chairs and biofeedback devices should be a personal choice made in consultation with a licensed, qualified physical therapist. Trust Your Face to a Double Board-Certified Facial Plastic Surgeon It is important to seek a fellowship-trained, double board-certified specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us References Epstein S, Sparer EH, Tran BN, Ruan QZ, Dennerlein JT, Singhal D, Lee BT. Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists: A Systematic Review and Meta-analysis. JAMA Surg. 2018 Feb 21;153(2):e174947. Walters ZA, Chang KY, Cervenka B, Collar R, Hsieh TY. Ergonomics in Otolaryngologic Surgery: A State of the Art Review. Otolaryngol Head Neck Surg. 2022 Aug 9:1945998221117095. Garg N, Xu V, Mandloi S, DeKloe J, Kumar A, McCann A, Chandna M, Tekumalla S, Krein H, Heffelfinger R. Ergonomics in Facial Plastic and Reconstructive Surgery: A National Evaluation. Facial Plast Surg Aesthet Med. 2024 Dec 20. Karasik D, Tranchito E, Welschmeyer AF, Gourishetti SC, Shipchandler TZ, Ponsky D, Rabbani CC. Improving Surgeon Well-Being: A Survey on Ergonomic Challenges and Solutions in Rhinoplasty. Facial Plast Surg Aesthet Med. 2024 Dec 26. Ryan MT, Montgomery EA, Fryer J, Yang AW, Mills C, Watson N, Noller M, Riley CA, Tolisano AM. Ergonomics in Otolaryngology: A Systematic Review and Meta-analysis. Laryngoscope. 2022 May 16. doi: 10.1002/lary.30216. Garg N, Xu V, Mandloi S, DeKloe J, Kumar A, McCann A, Chandna M, Tekumalla S, Krein H, Heffelfinger R. Ergonomics in Facial Plastic and Reconstructive Surgery: A National Evaluation. Facial Plast Surg Aesthet Med. 2024 Dec 20. --- ### The Importance of Post-Operative Recovery Incision Care and Our Plan URL: https://www.harmonface.com/blog/the-importance-of-post-operative-recovery-incision-care-and-our-plan Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck The post-operative recovery period is an important time where meticulous care can maximize healing and minimize down time. It is for that reason that Dr. Harmon has developed a comprehensive plan for the post-operative recovery period. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. First, Dr. Harmon discusses the importance of eating a well-balanced, nutritional diet , and getting adequate sleep before and after surgery with each of his patients. Care of each incision is of paramount importance during the first 5 – 10 days after surgery. Dr. Harmon has instituted a suture removal protocol for each procedure. He removes each stitch progressively over multiple days, balancing the need for the sutures to remain in place until adequate healing occurs with the desire to remove them as quickly as possible to minimize the visibility of the incision. As a result, Dr. Harmon has an opportunity to evaluate and monitor the progression of healing closely in the first days after surgery. That way any problems or concerns can be addressed promptly. It is also important to keep the incisions moist while they are healing. The incisions are covered with an antibiotic ointment for the first three (3) days after surgery to reduce the risk of infection and keep the incisions moist. The topical antibiotic is then discontinued, and the incisions are covered with Aquaphor ointment. This is done because applying antibiotics to incisions too long can result in an allergic reaction - called dermatitis - at the incision sites. The incisions remain cared for even after stitches are removed. Dr. Harmon applies a liquid incision dressing in areas where stitches are removed. This liquid incision dressing also allows protective tape to remain adherent to the incisions, which strengthens incisions and protects them from the sun. The tape and liquid incision dressing are removed after all sutures are removed. Finally, Dr. Harmon ensures all his patients apply silicone-based gels and a mineral-based sunscreen to the incisions after all stitches are removed for weeks-to-months to encourage the gradual fading of the incision lines. It is the above interventions that allow Dr. Harmon to deliver well-hidden incisions. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### The Importance of Maintaining Lower Eyelid Support During Lower Eyelid Surgery URL: https://www.harmonface.com/blog/the-importance-of-maintaining-lower-eyelid-support-during-lower-eyelid-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes Lower eyelid surgery (blepharoplasty) is a complex procedure that involves not only the treatment of lower eyelid bags but also loose muscle and skin in the lower eyelids. It is essential to maintain as much support of the lower eyelids as possible when performing surgery. This involves careful consideration of the most appropriate location for the surgical incisions as well as specialized procedures to strengthen the support of the “hammock” that suspends the lower eyelid. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Some Individuals Have Loose Lower Eyelids Every patient who comes in for a consultation for their lower eyelids undergoes a physical exam. The looseness of the lower eyelids is determined during this exam. Though very rare, individuals with loose lower eyelid tissue are at an increased risk of the lower eyelid being pulled down with healing, which can lead to an abnormal “rounding” of the lower eyelid and even incomplete eyelid closure in extreme circumstances. The Most Appropriate Surgical Approach is Determined by a Detailed Physical Exam The physical exam dictates the approach taken to rejuvenate the lower eyelids. The surgical approach can be adopted to the patient’s anatomy, thereby reducing the risk of the lower eyelids being pulled down. For example, a patient with any evidence of loose lower eyelid tissue will undergo eyelid surgery through a specialized incision hidden on the inside of the eyelid, called a transconjunctival incision. This approach not only creates a hidden incision but also preserves more of the soft tissue of the lower eyelids. The reduced risk of scarring of the muscle and other soft tissue reduces the risk of the eyelids being pulled down. Consider Procedures to Strength the Support of the “Hammock” That Suspends the Lower Eyelids There are specialized techniques to provide additional support to the “hammock” that suspends the lower eyelids in addition to approaches that reduce the risk of scarring in the first place (i.e., the transconjunctival incision). One procedure, called a canthopexy, involves a tiny incision and strengthens the support of the “hammock” of the lower eyelid, thereby reducing the risk of the lower eyelid being pulled down with healing. Close Post-Operative Follow Up by a Physician is Essential Close post-operative follow-up with a physician is essential after lower eyelid surgery (blepharoplasty). There are exercises and medications that can be injected to reduce or prevent scarring early in the healing process. However, it requires the presence of a physician at post-operative follow up appointments to perform these treatments. Dr. Harmon manages the care of his patients at all their post-operative follow up appointments. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### The “Fox Eye” Procedure: What is It and is it Worthwhile? URL: https://www.harmonface.com/blog/the-fox-eye-procedure-what-is-it-and-is-it-worthwhile Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes The “Fox Eye” procedure has become a trending topic on social media, including TikTok. The procedure stretches the side of the eyebrow and temple skin. It most likely involves the use of barbed stitches/sutures in a manner like threading in the face and neck. Everyone is entitled to their own conception of what is beautiful. However, the significant limits of the use of threading and the resultant significant distortion of the anatomy it causes make the procedure not worthwhile in the opinion of Dr. Harmon. This procedure is sometimes confused with the lateral temporal brow lift surgical procedure. In contrast with the “Fox Eye” procedure, this surgical procedure can provide a long-lasting and natural-appearing lift of drooping lateral eyebrows and smoothing of the temple tissue in the appropriate candidate. This blog post seeks to explain the problems with the “Fox Eye” procedure and to contrast it with the lateral temporal brow lift. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The “Fox Eye” Procedure Significantly Distorts the Facial Anatomy in an Unnatural-Appearing Way The “Fox Eye” look appears exaggerated and pulled. The area stretched to the side and up includes the most lateral portion of the eyebrow and the temple skin. The procedure does not appear to result in facial anatomy that approximates the range of what humans normally demonstrate. A similar effect can occur with older, less effective facelift techniques that can result in a distorted mouth and “windswept” appearance. This effect runs counter to the philosophy of Dr. Harmon, who strongly feels that directly addressing as many of the underlying causes of age-related changes to the face is the best way for natural appearing results. The “Fox Eye” Procedure is Likely Performed Using Dissolvable Barbed Stitches Threading, which involves the use of dissolvable barbed stitches/sutures inserted into the skin in multiple locations, is likely the most common method used to achieve a “fox eye” look. Dr. Harmon does not endorse the use of threading anywhere in the face. First, the stitch/suture is simply a commonly used dissolvable suture but with barbs on it. The effect is temporary because the suture is dissolvable, typically lasting only a few months. Second, the sutures are placed blindly into tissue planes, making appropriate placement difficult. Third, there is no surgical separation of the volume that needs to be lifted from the deeper structures of the face or the release of this tissue from tension points in the face that would be necessary to prevent distortion of the facial anatomy. The Lateral Temporal Brow Lift is a Surgical Procedure that Can Provide a Natural Appearing Lift of the Lateral Brow and Temple The lateral temporal brow lift contrasts with the “Fox Eye” procedure because it is a surgical procedure that involves the dissection of volume off the deeper structures of the face, including the release of tension points along the eyebrow. The result is the lifting of the lateral brow and smoothing of the temple volume in a long-lasting manner without distorting the surrounding anatomy. And while dissolvable stitches/sutures are used to suspend the tissue, this is only temporary until the lifting tissue has had time to heal against the deeper tissue again. As with all procedures, however, a consultation with a qualified surgeon is essential to determine whether an individual is a candidate for the lateral temporal brow lift. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### The Effects of Cigarettes on Healing URL: https://www.harmonface.com/blog/the-effects-of-cigarettes-on-healing Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Smoking cessation for many weeks prior to and after surgery is essential to maximize healing and reduce the risks associated with poor wound healing. The components of cigarettes that affect healing include nicotine, carbon monoxide, and hydrogen cyanide. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Nicotine Constricts Blood Vessels and Encourages Blood Clots Present not only in cigarettes but also liquid vaping products, cigars, smokeless tobacco products, and hookah tobacco, this highly addictive substance acts on tissue in two ways. First, nicotine constricts small blood vessels, restricting the flow of oxygen and nutrients to healing tissue. Second, nicotine encourages blood to clot, which also serves to restrict blood flow to healing tissue. We counsel patients to avoid all nicotine-containing products, not just cigarettes, peri-operatively. Carbon Monoxide Reduces the Ability of Blood to Carry Oxygen and Release It to Tissues Carbon monoxide, a well-known poison that is released from fireplaces, wood-burning stoves, gas ranges, and furnaces in homes, is also present in cigarette tobacco. Carbon monoxide acts to impair healing in two ways. First, carbon monoxide reduces the ability of blood to carry oxygen to tissue by replacing oxygen in the hemoglobin contained in blood. Second, carbon monoxide reduces the ability of blood to release oxygen to tissue due to the changes that occur to the hemoglobin in blood when carbon monoxide binds to it. Hydrogen Cyanide is a Poison that Prevents Cells from Utilizing Oxygen Originally used as a chemical weapon, hydrogen cyanide is present not only in cigarettes but also in pesticides, fumigants, and plastics. Hydrogen cyanide is a poison that stops the ability of cells to utilize oxygen delivered to it by the blood. This results in cell death and, as a result, poor healing. The Effects of Nicotine, Carbon Monoxide, and Hydrogen Cyanide are to Impair Healing and Increase the Risk of Infection The risk of infection and abnormal scarring increase significantly with smoking. The risk of poor tissue perfusion to the skin also increases, potentially leading to loss of skin after facial plastic surgery procedures, including facelifts , neck lifts , nose surgery , and eyelid surgery . Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### The Art of Visualization and Facial Plastic Surgery URL: https://www.harmonface.com/blog/the-art-of-visualization-and-facial-plastic-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Visual aids assist in explaining complex facial plastic surgery concepts. The Back of the Napkin: Solving Problems and Selling Ideas with Pictures by Dan Roam provides a good system for assessing how to communicate complex concepts to an audience in a manner that is simple but is dense with relevant information. This blog post seeks to summarize the system as described by Dan Roam as well as how we at Harmon Facial Plastic Surgery applied his system to communicating our philosophy on addressing facial aging comprehensively with advanced surgical techniques. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. “The Real Goal of Visual Thinking is to Make the Complex Understandable by Making it Visible” - Dan Roam Dan Roam states: “the real goal of visual thinking is to make the complex understandable by making it visible.” To that effect, he created a system to represent complex ideas visually. First, he suggests choosing an idea. Second, he suggests deciding through what framework the idea should be visualized. Third, he suggests deciding where on multiple scales this framework should be applied to an image. The framework through which the idea can be communicated includes who/what, how, and where, among others. The appropriate drawing, including visuals and tables/charts as needed, is largely based on this decision. More than one framework can apply to an idea. Dan Roam’s “SQUID” scale concept is applied once the appropriate framework(s) is/are decided on. The “SQUID” scale concept requires choosing where on a scale the visual aid will fall in different dimensions including from simple to elaborate, qualitative versus quantitative, individuals to comparison, among others. The choice of framework and scale on each dimension is dictated by the idea as well as the intended audience. How Harmon Facial Plastic Surgery Developed a Visual Aid Using This Technique We at Harmon Facial Plastic Surgery sought to communicate the fact that we offer a suite of complementary, advanced facial plastic surgery procedures – including the extended deep plane facelift, neck lift , lateral temporal brow lift , and lip lift – that can address the signs of facial aging comprehensively* and in a way that is natural appearing. Moreover, we sought to highlight the extended deep plane facelift , a technique in which Dr. Harmon is one of the few surgeons in the world fellowship-trained by its creator. This makes him uniquely qualified in the Cincinnati area to perform this technique. First, we determined that the WHO? and the HOW? are the most appropriate frameworks through which the visual aid should be created. The WHO? are our patients, whose excellent care we value most. The HOW? are the surgical techniques and the way they can restore a great deal of the youthful balance to the face that is lost with aging. Second, we chose the following on the scale for each dimension: SIMPLE rather than elaborate, QUALITATIVE rather than quantitative, EXECUTION rather vision, INDIVIDUAL rather than comparison, and CHANGE rather than status quo. In effect, we chose to visualize a simple, powerful idea about facial plastic surgery in a way that intelligent people with little available time would be able to understand quickly and easily. How the Above Process Translates into a Draft Hand Drawn Visualization How did we translate the idea of addressing facial aging comprehensively through the Harmon Facial Plastic Surgery philosophy and method? Moreover, how do we visualize this simply, qualitatively, individually, and emphasize change? A drawing on a piece of printer paper formed the first draft of this: The Draft Hand Drawn Visualization is then Interpreted by a Design Professional The next step was to hire a professional designer to translate this into a more visually appealing design. See the poster that hangs in our office below: The above image utilizes our brand logo, icon, and color. Our motto Feel Good About Feeling Good is emphasized. And the four highlighted procedures are visualized simply and attractively. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us *Not all procedures are indicated for every patient. There may be reasons why one or more procedures may not be appropriate for a specific patient. --- ### Tear Trough Filler: An Explainer URL: https://www.harmonface.com/blog/tear-trough-filler-an-explainer Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Hyaluronic acid filler in the tear troughs can address specific concerns about the interface between the lower eyelid and cheek. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether placement of hyaluronic acid filler in the tear troughs is an appropriate treatment for your concerns. The tear trough breaks a smooth, youthful transition from the lower eyelid to the cheek A youthful face has a smooth transition from the lower eyelid to the cheek. The tear trough is a line or depression that develops at the border between the lower eyelid and cheek. It worsens as the cheek droops and the lower eyelid bags develop. The tear trough is not a wrinkle but the location of a ligament separating the lower eyelid fat from the cheek fat . The deeper the tear trough the more visible it becomes due to its shadowing effects. Filler is placed precisely in the tear troughs with a microcannula Hyaluronic acid filler such as Restylane© products can be used to soften the appearance of the tear trough. Restylane© and most Juvederm© brand hyaluronic acid fillers are FDA-approved products but placed in the tear troughs off-label, meaning FDA-approval was not sought specifically for placement of these products in the tear troughs. Currently the only hyaluronic acid filler FDA-approved specifically for placement in the tear troughs is Juvederm© Vollbella© XC and Restylane© Eyelight™ . Other products have long been used safely and effectively in this area off-label, though it is important that injectors have a conversation with their patients about this fact. A blunt-tipped microcannula rather than a needle is typically used to deposit the filler at the tear trough precisely, adding enough volume to treat the site without adding so much that the lower eyelids look “puffy.” The microcannula may reduce the risk of bruising and swelling as well as the risk that the filler is injected into the wrong location, including a blood vessel. Recently, the media has published multiple articles calling into question the value of placing hyaluronic acid filler in the tear troughs, highlighting some of the rarest and most sensational risks associated with the procedure. This reporting, in my opinion, simply highlights the importance of an appropriately qualified provider administering the material at an appropriate location and depth in an appropriate patient ( 1 ). Filler can soften the tear troughs in individuals with appropriate anatomy The best candidates for placing filler in the tear trough often have a deep tear trough without severe lower eyelid bags. One should be cautious placing filler in the eyes with severe lower eyelid bags because it is more likely to make the area look “puffy.” Some swelling is expected after treatment, however. The swelling resolves gradually over a few days in most patients. Patients are counseled to apply cold compresses to their lower eyelids and cheeks for the first 48 hours after treatment to accelerate this process. Some individuals are more likely to benefit from lower eyelid surgery (blepharoplasty) Deep tear troughs with lower eyelid bags are usually best treated with lower eyelid surgery (blepharoplasty) . A consultation with a fellowship-trained, double board-certified facial plastic surgeon is recommended to determine candidacy for this procedure, because there may be factors that preclude this procedure for certain individuals. A detailed history and physical should always be performed prior to making the decision as to whether hyaluronic acid filler or surgery of the lower eyelids is the most appropriate treatment. Reasonable expectations must be established about what lower eyelid surgery can and cannot accomplish as with all plastic surgery procedures. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about age-related changes to your face and/or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References Torabi SJ, Massry G, Azizzadeh B. Are Tear Trough Fillers Really that Bad? Facial Plast Surg Aesthet Med. 2024 Dec 12. --- ### Surgical “Pearls” in Facial Plastic Surgery URL: https://www.harmonface.com/blog/surgical-pearls-in-facial-plastic-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information There are a massive number of books helpful to master the topics required to succeed in medical school and residency. Each medical specialty has their own sources, which range in size from large multi-volume texts to small clinical reference guides that include brief summaries of what are considered the most important, or high-yield, information “pearls.” Facial plastic surgery clinical reference guides exist as a valuable, though insufficient, source for clinical information for training residents and fellows. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Pearls Communicate Important Medical Knowledge Succinctly Residents of all specialties attend at least weekly lectures with experts in their field. Medical “pearls” include information distilled into bullet point form for these presentations. The purpose of medical pearls is to succinctly communicate the most salient information to new physicians who are often overwhelmed with clinical and administrative work during the day. The breadth and depth of information required to learn is so significant that most residents study late at night or early in the morning when their roommates or loved ones are sleeping. For example, I studied at night after my wife and son had fallen asleep. I found these clinical reference guides and presentations by attendings useful but insufficient. I always felt that the excluded context made it difficult to fully understand a topic. I also wonder whether some residents are less inclined to dive into the medical literature to confirm and expand on the information communicated because of the availability of these guides. Facial Plastic Surgery = Eliminate the Dog-Ear Deformity A friend and head and neck surgery co-resident at the University of Cincinnati who is an incredibly intelligent and insightful individual also recognized the limitations in depending on these “pearls” of knowledge as the basis for learning medical information in residency. He would joke that the knowledge required to understand each subspecialty in head and neck surgery could be distilled to a single sentence. His summary of the field of facial plastic surgery was “eliminate the dog-ear deformity.” A dog ear deformity is a fold of skin than can develop at the edge of an incision after orienting and closing that incision. A dog ear deformity can occur with any plastic surgery procedure in which the location and/or orientation of skin and subcutaneous tissue is re-arranged. An example includes the repair of a defect on the face after skin cancer is removed. A dog ear deformity can also occur with cosmetic procedures such as facelifts as well if the dissection is not performed properly. I told my friend and colleague that I would have a book bound for him titled A Complete Overview of Facial Plastic Surgery with only one page. That page would include the sentence “eliminate the dog-ear deformity.” This simple sentence does explain a great deal of plastic surgery. The practice of facial plastic surgery largely involves the creation and movement of tissue from one area of the face to another against the force of gravity. Proper incision and tissue flap design is key to allowing skin closure that is flush. Prevention and/or elimination of a dog-ear deformity reflects appropriate, considerate movement of tissue. However, it is also an incomplete description because plastic surgery involves the complex multi-vector movement of tissue in different layers requiring detailed knowledge of the surrounding superficial and deep anatomy to perform safe, effective surgery. There are also many other patient-specific considerations that require both exposure in training and experience performing to fully understand. Facial plastic surgeons are always learning and improving their craft. Surgical Pearls Are Valuable but Insufficient No ability to memorize pearls can replace the knowledge gained from experience in head and neck surgery residency, facial plastic surgery fellowship, and clinical practice. From the way to troubleshoot and address problems peri-operatively to the ability to evaluate a patient pre-operatively to determine the most appropriate treatment course for them, facial plastic surgery is filled with nuance. New information is coming out every day in the medical literature that may contradict what was previously assumed to be true and/or may complicate the picture of what is true, making decisions more difficult. In my opinion, the value of these pearls is as an exercise in analyzing and distilling information. They are a skeleton on which to flesh out the nuances of clinical practice. Our training and experience allow us to have a flexible mind when dealing with each individual patient because the answer to many clinical questions is not available in the textbook or in a scientific paper. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck . Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Skin Care After Laser Resurfacing of the Face URL: https://www.harmonface.com/blog/skin-care-after-laser-resurfacing-of-the-face Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Laser resurfacing of the face can address wrinkles and other irregularities of the tone and texture of the skin resulting in a softer, more youthful appearance to the face. Good skin care after treatment with a resurfacing laser is essential. The following post describes this process. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Skin Heals in an Average of Seven to Ten Days After Laser Resurfacing The first seven to ten days are essential to the healing process after laser resurfacing of the face. The top layers of the skin are healing. It is essential to avoid the sun during this time. It is also essential to keep the treatment areas moist and clean. A Skin Protectant/Moisturizer Such as Aquaphor© is Applied While Healing It is important to keep the treated skin moist while healing. A moisturizer such as Aquaphor© is applied to the skin twice daily until the top layers heal. The Face is Cleaned with Water and a Gentle Cleanser While Healing The face is generally washed with lukewarm water and a gentle facial cleanser while healing. A solution of diluted vinegar is sometimes used as well. Antibiotic and Anti-Viral Medications are Taken Every patient takes antiviral medications and antibiotics to reduce the risk of a bacterial infection and/or the activation of a dormant viral infection that also causes cold sores. A Moisturizer and Sunscreen are Applied After the Skin Has Healed The healing process does not end after seven to ten days. A slight pink hue often develops in some areas after the skin has healed, which usually fades during the first few months after treatment. It is important to avoid prolonged sun exposure for months after surgery during this time. It is important to keep a moisturizer on the skin in addition to wearing a hat and sunglasses and applying a mineral-based sunscreen. A good moisturizer is the Skinceuticals© product Epidermal Repair. My patients apply Epidermal Repair to the treated skin for approximately three months after the skin has healed. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Scar Treatment: An Explainer URL: https://www.harmonface.com/blog/scar-treatment-an-explainer Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Scar treatment can address specific concerns about the appearance of a scar on your face and/or neck. There are four general categories of treatments for scars, each of which may or may not benefit you. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether - and which - scar treatment is appropriate for your concerns. Topical Treatments Can Improve Healing and Reduce the Risk of Abnormal Scarring The enemy of surgical incision healing is sun-exposed, dry skin. To that end, topical treatments that keep surgical incisions moist and protected from the sun can improve healing and reduce the risk of abnormal scarring. The first few days after surgery require a topical antibiotic to both keep incisions moist and to reduce the risk of infection. Next, an occlusive moisturize such as Aquaphor© is used to continue to hold moisture in the skin around the incision. Finally, a silicone-based scar gel layered over with a mineral-based sunscreen with an SPF of 30 or greater is applied for months until the incision is completely healed. Injectable Treatments Can Reduce the Risk of Abnormal Scarring and Improve the Appearance of Scars Incisions can (rarely) scar excessively, resulting in discoloration and contour abnormalities. Careful use of dilute steroids injected into these scars starting a few weeks after surgery can soften them and improve their contour, making them flatter and more even. Fluorouracil is a medication that has been used early in the healing process after eyelid surgery (blepharoplasty) to reduce excessive scarring which can result in incomplete eye closure, called lagophthalmos. It is injected deep into scars just as they are starting to form. Resurfacing Treatments Can Improve the Color and Contour of Scars Resurfacing lasers , including the Erbium:YAG and CO2, are potentially excellent tools for treating excessive scarring. Similarly, chemical peels which also resurface the skin can be used to treat excessive scarring. Both lasers and chemical peels can improve the color and contour of scars. But both do involve a recovery process during which the top layers of skin heal. Unfortunately, resurfacing lasers and chemical peels cannot be used on darker skin tones due to the risk of skin lightening associated with these treatments. Surgical Scar Revision Can Remove Abnormal Scars Scars that do not improve with topical, injectable, or resurfacing treatments may require surgical removal. Surgical scar revision involves the excision of the scarred skin and closure of the normal surrounding skin. The purpose of this procedure is to allow the skin another opportunity to heal with more aesthetically pleasing results. Surgical scar revision surgery can also reorient scars in ways that better camouflage them on the face. Botulinum Toxin A (e.g., Botox®) is Used to Reduce Scarring It was first theorized that botulinum toxin A (BoTA) could be used to reduce scarring in 2000. While the use of BoTA for this purpose is considered FDA off-label, more research is being published to suggest that it could be effective when injected either during surgery or shortly after (1, 2). The potential mechanisms of action are the following: Reduced tension on the incision site. Increased tension at the incision site increases the risk of excessive scarring. This is the reason why deep plane facelift surgery, including the extended deep plane facelift , reduces the risk of abnormal scarring compared with other non-deep plane techniques . Reduced fibroblast hyperproliferation. Fibroblasts build connective tissue and excess proliferation can result in excess scarring. Reduced deposition of collagen. Fibroblasts produce collagen. Fluorouracil is Used to Reduce Scarring Fluorouracil is another medication that is used FDA off-label to reduce scarring. It is a chemotherapeutic agent that is commonly used in dermatology to treat pre-cancerous and cancerous skin growths. It functions as an antimetabolite, which means it stops the growth of particularly fast-growing cells. Fluorouracil is probably most used in the lower eyelid after lower eyelid surgery (blepharoplasty) to reduce the risk of and treat scarring that can lead to retraction of the lower eyelid, which can cause problems with eye closure. Like BoTA and steroids, it is important to have a detailed discussion of the risks, benefits, and alternatives to the use of this medication with your physician prior to considering these treatments. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about abnormal scarring in the face and/or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us References 1. Bi M, Sun P, Li D, Dong Z, Chen Z. Intralesional Injection of Botulinum Toxin Type A Compared with Intralesional Injection of Corticosteroid for the Treatment of Hypertrophic Scar and Keloid: A Systematic Review and Meta-Analysis. Med Sci Monit. 2019 Apr 22;25:2950-2958. 2. Kasyanju Carrero LM, Ma WW, Liu HF, Yin XF, Zhou BR. Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: Updated review. J Cosmet Dermatol. 2019 Feb;18(1):10-15. --- ### Retinoids versus Retinols: What's the Difference and Which is Better? URL: https://www.harmonface.com/blog/retinoids-versus-retinols-whats-the-difference-and-which-is-better Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Retinoids are derived from Vitamin A, which a common vitamin in human skin. They can be naturally derived or synthetically (i.e., lab) derived. Most retinoids are applied to the skin (i.e., topically) to treat age-related changes to the skin and/or prevent age-related changes to the skin. Those changes, called photoaging, include wrinkles, dark spots, and texture irregularities. Retinoids exert their effects by encouraging the formation of youthful collagen and discouraging the breakdown of collagen in the skin. Retinol is a form of retinoid. Tretinoin is another form of retinoid. Retinoids achieve their effect by acting as hormones. They are easily absorbed by the skin, which is unique compared with other products applied to the skin. This likely contributes to their effectiveness. It is important to have a discussion with a physician as to whether a retinoid such as retinol or tretinoin is appropriate for your face. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Tretinoin is an FDA-Approved Prescription Retinoid Tretinoin is the best-studied prescription retinoid medication for photoaging. It is important to note that, although tretinoin has been FDA-approved for the treatment of photoaging, there is strong evidence for its effectiveness in preventing the effects of photoaging as well. Even better, much of this data utilizes high quality research, including randomized, controlled studies, which I explain more about in this blog post . Retinol is a Cosmetic Ingredient that is Not FDA-Approved Retinol is a metabolic precursor to tretinoin. This means that, when retinol is applied to the skin and absorbed, it is converted into tretinoin over multiple steps. Tretinoin is the compound with the anti-aging effects. Retinol is included in many over-the-counter skincare products but is not FDA-approved. That is why it is not a prescription medication. There is evidence, however, that it is also effective in treating the signs of photoaging. Both Tretinoin and Retinol are Effective Topical Retinoids First and most importantly, the evidence in the medical literature demonstrates that both tretinoin – the FDA-approved prescription medication – and retinol – the cosmetics ingredient that is not FDA-approved – are effective in treating age-related changes to the skin. The earliest and best data came from research on tretinoin. More data, however, is being published to support the effectiveness of retinol. It is just that no company to date has chosen to go through the time-consuming and expensive process of getting FDA approval for retinol in one of their cosmeceutical products. The lack of FDA approval does make it difficult to choose the best over-the-counter product, because it is not regulated like a medication. Therefore, it is difficult to determine the most effective retinol-containing product. Side effects of retinoids include redness, skin irritation, and skin peeling. The severity of these symptoms is dependent on both the dose and frequency of use. However, people tend to develop tolerance to these compounds over time. Retinols are less likely to cause the above symptoms. Therefore, some suggest starting with retinol and transitioning to tretinoin with a gradual increase in dose and frequency of use once tolerance has been built. One also should consider the fact that the ingredients are very sensitive to the sun, becoming inactive very quickly with sun exposure. Many recommend applying them at night for this reason. It is important to discuss any plans to start using tretinoin or retinol with a physician. Bakuchiol is Being Promoted as an Alternative to Topical Retinoids There is a plant-derived product called bakuchiol which is currently being marketed as an alternative to retinoids (e.g., tretinoin and retinol) with fewer side effects. There is a long history of its use in Chinese and Indian medicine. However, the evidence for its effectiveness is currently weak. See this blog post for more information on bakuchiol. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. It is important to seek the advice of a dermatologist if you have concerns about your skin and feel a prescription retinoid such as tretinoin may be helpful to you. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us Reference Baumann L. Cosmeceuticals and Cosmetic Ingredients . McGraw-Hill Education; 2015. --- ### How Does a Non-Surgical Brow Lift with Botox® Work? URL: https://www.harmonface.com/blog/how-does-a-non-surgical-brow-lift-with-botox-work Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical A non-surgical brow lift can be achieved using medications such as Botox®. While not as effective or long-lasting as a surgical brow lift , a non-surgical brow lift can open the eyes up in a beautiful, natural-appearing way. Treatment of the brow with Botox® requires an understanding of the facial muscle anatomy. Moreover, the mechanism of achieving a brow lift non-surgically is commonly misunderstood by patients. This blog post seeks to help patients understand how a non-surgical brow lift with medications such as Botox® works. Seek a fellowship-trained facial plastic surgeon if you have concerns about your face or neck. A consultation with a well-trained, experienced injector is essential to determine whether a non-surgical brow lift is appropriate for you. Furthermore, it is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Only One Muscle Lifts the Eyebrows Only one muscle in the face lifts the brows. Called the frontalis muscle, it extends in a ribbon across the forehead. The frontalis muscle contributes to the horizontal wrinkles treated by placing medications such as Botox® in them and/or with skin resurfacing procedures . Multiple Muscles Pull the Eyebrows Down In contrast, multiple muscles depress, or pull down, the brows. The orbicularis oculi muscle surrounds the eye and contributes to eye closure in addition to depressing the brows. It is a portion of the muscle located off to the side of the eyes that is treated with medications such as Botox® for crow’s feet. The paired corrugator supercilii muscles and the procedure muscle are strong muscles that create eleven lines between the eyebrows. They also depress the medial eyebrows. These muscles are also frequently treated with medications such as Botox®. A Non-Surgical Brow Lift Temporarily Weakens the Muscle(s) that Pull the Eyebrows Down Many believe that treatment of the forehead with Botox® will help lift the eyebrows, likely because the muscle is located above the eyebrows. This is a common misconception. In fact, it is treatment of the muscles that pull the eyebrows down, including the orbicularis oculi (crow’s feet) and the corrugator muscles and procerus muscle (eleven lines) that can contribute to a non-surgical brow lift. This is because the muscle that lifts the brows will be stronger during the dynamic push-and-pull between muscles that lift the eyebrows and muscles and pull the eyebrows down. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### Lower Eyelid Botox® i.e., “Jelly Roll” Botox: Is it Safe and Effective? URL: https://www.harmonface.com/blog/lower-eyelid-botox-ie-jelly-roll-botox-is-it-safe-and-effective Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical The treatment of the lower eyelid with Botox® or similar medications has become a trending topic on social media, including TikTok. Commonly referred to as “jelly roll” Botox®, this Food and Drug Administration (FDA) off-label treatment has aesthetic goals. But does its apparent increasing popularity mean it is a safe and effective treatment? See a similar discussion on the placement of Botox® or similar medications in a neck and back muscle called the trapezius . It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. “Jelly Roll” Botox Targets the Lower Eyelid This treatment targets the lower eyelid with Botox® or similar medications. The target muscle is the orbicularis oculi, which is a muscle that wraps around the eye and is composed of multiple parts delineated by how close the muscle fibers are to the upper and lower eyelid margins. The most lateral portion of the orbicularis oculi is targeted by Botox® or similar medications when the crow’s feet are treated. In contrast, “jelly roll” Botox® targets the muscle at the lower eyelid near the margin of the lower eyelid. The Purpose of the Procedure is to Treat Bunching of the Lower Eyelid The purpose of this procedure is to reduce bunching of the orbicularis oculi muscle that can be exaggerated in certain individuals who demonstrate hyperactive muscle movement in the lower eyelid. This can be bothersome to some patients, especially when they smile. It can appear as if the muscle and skin are folded on themselves like an accordion and protruding beyond the eyelashes. Placement of Botox® or Similar Medications in the Orbicularis Oculi at the Lower Eyelid Has Important Safety Considerations There are important safety considerations with placement of Botox® or similar medications in the lower eyelid. First, the treatment is FDA off-label. As a result, its safety and effectiveness has not yet been official established by the United States (US) government. Second, the orbicularis oculi muscle has an important function in the lower eyelid in that its function is essential to maintain lower eyelid shape and in eye closure. Weakening of the muscle in this location can make the lower eyelid look saggy and overly rounded. It can also limit eye closure, which can lead to or exacerbate dry eye symptoms. Persistently dry eyes can then lead to vision problems. The above risks may not make treatment of this location Botox® or similar medications worthwhile at this time. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### Peri-Oral Rejuvenation: An Explainer URL: https://www.harmonface.com/blog/peri-oral-rejuvenation-an-explainer Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck The lips consist of complex anatomy that includes more than simply the red portion of the lips. Each anatomic area of the lip ages and may benefit from interventions targeted to those changes. The following information is adapted from a presentation I have given to other medical professionals. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Youthful Peri-Oral Anatomy The upper red lip has a well-defined “M” shaped border – called the vermillion border – with the peaks of the “M” called the cupid’s bows. The bottom lip is larger and more rounded than the upper lip with an ideal ration of size between the upper and lower lip at approximately 1:1.6, which is also known as the “Golden Ratio.” When most individuals refer to the lips, they are referring to the red lips as described above. However, this does not encompass the entire lip anatomy. The skin between the red upper lip, the base of the nose, and the nasolabial folds and the skin between the red lower lip, chin, and marionette lines (pre-jowl sulci) are also components of the peri-oral region. The nasolabial folds of the upper lip and the pre-jowl sulci of the lower lip are created by ligaments extending from the bone to the skin that hold up fat pads sitting above them. These fat pads droop down and to the center of our face as we age, leading to more prominent nasolabial folds and pre-jowl sulci. Age-Related Changes to the Peri-Oral Region The aging process occurs in three dimensions. First, the skin develops wrinkles (rhytids) and age spots. The depth and number of rhytids depends on several factors, including genetics and environmental factors such as smoking history, alcohol use history, and sun exposure. Overall, soft tissue and bone shrink, and soft tissue thins and droops. Probably the most noticeable change that occurs is a lengthening of the upper lip, which can eliminate the naturally youthful upper tooth (central incisor) show when the lips are relaxed and imparting a simian appearance to the lip. This effect becomes exaggerated when too much filler is placed in the lips for many years. The upper and lower red lips also shrink and lose definition, which can result in a loss of naturally youthful lip pout. The corners of the mouth, called the oral commissure, droop due to thinning of tissue. Finally, as described previously, superficial fat pads in the cheeks and along the jawline fall to the center of the face, leading to an accentuation of the nasolabial folds and pre-jowl sulci, which leads to marionette lines. Deep Plane Facelift Surgery is the Best Method to Address Deepened Nasolabial Folds and Marionette Lines Deep plane facelift surgery and, specifically, the extended deep plane facelift , is the gold-standard in facelift techniques. Deep plane facelift surgery is the only facelift technique that can naturally address the anatomic changes that lead to a deepening of the nasolabial folds and marionette lines. As discussed in a previous post , deep plane facelift surgery is distinguished from other facelift approaches by the fact that a composite skin and deep tissue – composed of muscle and the fascial layer called the SMAS – flap is lifted in the middle of the face and the ligamentous attachments in the cheeks and the jawline are released for a comprehensive, tension-free lift of not only the jowls but also the cheeks. This is what allows the nasolabial folds, marionette lines, and drooping oral commissures to be treated. The extended deep plane facelift advances deep plane surgery by extending the deep plane approach into the lateral neck, which allows the jawline to be better contoured all the way to the back corner of the jawline and the central neck to be more effectively tightened. Hyaluronic acid filler such as Restylane© and Juvederm© products are commonly used in the nasolabial folds and marionette lines to “blunt” their appearance. These products are also used around the corners of the mouth to provide a “lift.” While this non-surgical treatment can be appropriate in certain circumstances, the problem is they do not address the actual changes that occur with age, i.e. weakened ligaments, drooping fat, and loose muscle and skin. Attempts to eliminate the nasolabial folds and marionette lines with hyaluronic acid filler or other fillers including fat can overinflate the face and make patients look distorted by eliminating subtle transition points between the cheeks and lips. Skin Resurfacing and Nano-Fat Can Treat Peri-Oral Wrinkles Wrinkles around the mouth are treated primarily by resurfacing procedures, which fall under three categories: laser resurfacing, chemical peels, and mechanical resurfacing. All three approaches remove the top layers of the skin in a controlled fashion. The healing process after treatment results in the deposition of collagen in a more organized fashion that better reflects a youthful skin composition. Laser resurfacing devices include CO2 and Erb:YAG lasers. Resurfacing lasers target water molecules (H2O) in the skin, heating the tissue to a controlled depth. Most resurfacing lasers used today are fractional, which means the laser energy reaches the skin in organized columns with untreated skin in between. Fractional lasers heal faster and are less likely to result in complications than non-fractional lasers. Chemical peels are a diverse group of chemical mixtures (e.g., TCA peels, Hetter peels) which are applied to the skin for resurfacing. The depth of the peel is dependent on the mixture’s active ingredients and their relative concentration as well as the number of passes used. Mechanical resurfacing, otherwise known as dermabrasion, involves the use of a hand piece with a spinning tip that is often diamond coated and which effectively serves as a sander for the skin. The tips come in many shapes and sizes for use on different areas of the face. The rate of spin and number of passes also contribute to the depth of the resurfacing procedure. A complementary approach to resurfacing procedures on the mouth wrinkles involves the use of nano-fat. Nano-fat is harvested from the patient’s own body fat in the stomach, flank, or thighs just like fat augmentation procedures. The difference between nano-fat and the fat used to augment the face is that it is processed to be a thin liquid. Nano-fat is injected superficially into the wrinkles prior to the resurfacing procedure. The purpose of placing nano-fat in these wrinkles is primarily to improve healing after the resurfacing procedure and secondarily to soften the deeper wrinkles that may not be treated completely with the resurfacing procedure. The Lip Lift Can Treat Lip Lengthening and Thinning The lip lift procedure is the best approach to treat the lengthening of the upper lip skin as well as the loss of definition and projection of the red upper lip. Providers often try to address these changes with hyaluronic acid filler to poor effect. In fact, adding large volumes of filler to the upper lip can stretch the upper lip. Adding large volumes of filler to the upper lip can also over project the upper lip, leading to a “duck-lipped” appearance. The lip lift, which is also known as the sub nasal or bullhorn lip lift, involves the excision of skin and fat in a gullwing or bullhorn pattern at the base of the nose. This incision then hides in the creased of the base of the nose. This procedure can accomplish three things. First, it increases the height and improves the definition of the red lip. Second, it balances the length of the upper lip skin with the red lip height. Third, it improves the pout of the red lip. The lip lift is a complementary procedure to cosmetic dentistry procedures, because the lip lift can restore some of the youthful central tooth show that occurs when the lips are relaxed apart. Some providers perform lip flip procedures using botulinum toxin to the muscle surrounding the mouth, called the orbicularis oris. This procedure is not recommended , because it is generally not effective and can cause problems with speaking and drinking through straws for weeks-to-months after the procedure. Multiple Techniques Can Re-Volumize the Lips Some patients with deflated lips can benefit from procedures that restore their volume. In fact, many patients who undergo a lip lift also undergo lip volumizing procedures. Temporary options for lip volumizing include hyaluronic acid filler . Permanent options for lip volumizing include fat and SMAS, which is the strong fascia that lies over the fat and deep muscles of the face. The fat is removed from the stomach, flank, or thighs, processed, and injected using blunt-tipped cannulas into the upper and lower lips. SMAS is removed from immediately in front of the ear during the extended deep plane facelift procedure and inserted into the upper and lower lips through incisions hidden at the corners of the mouth. The patient above is an excellent example of how multiple procedures work simultaneously to rejuvenate the peri-oral region. This patient underwent a lip lift , fractional CO2 laser resurfacing with nano-fat grafting of the wrinkles around the mouth , and lip enhancement with hyaluronic acid filler to balance the bottom lip with the top lip. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### “Ozempic® Face” and Facial Plastic Surgery Considerations URL: https://www.harmonface.com/blog/ozempic-face-and-facial-plastic-surgery-considerations Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The term “Ozempic ® Face” has been widely circulated and commented on on the internet. Its popularity parallels the increased popularity of the use of Ozempic ® and its family of medications for weight loss. The term likely refers to the changes in the appearance of the face after the often significant, rapid weight loss associated with the use of these medications. The following blog post is not a comment on the clinical effectiveness or safety of the Ozempic ® family of medications for weight loss or diabetes, its original indicated treatment. Internal medicine physicians and endocrinologists are the experts who should be consulted with regarding the use of these medications. Rather, this blog post discusses the likely features referred to as “Ozempic ® Face” as well as the possible surgical and/or non-surgical treatment options for these features. This blog post also considers the potential concerns of this family of medications during anesthesia. As with all facial plastic surgery procedures, it is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Ozempic® (Semaglutide) is a GLP-1 Activator Ozempic ® is the trade name for semaglutide, one member of a family of medications called GLP-1 agonists. GLP-1 agonists bind and activate GLP-1 receptors all over the body, resulting in delayed emptying of the stomach, increased insulin release, decreased glucagon release, and increased pancreatic β cell growth (1). Ozempic® (Semaglutide) was Originally Used to Treat Type 2 Diabetes One effect of GLP-1 agonists is a decrease in the level of sugar (glucose) circulating in the blood (1). That is why Ozempic ® is used to treat type 2 diabetes. One potentially beneficial side effect of this family of medications is weight loss. Ozempic® is Now also Prescribed for Weight Loss It is unclear what the primary mechanism of weight loss is, though the medication has been demonstrated to decrease food intake overall. It is possible the medication works to decrease appetite in the brain. It is also possible that the slowed emptying of food from the stomach makes patients feel full more quickly. “Ozempic® Face” is a Flashy Term Applicable to Any Individual Who Experiences Significant, Rapid Weight Loss The term “Ozempic ® Face” simply refers to changes that can occur on the face of any individual who experiences significant, rapid weight loss, whether from the use of medications such as Ozempic ® or through bariatric surgery. The loss of a large amount of fat in the face very quickly can make the face appear more aged due to loosening skin, a loss of volume in the temples and cheeks, and the development of more prominent folds in the face such as the melolabial fold and marionette lines. These changes can extend into the neck where loosening neck muscle and skin become much more visible. The Features Attributable to “Ozempic® Face” Can be Addressed with Facial Plastic Surgery The above features can be addressed with surgical and non-surgical procedures, though surgery is typically the most effective and longest lasting treatment approach. Surgical procedures that may be beneficial for patients who have experienced significant, rapid weight loss from medications such as Ozempic ® or bariatric surgery include the extended deep plane facelift , neck lift , lateral temporal lift , and lip lift . As always, it is important to seek a consultation with a fellowship-trained facial plastic surgeon prior to considering any surgical or non-surgical procedure on the face and/or neck. The Potential for Delayed Clearance of Stomach Contents is an Important Peri-Operative Consideration What is more relevant specifically to treatment with GLP-1 agonists such as Ozempic ® for weight loss is the known effect of delayed gastric emptying with use of the medication. Delayed gastric emptying means that food is slower to leave the stomach and move into the intestines. This has many beneficial effects for blood glucose maintenance and also decreases appetite by making people feel fuller, which is beneficial for weight loss. However, one peri-operative concern about delayed gastric emptying is the risk of regurgitating food while under anesthesia, resulting in aspiration. It is currently not clear how severe of a risk this is and what the considerations should be for patients, especially those using the medication only for weight loss who are also seeking elective cosmetic plastic surgery under IV sedation. Update 06/29/2023: New Consesus-Based Guidance from the American Society of Anesthesiologists (ASA) The ASA has recently release guidelines on preoperative fasting for patients who are being treated with GLP-1 agonists for diabetes mellitus type 2 and weight loss. The panel specifically refers to the risk of aspiration in patients undergoing IV sedation in addition to general anesthesia in their guidance. They highlight the fact that additional research is required to improve guidance on taking the medication peri-operatively. They recommend holding a GLP-1 agonist dosed daily one day prior to the procedure and holding a GLP-1 agonist dosed weekly one week prior to the procedure, regardless of the condition being treated with the medication (2). More Research is Required to Determine Universal Peri-Operative Recommendations in Plastic Surgery An article in the British Journal of Anaesthesia recommends against withholding GLP-1 agonists such as Ozempic ® peri-operatively for patients with diabetes mellitus type 2. They argue that the benefits of blood glucose control peri-operatively outweigh the possible side effects. Moreover, they argue that long-acting GLP-1 agonists such as Ozempic® (once weekly dosing instead of once daily dosing) demonstrate less delayed gastric emptying, an effect which can also fade over time with use of the medication, called tachyphylaxis (3). Tachyphylaxis is the same process that occurs when patients become accustomed to the application of Retin-A (tretinoin) on the face and develop temporary redness and skin flaking. However, as with most subject matters in the world of plastic surgery - and as recommended by the ASA - more research is required to determine the peri-operative recommendations regarding the use of Ozempic ® and other GLP-1 agonists in patients who are trying to lose weight in addition to undergoing plastic surgery procedures. For example, the fact that many patients undergo facial plastic surgery procedures under IV sedation may result in recommendations that the medication be withheld temporarily to reduce the risk of aspiration during the procedure, especially because the patients who receive GLP-1 agonists for weight loss likely do not have problems regulating their glucose. This is especially relevant because many of the studies evaluating gastric emptying with GLP-1 agonist treatment utilize a method that is not considered the gold standard and may, in fact, underappreciate the extent of delayed gastric emptying, especially with solid foods (1). It is important to have a discussion with the provider prescribing the GLP-1 agonist as well as the anesthesiologist administering anesthesia to determine the safest plan for any plastic surgery procedure. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us References Maselli DB, Camilleri M. Effects of GLP-1 and Its Analogs on Gastric Physiology in Diabetes Mellitus and Obesity. Adv Exp Med Biol . 2021; 1307:171-192. Marchetti D. "American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists." American Society of Anesthesiologists , 29 June 2023, asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative, Accessed 03 July 2023. Hulst AH, Polderman JAW, Siegelaar SE, van Raalte DH, DeVries JH, Preckel B, Hermanides J. Preoperative considerations of new long-acting glucagon-like peptide-1 receptor agonists in diabetes mellitus. Br J Anaesth . 2021 Mar;126(3): 567-571. --- ### Overview of Facelift Techniques URL: https://www.harmonface.com/blog/overview-of-facelift-techniques Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck The following information is adopted from a lecture I give to head and neck surgery residents at the University of Cincinnati on the aging face and how it can be treated. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Introduction to Facial Anatomy and Facial Aging It is important to start any discussion about the changes that occur in our faces when we age with the fact that the face is composed of multiple stacked layers. Facial aging results in changes in all these layers, some more obvious than others. The focus of a facelift procedure – or any cosmetic facial plastic surgery procedure for that matter – is to address the most obvious of these changes, namely, loosening of skin and drooping fat. There are individual fat pads all over the face. Ligaments, which is soft tissue that act as support structures to the face, surround these fat pads. The ligaments surrounding these fat pads become more visible as they loosen and the fat pads drop, leading to more visible lines around the mouth (e.g., nasolabial folds, marionette lines) and the lower eyelids (e.g., tear trough). The fat pads along the jawline also begin to blend in with the neck, making the jawline look much shorter than it is. Skin loosens as the ligaments weaken and fat pads drop. The purpose of a facelift procedure is to address these changes. The first facelift was performed over 100 years ago. Multiple facelift techniques have been developed and evolved as our understanding of facial anatomy has improved. Facelift techniques can be broadly grouped into three (3) types, though there is wide variability in the details of each procedure in each group. Skin Lift, SMAS Pull Facelift The first type of facelift releases only skin and only pulls on the SMAS layer of tissue under the skin. The SMAS layer is a thick layer that lies under the skin but over the facial muscles and most of the fat pads in the face. They include a SMAS imbrication and SMAS plication, the details of which are not important except to say that this approach involves the most limited surgery. As a result, there is more limited improvement in the jowl than other approaches, no lifting of the cheeks, and little improvement in the nasolabial folds. The skin is placed under more tension than with other approaches because the retaining ligaments in the face are not released with the lift. SMAS Facelift The second type of facelift involves the lifting of skin as with the SMAS techniques described above. However, these facelift approaches go under the SMAS layer itself, albeit on the side of the face closer to the ear. There are many ways to go under the SMAS layer itself in this location, with multiple incision types and differences in the extent of the surgery. The improvement in jowls can be better than if the SMAS layer is just pulled up with sutures (stitches) like the first type of facelift procedures. The lift can also be made a little more vertical than a SMAS imbrication or plication, which is more natural. However, again, there is no cheek lift with these approaches, little improvement in the nasolabial folds, and persistent, though less, tension on the skin when the procedure is complete. This is because the area where this SMAS layer is addressed is very firmly adherent to the deep layers of the face, unlike the front of the face. As a result, there is less lift of the front of the face. Deep Plane Facelift If you observe the aging process closely, you will realize that most of aging occurs at the front of the face. The deep plane facelift and subsequently the extended deep plane facelift were developed to address the problems associated with the previous broad approaches to the facelift. Like the SMAS facelifts, the deep plane facelifts go below the SMAS layer. However, they do it at the front of the face, bypassing the areas on the side of the face that do not drop with age and targeting the areas at the center of the face that do drop with age. The front of the face is the primary location where aging occurs, as evidenced by the jowls and drooping of the cheeks. There are ligaments, or tension points, in this area of the face, that need to be released to lift those fat pads in a more natural, long-lasting manner. The deep plane facelift, the details of which were published in the 1990s, addressed the above. The extended deep plane facelift, the details of which were published in the 2000s, extended that concept to the side of the neck to better address aging of the neck but also to better improve the youthfulness of the jawline by restoring some definition and volume to the back of the jaw. Overall, while a more complex procedure, the benefits of a deep plane or extended deep plane approach are that, unlike the above approaches, the cheeks can be lifted, there is improvement in the nasolabial folds, and the skin is placed under no tension, thereby significantly reducing the risk of poor healing and widening of the incisions around the ears. Conclusion Facelift techniques will continue to improve over time. It is important that these improvements reflect an understanding of the anatomy, focus on addressing the actual changes that occur with aging, and maintain patient safety. The extended deep plane facelift is a natural evolution of these concepts and the current gold standard in facelift techniques. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthet Surg J . 2013 Aug 1;33(6):769-82. Jacono AA, Bryant LM, Ahmedli NN. A Novel Extended Deep Plane Facelift Technique for Jawline Rejuvenation and Volumization. Aesthet Surg J. 2019 Nov 13;39(12):1265-1281. doi: 10.1093/asj/sjy292. Jacono AA, Bryant LM, Alemi AS. Optimal Facelift Vector and its Relation to Zygomaticus Major Orientation. Aesthet Surg J. 2020 Mar 23;40(4):351-356. Jacono AA, Alemi AS, Russell JL. A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques. Aesthet Surg J. 2019 Aug 22;39(9):927-942. Shamouelian, D (2016). Rhytidectomy Essentials. In Wong BJF, Arnold MG, and Boeckmann JO (Eds.), Facial Plastic and Reconstructive Surgery: A Study Guide (pp. 347 – 365). Springer. Stuzin JM, Baker TJ, Gordon HL. The Relationship of Superficial and Deep Facial Fascias: Relevance to Rhytidectomy and Aging. Plastic and Reconstructive Surgery . 1992 Mar;89(3):441-9. Sykes JM, Riedler KL, Cotofana S, Palhazi P. Superficial and Deep Facial Anatomy and Its Implications for Rhytidectomy. Facial Plast Surg Clin North Am. 2020 Aug;28(3):243-251. --- ### Optimizing Nutrition Before and After Surgery URL: https://www.harmonface.com/blog/optimizing-nutrition-before-and-after-surgery Published: May 26, 2025 Author: Tirzah Thompson MS, RDN, LD Categories: General Information Tirzah Thompson MS, RDN, LD Nutrition goes a long way when preparing for and recovering from surgery! Proper nutrition can be the key to a successful surgery. What you learn here should empower you while relieving some of the stress you may feel going into and coming out of your upcoming surgical procedure. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Lifestyle The benefits from cessation of smoking could be an entire blog post on its own. It is highly recommended that you avoid smoking before and after a procedure. It is easier said than done, but it can make a huge difference. Smoking affects blood oxygen levels and the quality of blood circulation through the vessels. It decreases blood flow making surgical wounds less likely to heal well and more likely to become infected. Oxygen-rich blood and non-constricted arteries and veins are essential for healing. Avoiding excessive alcohol consumption is recommended as it is unhealthy and even in small quantities can cause blood thinning effects during surgery, which can contribute to bleeding and bruising. It is okay to drink alcohol in moderation until about two weeks before surgery. Within those upcoming two weeks and for a week or two post-operatively, it is best not to drink alcohol at all. Exercise is a wonderful thing for many reasons such as increasing blood flow, improving mood, boosting energy, and promoting better sleep. However, when you are having plastic surgery, it is advised to avoid any new or vigorous exercises. It is best to focus on maintaining your current level of fitness whatever that may be. I recommend focusing on stretching and strengthening. Yoga would be a great idea! Nutrition Avoiding or limiting highly processed foods and fast food is strongly advised to prevent inflammation and swelling from the high sodium content. If you usually cook with salt, try using spices instead! When you’re at the grocery store next, try looking for “no salt added” versions of your favorite canned goods. Try cooking at home whenever possible to cut down on your sodium consumption. In addition to cutting back on processed foods, following a well-balanced diet is always recommended. That includes whole foods, adequate calories, adequate fiber, adequate macronutrients, and adequate vitamins and minerals. Inadequate caloric intake can increase your risk for slower healing and infection. While following a well-balanced diet, maintaining adequate hydration is also very important. I usually tell my clients to shoot for at least 64 ounces per day! Let us dive into the importance of adequate macronutrients before and after surgery. There are 3 macronutrients: carbohydrates, protein, and fats. Carbohydrates Carbohydrates are essential for wound healing. When you eat carbs, your body breaks them down into glucose which provides energy for white blood cells. While we need carbohydrates, we can be thoughtful when it comes to eating them. Simple carbohydrates have very few sugar molecules so are digested fast and absorbed into the bloodstream. This causes blood sugar levels to quickly rise and later be followed by an energy crash. In contrast, complex carbohydrates contain fiber and more complex chains of sugars which are digested and absorbed slower. They enter the bloodstream more slowly which allows a steady release of energy. This steady release is much more sustainable than the dips and spikes you see with simple carbohydrates, especially when you are eating simple carbohydrates alone. It is suggested to avoid “naked carbs” which are simple carbohydrates that are not paired with protein or fat that would otherwise slow digestion, reducing the spikes in blood sugar. “Naked carbs” cause more hunger and cravings. Some examples of simple carbohydrates include fruit or fruit juice, chips, crackers, etc. The following are some ideas of how to incorporate protein and/or fats with complex carbohydrates: Add cheese to crackers, eat with wine or beer Pair fruit with nuts, nut butter, yogurt, or chocolate hummus Swap out your fat-free milk when eating cereal Try topping your toast/bagels with avocado or peanut butter As we have learned, fiber slows digestion, which can smooth blood sugar spikes. At least 25 grams per day is recommended. When increasing fiber in your diet, be sure to increase fluid intake. Remember at least 64 ounces of water per day is recommended! The following are some ideas of how to increase fiber in your diet: Swap white pasta and rice for wheat Eat whole fruits and vegetables with the skin on them instead of drinking juice Ditch your chips and grab some popcorn, which is whole grain Add chia seeds and flaxseeds into oatmeal, yogurt, or cereal Proteins Proteins are comprised of amino acids that our bodies use to repair muscle and bones and produce hormones and enzymes. Protein can be used as an energy source and carries oxygen throughout your body. It helps make antibodies that help our bodies fight infections and illnesses. I encourage my clients to start their day off with protein. Great sources of protein include red meat, poultry, eggs, fish/seafood, dairy, and beans. Breakfast should include at least 10 – 20 grams of protein. The remaining meals of the day should include at least 20 grams of protein. Fats Finally, fat is essential to give our body energy and support cell function. Fats help protect our organs and keep our bodies warm. Fat also helps our body absorb nutrients and produce hormones. I encourage you to include fat at every meal. Some examples include avocado, eggs, nuts, nut butters, hummus, butter, etc. Most Americans do not consume enough omega-3 fatty acids which are amazing for reducing inflammation! Try to aim for fish twice a week as they are very rich in omega-3s. Other sources include flaxseed, chia seeds, walnuts, and edamame. Micronutrients Micronutrients are especially important for before and after surgery. They include Vitamin A, Vitamin C, Zinc, and Iron. Vitamin A is a fat-soluble vitamin that supports our skin, eyes, and immune system. It is required for epithelium and bone formation, immune function, and cellular differentiation. The average adult needs about 700 – 900 mcg daily. Excellent sources of Vitamin A include carrots, sweet potato, spinach, squash, pumpkin, apricots, eggs, liver, salmon, milk, and goat cheese. Vitamin C is a water-soluble vitamin that is required for the biosynthesis of collagen. Vitamin C supports the immune system, helps wound healing, and serves as an antioxidant. Most people recognize oranges as a source of Vitamin C, but other foods with more Vitamin C than oranges include kale, strawberries, broccoli, red and green bell peppers, brussels sprouts, kiwi, and chili peppers. Zinc is a trace mineral that is responsible for a variety of processes including gene expression, growth and development, and immune function. It is also great for wound healing. Some sources include red meat, seafood, poultry, legumes, whole grains, vegetables, nuts, and seeds. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consult Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us More About Tirzah Thompson MS, RDN, LD Book: Dietitian Website: Dietitian Tirzah Instagram: @dietitiantirzah *The information in the blog post above is the opinion of the author and does not constitute direct medical advice from or necessarily reflect the opinion of Dr. Jeffrey Harmon or Harmon Facial Plastic Surgery. --- ### Now Offering FDA-Approved Restylane® Eyelight™ Hyaluronic Acid Filler for Undereye Hollows URL: https://www.harmonface.com/blog/now-offering-fda-approved-restylane-eyelight-hyaluronic-acid-filler-for-undereye-hollows Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical We at Harmon Facial Plastic Surgery are excited to announce that we are now offering Restylane® Eyelight™ hyaluronic acid filler at our practice! This Galderma product is FDA-approved for the tear troughs in patients with deep undereye hollows. Read an earlier blog post, Tear Trough Filler: An Explainer , for more information. Contact our office in Cincinnati, OH and schedule a consultation to determine whether you are a candidate for Restylane® Eyelight™! It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Restylane® Eyelight™ Has a Long Record of Safety and Effectiveness Restylane® Eyelight™ is effectively Restylane-L, one of Galderma’s earliest hyaluronic acid filler products. As a result, it has a long record of safety and effectiveness in the face and has been widely used FDA off-label in the tear troughs for many years prior to the recent approval by the FDA. Restylane® Eyelight™ is Effectively Restylane-L in a More Economical Form Restylane® Eyelight™ is effectively Restylane-L in a smaller vial. It is common for patients to require less than the 1 ml that is provided in a vial of Restylane-L. As a result, an effective treatment for undereye hollows is now available in a more economical form. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### Now Offering FDA-Approved Juvederm® Skinvive™ Treatment to Smooth and Hydrate Cheek Skin URL: https://www.harmonface.com/blog/now-offering-fda-approved-juvederm-skinvive-treatment-to-smooth-and-hydrate-cheek-skin Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical We at Harmon Facial Plastic Surgery in Cincinnati, Ohio are excited to announce that we are now offering Juvederm® Skinvive™, the first FDA-approved treatment for the improvement of skin smoothness and hydration in the cheeks using hyaluronic acid. Long popular worldwide, including Western Europe and Asia, this treatment is likely to become a beautiful complement to many other procedures, both surgical and non-surgical. Please read an earlier blog post for more information on the different depths hyaluronic acid filler can be placed. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Juvederm® Skinvive™ Has a Different Purpose Than All Other Hyaluronic Acid Fillers Whereas other hyaluronic acid filler products are used to increase volume in specific areas of the face, the purpose of Juvederm® Skinvive™ is to increase skin smoothness and hydration. The product is injected in microdroplets just below the top layer of skin, in the dermis. In contrast with hyaluronic acid filler placed on the skin, the hyaluronic acid placed deep to the skin retains water within the skin as opposed to drawing it out and away from the skin, an effect which is more pronounced in hot, dry climates. The Effects of Juvederm® Skinvive™ are Reported to be Longer-Lasting Than Topical Hyaluronic Acid According to the manufacturer, the effects can last as long as 6 months, much longer than the effects of applying hyaluronic acid filler to the skin daily. And, like the injection of other hyaluronic acid filler products in other locations and for different purposes, there is little-to-no downtime. Juvederm® Skinvive™ Can Compliment Other Non-Surgical and Surgical Procedures We are excited to explore how this new product can enhance your skincare regimen and complement the procedures we perform at Harmon Facial Plastic Surgery, including the extended deep plane facelift . Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### Neck Liposuction Versus a Neck Lift: Which Procedure is the Most Appropriate for Me? URL: https://www.harmonface.com/blog/neck-liposuction-versus-a-neck-lift-which-procedure-is-the-most-appropriate-for-me Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Neck liposuction and a neck lift procedure each address specific concerns about the neck and the area under the jaw. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Changes Can Occur in All Layers of the Neck Changes can occur at all layers of the neck with aging. The skin and muscles of the neck loosen, forming bands. Fat accumulates immediately below the skin and deep to the neck muscles. These changes can cause the jawline to lose definition and the neck to appear poorly defined. Neck Liposuction and a Neck Lift are Two Options for the Neck Individuals who present with concerns about their neck and/or the area under their jaw may benefit from either neck liposuction or a neck lift procedure. However, a detailed history and physical exam should always be performed prior to making this decision. Neck Liposuction Alone May Be Good for Younger Individuals Neck liposuction , which involves the careful placement of small incisions hidden under the chin and sometimes behind the earlobes, can be a good option to treat patients who have accumulated fat close to the surface of their skin but with minimal skin and muscle changes. Neck liposuction tends to be a better procedure for younger individuals. This younger patient demonstrated excess fat across her neck and the area under her chin, called the submentum. No excess skin or loose muscle was present. This patient was an excellent candidate for neck liposuction only. She could not be happier with her results only one week after surgery. This younger patient demonstrated excess fat only in the area immediately under her jaw, called the submental area. As a result, she desired a more subtle result. She is thrilled with her results four months after surgery. A Chin Implant with Neck Liposuction Can be a Powerful Procedure for Other Younger Individuals Some people not only have lost definition of their jawline and neck over time but also have a poorly-defined chin. A chin that does not project out adequately relative to the lips and nose can exaggerate the appearance of the jawline and neck. That is why a chin implant and liposuction can be so powerful when paired. The patient of ours below is an excellent example of this. This younger patient not only had concerns about the lack of definition to her jawline and neck, but also demonstrated a weakly projected chin. She received a small chin implant that contoured naturally to her jawline in addition to undergoing liposuction under her jawline and neck. A Neck Lift May be More Appropriate for More Complex Changes A neck lift is meant to address more complex changes to the neck more comprehensively, including the skin, muscle, and both superficial and deep fat. The superficial neck fat is usually removed under direct visualization with specialized instruments during a neck lift in Cincinnati. Performing only liposuction, especially aggressive liposuction, on an individual who is experiencing more complex age-related changes to their neck increases the risk of the skin scarring to the hanging muscle bands, worsening the appearance of the banding. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the neck and face when you have concerns about your neck and/or the area under your jaw. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Myth Versus Reality: Does a "Non-Surgical" Facelift or Neck Lift Exist? URL: https://www.harmonface.com/blog/myth-versus-reality-does-a-non-surgical-facelift-or-neck-lift-exist Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical The effects of some non-surgical procedures on the face and neck are often promoted as approaching/approximating the effects of a facelift and/or neck lift. These procedures fall into three categories: fillers, energy-based devices, and sutures, otherwise known as threading. In fact, many describe one or a combination of more than one of these non-surgical procedures as a “non-surgical” facelift and/or neck lift. The reality is that none of these interventions or combination of interventions approximate the effects of a facelift and/or neck lift. Instead, we feel the potential benefits of these interventions should be described for what they are and not compared with surgical procedures. The most effective way to treat age related changes to the face and neck remains surgery. More specifically, in the event of loose tissue and drooping volume in the face and neck, we feel the extended deep plane facelift and neck lift are the best surgical techniques to provide a natural appearing and long-lasting result. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Fillers Add but Do Not Lift Volume Fillers, including hyaluronic acid fillers and others, add volume to the face. They do not, however, lift volume in the face. Some argue that, by lifting the soft tissue and injecting filler inferior to it, treatment with hyaluronic acid filler can effectively lift this tissue. We believe this to be false. Hyaluronic acid filler is a gel with variable properties depending on its formulation . However, even the firmest, most “structural” fillers can still be injected through a small syringe. The idea that a gel could hold up drooping facial volume like a cantilevered balcony in a house makes little sense. Instead, fillers can increase the volume of an area in which they are injected such as the cheeks, lips, and chin. Sutures Temporarily Pull Skin but Do Not Lift Volume Naturally Threading involves the use of barbed, dissolvable sutures placed under the skin in multiple directions to pull skin in the cheeks, jawline, neck, brows, and other locations. See the following blog post describing the “fox eye” procedure using threads in the brows . Threading is sometimes referred to as a “non-surgical” facelift because of the pull it is purported to have on the skin. However, this comparison is inaccurate. Facial aging involves much more than simply loose skin. Facial aging involves drooping fat, muscle, and fascia in the face and neck. Appropriately addressing this volume requires surgical release of the deeper structures of the face and neck to prevent distortion of the mouth, eyes, and other surrounding structures that can occur by simply pulling on the skin. Furthermore, this suture dissolves within a few months. As a result, the potential effects of threading are relatively short lived, especially when compared with facelift and neck lift surgery. Energy-Based Devices Heat Fat and Skin but Do Not Lift Energy-based devices utilize ultrasound, radio waves, and/or plasma to heat up tissue, most commonly the fat immediately deep to the skin. These devices are often advertised as a “non-surgical” facelift, again an inaccurate statement. Simply heating up subcutaneous fat and skin does not lift volume. Furthermore, the “new collagen” formed, from our experience operating on patients who have undergone these procedures, should more accurately be described as scar formation, which can make performing a facelift and neck lift more complex . No Combination of the Above Approaches the Effects of a Facelift and Neck Lift Some even argue that a combination of hyaluronic acid fillers, threading, and energy-based devices can result in a “non-surgical” facelift. We feel this is inaccurate for the reasons discussed above. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### My Skincare Routine URL: https://www.harmonface.com/blog/my-skincare-routine Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information It is challenging to identify skin care products based on strong clinical evidence and a strong safety profile. The skin care products I currently use are not perfect. Therefore, my choices may not be well-tolerated or beneficial to others. Every individual’s skin is different. Consider an evaluation by a dermatologist to help determine the best tolerated, safest, and most effective products for your face. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. It is Difficult to Identify a Skincare Routine with Strong Clinical Evidence Supporting its Safety and Effectiveness I and many other physicians find it difficult to assemble strong data to support the effects of many skincare product ingredients. The cost of skin scare products sometimes but do not always reflect their effectiveness and safety. As a result, the products I use that are listed below are not a medical/professional endorsement of the brands or the products specifically. They have simply worked for me personally with little-to-no skin irritation. The Environmental Working Group (EWG) Has a Guide Called Skin Deep© to Help Consumers Choose Products with a Favorable Safety Profile EWG is a nonprofit organization founded in Washington, D.C. in 1993 whose stated mission is “to empower you with breakthrough research to make informed choices and live a healthy life in a healthy environment.” While any organization with a lobbying arm and funding from outside organizations – including organic agriculture organizations – should be judged with some level of skepticism, EWG has been consistent in advocating for the removal of harmful chemicals in personal care products consistent with standards established by chemical safety laws in the European Union (EU) and California, which are among the most stringent in the world. My wife, Fara, and I use an EWG app on our phones when we shop for home cleaning products as well as products for our son, Babak, and daughter, Roya. Fara and I also reference EWG’s Skin Deep © rating system when we shop for our own skincare products. It is not a perfect system, but we feel like it has empowered us to make somewhat better, healthier product choices for ourselves and our family. However, as you will see below, I do not depend entirely on EWG to make purchasing decisions. For example, some of the most effective ingredients in cosmeceutical products do not pass EWG’s muster. Also, many products highly rated by EWG have a high potential for allergic reaction due to their contents. This needs to be considered with all buying choices. Every individual needs to use their own resources and make their own decisions regarding what products they place on their face. Skinceuticals© CE Ferulic and The Ordinary© Pycnogenol 5% for Antioxidants There is evidence for the effectiveness of some topical antioxidants, not only to slow the development of the signs of aging but also to act as a photoprotective agent complementing a mineral sunscreen. As a result, I have chosen to apply antioxidants to my face. Please see a previous blog post discussing the changes that occur in the skin with aging for a more detailed description of the effects of Vitamin C. Pycnogenol is another antioxidant that has long been in use and is derived from a Mediterranean tree bark in France. There is evidence that it can act not only act as an antioxidant but also prolong and recycle the effects of Vitamin C. Neither of the products above have resulted in skin sensitivity and rash for me, though that is a potential risk with the use of antioxidants such as these. These products are not rated by EWG. Vanicream© Daily Facial Moisturizer I have been using Vanicream© moisturizers for many years. I found my son’s skin tolerates one of their moisturizers well. The company's products are inexpensive and can be found at most pharmacies. The Vanicream© Daily Facial Moisturizer blends well into my face and does not cause an itching rash that some moisturizers have caused me with frequent use. This product is rated 1 (best) by EWG . Mineral Sunscreen A mineral sunscreen, meaning a sunscreen with a physical barrier such as zinc oxide, is superior to a chemical sunscreen. A mineral sunscreen provides more effective coverage against both UVA and UVB sun rays than a chemical sunscreen. And some chemical sunscreens in the United States have ingredients that are known or potential carcinogens at high doses. The problem with a mineral sunscreen is that it can be difficult to blend in with the skin and it often leaves the skin feeling caked and uncomfortable. The "right" specific product may differ between individuals. The Lesson: Skincare is Difficult and Imperfect The evidence base for cosmeceuticals is generally weak because they are not regulated by the Food and Drug Administration (FDA) like medications. For example, there may be new evidence in the future that one or more of the ingredients in the above products are not beneficial. I work hard to adhere to the most consistent, highest quality, established evidence for the effectiveness of certain products. I also try to avoid the most harmful chemicals as determined by the entities that have passed the strongest chemical safety laws. However, I will likely make changes to this regimen over time with a goal of minimizing what I apply to my skin, though I will likely always apply a mineral sunscreen. I also hope to add a retinol to my regimen in the future. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face and/or neck. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us References Baumann, L. (2014). Cosmeceuticals and Cosmetic Ingredients (1st ed.). McGraw Hill/Medical. --- ### My Experience Undergoing Facial Plastic Surgery URL: https://www.harmonface.com/blog/my-experience-undergoing-facial-plastic-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information I have the privilege as a physician and surgeon of helping patients “feel good about feeling good.” I pride myself as being a well-trained facial plastic surgeon who can provide natural surgical and non-surgical results, safely. However, I often wonder if during my consultation with patients they are thinking: “sure, you know what you are doing, but do you truly understand what goes into making a decision to proceed with facial plastic surgery?” My answer to that question is yes, I do understand. I underwent a rhinoplasty at age 17. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. I Underwent a Functional and Cosmetic Rhinoplasty at Age 17 After an Injury I was injured at age 13 in the most embarrassing way. I was at a friend’s house running from their backyard into their basement. I did not realize my friend had closed the glass sliding door to the basement. Another friend had called out from behind me just before I approached the door. My nose met the glass as soon as I turned my head forward. The pain was excruciating. I knew something was wrong immediately. My nose swelled. I had immediate difficulty breathing through it. My nasal bridge was deviated to the right. I iced my nose and, as the pain subsided, largely forgot about it, unconcerned with my appearance. The swelling resolved. The difficulty breathing through my nose did not. And while the nasal bridge was significantly less deviated than it initially appeared, I became more bothered by it as I progressed through high school. By age 17 my nose was bothering me enough – I was having difficulty breathing during difficult workouts and races as a rower – that I decided to consult with a head and neck surgery trained facial plastic surgeon. He recommended a septoplasty and rhinoplasty to correct my deviated septum and nasal bridge and to improve my breathing. I Underwent Surgery with a Facial Plastic Surgeon at an Office-Based Surgery Center I underwent surgery at an office-based surgery center. See this link for more information on our office-based surgery suite. I have only two memories of my experience. My first memory was lying on the operating room table with the anesthesiologist and the surgeon’s head nurse at my side. I remember starting to count backwards and almost immediately going to sleep. My second memory was after surgery when I was changing in the bathroom to leave. I suddenly felt lightheaded and fell to the ground, almost hitting my newly operated on nose on the sink counter. My Recovery was Consistent with What I Counsel My Patients Like my patients I had a splint on my nose. Unlike my patients I had packing in my nose , which was extremely uncomfortable. More recent data and guidelines from the American Academy of Otolaryngology – Head and Neck Surgery do not recommend nasal packing after rhinoplasty. I spent one week largely sitting and sleeping in a recliner, anxiously waiting for the removal of my nasal packing. My head felt like an over-filled balloon, entirely due to the packing. I did take the prescribed pain medication once or twice, felt very nauseous, and discontinued its use. The packing was removed in clinic – along with the sutures – approximately 1 week after surgery. It felt so wonderful to have the packing and sutures out as well as the splint. My nose remained swollen after the cast was removed. I remember the most significant swelling resolved within two to three weeks. However. I noticed continuous improvements in the appearance of my nose for many months after surgery. My nasal breathing improved almost immediately after the packing, sutures, and splint were removed. This improvement continued over approximately the first month while all the interior swelling subsided. The change that took the longest to recover was normal sensation at the tip of my nose and the incision at the base of my nose. I remember a gradual onset of tingling and a slow improvement in sensation over many months. In fact, I believe it took a year before I regained all the normal sensation in my nasal tip and at the incision site. I Empathize with Those Considering a Rhinoplasty and Can Answer Their Questions from Experience I am very happy with the appearance of my nose these decades later. I am very grateful to the facial plastic surgeon who performed this procedure, though he retired and unfortunately passed away a few years ago. The sensation on my nose is normal. I am breathing well. I can feel some of the surgical changes made if I push hard on the skin overlying my nasal bridge, though there is no outward appearance of this due to the soft tissue envelope covering my bones and cartilage. In short, I answer questions about facial plastic surgery not only as a surgeon performing a procedure but also as a patient having undergone a procedure. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your nose. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Lip Lift versus Lip Filler URL: https://www.harmonface.com/blog/lip-lift-versus-lip-filler Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Have you wondered whether placement of hyaluronic acid filler such as Restylane© in the lips can impart a more voluminous and youthful appearance to your lips? Have you wondered how this compares with a surgical lip lift ? The lip lift is a procedure that can be performed under local anesthesia or IV sedation to address specific aesthetic concerns of the lip that lip filler cannot. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Lip Lift Can Address What Lip Filler Cannot The red portion of the upper lip loses height and volume as we age. Some individuals are born with thin, deflated lips. Lip filler can re-volumize deflated lips. However, lip filler cannot increase the height of the red lip without projecting it, potentially resulting in a “duck-lipped” appearance. In addition to the red lip, the area of the lip between the red lip and the base of the nose lengthens as we age. This can be worsened by overfilling the lip with hyaluronic acid. The lip lift can be an excellent option to improve the height of the red lip and restore a “pouty” appearance to the lip by reducing the overall length of the lip to a more youthful length. The incision is hidden in a natural crease at the base of the nose. Lip Lift Versus Lip Filler Deciding Between a Lip Lift and Lip Filler is a Decision Between Structural Change and Volume A surgical lip lift can restore more youthful proportions to the upper lip by excising skin in complex shapes based on precise measurements that are individually tailored. The procedure can improve facial balance by addressing lip proportion. In contrast, lip filler involves the placement of hyaluronic acid that is chemically cross-linked to have specific structural qualities, called rheology , in the space between the surface of the red lip mucosa and the deep muscle, called the orbicularis oris, for the purpose of adding volume to the red lip. The procedures are completely different. They address different problems. The following table lists some of the specific aesthetic issues each procedure is more appropriate to address: Lip Lift Lip Filler Lengthened, thinning upper lip skin Deflated upper lip Drooping of the outer edges of the upper lip Deflated lower lip A short, thin red upper lip Asymmetric red upper lip Loss of upper lip tooth show when lips are in repose Lip Filler Can Complement the Lip Lift There are a larger number of features in which lip lift surgery is more appropriate to address than lip filler. However, a lip lift and lip filler are not mutually exclusive, many patients can benefit from both procedures. While a lip lift addresses proportions, lip filler addresses deflation. It is common for a patient to undergo a lip lift followed by lip filler to maintain the volume of the red upper and lower lips. After all, the lip lift does not address age-related changes to the lower lip. It is important to note that while the lip lift can address aesthetic concerns that lip filler cannot, this does not prevent a patient from receiving hyaluronic acid filler in the future to re-volumize a deflated lip. In fact, hyaluronic acid filler can be a wonderful complement to the lip lift, as demonstrated in the before-and-after images below. The above patient underwent a lip lift followed by lip filler in order to balance her bottom lip volume with her top lip. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Kludges in Facial Plastic Surgery URL: https://www.harmonface.com/blog/kludges-in-facial-plastic-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The definition of a kludge is a solution that is clumsy, inelegant, inefficient, and difficult to maintain. There are many kludges in facial plastic surgery that should generally be avoided. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. My Experience with a Kludge The above photo is of me at age 22 when I lived and worked as a science teacher at Weill Cornell Medical College in Doha, Qatar, a small country that is a peninsula off Saudi Arabia. I carry many stories from my time here, but one is relevant to the conversation. That story is the time the apartment tower I was living in caught fire with me in it. I lived on the twelfth floor of an apartment complex with two towers and a shared base. The trash chutes collected to a common area in the basement. I was sitting in my room one evening when a loud voice starting yelling in Arabic as if through a bullhorn. This occurred seemingly randomly and constantly. I do not speak Arabic and, as a result, had no idea what was being said. My inclination was to remain in my room. I stayed in my room for about 20 minutes before deciding I needed to go the hallway of the apartment to determine whether I needed to leave the building. I opened the door to billowing smoke. A fire had broken out somewhere in the building. I crawled to the exit stairs. The stairs were too hot to crawl on. Instead, I ran down twelve flights of stairs through smoke and out of the exit as quickly as I could. Fortunately, no one was seriously injured. We were even able to return to our apartment the next day because the fire had engulfed the opposite tower only. We later learned a tenant in the opposite tower had thrown a cigarette down the trash chute, which caught the basement on fire. Apparently, many individuals delayed leaving the building for the same reason. The tower had been built for the Pan-Asian games a few years prior. All the tenants at that time spoke Arabic. However, few-if-any current tenants spoke Arabic. The most reasonable solution to prevent this from occurring again would have been to change the language of the fire alert from Arabic to English or some combination of languages and to educate the tenants on the proper way to identify a fire in the building and exit safely. Instead, the building management hired individuals from Nepal, all of whom suffered from what was and still is an abusive environment for laborers, to sit on plastic chairs with air horns in the hallway. They were instructed to blow the air horns in the unlikely event that another fire broke out. These poor individuals had to sit in the dark, because the hallways lights are motion-activated, and the management would not keep the hallway lights on. This was a kludgy, incompletely effective solution that reflected what management had (i.e., inexpensive labor). Kludgy solutions are common in facial aesthetics as demonstrated by the following examples. Botulinum Toxin Lip Flip and Adding Too Much Filler Instead of Lip Lift Surgery A lip flip non-surgical procedure is performed by injecting botulinum toxin (e.g., Botox® ) into the muscle surrounding the mouth, called the orbicularis oris, in the upper lip. This procedure is not recommended, because it is often ineffective and can cause problems with speaking and drinking through straws for weeks-to-months after the procedure. See this previous blog post for more detail on the non-surgical lip flip. Lengthening of the upper lip skin as well as the loss of definition and projection of the red upper lip is often addressed with hyaluronic acid filler to poor effect, largely due to too much volume being added and it being added to the wrong location. In fact, adding an excessive volume of filler to the upper lip can stretch the upper lip over many years. The non-surgical procedure can also over project the upper lip, leading to a “duck-lipped” appearance that looks unnatural. See this previous blog post about lip filler versus a lip lift . Lip filler can enhance the effects of a lip lift for deflated lips but should generally not be a substitute for a lip lift in the above clinical situation. Cheek, Nasolabial Fold, Marionette Line, and Jowl Filler Instead of Deep Plane Facelift Surgery A common solution to drooping cheeks with older facelift techniques is to add volume – often a great deal – using fat and/or hyaluronic acid filler. This can make patients look overly rounded because the body’s natural fat remains hanging down and towards the center of the face. In contrast with other facelift techniques, smaller volumes of fat are added during the extended deep plane facelift procedure and only when the patient is volume-deficient in the cheeks prior to surgery. See this previous blog post about cheek lifts versus fat grafting to the cheeks. Fat grafting can be appropriate for some individuals, though not all. Hyaluronic acid filler is commonly used in the nasolabial folds and marionette lines to “blunt” or “soften” their appearance. While this non-surgical treatment can be appropriate in many circumstances and when added conservatively, the problem is these non-surgical procedures do not address the actual changes that occur with age (i.e., weakened ligaments, drooping fat, and loose muscle and skin). As a result, there are inherent limitations associated with them. Also, attempts to eliminate the nasolabial folds and marionette lines with hyaluronic acid filler can make patients look distorted and inflated by eliminating subtle transition points between the cheeks and upper lips that are present naturally, even in youth. When too much volume is added to the cheeks, nasolabial folds, and marionette lines at the same time the overall effect is extreme and does not appear natural. See this previous blog post for more detail about when jawline filler is not aesthetically appropriate. Energy-Based Devices Instead of Deep Plane Facelift and Neck Lift Surgery There are multiple devices available that utilize an energy source (e.g., radiofrequency, ultrasound, plasma) to heat up the fat and other tissue immediately deep to the skin in the face and neck. They are sometimes referred to as non-surgical facelift procedures. They are also sometimes referred to as an option for individuals who may not be ready to undergo a surgical facelift and/or neck lift. While there are some aesthetic uses for these devices I feel they should not be classified as non-surgical facelift procedures, nor do I believe they are appropriate as a “stepping-stone” to a surgical facelift and neck lift. These devices heat up fat and cause scarring in the targeted tissue for the stated purpose of tightening skin. Age-related changes to the face are primarily due to drooping fat, weakening ligaments surrounding the fat, and loosening muscle and deep fascia. A facelift and neck lift should not be considered simply a skin lift or skin tightening procedure . Furthermore, the scarring that these devices cause make a surgical facelift more technically challenging such that deep plane facelift surgery is even more appropriate to reduce the risk of healing problems. See this previous blog post for more detail on the different facelift techniques utilized by facial plastic surgeons. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Is There Such a Thing as a “Scarless” Rhinoplasty? URL: https://www.harmonface.com/blog/is-there-such-a-thing-as-a-scarless-rhinoplasty Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Nose The term “scarless” rhinoplasty is widely marketed. In reality, all incisions heal in a manner different than untouched skin. Incisions can be well-hidden and so subtle that almost no other individual would notice their presence. They can also be poorly hidden and/or abundantly obvious due to abnormal features. The scarless rhinoplasty is approach that can hide the incisions from the view of the public. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The nose surgery (rhinoplasty) technique marketed as “scarless” is also referred to as a closed, or endonasal rhinoplasty. The technique was developed over one hundred years ago and is associated with some of the earliest rhinoplasty surgeries. However, the technique is currently not widely taught to training physicians. A closed rhinoplasty requires a detailed understanding of nasal anatomy, because it involves manipulating that anatomy in ways that do not match the classically learned visualization of the anatomy. All the incisions are placed inside the nose, also called the nasal vestibule. This approach can reduce post-operative swelling and bruising. But while this hides the incisions from external view, the same healing process occurs with these incisions as with others. Therefore, there truly is no such thing as a “scarless” rhinoplasty as defined by the technique used. This approach to rhinoplasty surgery can be an excellent option for the right individual. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your nose. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Is Silicone Gel Effective in Improving the Appearance of Surgical Incisions? URL: https://www.harmonface.com/blog/is-silicone-gel-effective-in-improving-the-appearance-of-surgical-incisions Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical You are likely aware of silicone-based scar gels by seeing ScarAway© or another over-the-counter brand in your local pharmacy. Surgeons in all specialties as well as dermatologists recommend these scar gels after procedures to promote healing and reduce the risk of scarring. But how well do they work? I reviewed the literature in order to determine whether silicone gels, placed post-operatively after surgical incisions have healed, can help reduce the appearance of incisions. Not surprisingly, quality studies are difficult to find. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. There are two ways of describing an abnormal scar, hypertrophic and keloid. There may seem to be little distinction between the two. However, the underlying process that causes them to form is radically different. Basically, a hypertrophic scar remains within the boundaries of the original incision or injury. A keloid, on the other hand, expands beyond it. The goal of silicone gels and patches are to not only reduce the risks of hypertrophic scar or keloid formation, but also to reduce the redness of an incision and accelerate the fading of the appearance of a scar. The two major problems with the studies I reviewed are 1) few of the incisions examined were located on the face and 2) silicone gels were usually compared with another treatment rather than no intervention at all (placebo). The second problem is unavoidable because it would be unethical to allow the control group to heal without an accepted alternative treatment to reduce the appearance of a scar. One of the most promising studies was a randomized, placebo-controlled, and double-blinded clinical trial evaluating whether silicone gel prevents hypertrophic scar development on chest (sternotomy) incisions. The researchers found that silicone gel application resulted in a better-appearing scars 3 months after surgery. However chest (sternotomy) incisions are notorious for poor healing and frequent scarring (1). This is unlike the skin of the face, which is widely understood to heal much better than other parts of the body. Also, most of the patients, in addition to heart problems requiring a chest incision, had other medical problems that could lead to poor wound healing such as diabetes. It is possible the silicone gels are more effective in patients with a much higher risk of poor healing. That being said, another quality study found no difference in healing with the addition of silicone gel to the incisions of those considered similarly “high risk” of forming an abnormal scar (2). The only randomized, placebo-controlled, double-blinded clinical trial focused exclusively on facial incisions I found was from 2018. The researchers looked at the use of silicone gel on forehead incisions for brow lifts (3). Only 13 patients participated, which is a very small number. No difference in the appearance of the incisions was identified at 6 months. Other, similar studies have shown no clinically meaningful difference in scar formation with the use of silicone gels on breast reduction incisions (4) and cesarean section incisions (5). The bottom line: First, it is important to note that we still do not know how silicone gels work to reduce the appearance of surgical incisions. It may be that silicone gels function like an occlusive dressing, holding moisture in and keeping bacteria out. It may also modify the underlying inflammatory process that occurs with any incision during healing. Either way, the end goal is to have an incision as soft, smooth, and flat as possible. There are few studies of quality design available to review. Those available are plagued by the same problems with other studies of this type, including small numbers of subjects. To make matters worse, these studies rarely focus on incisions on the face or on the most important outcome to me, the appearance of incisions after surgery - not simply the prevention of abnormal scarring (e.g. hypertrophic, keloid). On the other hand, there is little risk with the use of silicone gel, barring some limitations around the eyes and mouth as well as for those who are allergic to silicone. And silicone does help keep healing incisions moist, which is essential to healing. As a result, I encourage almost all of my patients to start using silicone gels after all sutures are removed twice daily for weeks to months as the incisions heal and blend in with the rest of the skin. I expect additional studies may result in evidence that this approach can help improve the appearance of incisions. In the end, factors other than whether or not silicone gels are applied are more important to the healing process, including proper closure technique, tension-free skin re-aaproximation, a healthy diet, adequate sleep, and sun protection with mineral-based sunscreens. References: Chan KY, Lau CL, Adeeb SM, Somasundaram S, Nasir-Zahari M. A randomized, placebo-controlled, double-blind, prospective clinical trial of silicone gel in prevention of hypertrophic scar development in median sternotomy wound. Plast Reconstr Surg. 2005 Sep 15;116(4):1013-20; discussion 1021-2. Gold MH, Foster TD, Adair MA, Burlison K, Lewis T. Prevention of hypertrophic scars and keloids by the prophylactic use of topical silicone gel sheets following a surgical procedure in an office setting. Dermatol Surg. 2001 Jul;27(7):641-4. Cadet N, Hardy I, Dudek D, Miszkiewicz K, Boulos P, Nguyen Q, Wong J. Prospective case-control trial evaluating silicone gel for the treatment of direct brow lift scars. Can J Ophthalmol. 2018 Feb;53(1):29-33. Niessen FB, Spauwen PH, Robinson PH, Fidler V, Kon M. The use of silicone occlusive sheeting (Sil-K) and silicone occlusive gel (Epiderm) in the prevention of hypertrophic scar formation. Plast Reconstr Surg. 1998 Nov;102(6):1962-72. Lin YS, Ting PS, Hsu KC. Comparison of Silicone Sheets and Paper Tape for the Management of Postoperative Scars: A Randomized Comparative Study. Adv Skin Wound Care. 2020 Jun;33(6):1-6. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Is it My Buccal Fat or Jowl Fat That Needs Treatment? URL: https://www.harmonface.com/blog/is-it-my-buccal-fat-or-jowl-fat-that-needs-treatment Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck There is a great deal of confusion among patients between buccal fat and jowl fat and their appropriate treatment, likely due to the complex shape of facial fat compartments. This blog post seeks to reduce that confusion. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. A consultation is essential to evaluate whether your concerns are related to your buccal fat, jowl fat, or both. A comprehensive, specific plan may then be developed to best address your concerns safely and effectively. There are Superficial (e.g., Jowl) and Deep (e.g., Buccal) Fat Compartments in the Face The face contains multiple compartmentalized fat pads that extend across the cheek as well as along the jawline. The fat pads along the jawline, like those in the cheek, droop with age, falling over the jawline. This results in jowling as well as the formation of marionette lines. There is little research evaluating the changes in size of the fat pads that form the jowls with age. This may be because studies of the volume of an area whose shape changes as it falls is difficult. It may also be difficult to account for other changes, such as weight gain or loss, over long periods of time when designing a study. However, plastic surgeons frequently observe that individuals experience enlargement of their jowl fat pads with age. I have found only one recent study – the only evaluating volume changes in the lower face with age – that supports what is widely seen clinically (1). This study identified thickening of the jowls with age. However, it should be cautioned that this study was limited by the fact that it simply compared a total of sixty women split into three age groups and did not follow them as they aged. However, it did account for things like body mass index (BMI) in each patient, thereby reducing the influence that overall weight has on the results. More and better-quality research is required to evaluate and characterize the changes that occur in the size and shape of jowl fat with age. In contrast, the buccal fat is located deep in the face, much deeper than the jowls. It also sits superior to the superficial jowl fat. Buccal fat winds through deep structures in the cheeks in a complex shape, surrounding important structures such as blood vessels, a salivary gland duct, and branches of the facial nerve. The research is mixed as to whether buccal fat increases in size, decreases in size, or remains the same size as we age. Many surgeons feel the buccal fat remains approximately the same size with age or even enlarges. More research is required, however. This is why only a portion of buccal fat is removed with buccal fat removal surgery . This is also why buccal fat is removed in individuals who do not anticipate significant weight loss, though long-term weight loss is difficult to predict. Treatment of Large Buccal Fat Pads Differs from the Treatment of Enlarged Jowl Fat Treatment of enlarged jowl fat differs from the treatment of enlarged buccal fat. The aesthetic goals of treating each area differ as well. Jowl fat sits closer to the skin and lower in the face compared with buccal fat. And unlike buccal fat, jowl fat falls over the jawline and forward towards the chin. The overall effect is that of making the jawline appear shorter and the face more bottom heavy. The best approach to treat the effects of falling jowl fat is through a facelift, specifically deep plane facelift surgery . Decreasing the size of jowl fat is more challenging in that the most appropriate treatment is not appropriate for most individuals. The size of jowl fat is commonly reduced using micro-liposuction, which is liposuction using a very small suction device. The jowl fat pad is small relative to fat removed using liposuction in other areas of the body, including the abdomen and thighs. As a result, the risk of “bumps” and other contour abnormalities is much greater with liposuction in this location. Therefore, only a small percentage of individuals who have very large jowl fat pads may see benefit from micro-liposuction when weighed against the risks. The more appropriate goal of treating the jowl fat is simply to bring it up closer to where it was when the patient was younger. In contrast, buccal fat pad removal targets an area between the cheeks and jawline in the center of the cheek in individuals with very round, “cherubic” cheeks. The aesthetic goal of buccal fat pad reduction is to reduce the volume of the area between the superficial cheek fat and superficial jowl fat to make this area slightly more concave. This differs greatly from the aesthetic goal of reducing the volume of the jowl fat pad. As always, a consultation is required to determine whether an individual is a good candidate for buccal fat removal. However, there is significantly less risk of contour abnormalities with buccal fat removal when compared with micro-liposuction of the superficial jowl fat pad. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us References Guo Y, Wen L, Wang X, Zou H, Liang W, Wang J, Zhu X. Analysis of age-related changes in lower facial fat compartments and of the course of blood vessels using computed tomography. Plast Reconstr Surg. 2023 Apr 4. --- ### Is Facial Plastic Surgery Like Architecture? URL: https://www.harmonface.com/blog/is-facial-plastic-surgery-like-architecture Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information I noticed the following excerpt from the personal essay I wrote for my facial plastic surgery fellowship application when looking through old email folders: "My passion for facial plastic and reconstructive surgery in many ways parallels my interest in modern architecture. Irving Gill, one of my favorite architects and a ' premonitory prophet of rationalist modernism ' in early twentieth century Southern California, designed residential structures which predated the popularity of the modernist style by decades. I recognize the importance of the qualities he possessed in facial plastic and reconstructive surgery. These qualities include an appreciation of context, a creativity bound by the limits of material and structure, and an obsession with detail. A student of Frank Lloyd Wright, Gill was heavily influenced by his mentor’s appreciation of how the environment communicated with his designs. Gill’s work, as exemplified by the Dodge House, demonstrated a deep understanding of the historical, social, and environmental context in which it was constructed. Similarly, I appreciate the importance of context in facial plastic and reconstructive surgery. I am fascinated by the concept of the face as a vehicle for communicating emotions and health. I wish to better understand the context in which patients negotiate their surroundings through their appearance in order to provide a surgical result which best matches how they see themselves. The first rhinoplasty I participated in clarified the challenge of understanding how the limits imposed by tissue and anatomy affect cosmesis, just as Gill created residences that were not only fireproof and earthquake resistant but also beautiful. It was a formative experience for me, because it was the first opportunity I had to realize both a cosmetic and functional outcome for a patient. What excited me about facial plastic and reconstructive surgery was how this concept carried through the field." Architecture remains my favorite art form and a passion. In fact, if you look at the shelving behind my practice manager’s desk you will see a book titled Architecture of the Sun: Los Angeles Modernism 1900 – 1970 by Thomas S. Hines, a famous architectural historian who taught at UCLA. I remain proud of the above portion of my essay, not only because I believe my argument holds true, but also because I believe architecture is not an art form - like sculpture - many have confidently argued has parallels with facial plastic surgery. Admittedly, the rest of my essay was uninspired. The remaining text included all the statements we are taught we are supposed to write in order to check the necessary boxes for fellowship directors. Irving Gill remains one of my favorite architects, not necessarily because his homes are the most beautiful, but because of the way he maintained the vernacular of Southern California while still pushing forward innovations in design, materials, and construction methods long before they became popular and widely adopted. This essay is meaningful to me because it freezes a moment in time prior to my embarking on the journey to become a facial plastic surgeon. I can reflect on my thinking then - which, of course, has changed - and contemplate the future. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. We Subconsciously Respond to Similar Features in Faces and the Built Environment The book Cognitive Architecture: Designing for How We Respond to the Built Environment by Anne Sussman and Justin Hollander provides additional insights into how facial plastic surgery and architecture relate. Human cognition includes a subconscious component which developed as an evolutionary survival mechanism to allow a rapid assessment of nearby dangers. Humans are hardwired to search for faces everywhere, including in the built environment. As a result, car designers design the front of vehicles look like human faces. It is also why humans tend to react more positively to buildings with a hint of an appearance of a human face. Humans intuitively feel more secure in environments with other humans nearby whose facial expressions are recognizable. As a result, humans intuitively prefer narrower streets because they feel safer. Humans prefer symmetry, balance, and gentle curves when looking at human faces. One example in the human face is the ogee curve, which is the s-shaped curve to the cheeks that is reflective of a youthful fullness of the superior cheek curving inward at the inferior cheek. Humans prefer these features buildings as well. These features of the human subconscious were intuitively understood by traditional - otherwise known as classical - architects. They were elucidated and measured only recently using modern biometric tools such as eye tracking which measures how frequently the human eye subconsciously focuses on areas in the visual field. A well-designed building elicits a positive emotional experience due to these subconscious processing mechanisms. Norman Crowe argues in Nature and the Idea of a Man Made World that "familiarity of some sort is a necessary component of 'beauty'." That familiarity is how humans perceive their bodies in relation to their natural environment. As previously explained, this translates to the built environment as expressed in classical architecture. Certain "familiar" facial features - such as a youthful ogee curve - elicit the same positive emotional response. I believe one of the goals of facial plastic surgery is to elicit such a positive emotional response in the patient and in others. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Is Bakuchiol a Safe, Effective Alternative to Over-the-Counter Retinols for Aging Skin? URL: https://www.harmonface.com/blog/is-bakuchiol-a-safe-effective-alternative-to-over-the-counter-retinols-for-aging-skin Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical The English-language literature on the use of the natural ingredient bakuchiol topically as an alternative to retinols in treating age-related changes to the skin (i.e., photoaging) will be reviewed. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Bakuchiol Has Long Been Used in Skincare Retinols are compounds that are converted into retinoic acid, which has been shown to increase collagen turnover and production and has been used to treat wrinkling and other signs of photoaging. Bakuchiol is a chemical derived from the babchi plant seed ( Psoralea corylifolia ), an herb long used in traditional Chinese and Indian ayurvedic medicine to treat multiple skin conditions. It is now being widely marketed in Western markets as an alternative to over-the-counter retinol-containing topical skincare products. A quick search on Google will identify many articles arguing the benefits of bakuchiol as a “miracle” alternative that is just as effective as retinols. Advertisements argue that it functions similarly to retinols but without the sensitivity reactions that often occur when starting retinols. And, it is important to note, the comparisons in the media are between bakuchiol and retinols, not the more potent, prescription-strength retinoic acid prescribed by dermatologists and other physicians . Evidence for Bakuchiol's Effectiveness is Lacking A review of the English language literature produced limited information on bakuchiol. The basis for the current craze for bakuchiol is a pilot study from 2014 (1) and a small trial from 2019 (2). Both of these studies utilized a very small study group and had multiple limitations, largely functioning as “marketing” studies for this product rather than rigorous studies comparing the actual effects of bakuchiol with retinols. In addition to a small study size, the time frame of the studies were too short compared with the known time to effect of prescription-strength retinoids. Future Research on Bakuchiol is Worthwhile It now seems like there has been an explosion of products that contain bakuchiol, usually included in mixture that has glycolic acids or other chemicals that resurface the skin. This suggests that there is very little evidence demonstrating the effectiveness of bakuchiol as an alternative to retinols for photoaging of facial skin. There is also some concern about whether individuals can experience an allergic reaction to this plant-based compound. That being said, future research is warranted. Bakuchiol may, in fact, prove a useful and effective adjunct to skin care regimens for treating photoaging. The available studies, however, do not definitively demonstrate this. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References Chaudhuri RK, Bojanowski K. Bakuchiol: a retinol-like functional compound revealed by gene expression profiling and clinically proven to have anti-aging effects. Int J Cosmet Sci. 2014 Jun;36(3):221-30. doi: 10.1111/ics.12117. Epub 2014 Mar 6. PMID: 24471735. Dhaliwal S, Rybak I, Ellis SR, Notay M, Trivedi M, Burney W, Vaughn AR, Nguyen M, Reiter P, Bosanac S, Yan H, Foolad N, Sivamani RK. Prospective, randomized, double-blind assessment of topical bakuchiol and retinol for facial photoageing. Br J Dermatol. 2019 Feb;180(2):289-296. doi: 10.1111/bjd.16918. Epub 2018 Sep 21. PMID: 29947134. --- ### Is a Non-Surgical Lip Flip Worthwhile? URL: https://www.harmonface.com/blog/is-a-non-surgical-lip-flip-worthwhile Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Botox® and other similar products can be placed in the upper lip to produce the effects of a non-surgical lip lift. The problem with this technique is that the effects tend to be minimal. There are also risks associated with asymmetry and temporary functional problems with the mouth. A surgical lip lift with or without filler (e.g., hyaluronic acid , fat) is usually a superior approach to addressing concerns about the upper lip. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Use of Botox® or Similar Products Around the Mouth is Considered Off-Label The use of Botox® or similar products around the mouth is considered an off-label use because it is not an FDA-approved location. This is not necessarily the reason to not undergo treatment here. For example, the FDA did not approve Botox® for use in the forehead until 2017 though it had been used safely and off-label in this location for many years prior. The Effects of a Lip Flip Tend to Be Minimal Only 1 – 2 units of Botox® are placed at this location. Like a non-surgical brow lift, the effects of placing such a small number of units – by necessity for reasons that will be discussed below – usually demonstrates minimal results. Visible Asymmetry is Possible When only 1 – 2 units of Botox® are injected in a site there is a risk of an asymmetry in effectiveness, either due to random effects of the medication or due to asymmetric placement of the medication. This can be visible though it can be corrected with the placement of additional units of Botox® at follow up. Functional Problems of the Mouth are Possible Patients are generally counseled that they may have trouble using straws or pursing their lips for a few days after the medication begins to work. However, these functional problems can last for the entirety of the effect of the treatment, which usually ranges from three to four months in most individuals. Lip Flip Versus Lip Lift is Temporary Muscle Adjustment Versus Structural Improvement A lip lift is a precision surgical procedure that helps restore more youthful length and proportions to the upper lip. In contrast, a lip flip involves the use of a neuromodulator such as Botox® to selectively and temporarily weaken a specific area of the upper lip such that the now unopposed pull of the remainder of the upper lip muscles lifts the lip up. A lip flip is a temporary muscle adjustment performed centrally at the border between upper lip skin and the red lip, called the vermillion border. A lip lift requires carefully designed skin removal and lifting of the upper lip skin and deeper fascia into natural creases in the base of the nose and at the edge of the mouth. Lip flip results last months. A lip flip is semi-permanent. A lip flip does not shorten the distance between the nose and the lip, change the height of the red lip, or roll out additional red lip, thereby providing more roundness to it. All these complex changes require surgery. However, while lip lift surgery is a safe procedure that can be performed under local anesthesia with limited downtime, a lip flip is a non-invasive, non-surgical procedure with little-to-no downtime. Moreover, it can be done in an exam/treatment room rather than an operating room. This makes a lip flip using a neuromodulator such as Botox a potential treatment option for a limited subset of patients. Patients who may benefit from a lip lift versus lip flip include: Lip Lift Lip Flip Age Range 40s to 70s 30s Expected Results Substantial Subtle Expected Length Semi-permanent (aging does not stop) 3 – 4 months (length of neuromodulator effect) Incision(s) Yes (though well-hidden) No Anatomic Changes Can Help Address Lengthened upper lip Thin red lip Drooping lateral lip Loss of tooth show Thin red upper lip The best way to know what the most appropriate treatment is for concerns about your upper lip would be to have a consultation with a fellowship-trained, double board-certified facial plastic surgeon such as Dr. Jeffrey Harmon. Dr. Harmon not only trained in fellowship with one of the most renowned facial plastic surgeons in the world, but he also completed his residency training at one of the most prestigious programs in the country. He is supremely qualified to help guide patients on making a decision between a lip flip and lip lift surgery. A Non-Surgical Lip Flip is a Poor Reflection of the Benefits of a Surgical Lip Lift A surgical lip lift can not only elevate the red portion of the lip but also reduce the length of the lip between the base of the nose and the red lip, working above to the muscle. In contrast, Botox® is placed directly in the ring-shaped muscle around the mouth, which is the reason why the potential problems described above can occur. The surgical lip lift can simultaneously improve the height of the red lip and correct the length of the lip between the base of the nose and red lip but also increase lip pout without over-projecting the lip. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### I Read One of the Best Books on Facial Plastic Surgery Not Written by a Physician URL: https://www.harmonface.com/blog/i-read-one-of-the-best-books-on-facial-plastic-surgery-not-written-by-a-physician Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Published in 1998, Lift: Wanting, Fearing, and Having a Face-Lift by Joan Kron is one of the best books I have read on facial plastic surgery written by a non-physician. It is also one of the best histories of facial plastic surgery I have read by any author, physician or not. The book is a time capsule of sorts, capturing a transition point in cosmetic facial plastic surgery before, for example, Botox® and hyaluronic acid fillers were Food and Drug Administration (FDA) approved and widely in use. The following blog post is a review of the book and a highlight of some of the wisdom the author imparts about her experience undergoing facial plastic surgery. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Reporter Joan Kron is a Phenomenal Writer with a Fascinating Career I discovered the reporter Joan Kron after reading her article “I’m 96 and I’ve Had Three Face-Lifts – Here’s What I Learned” in Allure magazine. She began working for Allure in 1990 at age 63. She reports that she was one of the only individuals in the office at the time old enough to undergo plastic surgery. She would have a 25-year career in reporting for the magazine on some of the most famous plastic surgeons in the world. She quotes many of these individuals in the book, which lends to the authority of her writing. It also reflects the fact that readers enjoy stories much more than simple explanatory journalism bereft of personal human input. But while I do not agree with all her beliefs regarding plastic surgery, I respect the fact that she was willing and able to utilize a reporter’s eye to analyze her personal experience with facial plastic surgery, communicating the following wisdom: “The most important lesson I can share may be that no two people have the same experience.” Her resulting book and many articles are interesting, insightful, and well-written. In fact, I learned a lot about the history of facial plastic surgery that I did not previously know. Moreover, she communicated this history both through interesting stories and by quoting some of the individuals who participated in this history. Her description of the history of chemical peeling and its origins and popularization in early Hollywood was particularly interesting to me. The mystery behind these early “lay-peelers” and the physicians who would pursue these secret and well-guarded recipes parallel the often-dramatic lives of the movie stars who were treated. Only two years after the publication of this book - in 2000 – would the history of chemical peels be consolidated, and the true nature of deep phenol chemical peels she describes be elucidated . Lift: Wanting, Fearing, and Having a Face-Lift is Simultaneously Outdated and Timeless It is important to highlight just how long ago 1998 is – 26 years! For example, the following is a list of the top five grossing movies in the United States (in order) in 1998: Titanic Armageddon Saving Private Ryan There’s Something About Mary The Waterboy The following is a list of the top five selling records (in order) of 1998: Titanic: Music from the Motion Picture by James Homer Let’s Talk About Love by Celine Dion Sevens by Garth Brooks Backstreet Boys by Backstreet Boys Come on Over by Shania Twain Botox® by Allergan was not FDA approved for cosmetic use – in the frown lines – until 2002, four years after this book was published. Restylane© by Galderma, the first FDA approved hyaluronic acid filler, was not approved until 2003. I highlight all of this to contrast the previously mentioned treatments with some of the treatments she discusses which are not widely in use anymore. Specifically, she describes the extensive use of bovine (i.e., cow) collagen injections in the face, which have been replaced by hyaluronic acid fillers that have proliferated and diversified since first being approved. The book was published in an era in which the use of lasers for skin resurfacing to treat age-related changes to the skin of the face was just beginning. For example, she compares CO2 lasers unfavorably with chemical peels, another method of skin resurfacing. However, with the advent of the less powerful but safer fractional ablative CO2 lasers and Erb:YAG lasers, these devices have become the most common method of skin resurfacing. It was remarkable to hear how frequently individuals who underwent deep chemical peels experienced lightening of their skin (hypopigmentation) from the author, something that is much less common these days. I do, however, still hear from some of my patients who underwent deep chemical peels in this era about how common it was to see white patches of hypopigmentation on their friends and family who also received this treatment. Anesthesia services have advanced since 1998. For example, specialized monitors that track a patient’s oxygen levels and end-tidal CO2 – a measure of air exchange in the lungs – had been available widely for only a few years but are now ubiquitous in hospitals, ambulatory surgery facilities and office-based surgery suites. Some medications that are now largely standard for anesthesia and have increased its safety (e.g., propofol) were not as widely used in the 1990s due to cost. Conversely, this was a time in which the use of prescription narcotic painkillers was first proliferating without a good sense of how addictive these medications can be. As a result, the author was taking narcotics for approximately 2 weeks after surgery, much longer than would be allowed or even recommended today. Overall regulation of the anesthesia services administered has improved greatly since this book was published with accreditation for all surgical facilities becoming standard – this was a requirement only in California at the time. Finally, while she correctly highlights the importance of the American Board of Medical Specialties (ABMS) and that a plastic surgeon is board certified in either the American Board of Otolaryngology – Head and Neck Surgery (ABOHNS) or the American Board of Plastic Surgery (ABPS), she ignores the importance of the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). A facial plastic surgeon is board certified by the ABOHNS first followed by the ABFPRS years later after passing additional exams and accumulating a requisite number of procedures completed. Being certified by both bodies means you are a dual/double board-certified facial plastic surgeon . I believe those individuals who have undergone residency training in head and neck surgery followed by fellowship training in facial plastic surgery an d who are dual board certified are uniquely qualified to care for aesthetic concerns of the face and neck, both due to the additional training required after residency (i.e., fellowship) and the additional board certification (i.e., ABFPRS). The Most Glaring Problem of Lift: Wanting, Fearing, and Having a Face-Lift is in the Mischaracterization of Broad Facelift Categories The most glaring inaccuracy, in my opinion, is in the way the author characterizes the different categories of facelift techniques. While she correctly identifies the earliest techniques for facelifting as well as the next iteration (i.e., SMASectomy) , she largely glosses over the development of deep plane facelift surgery. In fact, she describes Dr. Sam Hamra’s “composite” (deep plane) facelift approach in passing, though Dr. Hamra is now widely credited as pioneering deep plane facelift surgery – currently the gold standard in facelift techniques – with his 1990 paper . Instead, she describes a technique of facelifting developed by a French surgeon that has fallen out of favor and is not performed widely today. Joan Kron Speaks with Greater Authority Than Other Non-Physicians Because of Her Personal Connections and Experience with Facial Plastic Surgery There are many aspects of facial plastic surgery that are timeless. Among the many details about the technical aspects of surgery she clarifies are the differences between keloids and hypertrophic scarring – something I have noticed is very commonly confused. She emphasizes the importance of understanding whether eyelid and/or brow lift surgery is indicated rather than simply eyelid surgery alone . She also highlights the effects of skin tension on scarring. She pursues treatments with a healthy perspective, stating “I don’t want to change the topography, I just want to prune the trees.” This statement reflects wisdom. In addition, there are many universal patient experiences with facial plastic surgery that Joan Kron illustrates, noting “the conflicting emotions I had experienced…were strikingly universal” regarding her pursuit of facial plastic surgery. She explains that “most facelift patients have an idealized vision of themselves…it’s usually a more grown-up face, maybe a picture of yourself from ten years ago” and “many patients find themselves emotionally vulnerable during recovery.” All of this is true and requires the guiding hand of the surgeon and loved ones to help them through to enjoy their results once they have healed and reached this vision. Finally, she is honest about the fact that, with elective surgery, there are both rewards and risks. She explains that patients need to calculate the tradeoff themselves with the guidance of a well-qualified surgeon who you feel can maximize the chance of an excellent result but who can also handle any rare setbacks if they arise, explaining that “a competent surgeon knows how to treat them [complications], and will be there for the patient should problems occur.” And while she explains that “credentials matter” (see above), she also explains that “so does reputation, taste, experience in the procedure in question, and results that can be verified, preferably by satisfied patients” She sums up her experience undergoing facial plastic surgery with the following: “Was it all worth it? Unquestionably, yes. Would I recommend it to friends? Absolutely, as long as they go into it knowing it’s not makeup – it’s surgery.” Trust Your Face to a Double Board-Certified Facial Plastic Surgeon It is important to seek a fellowship-trained, double board-certified specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### Humanitarian Service in Belize URL: https://www.harmonface.com/blog/humanitarian-service-in-belize Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information I wrote the following article four years ago about my experience on a medical mission to the Corozal Community Hospital in Corozal, Belize in February of 2018 for the American Academy of Otolaryngology – Head and Neck Surgery (ABO-HNS). I was awarded a grant from the ABO-HNS to help fund my trip. They asked that I write this article in exchange for the grant. This week-long mission was a formative experience for me. And while I have not yet returned to Belize, I hope to serve the wonderful people there soon. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. This past February, I had the privilege of serving on a medical mission to the Corozal Community Hospital in Corozal, Belize. It was one of the most humbling and rewarding experiences of my life. Organized through Partners for Belize, the mission targets an underserved population of 25,000 in northern Belize, many of whom belong to rural Mennonite communities. I spent one week with my mentor, Devinder Mangat, MD, focused on the surgical treatment of congenital and acquired facial deformities in adults and children. The mission consisted of one day of pre-operative evaluation of patients followed by four days of high-volume surgery. Partners for Belize is well-established in the area, with 12 years of experience working in the community. As a result, it has established deep connections with local healthcare providers as well as the Ministry of Health. Approximately 60 people attended this medical mission in the capacity of pharmacists, nurses, primary care physicians, surgeons, surgical assistants, and support staff. We worked together to evaluate and treat hundreds of patients and performed almost 80 procedures. This was my first medical mission and, therefore, my first opportunity to apply my medical training abroad. Joveh Zetina is a five-year-old boy who presented on our screening day with an unrepaired unilateral cleft palate. The cleft had made it difficult for Joveh to maintain adequate nutrition. We repaired his cleft palate and observed him overnight. Fortunately, Joveh made a rapid recovery. He and his mother left happy and grateful. This experience reinforced my passion for otolaryngology. I gained confidence as a surgeon, grew closer to colleagues, and developed an appreciation for international mission work. I plan to continue international mission work throughout my career. I hope to return to the Middle East where I taught undergraduate pre-medical students eight years ago. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### How to Treat Drooping, Hooded Eyes That Can Make Us Look Tired URL: https://www.harmonface.com/blog/how-to-treat-drooping-hooded-eyes-that-can-make-us-look-tired Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes Our experience at Harmon Facial Plastic Surgery has been that most people do not present to our clinic specifically requesting a brow lift, let alone requesting to “lift of my entire eyebrow x inches.” Instead, most present feeling like their eyes look less open and are unsure why. They may pinch the skin on their upper eyelids, describing difficulty with applying makeup because it gets “caught under the folds of skin up there.” They often also pull up the side of their brows, explaining how this makes them feel more youthful, that more sunlight reaches their eyes this way. Broadly, these individuals seek an intervention that can open their eyes back up, highlighting their beautiful shape and color. Surgery is usually the best way to achieve this. It is important to consider both the eyebrows and the upper eyelids when developing a surgical plan because, while treatment of the eyebrows or the eyelids may be effective by themselves, treating both areas together is often the most effective and natural appearing. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Excessive Upper Eyelid Skin Removal with Surgery Can Make a Brow Lift Impossible Dr. Harmon has consulted with and treated multiple patients who have undergone upper eyelid (blepharoplasty) surgery elsewhere and now seek treatment of their drooping eyebrows. Too often, these individuals have presented with excessive skin and fat removal in the eyes. The telltale signs of this can include: A wide scar which is usually placed too close to the eyelash margin and away from the natural upper eyelid crease. Excessive show of the upper portion of the eyeball, called excess tarsal show. Difficulty closing the eyes, called lagophthalmos, which is not always apparent when awake but can be apparent when asleep. These individuals may not be able to undergo a brow lift because their eyes do not close completely if the brow is lifted. These examples demonstrate the connection between the eyebrow and upper eyelid. It is why Dr. Harmon always considers both areas when assessing the most appropriate treatment for age-related changes around the eyes. The Lateral Temporal Brow Lift Can Restore Some of the Youthful Eye “Glow” The lateral temporal brow lift is a surgical procedure that can address the most common feature of aging in the eyebrow, the drooping of its most lateral portion. Drooping can lead to hooding over the upper eyelid where the volume of the brow hangs over the lateral edge of the eye, making the eyes look less open. This procedure is performed with only two small incisions within the hair. And, while this may be the only procedure necessary to achieve the desired results, the upper eyelid itself also needs to be evaluated. Upper Eyelid (Blepharoplasty) Surgery Can Also Restore Some of the Youthful Eye “Glow” Upper eyelid (blepharoplasty) surgery is focused on excess folds of skin that can develop on the upper eyelid itself but extend to the interface with the drooping brow tissue. Importantly, every eyelid is different, even on the same individual. As a result, while the basic shape of the excision remains the same, there are and should be slight differences in how the skin is excised because of those often-subtle differences in the skin. Dr. Harmon also lifts the lateral brows when designing the upper eyelid surgery to preserve the ability to address the eyebrows in the future if that need/desire arises. The Lateral Temporal Brow Lift and Upper Eyelid (Blepharoplasty) Can Be Complementary The lateral temporal brow lift and upper eyelid (blepharoplasty) surgery can complement each other because these anatomical sites interact and blend in with each other. As a result, one cannot consider one procedure without considering the other. This philosophy carries through to other areas as well, for example, in the way the extended deep plane facelift complements the neck lift more completely than other facelift procedures. The following two patients are examples of the power of the combination of the procedures to "open up" the eyes in a natural appearing way. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### How to Select the Perfect Facial Plastic Surgeon URL: https://www.harmonface.com/blog/how-to-select-the-perfect-facial-plastic-surgeon Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information If you are looking to select a facial plastic surgeon, it is not as easy as searching “plastic surgery near me.” It is important to research a facial plastic surgeon’s credentials, study their style and approach for procedures, visit the facility, and — most importantly — find someone you can trust. Learn more about selecting the perfect facial plastic surgeon , and schedule a consultation with Harmon Facial Plastic Surgery in Cincinnati. Research Their Credentials Before scheduling a procedure with a facial plastic surgeon, look into their credentials and make sure they specialize in the procedure you would like to have done. Surgeons will include their educational background, training, and certifications on their practice website. Study Their Style and Approach There are dozens of different surgical and nonsurgical approaches to each area of the face. Study the style and approach that a facial plastic surgeon uses to perform their procedures. A good way to do this is to look at before and after photos, as well as research what different procedures entail. Research and Visit the Facility You want to feel comfortable in the clinic. Schedule visits and research the clinic’s amenities so you understand what your experience will be like from the consultation all the way through the procedure itself. Find Someone You Trust Most importantly, you should find a facial plastic surgeon that you trust. Dr. Harmon completed five years of training in head and neck surgery as well as subspecialty training in facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery, the premier national governing body for the training of facial plastic surgeons. Dr. Harmon has the background to provide and record of providing natural results. He treats his patients with integrity, consistency, and excellence. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Start your research now by requesting a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### How to Evaluate a Cheek Lift with the Deep Plane Facelift URL: https://www.harmonface.com/blog/how-to-evaluate-a-cheek-lift-with-the-extended-deep-plane-facelift Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck One major benefit of deep plane facelift surgery, including the extended deep plane facelift , is that unlike other facelift approaches the natural volume of the cheeks can be lifted. The benefits of this are best appreciated dynamically and in-person. However, images can capture some of the nuances of a cheek lift. See the following blog post discussing the differences between a cheek lift with deep plane facelift surgery and fat augmentation of the cheeks. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Ask them if they have been fellowship-trained in deep plane facelift surgery, specifically the extended deep plane facelift. The Face Can Look More Heart-Shaped One benefit from deep plane facelift surgery is that the face can appear overall more heart-shaped and less “bottom-heavy” or “boxy.” This is due not only to the cheek lift but also the treatment of the jowls. The Height of the Lower Eyelid Bags Can Improve One effect of a cheek lift associated with the extended deep plane facelift is that it can make the height of lower eyelid bags appear shorter. This is demonstrated by the vertical yellow lines on the images. This is because the natural volume of the cheek is lifted towards the lower eyelid. While a cheek lift is no replacement for lower eyelid surgery (blepharoplasty) , it can contribute to restoring some of the natural, smooth volume transition from the lower eyelids to the cheeks that is typically present in youth. A Smoother Transition Across the Cheek Can be Achieved A cross-face depression can develop as the natural volume of the cheeks falls down and to the center of the face with age. This is due to the fact that the volume falls away from a prominent bone on the lateral cheek. This area is indicated by the blue ovals on the images. Deep plane facelift surgery can improve this transition by lifting some of the natural volume of the cheek up into this depression, thereby filling it. The Depth of the Nasolabial Folds Can Improve The nasolabial folds are present naturally, even in youth. They are the result of a ligament that extends from the bone to the skin. These folds indicate the transition from the cheeks to the upper lip. As a result, their presence is necessary to impart a natural appearance to the face. However, the natural volume of the cheeks tends to fall down and to the center of the face with age. Deep plane facelift surgery, by lifting the natural volume of the cheeks, can relieve some of this overhang. This is demonstrated by the red ovals on the images. Every Patient is Unique and Results Can Vary Every patient has unique anatomy. For example, our natural volume varies in amount and location. As a result, the results of the extended deep plane facelift are expected to vary between patients. An area of the face may improve more or less than others. After all, no technique is perfect. We as facial plastic surgeons cannot “wind the clock back” to whatever age we choose. The extended deep plane facelift does, however, mean to address the signs of facial aging more comprehensively than other facelift approaches. This blog post is simply a guide to help you evaluate some of the improvements that can occur because of the procedure. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### How (Thoughtful) Surgeons Think. URL: https://www.harmonface.com/blog/how-thoughtful-surgeons-think Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information It can be difficult to adhere to strict scientific principles when recommending medical treatments to patients as a Cincinnati facial plastic surgeon simply because there is often so little quality data to support some recommendations. It is the nature of surgery more broadly, and plastic surgery specifically, probably because it is so difficult to develop and execute a high-quality study while ethically treating every individual with the most up-to-date standards of care. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. It is for this reason I thought it important to walk through how physicians think when we evaluate the effectiveness of treatments for patients. This will give you a window into how I think about what I recommend to my patients peri-operatively. The post will provide important context for follow up blog posts where I will comment on common peri-operative treatments intended to improve and accelerate healing. There are many ways to organize a study that evaluates the effectiveness of an intervention, whether it is a surgical procedure or medication. For example, suppose medication “A” (insert a Millennial, Silicon Valley-esque, non-sensical name) is thought to prevent abnormal scarring after surgery. However, your understanding of its effectiveness is purely anecdotal (“None of my patients have abnormal scarring because of medication ‘A’!”). At that point I dive into the medical literature for studies related to medication “A.” First, I look for studies with as many of the following qualities as possible: Controlled: The treatment group that receives medication “A” is compared with a treatment group (control) that either receives no intervention OR the accepted standard of care (see above). Blinded: The subjects receiving medication “A” and/or the individuals performing the evaluation do not know what intervention is being administered at any time. When BOTH the subjects and the evaluators do not know what treatment is being administered, it is double-blinded. And, just to be clear, this is the only time I will refer to the term “double-blinded” in a positive manner. Randomized: The subjects and/or treatment sites are randomly assigned to be treated with medication “A” or the control (no intervention OR the accepted standard of care). A controlled, randomized, blinded ( preferably double-blinded! ) study is an ideal study to review. Occasionally, there are even studies available that combine the data from multiple studies with those qualities into one large pool of data. These studies are called meta-analyses. An important example of a meta-analysis comes from my mentor and former fellowship director, Andrew Jacono MD, FACS in which he rigorously evaluated and confirmed the safety of the extended deep plane facelift, the gold-standard for facelift techniques and the technique he trained me to employ (1). But it is not enough to look for the above criteria only when evaluating the quality of a study. It is also important to understand what is actually being measured. So much of facial plastic surgery is based on subjective opinions on appearance, which leaves the assessment of the effects of treatment subject to error. Broadly, there are three different ways to assess the response to treatments in facial plastic surgery: Subjective ratings by observers and test subjects with a study-created scale (i.e. what do YOU think?) A standardized scale published in the literature (e.g. Vancouver Scar Scale [VSS], which sounds like fancy scale in hockey analytics) Objective assessment as performed by some measurement, such as a computer. It is important to note, however, that the quality of results from objective measurements is entirely dependent on the how we humans set up the measurement itself. After evaluating the studies for as many of the features above I review the data. And, if I cannot come to a firm, absolute conclusion – which is not uncommon – I weight the potential benefits with the potential risks for my patients. That is where the art of medicine blends with the science of medicine. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References 1. Jacono AA, Alemi AS, Russell JL. A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques. Aesthet Surg J. 2019 Aug 22;39(9):927-942. --- ### How the Face Ages and What to Do About It URL: https://www.harmonface.com/blog/how-the-face-ages-and-what-to-do-about-it Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The face ages in a somewhat predictable pattern, though at a different rate and to a different extent depending on multiple factors. Both genetics and lifestyle choices contribute to the aging process. A detailed understanding of the anatomy and how changes in anatomy lead to the sequelae of facial aging is required to make the most appropriate treatment recommendations. An individual’s aesthetic goals and specific concerns also need to be prioritized to provide optimal, natural results. The following is a concise description of what changes in the face and neck as we age. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Aging Hair The hair is composed of groupings of hair follicles, which themselves are a complex of cells that function to grow hair and support that growth. The above diagram is an illustration of the anatomy of a hair follicle. Hair follicles cycle through periods of hair growth, hair loss, and rest. This process occurs in everyone throughout their lives. While there are multiple reasons why a patient may lose their hair, the most common cause is the action of a family of hormones called androgens on the function of hair follicles. Called androgenic alopecia, this condition can affect both men and women. Androgenic alopecia results in hair in certain areas of the scalp shrinking and losing pigmentation. These hair follicles are eventually lost without being replaced. This process leads to balding. The diagram above is an illustration of what occurs to hair and hair follicles during balding due to androgenic alopecia. The onset and pace of hair loss due to androgenic alopecia varies between individuals and is heavily influenced by genetics. However, the pattern of hair loss in men and women due to androgenic alopecia is somewhat predictable. The pattern of hair loss for men has been described under the Norwood classification. The diagram above is a visual representation of the Norwood classification system and reflects the most common pattern of hair loss in men. Individuals progress in their hair loss starting at different ages and at different rates. Not all men progress to a Norwood VII classification. The pattern of hair loss for women has been described under the Ludwig’s classification. The diagram above is a visual representation of the Ludwig classification system and reflects the most common pattern of hair loss in women. Individuals progress in their hair loss starting at different ages and at different rates. Not all women progress to a Ludwig III classification. There are non-surgical and surgical treatment options available for both men and women who experience hair loss due to androgenic alopecia. Aging Forehead The forehead extends from the hairline to below the eyebrows at the rim of the eyes. It is composed of skin, muscle, and other soft tissue overlying the frontal bone of the skull. A long, thin muscle, called the frontalis, extends over the forehead like a ribbon. It is the only muscle responsible for lifting the eyebrows. It is also the target of Botox® in the forehead. Other muscles of the forehead, including the orbicularis oculi, corrugator, and procerus, pull the eyebrows down. Botox® to the crow’s feet targets the orbicularis oculi. Botox® to the “11 lines” or “frown lines” between the eyebrows targets the corrugator and procerus muscles. The eyebrows lie over strong ligaments that extend from bone to skin. That is illustrated in the above diagram outlined by the yellow box. A youthful eyebrow has a fat pad extending across it and over these ligaments. The temple is composed of complex layers of skin, fat, fascia, and a muscle called the temporalis, which contributes to chewing. The ligaments surrounding the eyes start to weaken with age, resulting in a drooping, or ptosis, of the eyebrows. While ptosis can occur across the eyebrows, it most commonly affects the lateral eyebrow resulting in “hooding” of the upper eyelid. Lateral eyebrow hooding can make you look sad or tired. A brow lift can treat these symptoms. Fat is sometimes lost deep to the eyebrows and in the temples. This can hollow out the lateral portion of the forehead. If volume is lost in this location, there are non-surgical and surgical procedures that can treat this. Finally, wrinkles can develop on the forehead and between the eyebrows. The wrinkles can be present at rest, called static wrinkles, and be exaggerated with movement, called dynamic wrinkles. The treatment of static and dynamic wrinkles differs. Aging Eyes The upper and lower eyelids are composed of layers of the thinnest tissue in the face, though they contain skin, multiple muscles, fascia, and mucosa. Multiple fat pads populate the area around the eye. They are held back by a thin, fibrous tissue called the septum. The diagram above is an illustration of the complex anatomy of the upper and lower eyelids. The skin loosens in the upper and lower eyelids with age, becoming redundant. Excessive upper eyelid skin can obstruct vision in extreme cases. Otherwise, this redundant skin results in significant wrinkling of the upper and lower eyelids. The muscle deep to the eyelid skin can weaken and sag, most significantly in the lower eyelid. The fat pads sitting behind the septum in the upper and lower eyelids push against the septum with age, resulting in eyelid bags. Redundant skin, sagging muscle, and prolapsing fat behind the septum with age can result in a tired appearance. The most appropriate treatment for these changes is usually surgical . Aging Face The lower two thirds of the face is a complex of skin, fascia, superficial fat compartments, muscle, deep fat compartments, and bone. A youthful face demonstrates smooth transitions between one area of the face to the other. The above image demonstrates a smooth transition between the lower eyelid and cheek in a young individual. The loosening of skin and fascia as well as the weakening of tight ligaments surrounding the fat pads in the face results in drooping of the fat, mostly in the central face as indicated in the diagram below within the blue boxes. The result is a loss of a seamless transition between areas of the face, including the lower eyelids and cheek (tear troughs), the cheek and upper lip (nasolabial folds), and the cheek and lower lip (marionette lines). It is the sharpening of these borders and sagging of soft tissue volume in the face that imparts an aged appearance as demonstrated in the illustration above. The overall result is a loss of a youthful heart-shaped appearance to the face and a more bottom-heavy face. Other than the tear troughs, nasolabial folds, and marionette lines, some individuals develop a depression angled out and down across their cheek. This is a result of the cheek fat pad falling away from a prominence in the cheek bones. While there are some non-surgical procedures that can improve the appearance of these depressions, only surgery can address the signs of aging of the lower two thirds of the face comprehensively. Aging Lips Often neglected by plastic surgeons, the lips age like the rest of the face. The lips are composed skin extending from the base of the nose to the nasolabial folds and the red lip as well as the red lip itself. The lower lip includes not only red lip but also the skin between the lower lip, chin, and marionette lines. As evidenced by the above illustration, there is little tissue between the skin and muscle surrounding the lip, called the orbicularis oris. The orbicularis oris muscle is in almost constant use when awake. As a result, deep wrinkles radiating out around the lips can develop. There are surgical options to treat these wrinkles, also known as smoker’s lines. Not only does the lip skin wrinkle, but it also lengthens with age. The upper lip skin often lengthens while the red lip loses height and definition. The result is a loss of upper lip pout and a loss of upper tooth show when the lips are gently parted. There are non-surgical and surgical options to treat these changes. Aging Neck The neck is composed of multiple layers of skin, muscle, fat, fascia, cartilage, and bone. The most superficial muscle in the neck, called the platysma, extends from the clavicle bones over the jawline. Skin loosens and sags with age. The platysma muscle weakens, most significantly at the midline, and sags with age as well. This results in thick, ropey bands in the center of the neck. Loosening of the platysma muscle along the jawline contributes to jowls but also to a scalloping or blending in of the back corner of the jawline with the neck. The effect of the development of jowls and the scalloping of the jawline is a neck that appears shorter than it is. Fat can accumulate under the jawline and in the neck immediate below the skin and deep to the platysma muscle. Severe excess of this fat can severely blunt the transition from the neck to the jawline. The best treatment for the above changes to the neck is usually surgical . Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us References Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthet Surg J . 2013 Aug 1;33(6):769-82. Jacono AA. The Art and Science of Extended Deep Plane Facelifting and Complementary Facial Rejuvenation Procedures . Quality Medical Publishing Inc; 2021. Jacono AA, Bryant LM, Ahmedli NN. A Novel Extended Deep Plane Facelift Technique for Jawline Rejuvenation and Volumization. Aesthet Surg J. 2019 Nov 13;39(12):1265-1281. doi: 10.1093/asj/sjy292. Jacono AA, Bryant LM, Alemi AS. Optimal Facelift Vector and its Relation to Zygomaticus Major Orientation. Aesthet Surg J. 2020 Mar 23;40(4):351-356. Randall VA. Chapter 2: The Endocrine Control of the Hair Follicle. In: Blume-Peytavi U, Tosti A, Whiting DA, Trueb RM, eds. Hair Growth and Disorders . Springer; 2008: 23 - 39. Stuzin JM, Baker TJ, Gordon HL. The Relationship of Superficial and Deep Facial Fascias: Relevance to Rhytidectomy and Aging. Plastic and Reconstructive Surgery . 1992 Mar;89(3):441-9. Sykes JM, Riedler KL, Cotofana S, Palhazi P. Superficial and Deep Facial Anatomy and Its Implications for Rhytidectomy. Facial Plast Surg Clin North Am. 2020 Aug;28(3):243-251. --- ### How Teaching Has Affected the Way I Practice Medicine URL: https://www.harmonface.com/blog/how-teaching-has-affected-the-way-i-practice-medicine Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Teaching involves not only the transmission of knowledge but also the organization of knowledge into a digestible framework whose construction imparts a way to organize other information. In other words, teaching involves teaching students how to learn as much as what to learn. It is that process of constructing the “framework” that allows me to organize my knowledge into a logical, organized, evidence-based facial plastic surgery clinical practice in Cincinnati, Ohio. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. My First Experience Teaching Colors Went Poorly My mother still enjoys telling the following story about me as a young boy: I was teaching my younger sister the colors. I became bored after teaching her a few colors, explaining that all the remaining colors are “orange.” My mom explains it took months for her to convince my sister that all referred to colors are not, in fact, orange. Fortunately, the damage done to my sister was temporary. She is now a brilliant cardiology pharmacist. I Developed a Love for Teaching as a Teaching Assistant at Cornell University I was a teaching assistant in college at Cornell University in a biology class that was student-directed. Lessons and tests were created by us, the teaching assistants. This experience taught me how to put myself in a student’s shoes, to design lessons and exams that not only communicate information but also teach students how to analyze and solve problems more generally. This is partly because all the exams were oral rather than written, forcing not only my students but me to actively engage with the material. This experience gave me the confidence and tools to engage in self-directed learning on some of my other interests, including architecture and foreign policy. My Self-Actualization Moment as a Teacher Occurred in Doha, Qatar I later became a biology and chemistry teacher to undergraduate students at Weill Cornell Medical College in Doha, Qatar. It was a job I almost lost. I had applied months prior to my college graduation. I was given a phone interview that went well. However, I heard nothing from the institution all year. I started making plans to return home for a year prior to medical school, unsure what I would do, when I received a phone call from a very unusual number. An individual named Sean Pierson left a voicemail in a very sweet British accent asking whether I would be joining them in Doha in August. I learned they had sent my job offer and follow up emails to the wrong address for months. I applied what I learned as a teaching assistant to this job, which I held between undergraduate and medical school at the University of Cincinnati . Moreover, I applied what I learned to an entirely new social and cultural context, adapting to these differences. For example, Ramadan occurred at the height of the summer when temperatures were routinely greater than 100 degrees Fahrenheit. Most students fasted during the day. And because the school ran on an American schedule, classes were held during normal daylight hours. It was obvious the students were retaining very little during these days. I adjusted lessons to account for this and, frankly, expected less from them during this time. They more than made up for this time over the course of the year. My students demonstrated themselves to be very thoughtful and intelligent like the students I taught in college. This experience taught me to meet people where they are, because it may be very different than where I am. Another example was in helping students write essays in English who are primarily Arabic-speaking. I learned competent writing in Arabic tends to be very long and descriptive as opposed to focused and efficient as in American English. Despite this, it was remarkable how quickly and easily my students adapted to this difference in focus. I also learned about the beauty of the Arabic language from them. My students helped me understand how deeply language guides and organizes our perception of the world. It was another lesson in empathy. My experience in Doha was a self-actualizing time for me. I knew that whatever the specialty I choose, teaching would be a part of my career. I Have Applied What I Have Learned About Learning to Teaching Residents A huge amount of time in residency involves teaching the younger residents and medical students. I made it a point not only to teach the younger residents but also to help them develop a framework for acquiring and applying medical knowledge, because it was important to me not only that the team I was leading as a chief resident would be clinically competent but also that I would help develop younger doctors going out in the world who will be taking care of patients. That is why I still teach the residents at the University of Cincinnati today, years later. The Opportunity to Teach Facial Plastic Surgery is a Gift The opportunities I have had to teach have not only allowed me to remain up to date on the medical literature but has also affected how I consult with patients. I respect their intelligence and desire to be well-educated on how to best address their aesthetic concerns. I believe it is reflected in our consultation. It is important to meet patients where they are. It is in placing myself in the shoes of patients that I truly understand how to alleviate their concerns and answer their questions. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### How I Work with Dermatologists to Repair Skin Cancer Defects URL: https://www.harmonface.com/blog/how-i-work-with-dermatologists-to-repair-skin-cancer-defects Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck It is a privilege to team up with dermatologists to assist in the treatment of skin cancer. As a facial plastic and reconstructive surgeon, I am enlisted to repair particularly sensitive, aesthetically important areas of the face, such as the nose. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. 1. A Patient is Evaluated and Diagnosed with Skin Cancer by a Dermatologist A patient is first evaluated by a dermatologist, who identifies an area of concern and biopsies it. If that biopsy returns as skin cancer, the patient is usually referred to another dermatologist who specializes in a surgery called Mohs. Mohs surgery involves the careful removal of skin cancer, layer-by-layer in all directions, until there is no longer cancer present at the margins of the removed tissue. The area where the skin cancer was removed then needs to be repaired using tissue (e.g., skin, fat, muscle, mucosa) from other areas of the face immediately adjacent to the defect, within the region of the face, or farther away. My services are often enlisted by the dermatologist to perform the repair. 2. The Patient Comes to Me for a Consultation Next, I have an opportunity to meet with the patient in consultation. I perform a detailed history and physical examination. The depth and extent of the defect is not clear prior to Mohs surgery. As a result, we discuss a range of options to treat the predicted defect. We always discuss the possibility that the defect will be deeper and/or wider than anticipated. As a result, it is important to have not only a “Plan A” but also a “Plan B” and “Plan C” for the repair. These plans are discussed with the patient. 3. The Dermatologist and I Coordinate a Date for Surgery My office then coordinates with the dermatologist’s office to determine the most appropriate date for surgery. The patient undergoes Mohs surgery with dermatology in the morning. Our goal is to schedule the repair in the afternoon on the same day as the Mohs surgery. However, the repair can usually be scheduled for the following day if necessary. 4. I Manage the Post-Operative Incision Care I manage the post-operative care of the patient. This includes suture removal and care of the incision(s). Some patients need multiple, staged procedures to complete the repair. The team at Harmon Facial Plastic Surgery work to make the initial and any subsequent procedures as convenient as possible. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### How I Eliminate or Significantly Reduce Pain When Injecting Dermal Filler URL: https://www.harmonface.com/blog/how-i-eliminate-or-significantly-reduce-pain-when-injecting-dermal-filler Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical One of the most common questions I receive when discussing an individual’s desire for hyaluronic acid filler is whether the procedure is painful. That is a very reasonable question. After all, I am using needles and micro-cannulas to place this product in specific areas of the face. These areas can be sensitive. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Topical Anesthesia is Not Sufficiently Effective Many injectors utilize a suite of topical approaches to anesthesia, including topical creams or gels and vibratory devices. I have found that these approaches are helpful but inadequate to making placement of filler a comfortable experience. Regional Blocks Transform the Experience In addition to the above topical techniques, I take advantage of predictable facial anatomy to selectively anesthetize nerves that supply sensation to specific regions of the face. I use a tiny amount of local anesthesia injected within the vicinity of these nerves to generate broad numbness in the treatment area for the duration I need to place the filler. Performing these regional blocks also prevents the distortion of the treatment area with local anesthesia, which would make it difficult to achieve good aesthetic results. For example, I perform regional anesthesia prior to placement of hyaluronic acid filler in the lips. The lips are a very sensitive area of the body. However, injection of filler here need not be painful. There are two (2) pairs of nerves that supply most sensation to the lips. The first, the infra-orbital nerves, exit from the cheeks to the side of the nose and supply sensation to the upper lip. The second, the mental nerves, exit the jaw above and on either side of the chin and supply the sensation to the lower lip. Careful placement of local anesthesia to these locations can anesthetize the upper and lower lip in the areas where hyaluronic acid filler needs to be placed. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### How Having Children Changed the Way I Practice Medicine URL: https://www.harmonface.com/blog/how-having-children-changed-the-way-i-practice-medicine Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information My wife, Fara, and I are building a facial plastic surgery practice in Cincinnati , Ohio that our children will be proud of as they grow and mature. Our children are the most profound, beautiful gift we have ever been given. And whether our son and daughter choose to enter the field of medicine, Fara and I hope that our example will lead them to a life focused on the care of others. Their existence is the embodiment of our practice’s values. We at Harmon Facial Plastic Surgery care for our patients as we care for our children. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. We Handed Over the Care of Our Son for Surgery Our son had long had difficulty breathing through his nose at night. This difficulty worsened significantly when he had an upper respiratory tract infection. I had seen these symptoms countless times as a head and neck surgeon. I knew his adenoids – tonsils located in the back of the nose – were enlarged. Enlarged adenoids can cause nasal obstruction that worsens when children are sick as they swell. X-rays confirmed my suspicion. Fortunately, I trained at Cincinnati Children's Hospital (CCHMC) and, as a result, know the staff well. One of my close friends and former co-residents is a pediatric head and neck surgeon at CCHMC and would be doing the surgery. Our son refers to him as “Doctor Doug.” He is a wonderful person and a wonderful surgeon. Our son could not have been in better hands. I have witnessed children falling asleep in the induction room hundreds of times as a resident. The induction room is adjacent to the operating room. It allows parents to be present until their child is asleep in some but not all cases. Similarly, I have performed an adenoidectomy hundreds of times. And while this experience prepared me for how to behave after our son fell asleep – hand him over to the care of the anesthesiologist quickly so a breathing tube can be placed – I was not prepared for how I would feel when I left the induction room. I was also not prepared for how I would feel witnessing the fear in my wife’s eyes upon leaving the induction room. We had truly given up control over the health and safety of our child for the first time since his birth. I was not worried about our son receiving anesthesia medications, nor was I worried about the surgery, which is extremely low risk. My only concern was whether there would be surprise difficulty placing a breathing tube. This concern dates to my years responding to airway emergencies at CCHMC and the University of Cincinnati Medical Center where I was the airway specialist expected to place a breathing tube when the anesthesiologists were unable to. It is very difficult to give that responsibility up because I know my capabilities in this regard. It was especially difficult when it was our son. It is in giving up control over the medical outcome of our own child to another provider that I understood how it feels for loved ones of patients to give that up to me as a facial plastic surgeon. The anesthesiologist had no difficulties placing a breathing tube. Surgery lasted minutes. Our son recovered comfortably at home. He is now breathing through his nose well. Surgery was the best decision we could have made for him. I Understand How Significant the Decision to Undergo Surgery is The essential core of any successful aesthetic facial plastic surgery practice is excellence in patient care. I care for my patients as my family. However, I did not truly understand what that meant until I had children and then entrusted the care of one my children to another surgeon. I understand not only how patients themselves feel when they submit their care to me but also how it feels as a loved one handing that care over. I always practice with that in mind. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Guide to Botox® URL: https://www.harmonface.com/blog/guide-to-botox Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical This blog post is adapted from a presentation we have given for interested groups who wanted more information about the use of Botox® in Cincinnati . We at Harmon Facial Plastic Surgery recognize the intelligence and sophistication of our clients. They want to understand the treatments they receive at a deeper level. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. A Brief History of Botox® Research on the use of botulinum toxin (e.g. Botox®) for therapeutic purposes began in the 1960s for patients with strabismus, or “cross eyes.” It was first FDA-approved for therapeutic use on strabismus in 1989. It was not until 2002 – thirteen years later - that the FDA approved Botox® for cosmetic use. It was first approved for cosmetic use between the eyebrows, also known as the glabella or “eleven lines.” Botox® was then approved for additional areas (underarms, crow’s feet, and forehead) over the next 15 years. Other botulinum toxin products (Xeomin©, Dysport©, Jeuveau©) gained approval for cosmetic use in that period as well. How Botox® Works Botox® is delivered at much lower doses for therapeutic and cosmetic purposes than exists naturally. However, its mechanism-of-action is the same. It works at the junction between the muscle and nerve that signals the muscle to contract. Botulinum toxin binds to a terminal at the end of the nerve and prevents the release of molecules that would otherwise signal the muscle to contract. Its effects wear off as the body gradually breaks down and replaces these proteins. The treatment is effective for dynamic rhytids, or coarse wrinkles that develop when we move our faces. When evaluating the effectiveness of any treatment it is best to find the highest quality studies, which are generally randomized controlled trials (RCTs). Even better are studies that combined the data from multiple RCTs. The Cochrane Library is the gold-standard source of medical research. However, it is not always possible to find research on any subject you desire in this database because of the immense work involved studying each question. Fortunately, The Cochrane Library has published on the effectiveness of botulinum toxin in a paper entitled “Botulinum Toxin Type A for Facial Wrinkles.” They evaluated 65 RCTs that included a total of 14,919 patients. Injection of botulinum toxin in the glabella was compared with placebo. Results ranged from 4 weeks to 2 years after treatment. They concluded that botulinum toxin is likely effective at week 4 after treatment, which is an important finding. Its effectiveness is reflected in its ubiquity. Botulinum toxin was the most popular non-surgical cosmetic procedure worldwide in 2020 according to statistics compiled by the International Society of Aesthetic Plastic Surgery (ISAPS) , with approximately 6.2 million injections performed. The most common age range to receive injections was 35 – 50 years. Common Questions About Botox® A common question is whether Botox® administration is painful. A 31-gauge insulin needle is used, the smallest needle size available in clinic. As a result, treatment is generally associated with little-to-no pain. Another common question is whether Botox® administration is safe. The answer is yes in a significant majority of cases. Its approval by the FDA is an endorsement of its overall safety profile. The best way to evaluate the safety of Botox® treatment is to review both the highest quality data (i.e. RCTs) but also the Adverse Event (AE) reporting to the FDA that occurs whenever a medication is approved for use by the FDA. A 2005 study of FDA-reported AEs associated with botulinum toxin type A used for both therapeutic and cosmetic purposes demonstrated the vast majority of reported AEs at the time were labelled “non-serious,” with 63% of those AEs being a “lack of effect,” 19% involving an injection site reaction (e.g. pain, bruising, swelling, allergic reaction), and 11% involving eyelid ptosis, or a drooping eyelid, which is a temporary possible risk that can be decreased with appropriate technique. A significantly smaller percentage of AEs were labelled as “serious,” the most common of which was swallowing difficulties. It is important to note, however, that reported AEs included injection of botulinum toxin for neck banding, which is in an area very close to muscles that contribute to swallowing. That could explain the above reporting. Moreover, a large majority of AEs reported with botulinum toxin administration were for therapeutic use (e.g. strabismus), not cosmetic use. It is suspected that serious AEs are likely related to both the amount used and the location it is used. Therapeutic uses involve much higher doses than cosmetic uses and are placed in areas with a higher risk of functional problems. Assessing individuals for possible contraindications and appropriate counseling and informed consent is essential. It is very important to evaluate patients who may not be good candidates for the medication. One example is patients with a history of neuromuscular disorders, including Myasthenia Gravis (MG) and Lambert-Eaton Syndrome (LES). Pregnant and/or nursing mothers should not receive it. Patients actively taking aminoglycoside antibiotics or streptomycin should not receive it because the antibiotics could potentiate the effects of the medication. Dr. Harmon has a detailed discussion of the potential benefits and risks of injecting Botox® with every client who is interested in treatment. As a fellowship-trained facial plastic surgeon, he has the detailed understanding of facial anatomy necessary to provide these treatments safely and effectively. Botox® As Part of Long-Term Care of the Face A consistent regimen of Botox® or other neuromodulator treatment places patients in the office with Dr. Harmon 3 – 4 times each year. This often is more consistent, close follow-up for cosmetic concerns than for medical problems/concerns with a primary care provider. These repeated visits allow Dr. Harmon to lead monitoring of age-related cosmetic changes. This professional relationship may prove invaluable when the time comes to deciding whether other treatments, especially facial plastic surgery, could be beneficial. Dr. Harmon has noticed that, often, when the primary contact patients have is with a non-surgeon, they may be recommended other non-surgical procedures that cost a great deal, have little benefit when compared with surgery, and result in changes that may make surgery more difficult . Therefore, long-term maintenance using Botox® under the care of Dr. Harmon may reduce the risk of expensive, ineffectual care. Dr. Jeffrey Harmon’s Botox® Administration Technique and Philosophy Reflect His Expertise and Experience with Facial Anatomy Dr. Harmon is a double board certified (American Board of Facial Plastic and Reconstructive Surgery, American Board of Otolaryngology – Head and Neck Surgery), fellowship trained (American Academy of Facial Plastic and Reconstructive Surgery) facial plastic surgeon. He sits down with each patient in consultation prior to their first treatment with Botox® to review their medical history, discuss their aesthetic goals, and conduct a physical exam to confirm that treatment with Botox® could be effective. He treats sites in a manner that maximizes safety and effectiveness. First, he discusses any previous treatment with neuromodulators to determine what patients did and did not like about their previous treatments. Second, he compares this information with his findings on physical exam. The ultimate neuromodulator dosing used depends on: Previous dosing requirements The total area involved with dynamic wrinkling The severity of dynamic wrinkling in the area(s) being treated Dr. Harmon then sees all first-time patients approximately two (2) weeks after their treatment, when Botox® is expected to reach maximal effectiveness. This allows him to evaluate the overall effectiveness of treatment and add more, if needed. Then, Dr. Harmon has a good idea of the “ideal” dosing for that individual patient. He follows specific treatment protocols that minimize the risk of Botox® diffusing from the treatment site to cause a drooping eyebrow and/or eyelid. These protocols also allow sufficient persistent movement in select areas to minimize the risk of the face looking “frozen” after treatment. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References Brin MF, Boodhoo TI, Pogoda JM, James LM, Demos G, Terashima Y, Gu J, Eadie N, Bowen BL. Safety and tolerability of onabotulinumtoxinA in the treatment of facial lines: a meta-analysis of individual patient data from global clinical registration studies in 1678 participants. J Am Acad Dermatol. 2009 Dec;61(6):961-70.e1-11. Camargo CP, Xia J, Costa CS, Gemperli R, Tatini MD, Bulsara MK, Riera R. Botulinum toxin type A for facial wrinkles. Cochrane Database Syst Rev. 2021 Jul 5;7(7):CD011301. Cohen JL, Scuderi N. Safety and Patient Satisfaction of AbobotulinumtoxinA for Aesthetic Use: A Systematic Review. Aesthet Surg J. 2017 May 1;37(suppl_1):S32-S44. Coté TR, Mohan AK, Polder JA, Walton MK, Braun MM. Botulinum toxin type A injections: adverse events reported to the US Food and Drug Administration in therapeutic and cosmetic cases. J Am Acad Dermatol. 2005 Sep;53(3):407-15. Guo Y, Lu Y, Liu T, Zhou Y, Yang P, Zhu J, Chen L, Yang Q. Efficacy and Safety of Botulinum Toxin Type A in the Treatment of Glabellar Lines: A Meta-Analysis of Randomized, Placebo-Controlled, Double-Blind Trials. Plast Reconstr Surg. 2015 Sep;136(3):310e-318e. Jia Z, Lu H, Yang X, Jin X, Wu R, Zhao J, Chen L, Qi Z. Adverse Events of Botulinum Toxin Type A in Facial Rejuvenation: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg. 2016 Oct;40(5):769-77. Sundaram H, Signorini M, Liew S, Trindade de Almeida AR, Wu Y, Vieira Braz A, Fagien S, Goodman GJ, Monheit G, Raspaldo H; Global Aesthetics Consensus Group. Global Aesthetics Consensus: Botulinum Toxin Type A--Evidence-Based Review, Emerging Concepts, and Consensus Recommendations for Aesthetic Use, Including Updates on Complications. Plast Reconstr Surg. 2016 Mar;137(3):518e-529e. --- ### How Could Non-Surgical Procedures Affect My Future Facelift and Neck Lift Surgery? URL: https://www.harmonface.com/blog/how-could-non-surgical-procedures-affect-my-future-facelift-and-neck-lift-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical While often beneficial for their indicated use(s), non-surgical procedures, including injectables and energy-based devices (e.g., radiofrequency, ultrasound), can alter the tissue in the areas treated by facelift and neck lift surgery. These treatments do not typically preclude surgical treatment of the face and neck. However, they can affect the healing process post-operatively. They also alter the calculus of what facelift and neck lift approach would likely be the safest and most effective. This is why an in-person consultation with a qualified surgeon who has experience operating on patients who have undergone these non-surgical procedures is essential prior to considering any facial plastic surgery procedure. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Hyaluronic Acid Filler Does Not Significantly Distort Anatomy It is not uncommon to encounter hyaluronic acid filler in the jawline, cheeks, and/or tear troughs when performing extended deep plane facelift surgery. It is understandable that many choose to pursue non-surgical treatments for age-related changes prior to considering surgery. Our experience has been that hyaluronic acid fillers do not significantly distort the anatomy because they appear distinct from normal tissue. In fact, hyaluronic acid filler appears similar in our tissue as it does in the vial. It can also be removed intra-operatively as is often desired by patients. Poly L-lactic Acid Significantly Hardens the Subcutaneous Layer Poly l-lactic acid, also known as Sculptra©, is a filler that is intended to add volume to the face long-term through the production of new collagen in the areas injected. Our experience operating on patients who have received poly l-lactic acid injections is that the tissue planes, while intact and distinguishable, are often much “harder,” like scar tissue. Energy Based Devices Also Harden the Subcutaneous Layer Energy-based devices utilizing energy sources such as radiofrequency, ultrasound, and plasma can alter the anatomy of the face and neck in a manner like poly l-lactic acid. This is because the purported creation of new collagen with these devices caused by the heat they generate is often similar to scar tissue. Moreover, these devices do not lift the volume of the face and neck like facelift and neck lift surgery do. Fat Grafting Can Significantly Distort Anatomy Fat grafting – a surgical procedure – can significantly distort surgical anatomy. It is important to note that fat grafting , when appropriate, can be an effective procedure for those with significant volume loss in their face. For example, many individuals experience a significant loss of fat in their temples and could benefit greatly from fat grafting. Fat does, however, embed in the tissue such that it is more difficult to distinguish between the various tissue layers of the face. Deep Plane Facelift Surgery is Likely the Most Effective Approach After the Above Procedures Like revision/secondary facelift surgery , we at Harmon Facial Plastic Surgery feel deep plane facelift surgery is the best approach for patients who have undergone any of the above procedures. This is because the blood supply to the skin is better preserved when compared with other approaches, thereby improving healing. Also, deep plane surgery often bypasses the areas treated with the above procedures, allowing for a more effective lift. Dr. Harmon is one of the few surgeons in the world, and the only surgeon in the Cincinnati area , fellowship trained by Dr. Andrew Jacono, the surgeon who developed the extended deep plane facelift. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### How Cellphone Cameras Distort Facial Features URL: https://www.harmonface.com/blog/how-cellphone-cameras-distort-facial-features Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Many people are bothered by their appearance when looking at selfie photos taken on their cellular phone cameras. Unlike professional cameras, the cameras built into cellular phones distort the actual appearance of the face in predictable ways. The above photo is a selfie taken of me and my wife Fara at Van Gogh Exhibition: The Immersive Experience . It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Most Cellular Phone Cameras Have Wide-Angle Lenses to Capture Distant Landscapes The distortion associated with the use of cellular phone cameras is worse the closer the camera is to the focus. That is why selfies tend to be so distorting, especially of the center of the face. This includes the forehead , eyes , and nose . That is why it is common for individuals to be more bothered by the appearance of their nose in selfies as opposed to when looking in the mirror, though appropriate concerns about the appearance of their nose likely persist when looking in the mirror. The Photos Taken in Clinic Involve a Lens That Better Approximates Human Vision The cameras used to take pre-operative and post-operative photos are Digital Single-Lens Reflex (DSLR) cameras that allow lens attachments with different focal lengths. The 50mm focal length lens more closely approximates human vision. As a result, images of facial features better approximate reality. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### How are Hair Follicles Kept Alive Prior to Transplantation? URL: https://www.harmonface.com/blog/how-are-hair-follicles-kept-alive-prior-to-transplantation Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Hair Follicular units, which are composed of one or more hair follicles (usually up to four) and important support structures for the hair generating follicles, are removed from a donor site in the back of the scalp and transferred to areas of hair loss during hair restoration surgery . One important factor, among many, to a successful hair restoration surgery procedure is the survival of these grafts between their removal from the donor site and implantation in the recipient site. As a result, extensive research has been conducted to determine the ideal solution to maintain these follicular unit grafts. However, there is no perfect graft solution. We at Harmon Facial Plastic Surgery feel our graft solution provides the best support to the follicular units prior to their transplantation based on the best-available scientific evidence. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Grafts are Stored in a Specialized, Chilled Solution Solutions surrounding cells can contain a concentration of electrolytes lower, the same as, or higher than the internal composition of the cells themselves. This affects the shift of fluid between the outside to inside the cells. Solutions such as saline and Plasmalyte are often used to preserve hair follicles. We at Harmon Facial Plastic Surgery use chilled Hypothermosol . Hypothermosol models the interior of the cells in hair follicles. This allows hair follicles to survive for hours off the scalp. Chilled solutions are especially important in reducing the oxygen demand of the follicular units and, therefore, the energy requirements of the grafts when they are outside of the body. This solution is more expensive than the alternatives. We feel our patients deserve this. ATP is Energy Added to the Solution The addition of energy in the form of the molecule ATP can extend the survival of grafts in the chilled Hypothermosol solution from hours to days based on research. Again, this is an added expense. However, it is worth it to provide the best result possible for our patients. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### How Are Drains Cared for After Extended Deep Plane Facelift and Neck Lift Surgery? URL: https://www.harmonface.com/blog/how-are-drains-cared-for-after-extended-deep-plane-facelift-and-neck-lift-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Small drains are an important component of the post-operative recovery after an extended deep plane facelift and neck lift at Harmon Facial Plastic Surgery in Cincinnati. While they are usually in place only for one day, the care of these drains is essential while they remain in place. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Drains are an Essential Component of the Post-Operative Recovery Small drains extending from the side of the neck to the central neck are placed on both sides of the face during extended deep plane facelift and neck lift surgery. These drains exit above the incision behind the ears and within the hair. Bulbs are placed on the end of the drains to place the drains on suction. Drains are an essential component of the post-operative care after extended deep plane facelift and neck lift surgery because they can reduce bruising and swelling and reduce the risk of the accumulation of blood or other body fluid under the tissue of the face and neck. It takes time for everything that was lifted to heal back down. The placement of drains can accelerate this process. Drains Usually Remain in Place for Only One Day The drains are secured to a loose-fitting dressing around the head and neck. Patients are evaluated the morning after surgery. The drain output is measured. The drains are generally removed the morning after surgery if the output remains within an appropriate range of volume. There are narrow exceptions, however. Drains are Observed and Emptied Prior to Their Removal Drains are observed for their output by the patient’s caregiver after surgery. The bulbs to which the drains are attached have a side port that allows the bulbs’ contents to be emptied as needed. This process is simple and helpful to ensure healing progresses as expected. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### History of Brow Aesthetics and Lateral Temporal Brow Lift URL: https://www.harmonface.com/blog/history-of-brow-aesthetics-and-lateral-temporal-brow-lift Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Eyes More advanced surgical techniques for addressing a drooping brow have been developed as our understanding of facial anatomy has advanced. This is in line with an evolving preference for more natural, subtle results for a brow lift. People with concerns about drooping eyebrows often benefit from a lateral temporal brow lift. Women tend to have a more “peaked” eyebrow than men. However, as aesthetic preferences have changed this peak has become less dramatic, reflecting a more sophisticated desire for a natural look to their eyebrows. That is where the lateral temporal brow lift comes in. The lateral temporal brow lift is the most advanced surgical technique to provide a long-lasting, natural, improvement in drooping eyebrows while preventing the development of an unnaturally “surprised” appearance. It is the best approach for most patients, who are usually bothered by drooping of the sides of the eyebrows. Like the extended deep plane facelift, the lateral temporal lift involves the release of all the tension points around the eyebrow so that it can be lifted precisely and without tension, thereby improving results, healing, and longevity of the procedure. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Harmon Facial Plastic Surgery Offers Virtual Consultations URL: https://www.harmonface.com/blog/harmon-facial-plastic-surgery-offers-virtual-consultations Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Some individuals desire virtual consultations due to distance from the office of Harmon Facial Plastic Surgery in Cincinnati. Other individuals desire virtual consultations prior to considering an in-person consultation. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. HIPAA-Compliant Video Consultations are Available Dr. Harmon uses the HIPAA-compliant videoconferencing software from Doximity© to host virtual consultations for patients who live far from the office or who desire the consultation format. Final decisions regarding surgical planning cannot be made, however, until an in-person consultation is had. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Hair Loss Treatments: An Explainer URL: https://www.harmonface.com/blog/hair-loss-treatments-an-explainer Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Hair Hair loss treatments can address specific concerns about the appearance of the hair on your scalp due to a condition called androgenic alopecia. There are three general categories of hair loss treatments for androgenic alopecia, each of which may or may not benefit you. It is important to first undergo an evaluation by a dermatologist to determine whether there are alternative causes to your hair loss, such as thyroid problems, vitamin deficiencies, infections, auto-immune conditions, or psychiatric illnesses. Seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether – and which – hair loss treatment is appropriate for your concerns once alternative causes have been ruled out. Medications are Often the First Treatments Used for Hair Loss Medical treatment is often the first treatment tried for hair loss and is an important adjunct to surgical and non-surgical procedures. The two most frequently administered medications for hair loss are finasteride and minoxidil. Finasteride, which is available in oral and topical form, is generally prescribed to men only. Finasteride is an FDA-approved medication and an anti-androgen, meaning, it blocks the action of an enzyme called 5-alpha-reductase, which normally converts testosterone to other hormones that can cause hair loss. Finasteride is commonly prescribed for prostate enlargement. However, a much lower dose can be prescribed for hair loss. The topical form is less widely used but is sometimes combined with topical minoxidil. Minoxidil in topical form is an FDA-approved treatment for hair loss. Unlike finasteride, it is commonly prescribed to women and men. There are multiple potential mechanisms for the function of minoxidil in treating hair loss. It is important to note that, while finasteride and minoxidil can be effective treatments for hair loss, their effects last only if they are taken continuously. Hair is often lost again when these medications are discontinued. There are also many treatments being marked for hair loss that are not FDA-approved. Most are regulated as nutritional supplements, which have significantly lower standards for effectiveness, safety, and consistency in formulation. For example, saw palmetto is a common ingredient in these products for men due to the limited evidence that it may function similarly to finasteride. As with any medication, it is important to have a detailed discussion with your provider about the potential benefits, risks, and alternatives to the use of the medications and nutritional supplements above. Non-Surgical Procedures for Hair Loss Can be Useful Adjunctive Treatments One of the most popular and well-known non-surgical treatments for hair loss is platelet-rich-plasma (PRP) . PRP, which is isolated from the patient’s own blood drawn the day of the treatment, is a concentration of platelets whose effects are “activated” when injected around the hair follicles in the patient’s scalp. Platelets release multiple signaling molecules that can help dormant hair start growing again. There is also evidence that PRP can improve the thickness of hair in some cases. Both men and women receive this treatment. It is typically administered once monthly for three sessions followed by a fourth session approximately six to eight months after the first. Treatments can be repeated every six to twelve months. Like hair restoration surgery, it typically takes a few months to notices the effects of this treatment. This treatment can be performed while taking medications and/or with hair restoration surgery to enhance the effects of treatment. PRP may benefit younger individuals who have less hair loss (e.g., mild-to-moderate) and/or who are not ready for hair restoration surgery. Other injectable treatment options include products such as exosomes. Exosomes are membrane-bound structures that carry different materials, including proteins and mRNA. There have been some promising studies performed in cultures in a lab, but no good human studies performed to demonstrate the effectiveness of exosomes in the treatment of hair loss. Another non-surgical treatment option is low-level light therapy. This involves the placement of a device over the scalp that emits red or near-infrared light. It requires multiple treatment sessions. It can also function as an adjunct to other treatments (e.g., PRP, hair restoration surgery, medications). The mechanism by which it can help treat hair loss is unclear and the evidence for its effectiveness is incomplete. However, like exosomes, it does show promise. Surgical Procedures for Hair Loss are the Most Definitive Treatment for Hair Loss Hair restoration surgery has advanced far beyond the unsightly – and obviously unnatural – “plugs” many people still associate with it. This is because techniques, technology, and our understanding of anatomy have improved greatly over the past twenty to twenty-five years. We have learned how to safely and effectively isolate miniscule groupings of hair follicles, called follicular units, and transplant them to other areas of the scalp to provide natural results for patients. Much of the marketing behind hair restoration surgery is based on the device offered to perform this procedure. However, that is not the best way to explain hair restoration surgery to patients. There are effectively two methods of surgical hair restoration surgery. Both operate on the understanding that hair follicles respond differently to their chemical environment on different areas of the scalp. There are some areas of the scalp where even individuals losing their hair tend to keep it, specifically over the ears extending to the back of the lower area of the head and nape. These hair follicles tend not to go dormant and disappear with the hormone-related changes that lead to androgenic alopecia. It is these hair follicles that are isolated and transplanted to areas of the scalp where hair is lost. One approach to hair restoration surgery is follicular strip harvesting and transplantation, also called FUT. This procedure involves the removal of a thin strip of skin from the back of the head with the hair follicles intact followed by careful closure of this site so the surrounding hair can grow over the incision as it heals. This is usually the best initial approach – though there are always exceptions – to hair restoration surgery, because it can provide the largest concentration of follicles from the smallest harvested area. The follicles also tend to be healthier, less traumatized and, therefore, more likely to survive and grow. The other approach is typically associated with the frequently marketed devices. Called Follicular Unit Extraction, or FUE, it differs from FUT in that a drilling device is used to isolate and extract individual follicular units rather than a strip with many follicular units. The harvested sites need to be spread evenly and randomly throughout a predefined area of the scalp. There are many different devices and many different drill shapes and sizes available for this procedure. FUE can be a good initial option if a patient wears their hair very short. Otherwise, it usually serves as an adjunct to FUT. For example, FUE can be used to harvest additional follicular units as needed if the FUT procedure falls short of the goal number of hair follicles. FUE can also be used for follow-up procedures when fewer follicular units are required. It is important to note that the density of hair follicles available for an FUT procedure drops dramatically when the strip is harvested in areas where FUE has been performed. That it is why FUT is usually the best first option. A commonly held concern among patients is the appearance of the hair follicle harvest site after surgery. There is a misconception that FUT can result in abnormal scarring and FUE cannot. FUT harvest sites are closed in multiple layers to minimize tension on the site. Hair is left in place around the surgical site to grow over it. As a result, few patients have noticeable scars after surgery. FUE results in small, pinpoint incisions that, if distributed properly, are generally minimally visible as well. The procedure does not end with the harvest of hair follicles. The surgeon then determines the location, angle, and pitch the hair follicles will be placed on the scalp by creating “wells” in which the follicular units can be placed. A team of technicians isolates the follicular units and places them in these wells. This team is essential to the success of any hair restoration surgical procedure. The design of the hairline and the appropriate distribution and position of each follicular unit requires intense concentration, skill, and an artistic eye. Medications such as topical minoxidil and non-surgical procedures including PRP and low-level light therapy are often incorporated into the procedure as adjunct treatments. Like PRP, it takes months before these transplanted follicular units start growing hair. In fact, it usually takes one year before the final results are evident. More than one session is often required to achieve ideal results. In fact, the International Society for Hair Restoration Surgery (ISHRS) surveys their members each year to learn more about hair restoration practice patterns. The 2021 statistics cited the average number of hair restoration surgery sessions required to achieve the ideal result was 1.4. A second session is more likely required when there is little-to-no hair in the area of the scalp transplanted, as demonstrated by the image of the patient below. The patient below is six months out from FUT hair restoration surgery. He is expected to experience additional improvements in the appearance of his hair for at least six more months. A second FUT procedure was planned prior to his first surgery for one year after his first. The goal of his first FUT procedure was to establish his hairline as well as establish density at the center of his scalp. The goal of the second FUT procedure is to increase the density of his hair in the area that was previously transplanted and to build out hair in his temples. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about hair loss. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Four Strategies to Reduce Swelling after Deep Plane Facelift Surgery URL: https://www.harmonface.com/blog/four-strategies-to-reduce-swelling-after-deep-plane-facelift-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Swelling is normal and expected after any facelift surgery, including the extended deep plane facelift. It gradually resolves without intervention in almost all cases ( see the extended deep plane facelift page for the average expected recovery time ). Swelling is largely due initially to the normal healing (i.e., acute inflammatory) response after surgery followed by the fact that the lymphatic drainage system – the system that carries the body’s natural fluid through the body and back to the heart – requires time to heal as well. However, there are multiple strategies available to patients to accelerate the resolution of swelling after surgery. Please note that the below strategies may not be appropriate for every patient. There are potential benefits, potential risks, and alternatives to all of the treatments below, including simply the passage of time. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Speak to your surgeon about their preferred strategies to reduce swelling after facelift surgery. 1. Head Elevation I have my patients keep their head elevated while sleeping for two weeks after surgery, either by sleeping on a recliner or on two pillows in their bed. This allows the body’s lymphatic fluid to move away from the face more efficiently due to the added effects of gravity. 2. Oral Steroids A short course of low-dose steroids taken by mouth after surgery can reduce the swelling that naturally increases approximately day two after surgery and typically peaks at approximately one week to ten days after surgery. Oral steroids, while not necessary for healing, reduce the acute inflammatory response that occurs during the first few days after surgery. 3. Steroid Injections Low dose, low concentration steroids can sometimes be injected in the deep tissue in areas starting multiple weeks after surgery to accelerate the resolution of small areas of significant, persistent swelling. It usually takes approximately two weeks for these injections to be effective. Patients are counseled that among the potential risks of steroid injections there is a low risk of soft tissue atrophy, changes in the pigmentation of the skin, and the development of small blood vessels, called telangiectasias, on the skin after steroid injection. 4. Lymphatic Massage Lymphatic massage can usually be started approximately four to six weeks after surgery. Lymphatic massage can assist with the clearance of fluid from the face while the lymphatic system heals. However, it should be performed by an individual who is well-trained and specializes in the appropriate technique. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Fat Grafting Versus a Cheek (Midface) Lift: Which Procedure is the Most Appropriate for Me? URL: https://www.harmonface.com/blog/fat-grafting-versus-a-cheek-midface-lift-which-procedure-is-the-most-appropriate-for-me Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck Fat grafting and a cheek lift procedure each address specific concerns about the cheek and the cheek-eyelid interface. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Extended Deep Plane Facelift Can Provide a Cheek Lift The extended deep plane facelift and deep plane facelift are unique among facelift procedures, because these procedures can lift the cheeks up to a more youthful position. The effect of a cheek lift can be an improvement in the folds around the upper lip (melolabial folds) and lower eyelids (tear troughs) and a more heart-shaped appearance to the face. In fact, a cheek lift can enhance the effects of lower eyelid surgery by smoothing the transition from the lower eyelid to the cheeks. Fat Grafting Can be Used Selectively Fat grafting , also called fat volumization or fat augmentation, involves the isolation of fat from other areas of the body that is then injected into different layers of the face to improve the appearance of the melolabial folds and tears troughs and to restore a more heart-shaped appearance to the face. Fat grafting can be an excellent option for patients who have lost volume in their face with age. It can also be a good option in small volumes to enhance the effectiveness of the cheek lift. A Cheek Lift is Superior to Fat Grafting for Most Individuals However, fat grafting the face without performing a midface lift in an individual with adequate facial volume can make the face look overly inflated and unnatural. This is because of the persistent volume in an area of the face that normally has less with age. As a result, adding volume around the drooping cheeks can make the face look unnaturally large. Also, the fat grafted to the face can be unpredictably absorbed. The larger the volume added the higher the risk of lumps and other contour irregularities developing, especially if the fat is placed close to the surface of the skin. Fat placed deeper is much less like to result in such abnormalities. A a detailed history and physical exam should always be performed prior to making the decision as to whether fat grafting or a cheek (midface) lift is most appropriate. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your cheeks. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Exosomes for Hair Loss: Are They Ready for Prime Time? URL: https://www.harmonface.com/blog/exosomes-for-hair-loss-are-they-ready-for-prime-time Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Hair Our understanding of the complex process of hair growth has advanced rapidly. As a result, new possibilities for treating hair loss have been discovered. One such discovery is the exosome. Exosomes have become an exciting area of research for the treatment of androgenic alopecia – also known as male-patterned or female-patterned hair loss – which is the most common form of hair loss in humans. The following blog post is a summary of the current literature on the use of exosomes to encourage hair growth. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. What are Exosomes? Exosomes facilitate communication between cells, even at great distances from each other. It is helpful to think of exosomes like packages delivered between cells. These exosome “packages” have protein markers on their surface that function much like an “address” which ensure the exosome reaches the appropriate cell. Both human and animal cells make exosomes, suggesting their importance in the function of life of all kinds. Exosomes are much smaller than the cells they come from. They contain a combination of proteins and genetic material, the “package contents,” which induce changes in cells they communicate with. Exosomes from many different cell types have been studied for their therapeutic effects in hair growth. The most common, and promising source is derived from dermal papilla cells (DPC). The dermal papilla is one component of a hair follicle, which is a complex organizational body for hair formation. DPCs are a source of stem cells - cells with the potential to turn into many different other cells – for the hair follicle itself. Therefore, it makes sense that exosomes derived from these cells would contain signals, or “package contents,” that could encourage hair growth. Why are People Excited About Exosomes? Hair follicles are constantly cycling between three stages, called anagen, catagen, and telogen. Anagen is the growth phase of a hair follicle and lasts many years. Catagen is the phase in which the hair breaks down. This lasts only a short period of time. The third stage is telogen, which is a resting phase. Telogen lasts an intermediate amount of time. Exosomes are thought to be a potential minimally-invasive treatment option for encouraging the transition of hair follicles to the anagen phase, similar to platelet-rich plasma . What Evidence is There That Exosomes Work? The evidence that exosomes work is largely limited to studies on animals and human cells in the laboratory, otherwise known as pre-clinical studies. More specifically, a review of the available literature on the use of exosomes in hair growth demonstrated 15 of these pre-clinical studies and only 1 clinical study on human subjects ( Gupta AK et al ). Furthermore, a search of “hair loss” and “exosomes” on the website ClincalTrials.gov , a government website listing all registered clinical trials, shows only two, one in Iran and one in Pakistan. Overall, the evidence for the effectiveness of exosomes is encouraging. However, there are many questions that need to be answered and challenges that need to be overcome before they are determined a safe, viable treatment for hair loss. What are the Current Challenges to Making Exosomes a Viable Therapy for Hair Loss? There is no agreed upon ideal cell origin for the exosomes or signals to include in the exosomes. There is no agreed upon ideal method for delivering the medication at an amount and for an amount of time that would be most effective. It is difficult to produce and isolate exosomes at the scale needed for them to be a viable treatment for many. In addition, exosomes must be stored at very low temperatures, which would increase their cost. What Does the Food and Drug Administration (FDA) Have to Say About Exosomes? The FDA considers exosomes to be a biological drug. As a result, exosome therapy is highly regulated. There are currently no FDA-approved treatments for hair loss using exosomes. In fact, the FDA has released warnings about the use of exosomes due to reports of complications from the use of exosomes on patients. It is for the above reasons that we feel exosomes are not yet ready for mass therapeutic use is medical practices. Additional research, including clinical trials, are necessary. Could Exosomes Replace the Need for Hair Restoration Surgery? No, exosome therapy will not replace the need for hair restoration surgery . Exosome therapy does not create new hair follicles in areas where they have been lost. Instead, exosome therapy is hoped to encourage growth of dormant hairs follicles. However, it could support the growth of transplanted hair follicles after surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us References Buontempo MG, Alhanshali L, Ide M, Shapiro J, Lo Sicco K. Examining the Uncertainties Surrounding Exosome Therapy in Androgenetic Alopecia: A Call for Evidence-Based Practice. J Drugs Dermatol. 2024 Mar 1;23(3):e86-e90. Gangadaran P, Rajendran RL, Kwack MH, Jeyaraman M, Hong CM, Sung YK, Ahn BC. Application of Cell-Derived Extracellular Vesicles and Engineered Nanovesicles for Hair Growth: From Mechanisms to Therapeutics. Front Cell Dev Biol. 2022 Jul 14;10:963278. Gupta AK, Wang T, Rapaport JA. Systematic review of exosome treatment in hair restoration: Preliminary evidence, safety, and future directions. J Cosmet Dermatol. 2023 Sep;22(9):2424-2433. Hartman N, Loyal J, Fabi S. Update on Exosomes in Aesthetics. Dermatol Surg. 2022 Aug 1;48(8):862-865. Kost Y, Muskat A, Mhaimeed N, Nazarian RS, Kobets K. Exosome therapy in hair regeneration: A literature review of the evidence, challenges, and future opportunities. J Cosmet Dermatol. 2022 Aug;21(8):3226-3231. Xiong M, Zhang Q, Hu W, Zhao C, Lv W, Yi Y, Wang Y, Tang H, Wu M, Wu Y. The novel mechanisms and applications of exosomes in dermatology and cutaneous medical aesthetics. Pharmacol Res. 2021 Apr;166:105490. Zhou Y, Seo J, Tu S, Nanmo A, Kageyama T, Fukuda J. Exosomes for hair growth and regeneration. J Biosci Bioeng. 2024 Jan;137(1):1-8. --- ### Dry Skin and Moisturizers: An Explainer URL: https://www.harmonface.com/blog/dry-skin-and-moisturizers-an-explainer Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical It is important to maintain the moisture of your skin , especially during the winter months with its cold, dry air. This blog post does not promote a specific skin product. Instead, it is intended to empower those interested to better understand some of the ingredients in moisturizers. Our hope at Harmon Facial Plastic Surgery is that this will help individuals make better-informed choices. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Symptoms of Dry Skin Symptoms of dry skin include flaking and peeling, a rough texture, thin cracks, itchiness, and a feeling of tightness. Products to Improve Dry Skin Act in Multiple Ways Ingredients in skincare products moisturize the skin in multiple ways: 1. Emollients are occlusive ingredients that keep moisture in the skin that is already present, thereby softening and smoothing the skin. 2. Humectants absorb water. They are often used with emollients to help keep the moisture absorbed on the skin. 3. The skin barrier is composed of lipids that include cholesterol, fatty acids, and ceramides in a specific ratio. Many moisturizer products contain these lipids in some combination. Emollients Keep Water in the Skin Emollients keep water already present in the skin from being lost into the air. As a result, they act as a moisturizer. Emollients also soften and smooth the skin through their effects. Emollients are in almost all moisturizing products. They vary in viscosity (i.e., thickness) and effectiveness. While they are more effective as a moisturizer, thick, greasy emollients are generally not well-tolerated for long-term daily use on the entire face. One of the most used and effective emollients is petrolatum. It is found in products such as Aquaphor©, Vaseline©, ChapStick©, and many others. However, petrolatum is thick (i.e., viscous) and greasy. Products like Aquaphor© and Vaseline© that contain a large amount of petrolatum may be good options to apply to incisions after surgery and during the early stages of healing because moisture encourages healing. Another benefit is that petrolatum is non-allergenic. Another example of an emollient is dimethicone, which is derived from silicon. Dimethicone is found in many moisturizers because it is thinner and, therefore, less likely to feel greasy. Silicon-based emollients like dimethicone are major ingredients in scar gels , which are typically used for months on surgical incisions to improve healing. They are, however, less effective emollients than petrolatum. It is for that reason that petrolatum-containing products are often used early in incision healing and silicon-based scar gels are used later and longer-term. Some plant-based oils, such as olive oil, can also function as emollients. One component of olive oil, squalene, is found in many moisturizers. The hydrogenated version of squalene, called squalane, is more stable than squalene and less comedogenic (less likely to clog pores). Squalane is used instead of olive oil because olive oil contains other compounds, such as oleic acid, that may damage the skin barrier. Humectants Absorb Water Humectants absorb water. Humectants can absorb water from the atmosphere in humid conditions. However, they can also absorb water from the skin in dry atmospheric conditions. That is why humectants are often combined with emollients such as those listed above. Humectants include ingredients such as glycerin and hyaluronic acid. Glycerin is one of the longest used and most effective humectants. It can be found in many moisturizers. It contributes to repair of the skin barrier. It is non-allergenic. Hyaluronic acid is another humectant and, like glycerin is non-allergenic. Hyaluronic acid needs to be small enough to be absorbed by the skin. The problem is that size of the hyaluronic acid compound is generally not specified on packaging . Humectants like hyaluronic acid are often advertised as being able to treat the appearance of wrinkles. The mechanism of action is through the absorption of water, which causes the top layer of skin to swell, thereby temporarily creating the appearance of smoother skin. The Skin Barrier is Composed of Lipids in Specific Ratios According to Dr. Leslie Baumann in the textbook Cosmeceuticals and Cosmetic Ingredients , the skin barrier is composed of lipids which include ceramides, cholesterol, and fatty acids in a specific ratio. Alterations in this ratio can damage the skin barrier. The skin barrier helps prevent water loss. Phytosterols, which are plant-based alternatives to cholesterol, are sometimes included in moisturizers. One fatty acid included in moisturizers is stearic acid, or stearate, which is FDA-approved for use in skincare . It occurs naturally in the human body but can also be found in some plant and animal butters. Its prevalence in butters makes it among the oldest cosmeceutical products currently in use. Ceramides, which historically came from animals followed by plants such as wheat germ, are now created synthetically. Naturally occurring ceramides are readily absorbed by the skin. Synthetic ceramides are less studied. Synthetic ceramides are the more commonly found ceramides in cosmeceutical products. The ingredients list for most moisturizers does not specify the ratio of lipids present in the mixture, which is important to determine how effective it is. Ingredient Labels are Incomplete It is difficult to identify the most appropriate moisturizer. Many products emphasize the ingredients that are the less effective but more distinct. Some plant based ingredients are less effective than synthetically produced ingredients and are more likely to cause an allergic reaction. The size of important compounds is not listed, which is sometimes indicative of the ingredient’s effectiveness (e.g., hyaluronic acid). Finally, the relative ratios of important ingredients (e.g., ceramides, sterols, and fatty acids) are not listed, which can also be indicative of the overall effectiveness of the moisturizer. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us Reference Baumann L. Cosmeceuticals and Cosmetic Ingredients . McGraw-Hill Education; 2015. --- ### Dr. Jeffrey Harmon Named a Top Doctor 2024 by Cincinnati Magazine URL: https://www.harmonface.com/blog/dr-jeffrey-harmon-named-a-top-doctor-2024-by-cincinnati-magazine Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Dr. Jeffrey Harmon is honored to have been added to the list of top doctors in Cincinnati Magazine for 2024 . It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Dr. Jeffrey Harmon was honored to be named a top doctor by Cincinnati Magazine in 2024. The Top Doctors list is the result of voting by physician peers who indicate those who they feel should be acknowledged in their respective field of medicine. In this case, Dr. Harmon was acknowledged in the field of Plastic and Reconstructive Surgery. More specifically, Dr. Harmon is an American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) fellowship-trained facial plastic surgeon focused solely on the surgical and non-surgical care of the hair, face, and neck. The AAFPRS, the pre-eminent body for the training of facial plastic surgeons, believes you should “Trust Your Face to a Facial Plastic Surgeon.” We agree! We believe this honor reflects our focus on providing the most advanced techniques in facial plastic surgery in a warm, caring environment. Our moto at Harmon Facial Plastic Surgery is to Feel Good About Feeling Good™ . We sincerely hope you do, in every facet of your lives. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### Double/Dual Board-Certified Facial Plastic Surgeon: What Does it Mean? Why is it Important? URL: https://www.harmonface.com/blog/doubledual-board-certified-facial-plastic-surgeon-what-does-it-mean-why-is-it-important Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information There are a few routes available to be considered qualified to perform plastic surgery on the face and neck. There is one path, however, to become a surgeon focused exclusively on plastic surgery of the face and neck. This path is long and arduous, usually requiring not only extensive training as a head and neck surgical resident but also specialized fellowship training in facial plastic and reconstructive surgery. This training is followed by rigorous testing, first to become board certified in Otolaryngology – Head and Neck Surgery and, approximately two to three years later, board certified in Facial Plastic and Reconstructive Surgery. This blog post seeks to explain this path in greater detail to explain why it is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Journey to Become a Facial Plastic Surgeon Starts in Residency Earning a five-year residency position in Otolaryngology – Head and Neck Surgery, also known as Ear, Nose, and Throat (ENT) surgery, is among the most difficult in medicine. It is a highly competitive subspecialty that includes most surgery of the head and neck. For example, otolaryngologists are trained extensively in facial plastic surgery, both reconstructive and cosmetic, sinus surgery, surgery of the airway and voice box, cancer removal, and ear surgery. Otolaryngologists work closely with neurosurgeons and orthopedic surgeons who perform procedures on the brain, spine, and large blood vessels of the head and neck. The basis for an otolaryngologist’s expertise in facial plastic surgery is not only the training received specifically in facial plastic surgery but in the experience gained operating on the complex anatomy of the head and neck generally. Residency training is through the American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) , the preeminent body for training head and neck surgeons. Most Facial Plastic Surgeons Pursue Additional Fellowship Training After Residency Most facial plastic surgeons pursue an additional one to two years of subspecialized training in facial plastic surgery after completing a residency in otolaryngology. This allows a physician to gain additional experience and knowledge in the surgical and non-surgical care of the face, neck, and hair. In fact, fellowship training is usually the time in which a physician undergoes the most intensive training is cosmetic surgery. Fellowship training is through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) , the preeminent body for training facial plastic surgeons. Double/Dual Board Certification in Facial Plastic Surgery Requires Years of Testing and Experience A facial plastic surgeon first becomes board certified by the American Board of Otolaryngology – Head and Neck Surgery (ABO-HNS) after completing intense oral and written exams following residency. We then undergo additional testing – both oral and written exams – after fellowship training through the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) . A facial plastic surgeon becomes board certified by the ABFPRS only after passing these exams and accumulating sufficient experience over multiple years that the board deems sufficient to bestow certification. Trust Your Face to a Double Board-Certified Facial Plastic Surgeon It is important to seek a fellowship-trained, double board-certified specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### Doctoring as Soul Craft: The Value of Perfecting a Physical Trade URL: https://www.harmonface.com/blog/doctoring-as-soul-craft-the-value-of-perfecting-a-physical-trade Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information A surgeon mentor once told me many years ago: “Jeff, we are like plumbers.” I initially perceived this negatively. However, the positive reality of this comment became clear to me over time, particularly after reading Shop Class as Soulcraft: An Inquiry into the Value of Work by Matthew B. Crawford, who advances the argument for “work that is meaningful because it is genuinely useful.” The book not only transformed my perspective on the value of the craft trades (e.g., electricians, masons, plumbers) but also my perception of my chosen specialty, facial plastic surgery. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. “Any discipline that deals with an authoritative, independent reality requires honesty and humility.” – Matthew B. Crawford (author) Matthew B. Crawford, a professor in philosophy and motorcycle mechanic from the Bay Area, became an electrician as a teenager, learned the mechanics trade in his 20s, earned his PhD in philosophy and dipped his toes in the Washington D.C. think tank world as well as consulting prior to leaving it all to start a motorcycle repair shop in a grungy building in Richmond, Virginia. He now works as a professor at the University of Virginia from his home in Silicon Valley. His central argument in Shop Class as Soul Craft calls to mind the story the author Robert Pirsig tells in his book Zen and the Art of Motorcycle Maintenance: An Inquiry into Values in that both argue that “real knowledge arises through confrontations with real things.” In the case of Mr. Crawford and Mr. Pirsig, that is motorcycle mechanics. Matthew B. Crawford praises work that is technical, requires manual dexterity, is embedded in the community, and cannot be outsourced. He includes medicine in his list of jobs as well as the building trades and mechanics. This contrasts with more traditionally white color jobs, including his work as a consultant and in a think tank, which he feels have become so systematized as to demand little independent judgement and skill. He argues that independence means having the agency to harness your own knowledge, experience, and skill to work towards an end that flows from something that physically exists. That is because there is universal validity in the end-product of the work or craft, such as a motorcycle that runs properly or a well-lifted face and neck that imparts a more naturally youthful appearance. Like a table or chair, these end-products are a long-lasting, physical example of the execution of good judgement. He provides multiple examples of problems he has encountered with motorcycles for which there are multiple possible explanations. He walks through the process by which a skilled mechanic utilizes the evidence and their understanding of the possible causes to determine a specific course of action to evaluate and treat the problem. The effort made is like an artist drawing what they see, which appears easy because of our ability to picture an image in our mind’s eye but is quite difficult to translate to a piece of paper. Like an artist, mechanic, or tradesman, surgery requires a combination of technical skill and judgement derived from study, training, and experience that allow a surgeon to see things in a way others do not. “The surgeon’s judgement is simultaneously technical and deliberative, and that mix is the source of its power.” – Mike Rose (author) Matthew B. Crawford states “craftsmanship means dwelling on a task for a long time and going deeply into it, because you want to get it right.” That is an apt description of medical school, residency, and fellowship that, in my case, took a decade to complete. I completed one of the most rigorous aesthetic fellowship programs in the world through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with Andrew Jacono MD, FACS. Not only was I trained in the most advanced facial plastic surgery procedures available by a master surgeon who developed, among other procedures, the extended deep plane facelift , but I also gained the experience of learning how to approach the complex variation that exists in the anatomy between individuals. While we share the same basic anatomy – and this is why specific surgical procedures can be taught – there are many minor, albeit significant, variations in this anatomy that is relevant to surgery. Anatomic variation can be learned by reading, because there are normal anatomic variations that exist naturally whose chances of an encounter intraoperatively are measurable. However, there is much more to understanding anatomic variability than this, and it comes down to feeling. The feel of tissue is relevant to executing the fine steps of surgery. It is not something that can always be visualized, and it is sometimes difficult to explain. However, it factors into our clinical judgement as another data point. Haptic feedback allows our trained hands to respond reflexively to the tissue, pushing in some areas and limiting ourselves in others. We are simultaneously factoring in visual data as well as our knowledge of medical literature and experience when making judgements intraoperatively. As the author Mike Rose writes: “that mix is the source of its [surgical] power.” “The ability to yield, to bend, to give way, to accommodate, he said, was sometimes a source of strength in men as well as in wood, so long as it was helmed by inner resolve and by principle.” – Daniel James Brown (author) of George Yeoman Pocock (Rowing Coach and Boat Builder) I have long had a love for wooden crew boats. One of my favorite books, The Boys in the Boat: Nine Americans and Their Epic Quest for Gold at the 1936 Olympics by Daniel James Brown, tells the story of the University of Washington crew’s unlikely win over the Nazi German team in the 1936 Olympics while rowing in one of these wooden boats. My favorite part of the book is the story of George Pocock, the English boat builder and coach who was the brains and soul behind the University of Washington team, despite not being the head coach. He started a boat building company that got its financial start building planes for the United States during World War I. Pocock Racing Shells is now an internationally renowned boat-building company that still exists in the Seattle area. The author describes the great skill and effort George Pocock exhibited when building wooden crew boats, which are composed of multiple types of wood placed in areas that maximize the natural features of the wood to optimize the performance of the boats. More detail about George Pocock’s life can be found in the book Ready All! George Yeoman Pocock and Crew Racing by Gordon Newell and Dick Erickson. His story and my love for rowing has inspired me to build my own wooden single-person crew boat. A close friend of mine’s father is a carpenter – he designed and built the frame on which my photo background hangs in the office – who built his own boat years ago. We have long discussed building a boat together. It is a dream of mine which I hope to fulfill sooner rather than later. I will make sure you all remain up to date on the process of designing and building the shell when we start. George Pocock was an inspiration to his team and to boat builders around the world. He recognized many of the same qualities that make a master boat builder in his rowers. Matthew B. Crawford recognized the same qualities in masters of the trades, including medicine. These qualities include honesty, humility, resolve and focus. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us --- ### Do I need to wear a large, heavy, compression dressing after my facelift? URL: https://www.harmonface.com/blog/do-i-need-to-wear-a-large-heavy-compression-dressing-after-my-facelift Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Face & Neck A common question asked during consultation for facelift surgery is what the post-operative dressings will look and feel like. Many express a concern about being required to wear large, heavy compression dressings for days after surgery. They ask if this will be required after the extended deep plane facelift . The short answer is no , for the following reasons: Compression dressings have historically been used to prevent or reduce the risk of blood accumulating under the skin after surgery, called a hematoma. Unfortunately, there is no evidence compression dressings significantly reduce the risk of hematoma formation. Instead, the use of a special local anesthesia mixture, blood pressure control during and after surgery, and meticulous surgical technique to minimize the transection of blood vessels are the best ways to minimize the risk of hematoma formation (1), (2), (3), (4). Tight compressive dressings can reduce blood flow to the skin, which can harm wound healing. Dr. Harmon avoids tight compressive dressings after surgery for the same reason he strongly advises against icing the face or neck after the extended deep plane facelift . Like compressive dressings, cooling of the skin after surgery can reduce blood flow to the skin, thereby harming wound healing. The dressing Dr. Harmon places over patients after facelift surgery is soft and VERY loosely fitted. It is generally removed the day following surgery. After removal, he places an ACE wrap around the head. This ACE wrap functions to protect the incisions and provide support to the neck while it heals. The ACE wrap is generally worn day and night for 7 days then nightly only for an additional 7 days. The above protocol maximizes comfort patients while minimizing risks to patients. References: Kleinberger AJ, Spiegel JH. What is the best method for minimizing the risk of hematoma formation after rhytidectomy? Laryngoscope. 2015 Mar;125(3):534-6. Schroeder RJ 2nd, Langsdon PR. Effect of Local Tranexamic Acid on Hemostasis in Rhytidectomy. Facial Plast Surg Aesthet Med. 2020 May/Jun;22(3):195-199. Couto RA, Charafeddine A, Sinclair NR, Nayak LM, Zins JE. Local Infiltration of Tranexamic Acid With Local Anesthetic Reduces Intraoperative Facelift Bleeding: A Preliminary Report. Aesthet Surg J. 2020 May 16;40(6):587-593. Kochuba AL, Coombs DM, Kwiecien GJ, Sinclair NR, Zins JE. Prospective Study Assessing the Effect of Local Infiltration of Tranexamic Acid on Facelift Bleeding. Aesthet Surg J. 2021 Mar 12;41(4):391-397. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Cosmetic Laser Treatments: An Explainer URL: https://www.harmonface.com/blog/cosmetic-laser-treatments-an-explainer Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical Laser treatments can address specific concerns about the skin on the face and neck. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether a laser treatment is appropriate for your concerns. A Laser is a Powerful, Targeted Form of Light Used for Skin Rejuvenation A laser is a powerful form of light of a single wavelength that targets specific molecules in tissue. This allows specific areas of tissue to be treated without affecting the surrounding areas. There are Multiple Types of Lasers Used for Skin Rejuvenation Many lasers are used in for skin rejuvenation. Each treats specific features of the skin. Among the most used lasers are resurfacing lasers and vascular lasers. A device commonly believed to be a laser is Intense Pulsed Light Therapy (IPL). It is not, however, a laser but a device that delivers energy to the skin at multiple wavelengths – as opposed to one – at the same time. Resurfacing Lasers Can Provide the Most Obvious Skin Rejuvenation Results Resurfacing lasers such as the CO2 laser and Er:YAG laser can provide some of the most obvious skin rejuvenation results of any laser. These lasers can treat signs of photoaging such as age spots, sunspots, and fine and moderate wrinkles. These lasers target the water molecule, heating it up and vaporizing skin precisely and at a controlled depth. The skin then heals with a more youthful appearance. In contrast with the CO2 laser and Er:YAG laser, non-ablative resurfacing lasers such as Nd:YAG heat up the water in skin without vaporizing it. Ablative lasers are more effective than non-ablative lasers in treating signs of photoaging. However, the recovery is often a few days longer with ablative lasers, which many individuals feel is well worth the results. Both ablative and non-ablative lasers are now manufactured to deliver treatment in a fractional form. This means that the laser is not one single column of energy but many small columns. This leaves intact skin in small areas between these columns, which allows the treatment site to heal more quickly and with a lower risk of side effects. Strict sun avoidance is important for weeks to months after treatment with any resurfacing laser. This includes wearing hats and applying a mineral-based sunscreen of SPF30 or greater to the site after healing is complete. Harmon Facial Plastic Surgery offers fractional CO2 laser resurfacing treatments for some skin changes related to aging, because we feel it best balances providing an effective and safe treatment. A detailed conversation is had with everyone interested in this treatment about the expected results and potential risks with this procedure. Vascular Lasers Treat Skin Features Caused by Blood or Blood Vessels Vascular lasers such as pulsed dye lasers target the molecule hemoglobin, which is present in blood and blood vessels. Vascular lasers are often used to treat bruising, minute blood vessels in the face, dilated veins near the surface of the skin, rosacea, and other vascular abnormalities of the skin. It can soften scar tissue and improve redness of some scars. Intense Pulsed Light (IPL) is Less Effective but Has Less Down Time IPL delivers light in a wide range of wavelengths - as opposed to a single wavelength with a laser - to the skin. It is a non-ablative treatment (like the Nd:YAG laser) for skin conditions such as bruising, age spots, and sun spots. There is usually little to no down time after treatments. The risk of complications is usually less with IPL versus lasers. However, it is less effective than lasers and often requires multiple treatments. The Expected Recovery and Risks Differ for Each Laser The recovery and risk profile differs for each of the lasers above. It is important to have a detailed conversation with a specialist who understands the expected recovery and risks for every laser treatment as well as someone who can determine which laser treatment(s) may benefit you. Can Early Laser Treatment of Surgical Incisions Improve Healing? There are multiple factors that optimize surgical incision healing , from proper surgical technique, proper closure technique, sun avoidance and protection, and the application of antibiotics and moisturizers. However, an unsightly scar may still develop despite optimal closure and appropriate post-operative incision care. Lasers can improve the appearance of a scar. However, there are no strict guidelines dictating when to treat surgical sites with a laser. Laser treatment of incisions usually starts at a minimum of 6-8 weeks after surgery. Could earlier treatment of incisions alter the chemical cascade during healing and prevent scar formation? One of the most important differences between scar and normal tissue is the orientation of the support framework on which the skin heals (1, 2). Early laser treatment may result in a “shift” of the molecular signaling during healing, leading to the development of a more “normal” support framework. The most common lasers used to treat incisions are called fractional resurfacing lasers, which include the Erbium:YAG and CO2, which is the laser used by Dr. Jeffrey Harmon at Harmon Facial Plastic Surgery (3, 4). Studied as early as 1956, treatment of incisions 7 days after surgery or even during surgery with a resurfacing laser have shown some of evidence of their effectiveness (5 - 8). For example, the dermatologists Dr. Ozog and Dr. Moy have published on the use of a fractional resurfacing CO2 laser immediately after surgery to stimulate healing and prevent scar formation. They performed a randomized, blinded, split-scar – split scar means half the scar was treated and half the scar was not - study on 10 patients with linear incisions and found improvement in the appearance and texture of scars on the treatment side on evaluation 2-3 months after surgery (7 – 8). A French physician utilized a diode laser on incisions immediately after they were created and found some benefit to healing (9 – 11). While promising, the above referenced studies involved very few patients and relatively subjective scoring of the appearance of the scars. More research is required to identify the optimal laser and the optimal timing of laser use to reduce or prevent scarring after surgery. In the meantime, appropriate surgical technique, closure, and appropriate incision care after surgery are the best approaches to reducing the risk of excessive or abnormal scarring after surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about age-related changes to your face and/or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References 1. Capon A, Mordon S. Can Thermal Lasers Promote Skin Wound Healing? Am J Clin Dermatol . 2003: 4(1): 1 – 12. 2. Namazi MR, Fallahzadeh MK, Schwartz RA. Strategies for prevention of scars: what can we learn from fetal skin? Int J Dermatol . 2011; 50(1): 85 – 93. 3. Ollael S et al. Use of Lasers in Acute Management of Surgical and Traumatic Incisions on the Face. Facial Plast Surg Clin North Am . 2011; 19(3): 543 – 550. 4. Mirmanesh M et al. Peri-Procedure Laser Scar Therapy Protocol: A Pilot Survey of Plastic Surgeons’ Practices. Aesth Plast Surg . 2017; 41(3): 689 – 694. 5. Laubach HJ et al. Skin Responses to Fractional Photothermolysis. Lasers in Surgery and Medicine . 2006; 38: 142 – 149. 6. Greenbaum SS, Rubin MG. Surgical Pearl: The high-energy pulsed carbon dioxide laser for immediate scar resurfacing. J Am Acad Dermatol . 1999; 40: 988 – 990. 7. Ozog DM and Moy RL. Discussing Fractional Carbon Dioxide Laser and Other Physical Treatments for Scar Prevention With Patients. JAMA Dermatol . 2015; 151(8): 815 – 816. 8. Ozog DM and Moy RL. A Randomized Split-Scar Study of Intraoperative Treatment of Surgical Wound Edges to Minimize Scarring. Arch Dermatol . 2011; 147(9): 1108 – 1110. 9. Capon A et al. Laser Assisted Skin Closure (LASC) by Using an 815-nm Diode-Laser System Accelerates and Improves Wound Healing. Lasers Surg Med . 200; 28(2): 168 – 175. 10. Capon A et al. Scar Prevention Using Laser-Assisted Skin Healing (LASH) in Plastic Surgery. Aesth Plast Surg . 2010; 34: 438 – 446. 11. Capon A, Iarmarcovai G, Mordon S. Laser-Assisted Skin Healing (LASH) in hypertrophic scar revision. Journal of Cosmetic and Laser Therapy . 2009; 11: 220 – 223. --- ### Concept of 'Flow' and Surgery URL: https://www.harmonface.com/blog/concept-of-flow-and-surgery Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The author James Clear describes a system in the book Atomic Habits to identify activities in which one could excel by asking the following questions: What feels like fun to me but work to others? What makes me lose track of time? Where do I get greater returns than the average person? What comes naturally to me? Question 2 refers to the concept of 'flow,' which is a mental state achieved when you are so focused on a task that everything else fades away. James Clear argues that flow tends to be reached more often with activities that sit in a 'Goldilocks Zone,' neither too difficult nor too easy. He argues that it is in this zone that maximal motivation and focus can be achieved. I have routinely experienced flow during two pursuits, surgery and rowing. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. ‘Flow’ in Rowing Refers Not Only to the Water As written in Atomic Habits , the concept of ‘flow’ in athletics is commonly referred to as being “in the zone.” This is especially appropriate when describing rowing because it describes the feel of a boat moving through water when the entire boat is in the zone. I rowed primarily in an eight-person racing shell, which is the term for a rowing boat. Four oars extend ten feet to the tip on each side of the shell. All eight rowers need to move the long oars in perfect harmony, both to balance the boat and to maximize the power generated pulling through the water. While a shell can move fast when the rowers are slightly out of sync, the wasted energy is palpable. There are times, however, when the boat feels of one mind. No energy is wasted. The blades hit the water at the exact same moment, pull through with ease, and exit with the shell in perfect balance. Even our coxswain – the individual who sits at the back of the boat, steers, and coaches the team – described feeling when the boat experienced flow. It felt like we were moving faster and with more intention but with less effort. ‘Flow’ in Surgery Engages All Senses and Cognition The concept of flow applies in the operating room as well. Flow describes not a mindlessness but an all-encompassing focus that optimizes the careful execution of each step in the procedure. For example, I ask my patients what background music they would like to listen to in the operating room before surgery . A common reply is “whatever you would like.” I then explain that when I am in the operating room, I hear no background music playing. I am “in the zone.” All attention is focused on their care. All senses are engaged with them, from what I see to what I hear, including their vital signs on the patient monitor. My surgical team – consisting of an anesthesiology physician, nurses, and scrub technologists – facilitates this flow state. Like rowing, achieving a flow state makes the procedure feel like I am working with more intention but less effort, though the opposite is true. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck . Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Can Botox® and Similar Products Improve the Appearance of Scars? URL: https://www.harmonface.com/blog/can-botox-and-similar-products-improve-the-appearance-of-scars Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical The treatment of scars is complex and often requires multiple modalities of treatment, including lasers, chemical peels, topical medications, injected medications, and even surgery. For more information on the treatment of scars, please visit the linked blog post . One proposed treatment for scars is Botox® and similar medications which are also referred to as Botulinum Toxin-A. A recent study sought to answer the question of whether Botulinum Toxin-A is an effective treatment for scars by combining the data from multiple previous studies to perform something called a systematic review and meta-analysis, which is a qualitative and quantitative study of the effects of an intervention. For more information on how physicians review the literature, please visit the linked blog post . It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. A Systematic Review and Meta-Analysis Demonstrated the Effectiveness of Botox® and Similar Medications in Treating Scars A systematic review and meta-analysis published in medical literature reviewed approximately 20 studies to evaluate the effects of Botulinum Toxin-A on scar formation. This study demonstrated an improvement in the appearance of scars with treatment with Botulinum Toxin-A when compared with incisions that were not treated, also known as the control ( 1 ). A more recent systematic review and meta-analysis confirmed these findings, especially for the use of Botulinum Toxin-A in the forehead and upper lip ( 2 ). Typically, the best method to assess scar formation is with what is called a split-scar study. A split-scar study involves the treatment of half the scar with the other half of the scar serving as the control. Many of these papers included split-scar studies and utilized methods of assessing the appearance of scars that have been approved as being objective enough to be included in medical studies. The Mechanism of Action by Which Botox® Can Improve Scar Appearance is Not Known The mechanism by which Botox® and other similar products can improve the appearance of scars is not yet clear. It may be that the medication affects the cascade of signaling molecules that affect the healing process. It may also be that, by reducing the contraction of muscles around the incision, there is less tension on that incision, thereby improving the appearance of the scar. More research is required to determine the mechanism of action of Botulinum Toxin-A on scar formation. Botox® and Similar Products are a Promising Treatment for Scars but Remain FDA Off-Label While the potential benefits of the treatment of scars with Botulinum Toxin-A is promising, It is important to note that the FDA has not yet reviewed and approved the use of Botox® and similar products for the treatment of scars. However, as with many other interventions, the road to FDA approval starts with research demonstrating the effectiveness of the treatment, as evidenced by the above study. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us References Rammal A, Mogharbel A. Effectiveness of Botulinum Toxin-A on Face, Head, and Neck Scars: A Systematic Review and Meta-Analysis. Facial Plast Surg Aesthet Med. 2023 Nov 7. Rammal A, Mogharbel A. Effectiveness of Botulinum Toxin-A on Face, Head, and Neck Scars: A Systematic Review and Meta-Analysis. Facial Plast Surg Aesthet Med. 2024 Jul-Aug;26(4):379-385. --- ### Can a Patient Undergo More than One Procedure in a Single Surgical Session? URL: https://www.harmonface.com/blog/can-a-patient-undergo-more-than-one-procedure-in-a-single-surgical-session Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Many patients can undergo more than one facial plastic surgery procedure in one surgical session. However, whether a patient can undergo more than one procedure in a single session depends on multiple factors. A detailed discussion with your surgeon is required to determine whether one or more procedures is indicated. A surgical and anesthesia plan is then developed that is safe and as effective as possible. This plan may involve one or more procedures. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Level of Sedation Required to Perform the Procedure is a Factor Some procedures, such as the extended deep plane facelift , neck lift , lateral temporal brow lift , lower blepharoplasty , and nose surgery (rhinoplasty) usually require some level of sedation, whether it is oral sedation, IV sedation, or anesthesia with the use of a breathing tube ( see previous blog post ). Sedation allows patients to sleep during longer, more involved procedures that otherwise could be uncomfortable. Patients often prefer to add other, shorter procedures during a single surgical session involving sedation to have one recovery period. This is a major convenience, because it not only limits the total number of days patients need to recover, but it also allows patients to achieve a more complete aesthetic result earlier. The Length of Time Required to Perform Each Procedure is a Factor Other patients prefer to separate multiple procedures. This may involve undergoing the longer procedures first, followed by the shorter procedures later. This also may be reversed. For example, a patient may elect to undergo upper eyelid surgery (blepharoplasty) , a lip lift , buccal fat removal , and/or neck liposuction under local anesthesia prior to or after an extended deep plane facelift and neck lift. One benefit of this is that patients are sedated for less total time, which is preferable to some patients. The Medical History is an Important Factor Many patients are very healthy and tolerate longer operative times. Other patients have medical conditions with which shorter operative times would be best. This should be discussed in consultation with your surgeon and your surgeon with their anesthesia provider. It Can be Beneficial to Perform Some Procedures Together It is common to perform a lateral temporal brow lift and/or a lip lift with the extended deep plane facelift and neck lift. There are multiple benefits to adding these procedures. First, each addresses signs of aging that the extended deep plane facelift and neck lift do not address. Second, the lateral temporal brow lift allows a shorter facelift incision. Some Procedures Cannot be Performed Together Some procedures may require a stepwise approach; that is, it may be better to allow one procedure to heal prior to proceeding with the next. For example, it may be necessary to undergo a rhinoplasty and a lip lift separately because the surgical incisions are so close. The Surgeon and Anesthesiologist Develop a Plan A final surgical plan and a final anesthesia plan that reflect the considerations above are developed in conversation between the surgeon and anesthesiologist if sedation is required. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! CONTACT US --- ### Can a European Mountain Shrub Effectively Treat Surgical Bruising? URL: https://www.harmonface.com/blog/can-a-european-mountain-shrub-effectively-treat-surgical-bruising Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical It is common practice to recommend vitamins and other supplements peri-operatively with the intention to help with recovery and healing. Arnica montana, a Swiss mountain shrub otherwise referred to as arnica, is widely used to reduce bruising and swelling after surgery. l evaluated the medical literature to determine the effectiveness of arnica, focusing on high-quality studies ( see previous blog post “ How (Thoughtful) Surgeons Think ” ) that specifically evaluated its effectiveness for facial plastic surgery procedures. The first procedure I looked at was nose surgery ( rhinoplasty ) because, depending on the approach taken, some bruising and swelling around the eyes is expected. The first study, from 2007, was randomized and controlled (1). It evaluated the effectiveness of arnica taken by mouth. Unfortunately, no difference was found between the use of oral arnica and placebo (no intervention) on the extent and severity of bruising. This study used subjective ratings by researchers. In contrast, a meta-analysis from 2017 combining data from three other randomized, controlled studies comparing the effects of oral arnica with placebo found a significant decrease in post-operative swelling and bruising with the use of arnica during the recovery period (2). At least one of those studies utilized a more objective assessment of the bruising utilizing a computer program (3). My review of the literature suggests oral arnica could be effective in treating bruising after nose surgery. The second procedure I looked at was eyelid surgery ( blepharoplasty ). I found a placebo-controlled, randomized, double-blinded study evaluating bruising after upper eyelid surgery utilizing the oral arnica (4). No difference in the area or the severity of bruising was noted with the use of oral arnica. The third procedure I looked at was facelift surgery. I found one influential (i.e. frequently cited) paper from 2006 (5). This study was randomized, double-blinded, and placebo-controlled. Like the above studies, this study gave oral arnica to patients undergoing a facelift. One innovation of this paper was that the researchers not only collected data from a subjective scale completed by healthcare providers and the patients themselves, but also a more objective measurement of the change in color and extent of bruising as measured by a computer program. Neither the subjective nor the objective results showed a difference in the severity of bruising with the use of oral arnica. All of the above-cited studies utilized oral arnica. However, topical arnica is also available. There are many formulations of topical arnica that exist at different concentrations, including a popular patch placed under the eyes after surgery called Ocumend©. A single-blinded, randomized, controlled trial was performed and published in 2010 looking at the use of topical arnica. A bruise was induced on the arm by a laser and the treatment of these bruises with topical arnica was evaluated. The results were measured using a standardized scale previously published in the literature. This study demonstrated a significant improvement in bruising with topical arnica (6). I can attest to the effectiveness of topical arnica from my use of Ocumend© pads on the lower eyelid and upper cheek, which has an even higher concentration than the arnica used in this study. The Bottom Line Oral arnica may be effective in reducing post-operative bruising after nose surgery. Topical arnica can also be an effective treatment for bruising of the lower eyelids and cheek after lower eyelid surgery and/or some nose surgeries. As a result, I offer my patients arnica in these scenarios. The effectiveness of oral arnica for upper eyelid surgery and facelift surgery is simply not supported by the available data. As a result, I do not feel it makes sense to offer it at this time. That being said, this could change in the future as more and better studies are released. References: Totonchi A, Guyuron B. A randomized, controlled comparison between arnica and steroids in the management of postrhinoplasty ecchymosis and edema. Plast Reconstr Surg. 2007 Jul;120(1):271-274. Lee HS, Yoon HY, Kim IH, Hwang SH. The effectiveness of postoperative intervention in patients after rhinoplasty: a meta-analysis. Eur Arch Otorhinolaryngol. 2017 Jul;274(7):2685-2694. Chaiet SR, Marcus BC. Perioperative Arnica montana for Reduction of Ecchymosis in Rhinoplasty Surgery. Ann Plast Surg. 2016 May;76(5):477-82. Kotlus BS, Heringer DM, Dryden RM. Evaluation of homeopathic Arnica montana for ecchymosis after upper blepharoplasty: a placebo-controlled, randomized, double-blind study. Ophthalmic Plast Reconstr Surg. 2010 Nov-Dec;26(6):395-7. Seeley BM, Denton AB, Ahn MS, Maas CS. Effect of homeopathic Arnica montana on bruising in face-lifts: results of a randomized, double-blind, placebo-controlled clinical trial. Arch Facial Plast Surg. 2006 Jan-Feb;8(1):54-9. Leu S, Havey J, White LE, Martin N, Yoo SS, Rademaker AW, Alam M. Accelerated resolution of laser-induced bruising with topical 20% arnica: a rater-blinded randomized controlled trial. Br J Dermatol. 2010 Sep;163(3):557-63. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us --- ### Botox® for Underarm Sweating URL: https://www.harmonface.com/blog/botox-for-underarm-sweating Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical FDA-approved in 2004, Botox® for underarm sweating (hyperhidrosis) can be an effective treatment for those experiencing severe and persistent underarm sweating. Please seek a skilled and experienced injector in Cincinnati to help determine whether this is an appropriate treatment for you. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Neurotransmitter Blocked by Botox® in Muscles is the Same as Sweat Glands Acetylcholine, the neurotransmitter molecule that causes muscle contraction, also causes sweat glands to secrete sweat. Botox® acts at the site of injection to inhibit the release of acetylcholine. Therefore, Botox® can function to inhibit the release of sweat from the underarms. The Effects of Botox® for Hyperhidrosis Can Be Long-Lasting Approximately 50 units of Botox® are heavily diluted and injected on either underarm. The effects of Botox® on underarm sweating can last six months to one year, longer than the effects when placed in the face for cosmetic purposes. Achieving a Proper Depth of Botox® Injection is Essential The injection of Botox® for underarm sweating is more shallow than cosmetic injections of the face because the sweat glands reside closer to the surface of the skin than muscle. A proper depth of injection is essential to achieving ideal results. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Book Reviews: The Centenarian Decathlon URL: https://www.harmonface.com/blog/book-reviews-the-centenarian-decathlon Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The two books reviewed below fall under the theme of longevity and aging well . The first book presents a broad argument for transforming how medicine is practiced by focusing on preventing the development of chronic disease rather than treating chronic disease when it occurs. The second book offers a practical guide to maintaining mobility with age, which can be associated with improved health in old age. As always, the purpose of these reviews is to entertain and not to provide direct medical advice nor to serve as replacement for appropriate medical advice. The opinions of the authors do not necessarily reflect the opinion of Dr. Harmon and/or Harmon Facial Plastic Surgery. Instead, we have found that these books ask interesting questions and are also entertaining. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Outlive: The Science and Art of Longevity by Peter Attia MD Dr. Peter Attia arrived at his current career as a clinician, author, and podcast host circuitously, leaving general surgery residency at Johns Hopkins University to work in consulting then returning to medicine years later. He is a fitness fanatic with a love for boxing and Formula 1 (F1) racing – Dr. Harmon never truly appreciated the athleticism required to drive F1 cars until he read this book – which is reflected in the pages of this book. His clinical practice model reflects his belief that medicine as it is currently practiced does not adequately address the core causes of poor health in our later years. Dr. Attia intervenes intensely with his patients as early as possible to maximize their healthy functionality for as long as possible. He calls this disease prevention model Medicine 3.0. He contrasts this with Medicine 2.0, which he argues was developed approximately one hundred years ago to treat infectious diseases as well as chronic diseases after they have developed. The book explains the purpose and goals of Medicine 3.0, discusses the causes of heart disease, cancer, and neurodegenerative diseases such as Alzheimer’s, and proposes solutions to reduce our risk of such diseases. Dr. Attia advocates for more extensive testing for cholesterol abnormalities and problems with glucose management as well as more aggressive treatment of these conditions. He feels that, by the time lab values demonstrate there is a problem with cholesterol and/or glucose management according to current guidelines it is already too late to adequately treat and prevent future complications, which can include not only heart disease but also cancer and neurodegenerative diseases. He feels that an intensive exercise regimen and a focus on building muscle mass as well as maximizing an individual’s oxygen use capacity (i.e., VO2 Max) are key to the prevention of chronic disease. He also feels that a finely measured, data-driven, individually optimized diet is also important focused on minimizing glucose spikes with meals. He also advocates for earlier screening for cancer (e.g., colon, breast) than current guidelines recommend. He argues that survival rates for cancer are so much higher when caught early that the cost of earlier screening is justified. Dr. Attia’s arguments inspired Dr. Harmon to have a conversation with his primary care physician about advancing his screenings. It remains to be seen whether and when the medical subspecialty governing bodies and insurers will adopt new screening guidelines in the future. Among the most interesting information from the above sections of the book is the extent to which vascular disease as caused by high cholesterol, persistently elevated blood glucose, and high blood pressure contribute to the development of heart disease, cancer, and neurodegenerative diseases. For example, Dr. Attia explains that the relationship between vascular disease and neurodegenerative diseases such as Alzheimer’s Disease is gaining increasing attention in the medical literature. Two of the most valuable chapters in the book discuss the importance of sleep and maintaining good emotional health. These two areas are the most personal for Dr. Attia, and he highlights significant stories from his own life that illustrate the importance of getting good quality sleep as well as addressing problems with emotional health. Dr. Harmon agrees wholeheartedly with the importance of both and hopes patients understand the importance of emotional self-care in addition to physical self-care. Overall, the book is a powerful argument for setting a goal of not only a long life but a healthy and functional life. Whether Dr. Attia's proposed solutions are the correct ones remain to be seen. For example, Dr. Attia sometimes deviates into topics that are much more controversial. For example, he places patients on the immunosuppressive agent tacrolimus – a medication commonly used in patients who have undergone an organ transplant – due to his review of data that he feels makes a strong argument that it can increase our functional lifespan. This is not something most physicians - or physician organizations - would recommend and is, in fact, not currently approved by the Food and Drug Administration (FDA) for the purpose Dr. Attia discusses. And while there are many other well-argued and potentially transformative methods of improving disease prevention in this book, most are dependent on involved and expensive testing and technological solutions (e.g., constant blood glucose monitor, VO2 Max testing) that would seem to be unlikely to be adopted by most without adequate financial resources and the intense engagement of a primary care provider who is well-qualified to provide such care. Built to Move: The 10 Essential Habits to Help You Move Freely and Live Fully by Kelly Starrett and Juliet Starrett Built to Move , a spiritual cousin to the previously reviewed book The Blue Zones by Dan Buettner, also complements the arguments made in Outlive . In fact, the authors of Built to Move reference Dr. Peter Attia’s concept of a “Centenarian Decathlon” when discussing their primary thesis, which is that maintaining the ability to move fluidly in many positions is a core physical goal and predictive of maintaining good functional health in old age. For his part, Dr. Attia also includes a chapter in his book arguing for maintaining good mobility with age to prevent injury. Dr. Harmon had become interested in the above thesis prior to reading Built to Move . His interest originates from one of the most difficult choices he has made, which was to stop rowing in college. He was a nationally competitive rower in high school and was recruited to row lightweight crew at Cornell University. Rowing is one of Dr. Harmon’s great passions, which is why it was so difficult for him to gradually lose that passion over time as the toll of the required weight loss and the need to work so hard to prepare for the MCAT and medical school weighed on him. He also noticed teammates struggling with chronic back pain, often taking long breaks from the team, never fully recovering prior to their return. And while Dr. Harmon did not injure his back, he had a sense that he was highly likely to if he continued. Somewhat strangely for someone his age, his primary concern was whether he would be able to hold his grandchildren in the future, an ability which is highly correlated with functional health in old age. The authors of Built to Move , Kelly and Juliet Starrett, list ten “Vital Signs” that are indicative of abilities that are predictive of good functional health. They recommend exercises to promote optimal performance with each sign. The Vital Signs include: 1. Getting up and down off the floor – Highly predictive of mortality in old age, the authors recommend sitting on the floor more often with the hips extended in order to encourage standing up from sitting. 2. Breathing – The authors recommend slow, diaphragmatic breathing through the nose. 3. Extending your hips – See Vital Sign 1. 4. Walking – The authors advise taking 10,000 steps per day. 5. Future-Proofing your neck and shoulders. 6. Diet – The authors recommend 800 g of fruit and vegetables per day as well as a weight-based approach to determining the appropriate amount of protein intake per day. 7. Squatting. 8. Balance. 9. Movement-Rich Environment. 10. Sleep – The authors recommend 7 to 9 hours of consistent sleep each night. The prescribed exercises are intended to anchor the regular cardiovascular and strength training multiple governing bodies recommend we get each week. The exercises are easy to perform at home with off-the-shelf or inexpensive products like PVC pipes and foam rollers. The authors also advise testing yourself to gauge your improvement and set goals. Their arguments appear sound – though Dr. Harmon is not a physical therapist and cannot speak professionally about specifics – and the prescriptions are easy-to-understand and implement. The exercises - which Dr. Harmon would only do in consultation with a qualified physical therapist - recommended in Built to Move may help Dr. Harmon maintain the high surgical standards he holds himself to for many years while also allowing him the functional capacity to enjoy playing with future grandchildren. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more . Contact Us This blog post is for entertainment purposes only and does not constitute direct medical advice. Moreover, the above information should not be used as a replacement for appropriate medical advice. Dr. Harmon is not a primary care provider, physical therapist, or registered dietician. The views of the authors above do not necessarily reflect the views of Dr. Harmon or Harmon Facial Plastic Surgery. It is essential that you have a consultation with a qualified medical provider prior to considering any treatment for any reason. This will allow you the opportunity to discuss any potential benefits, risks, and alternatives to the treatment. --- ### 5 Questions for a Designer: Reztark Design Studio URL: https://www.harmonface.com/blog/5-questions-for-a-designer-reztark-design-studio Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The following interview is with Christie L. Krazter, Principal at Reztark Design Studio. Reztark Design Studio developed the architectural and interior design plans for Harmon Facial Plastic Surgery. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Tell us about your educational and professional background and that of the team that worked on the Harmon Facial Plastic Surgery office. I am an Interior Designer with a Bachelor of Science in Interior Design from the University of Cincinnati. I have 35 years of experience in all areas of design: retail, hospitality, restaurant, multifamily, senior living, medical office, and workplace. The team for Harmon Facial Plastic Surgery was comprised of architects, interior designers, and graphic designers. They all have professional degrees with 10 plus years of experience. Instagram: @reztark Describe your team's creative process when designing the architecture and interiors for brands. At Reztark, we believe in a wholistic, egoless approach to design. We believe our clients are very much a part of team process. Most clients/ brands know who they are as a brand better than we do so we actively listen to our clients. If a client is not sure who they are, we go through a process of evaluating their brand and giving it definition describing what they are or want to be. Every project has its own specific requirements which direct us in our process for the design. No 2 projects are ever the same. How do you think an interior in a medical practice should make patients feel? In a medical office a patient and employee should be well taken care of, safe and calm. It is as important for the patients as well as the staffs feelings and emotions be considered in the final solution for the design. Instagram: @reztark How did you interpret the branding provided by Harmon Facial Plastic Surgery and translate it so beautifully into the design of the office design and interior? Every detail from the layout and flow of the office to the door frames, lighting and the furniture reflect the values and mission of the practice so beautifully. Dr. Harmon had a very strong passion for his practice. We took what had been developed as a Brand and listened to how the team at Harmon Facial Plasdtic Surgery felt about the practice. Dr. Harmon loves architecture and design which made it easy to communicate our passion for the interiors. They are all about the details as a facial plastic surgery center. The patients needed to know they would be taken care of with the same level of detail as the interior provided. It is very important to use color, finishes and light to make a patient look and feel wonderful about themselves. Does your team at Reztark have an as-yet unfulfilled dream design project? We are always looking for new ways to develop a design through construction technics to interior materials and new technologies. Active learning is the most needed part of our jobs. We are currently the firm responsible for the renovation and redesign of the Terrace Plaza Hotel. It will be a signature project once complete. We are also working on a very dense mixed-use project in Blue Ash, Ohio called the Blue. We love the Rubix cube of complex projects. Reztark Contacts Website: reztark.com LinkedIn: Reztark Design Studio Instagram: @reztark Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### 5 Questions for a Designer: Angela Kowalski URL: https://www.harmonface.com/blog/5-questions-for-a-designer-angela-kowalski Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information Angela Kowalski is the creative for the branding of Harmon Facial Plastic Surgery. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Tell us about your educational and professional background. I'm currently Creative Director for the brand Califia Farms where I oversee all creative efforts that show up in various global markets. This includes strategic brand identity development, packaging, advertising campaigns, and multi-media marketing. The work couldn't be done alone, so for the past 5 1/2 years, I've been building out a powerhouse of a creative team who exercises multi-disciplinary capabilities. I'm lucky that both the type of work and team have made my time at Califia most enjoyable. Before my stint here, I spent the core of my time at various big and small agencies that cultivated brands in a variety of industries. It was at these firms that I gained experience in brand development - from market entry strategy to brand identity, and further along, to packaging, experiential design, web design and all forms of marketing for both digital and print placements. Throughout my career, it's been important to always leave room for personal projects that allow me to put my personal passions into practice. Today still, I welcome projects that provoke my interest and push me creatively. There's nothing I enjoy more than to take the knowledge that I've gained in big brand settings and apply it to a young brand trying to get its feet off the ground, stand out from competition and make an impact in people's lives. It's been a rewarding and educational ride, and none of it would be possible if it wasn’t for my teachers at Savannah College of Art and Design (SCAD) over ten years ago. Instagram @angkowal Describe your creative process when designing for brands. Simply put, I get curious. I get REALLY curious about the brand, it’s purpose, the person/people that are brave enough to launch it, and even more inquisitive about the people the brand is for - it's critical to dig deep to understand the true value a brand offers and why it's unique to anything else in the market. You and I discussed our appreciation for the power of font design and placement as an expression of a brand. How did these concepts express themselves in the branding for Harmon Facial Plastic Surgery? Every element has a cognitive impact on an individual's perception. Therefore, individual elements in a brand system and all the minutia details matter - from type treatment, shape, color, tagline to negative space, images, texture, layout, etc. As a designer, it’s my job to communicate on behalf of a brand. When it's done right, the perception of a brands value, personality, confidence is apparent. This was front of mind when looking at every detail of the brand identity for Harmon Facial Plastic Surgery. With an identity aesthetic that's relatively minimal, it was most important that certain elements, like spacing and typography, worked harder to convey the tone and confidence in the brand you see today. Instagram @angkowal How did the phrase and logo "Feel Good About Feeling Good" come about? What does it mean to you? This tagline was born from the unadulterated intention behind Dr. Harmon's practice. It's the true value of what his services provide someone. At the end of the day people want to be happy and feel good and there's no guilt in that. At Harmon Facial Plastic Surgery, it’s not as much about plastic surgery as it is about helping someone feel good about themselves. Do you have an as-yet unfulfilled dream design project? I’ve been very fortunate to work on some amazing design projects. From branding wellness brands to designing packaging in the alcohol aisle. From grass root organizations that are driving big impact in small communities to branding restaurant concepts for top Los Angeles chefs. I will always welcome a project in those categories. Additionally, I think at this point I may be ready to paint a mural of all things - it's something I’m really intimidated by, but I think it would be a cool way to share another passion of mine on a larger scale. With a steady hand, it might just be enough to move people to feel something and at the end of the day, that's what motivates me in both the design and fine art spaces. Contact Information Website: akcreative.net (request access through one of the below links) Email: angkowalski@gmail.com LinkedIn Name: Angela Kowalski Instagram: @kowal_studio , @angkowal Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Book Reviews URL: https://www.harmonface.com/blog/book-reviews Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: General Information The following blog post is a series of book reviews and recommendations that reflect our mantra "Feel Good About Feeling Good." It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Clean: The New Science of Skin by James Hamblin, MD There is a tendency in skin scare to ere towards the maximalist approach, with more creams, ointments, oils, and moisturizers used more frequently. This is encouraged by the cosmeceuticals industry as well and modern wellness vendors as exemplified by the current trend towards multi-step skin care treatments as popularized by Korean skin care brands. But what if less – much less – is more? And what are the implications of shifting our understanding of clean, healthy skin? James Hamblin MD, an internal medicine physician turned journalist for The Atlantic Magazine, set out to understand the skin care industry, later broadening his reach to how we conceptualize what is “clean” and how this has changed in society, all through the eyes of cleaning products. He starts with soap. And he starts by explaining why he has not cleaned himself with anything other than water for the past 5 years while researching the book. The book is a tour de force of history, emphasizing the amazing strides that have come from the development of germ theory and the subsequent mass marketing of soap to the public to achieve a level of cleanliness/sterility that was meant to combat the infectious public health illnesses of the time. He also dives into the poorly regulated market of cosmeceuticals, concluding that the vast majority of what is placed in skin care products today has no evidence for its effectiveness. He calls into question the actual benefits of all the expensive skin care products people are encouraged to buy. I agree with Dr. Hamblin. Very few ingredients in marketed skin care products have demonstrated significant clinical effectiveness. The industry is filled with half-truths and outright lies. The worst part is that their behavior is legal, simply because it is such a poorly regulated industry. Dr. Hamblin pivots to the idea that much of our modern skin illnesses can be traced to an imbalance in the bacterial composition of the skin, called the microbiome. The act of exfoliating, washing, moisturizing, and toning the skin is chasing what our body does naturally. He meets individuals who are performing research on introducing bacteria to the skin to treat conditions such as eczema. In the end, he suggests that we are on the verge of a reconceptualization of our understanding of disease of the skin and how to maintain the health of our skin. He emphasizes the preliminary nature of business introducing “pro-biotic” skin care products into the market and suggests that simply embracing our natural propensity to interact with each other and to expose ourselves to “good” bacteria may go a long way in preventing pediatric dermatological illnesses. We at Harmon Facial Plastic Surgery are not ready to recommend any product or activity mean to introduce bacteria to the skin for the purposes of skin care. However, we strive to provide recommendations that are affordable and effective with the best available evidence. Eat a well-rounded diet , mostly plants, of food free of pesticides and antibiotics. Wear a mineral-based sunscreen of at least an SPF of 30. Exercise, preferably outside. Socialize with your loved ones, safely. Use a simple moisturizer of your choice, which can be inexpensive or not. And consider a retinol and/or Vitamin C serum for photoaging as tolerated. Healthy skin is as much a matter of how we live as it is a matter of what we put on it. I am Invincible by Norma Kamali I am Invincible by the famous fashion designer Norma Kamali is a fantastic book option. For those who are unaware, Normal Kamali got her start in a small clothing shop in New York City in the 1970s where she designed clothes inspired by the styles she saw in London in the late 1960s. She went on to design accessible, comfortable, high fashion clothing that evolved through the decades (think puffer coat ). She explains her approach to style, which in summary is to have a “uniform.” We here at Harmon Facial Plastic Surgery love this recommendation, as you will see Dr. Harmon in his “uniform” each day: brown loafers or oxfords, relaxed wool or thick cut chinos, a tailored white button down (usually from the wonderful team at Romualdo in Madeira) and his white coat. Now in her 70s, Norma Kamali is also a model for healthy living. This book not only discusses her fascinating personal and professional life, but also her philosophy of health, including her approach to eating a healthy, diverse, and well-balance diet, exercise, and sleep. The Blue Zones Solution: Eating and Living Like the World’s Healthiest People by Dan Buettner and How to Eat: All Your Food and Diet Questions Answered by Mark Bittman and David L. Katz MD Though wildly different in style and structure, the information these books communicate reinforces each other. The Blue Zones Solution: Eating and Living Like the World’s Healthiest People by Dan Buettner reviews the data gathered and lessons learned while studying populations of people throughout the world with a relatively large number of centenarians, or individuals who live to be at least one hundred. This research started as an assignment by The National Geographic Society. Located in Greece, Italy, Japan, Costa Rica, and Southern California, Mr. Buettner labeled these communities “blue zones.” He derived the following 9 “lessons in longevity” from these communities: 1. Live in a physical environment that constantly and passively encourages movement 2. Live with a purpose beyond employment 3. Identify time to relax and wind down 4. Stop eating when your stomach is 80% full 5. Eat a primarily plant-based diet with little meat 6. Appropriate/moderate wine drinking 7. Create a social circle that supports healthy behaviors 8. Attend faith-based or other community services weekly 9. Place family first and keep parents/grandparents nearby Mr. Buettner highlights some of the healthy foods that are commonly consumed by each of the above communities, explaining their health benefits and how the macronutrients and micronutrients in these foods relate to each other despite the diets varying between the communities. He not only emphasizes the importance of what foods are eaten but also how the acts of acquiring, preparing, presenting, and consuming food are performed and respected as a significant daily event in the lives of these individuals. He moves on to discuss case examples of communities who changed their health by adopting behaviors like those adopted by blue zone communities, including small towns in Iowa. The book then moves on to present concrete ways we all can adopt “blue zones behaviors” to improve our health. These include moving our diet to a primarily plant-based diet with minimal dairy and meat as a small side dish or garnish eaten infrequently. Mr. Buettner emphasizes the importance of treating the act of preparing and consuming food as sacred and something that should be shared with family and/or friends in a distraction-free environment. He summarizes the dietary example of blue zones communities with an easy-to-understand list of 4 foods to always have available and 4 foods to avoid completely, such as sugar sweetened beverages, salty snacks, processed meats, and packaged sweets. Mr. Buettner recommends “de-conveniencing” the home to encourage more physical activity as a baseline behavior. His suggestions include using more non-mechanized appliances and a push lawnmower. He makes concrete recommendations for organizing the kitchen and bedroom to maximize health. Finally, he includes easy-to-follow recipes inspired by the meals consumed by members of blue zones communities that reflect the recommendations made earlier in the book. Mark Bittman and Dr. David Katz go into more detail about the science of nutrition in How to Eat: All Your Food and Diet Questions Answered than Mr. Buettner, including some of the misunderstandings and controversies associated with the field of nutrition. Not only does this book reference blue zones but Dan Buettner references some of Mark Bittman’s recipes in The Blue Zones Solution . How to Eat is written as a long Frequently Asked Questions session that also feels like a back-and-forth conversation between two knowledgeable friends. Mr. Bittman and Dr. Katz demonstrate a wonderful ability to cut through the confusion about various fad diets and otherwise heavily restricted diets that have caused many to unwisely exclude broad categories of food. The idea of the relative benefit of individual foods is brought up frequently. For example, there is controversy as to whether dairy products should be a component of a maximally health diet. Mr. Bittman and Dr. Katz explain that, with every food, it really depends on what you are replacing that food with. For example, they explain that if an egg is replacing bacon for breakfast, then it may be good. However, if an egg is replacing plain yogurt with muesli and berries then it may not be good. How to Eat reinforces the stories in The Blue Zones Solution and fleshes out the reasons why the interventions made by Mr. Buettner in communities throughout the United States have been effective in improving population health in those communities. We at Harmon Facial Plastic Surgery are not dieticians. The nutrition recommendations provided in the above books do not necessarily reflect the opinion of Harmon Facial Plastic Surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us to learn more! Contact Us --- ### Addressing Smoker’s Lines (Peri-Oral Rhytids) URL: https://www.harmonface.com/blog/addressing-smokers-lines-peri-oral-rhytids Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: Non-Surgical One of the most common concerns people express about their face as they age is the presence of smoker’s lines, or peri-oral rhytids, around the mouth. These stubborn lines are difficult to treat. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. I Utilize a Dual-Pronged Approach: Resurfacing and Nano-Fat Transfer Dr. Harmon often utilize a dual-pronged approach to treating peri-oral skin, including rhytids. The first prong involves the use of a refined form of an individual’s own fat, called nanofat. Nanofat is placed under the skin around the mouth. The second prong is a fractional CO2 laser, which is used after injecting nanofat. This laser resurfaces the skin which, along the with nanofat components, can encourage more organized collagen deposition, thereby improving the appearance of wrinkles and overall skin quality and texture ( 1 , 2 , 3 , 4 , 5 , 6 ). This approach can better address the actual changes going on in the skin – called histological changes – when compared with utilizing only one of the two prongs or hyaluronic acid filler to simply fill in the lines. This 58-year-old patient came to Dr. Harmon to address sagging cheeks and jowls, loose tissue in her neck, facial wrinkles, and a lengthened upper lip. An extended deep plane facelift , neck lift , and lip lift were performed. Lip filler was added to balance out her bottom lip with her top lip. Finally, the patient underwent treatment with a fractional CO2 laser in addition to nano-fat grafting of the wrinkles around her mouth. The patient is thrilled with her results only a few months after surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified , fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching “plastic surgery near me.” Get in touch with us today to learn more! Contact Us References Akbari F, Hadibarhaghtalab M, Parvar SY, Dehghani S, Namazi MR. Toward facial rejuvenation; A clinical trial to assess the efficacy of nano fat grafting on wrinkles. J Cosmet Dermatol. 2024 Feb;23(2):600-606. La Padula S, Ponzo M, Lombardi M, Iazzetta V, Errico C, Polverino G, Russo F, D'Andrea L, Hersant B, Meningaud JP, Salzano G, Pensato R. Nanofat in Plastic Reconstructive, Regenerative, and Aesthetic Surgery: A Review of Advancements in Face-Focused Applications. J Clin Med. 2023 Jun 28;12(13):4351. Tonnard P, Verpaele A, Carvas M. Fat Grafting for Facial Rejuvenation with Nanofat Grafts. Clin Plast Surg. 2020 Jan;47(1):53-62. Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013 Oct;132(4):1017-1026. Tran VVT, Jin X, Hong KY, Chang H. Effects of Nanofat in Plastic and Reconstructive Surgery: A Systematic Review. Plast Reconstr Surg. 2024 Sep 1;154(3):451e-464e. Uyulmaz S, Sanchez Macedo N, Rezaeian F, Giovanoli P, Lindenblatt N. Nanofat Grafting for Scar Treatment and Skin Quality Improvement. Aesthet Surg J. 2018 Mar 14;38(4):421-428. --- ### A Piece of Medical History Fell into My Possession Under Strange Circumstances URL: https://www.harmonface.com/blog/a-piece-of-medical-history-fell-into-my-possession-under-strange-circumstances Published: May 26, 2025 Author: Dr. Jeffrey Harmon Categories: History I inherited a physician examination table from my mother’s family when I graduated from medical school. The table was a strange inheritance because there are no other physicians in my family. My mother explained that it was found in the attic of one of my great grandparents’ homes in rural Central Kentucky. It is not clear how the table wound up in my mother’s possession. It would become clear years later, however, that it is a historical piece fit for a museum. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. I Inherited a Very Old Physician Exam Table Despite Having No Physician Relatives The table is in moderately good shape for its – obviously old – age. It is broken off the larger base and the table itself has a long narrow fracture. Otherwise, it is intact. The wood is solid walnut. The drawers contain holders for small cylindrical vials. The metal handles of the drawers are intricately decorated with floral patterns, evoking a Belle Epoque attention-to-detail that has long been lost in the design of medical offices. Stirrups extend from an opening at the top of the base. A secret compartment at the back of the bottom drawer contains a wired barrier, the purpose of which is unclear. I imagine the local town general practitioner gave the table to my great grandparents after a long career caring for the local population, going on house calls, administering tinctures, and delivering babies. My grandmother described her experience with a similar practice as recently as my mother’s childhood. I thought little of the table for years until the end of residency when my wife and I considered sending it to a carpenter for restoration. I found a reputable carpenter and emailed him, described the table, and asked for an approximate cost to repair. I explained that I believed the table was made in the early 1900s. He requested photos. The carpenter called me within only a few hours of emailing him the photos. He explained that, in fact, this table was likely made in the 1800s, possibly even during the Civil War, based on its appearance. The only clue I had to its age was a metal tag with the company name, Codman & Shurtleff Makers Boston, screwed to the side of the table. Codman & Shurtleff Makers Boston was Founded in the mid-1800s Information on Codman & Shurtleff Makers Boston is difficult to find and consists mostly of antique surgical instrument sales online. A quick scan of eBay found an example of the patented steam atomizer as well as Civil War-era dental instruments and a syringe. The most detailed company profile available is from a letter sent to a “Mr. Shurtleff” – of the original Shurtleff family, I assume – from the Product Coordinator of a subsidiary company to Johnson & Johnson: “In 1838, a mechanic in Roxbury, Massachusetts, designed a Pocket Cupping instrument for the application of Ether. The enthusiastic response of the Boston medical community encouraged Thomas Codman to apply his talents to crafting a number of medical and surgical items. Hence, the origins of Codman & Shurtleff, Inc. were well rooted in medical device innovation. Thomas' son Benjamin, graduated from Harvard Medical School in 1845. After purchasing the entire stock of dental supplies from druggist Joseph Burnett, Dr. Codman opened his Dental Depot on Tremont Street. Later, in 1853, he took Asahel Shurtleff on as his assistant and added surgical instruments and anatomical supplies to the line, establishing the Benjamin S. Codman & Company. In 1857, he was joined in partnership by Shurtleff and F.O. Whitney, and Codman & Shurtleff was established. Its line of medical, surgical, dental and veterinary instruments and supplies became more extensive; ear, nose, and throat instruments became a major portion of the business. With an increasing demand for a variety of atomizers used in the treatment of respiratory diseases, the Company began to produce its Patented Steam Atomizer in 1860. This product was an international best seller for over 20 years. During the same period, the Company introduced its General Surgery and Amputation Set, it designed to be used on the battlefield by Army surgeons during the Civil War. As a result, the Company prospered and its reputation grew significantly. Dr. Codman's death in 1894 dissolved the partnership and placed the Company into receivership.” The Shurtleff family reportedly purchased the assets of the company and re-incorporated into Codman and Shurtleff, Inc. in 1904. This fits the timeline that carpenter gave me that the table was likely made in the 1800s, as the tag on the table refers to the original Codman & Shurtleff Makers Boston company that was formed prior to its dissolution in 1894. As a result, my research suggests the physicians table was manufactured between 1857 and 1894. The Dilemma: to Preserve or Restore The Department of Otolaryngology – Head and Neck Surgery at the University of Cincinnati Medical Center, where I completed my residency training, has a beautiful collection of antique ear, nose, and throat (ENT) instruments, most of which were donated by an alumnus of the residency program. I have wondered whether any of those ENT instruments were produced by Codman & Shurtleff Makers Boston, who gained a reputation producing instruments for the specialty. I have also wondered whether the table I inherited should sit behind glass windows in the department as well. The carpenter who evaluated the piece explained that there are two trains of thought regarding antique wood furniture. Some feel preservation is ideal, especially if we plan to donate the table to a museum. However, he recommended full restoration of the table. He explained it is worth displaying it in our home due to its history and personal meaning. My conversation with the carpenter was eight years ago. The table has moved with us from Cincinnati to New York City and back. We once considered selling it, believing the table would be useless in our house. However, we have grown to appreciate its meaning over time, due both to its historic and family value. It also fits with my interest in the history of medicine, of which I have written about on the blog previously . My wife and I now plan to fully restore this table and display it prominently in our house, a symbol of my life’s calling and a connection to my extended family, however foggy. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more. Contact Us --- ### What Should I Wear the Morning of Surgery? URL: https://www.harmonface.com/blog/what-should-i-wear-the-morning-of-surgery Published: May 7, 2025 Author: Dr. Jeffrey Harmon Categories: General Information You will meet the entire surgical care team, complete paperwork, take photos, and change your clothes for the operating room the morning of surgery at Harmon Facial Plastic Surgery in Cincinnati. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Dress Comfortably We recommend that patients wear comfortable, stretchy pants or sweatpants and a shirt that buttons from the front. Patients can wear their pants in the operating room. However, their shirt is replaced with a long gown. It is much easier to put on a shirt on after surgery that does not need to be pulled over the face. A Long Gown and Non-Slip Socks Will Be Provided A long gown that ties from the back and non-slip socks are provided to patients before they enter the operating room. Patients will change back into their normal clothes prior to leaving the office. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon . Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati . Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati . Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono , on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! --- ### Will I Encourage My Children to Become Physicians? URL: https://www.harmonface.com/blog/will-i-encourage-my-children-to-become-physicians Published: April 11, 2025 Author: Dr. Jeffrey Harmon Categories: General Information I Received Contradictory Advice from Mentors When Starting the Practice I solicited as much advice as I could from my professional network when my wife and I founded Harmon Facial Plastic Surgery. Unfortunately, much of that advice was contradictory. For example, I was advised by one mentor to initially sublet space from another physician. I was advised by another mentor to start my practice in a new, personalized space. Once I had made the decision to build out a new office I was advised both to and not to build an accredited office-based surgery suite (OBSS). I chose to build the OBSS. Ask People Not For Advice but What They Did and Why I realized over time, rather than asking people for advice, it is more helpful to ask them what they did and why. Everyone’s professional journey is unique and cannot be copied for many reasons. However, I have found making my own decisions easier when I understand why other people made them and, most importantly, what the consequences were. I have gained the most valuable information from the reflections of thoughtful individuals on their choices years after they were made. I Have Had the Opportunity to Reflect on My Choices Which Led Me to Facial Plastic Surgery I could imagine no other career for myself. It has become a vocation. However, looking back, many things needed to have gone “right” for me to reach the point at which I was able to become a fellowship trained, double board-certified facial plastic surgeon. For example, I needed to score high enough on multiple rounds of standardized testing (e.g., MCAT, USMLE). I needed to consistently earn high grades in college and medical school. I needed to be invited to interviews for medical school, residency, and fellowship. I needed to interview well. I needed to build the experience necessary to achieve board certification. It was an amalgam of hard work, persistence, and luck that led me – improbably, for anyone – to my profession. Moreover, I achieved a great deal without the perspective or guidance of a parent or other relative. I Hope to Provide My Children with Perspective, Not Necessarily Guidance I was the first physician in my family. As a result, I navigated college, medical school, residency, and fellowship without an example or the perspective of someone who had gone through it as well. If one or both of my children pursues a career in medicine, I would be able to provide them with a perspective I never had. I would highlight both the positive and negative aspects of a career in medicine. That is something I never fully appreciated during my education and training. I believe they need a balanced perspective to understand how their professional choices could affect their lives when they are adults because the decision to enter medicine is made when you are young. I Hope to Model My Values for My Children I hope the values my wife and I model will help them become grounded, kind, happy, and successful individuals who are good to others. One of the things I am cognizant of is that I do not project my own desires, regrets, and aspirations onto my children. I strive to simply be an example; to be not only the father they deserve but also the physician they deserve to be cared for by. This does not mean that I would not derive great joy to watch my son and/or daughter become a facial plastic surgeon and pass the practice on to them. Trust Your Face to a Fellowship-Trained, Double Board-Certified Facial Plastic Surgeon It is important to seek a fellowship-trained, double board-certified specialist in plastic surgery of the face and neck when you have concerns about your face or neck. ---