Question Number One

What can be done with cosmetic surgery?

Another way of asking the same question is " What results can be expected from cosmetic surgery? " And what most of us are interested in eventually, is not just what has been done for someone else, but What can be done for me?

This web site is for the answer to these questions. What can be done is shown in pictures and explained in words. What can be done for each person can be imagined by seeing what has been done for others. But a more specific answer is shown in drawings of each persons face. And anyone can do the drawings.

We want to know in advance as clearly as possible what is going to happen to us and what the result will be. What we fear most is the unknown. Here we want to share all the experience we have had in more than thirty years ofcosmetic surgery, and to explain how to find out and know as clearly as possible what the results of doing something cosmetic would be like.

We have chosen the word " result " to mean all the consequences of surgery both good and bad.

Can anything be done for my face that would be safe, easy and painless and would not change my appearance except for the improvement, and have enough improvement in appearance that would be visible to and look good to everyone who sees me, that would be completely natural with no scars and of little cost and great benefit? The answer is usually Yes .

Let us explain and show in this web site as clearly as we can how that can be pre-determined so that it is much less a matter of taking a chance.

See what has been done in photographs

Instead of explaining only in words,it is faster and easier to see results. The quickest way to see results is with good quality photographs. If we can see the good quality before and after results of the doctors work, then we know what can be done.Or at least what canbe done by that doctor.

It is very goodif one knows in advance what changes are to be made, how much improvement, how soon the recovery, and all the good and the bad as clearly as possible so that there is much known and little left to the unknown. And this is why we show a lot of pictures and do a lot of planning with drawings.

To say in words that the results can be from bad to excellent is worth much lessthan seeing them for yourself. The quickest, easiest way to see and study results is with photographs.

Digital photographs and retouching

But let us beware of digital photographs as shown on the internet. Retouching of photographs dates back more than 100 years. Most of the glamour photos of movie stars were retouched extensively. The most famous photographers such as Ansel Adams retouched and enhanced their photographs.

And now with digital technology, every magazine cover is digitized before it is printed. Even of the most famous and beautiful models gracing the ads and covers on the newsstands, everything of face and body are retouched routinely. They are scanned photographs at 35Mb or greater size, and each of the 35 million or more pixels can be changed individually with the most subtle (and sometimes not so subtle at all) beneficial changes which no one can tell and no one will ever know. All internet pictures are digital.

This is a danger for the observer of cosmetic surgery results on the internet. Any or all of the surgery results in the before and after pictures can be enhanced either by making the before look worse or the after better. And sometimes both are retouched.

All of the photographs we show you here andin the office of the more than 200,000 available are from film, and not digital. You are very welcome to see the negatives and slides from which they are made - dates and everything.

In this site no retouching of any surgery results has been done. Everyone is invited to see the slides and negatives of the befores and the afters shown. Almost all the pictures, except the drawings, are from film and were not originally digital. The slides are dated by the developer. And the negatives are in strips with other photos taken on the same dates. And this should be required of all results shown on the internet or in the surgeons office. When visiting us in the office, we hope you will ask to see the original slides and negatives of random choices if the results photographs look exceptionally good. We will not only NOT be offended, but pleased that you are interested.

The Scales of Balance

Since the word " results " has been chosen to include all of the effects of surgery, both the good and the bad, the results can be expressed as scales of balance with the good on one side and the bad on the other. In cosmetic surgery the good should far outweigh the bad or the surgery should not be done. In the visit with a cosmetic surgeon a prediction or estimation of all the good and bad effects of each procedure and change in appearance that is contemplated can be given to the person who is considering having the work done.

What can be done with cosmetic surgery can be shown with photographs. To be believed the photographs of work done of the face should be on film and not just digital. The lighting, camera settings,makeup, position, and expression of the subject should be the same in the before and after so they can be compared for what the surgery has accomplished.

The stages of progress from one day after surgery until the person is looking and feeling well can also be clearly seen in pictures. See samplesof day-by-day recovery under the Nose and Face sections of the menu.

The importance of photographs

If someone asks me if I know a good surgeon they could go to in New York, Miami or Berlin, the answer is Yes, I know some surgeons there. And some of them are very nice, very pleasant to see at meetings, and good friends. Some I know quite well having seen them and known them for years. But I would not go by just that. It would be much better if I could see before and after photographs of the work they have done and to know what kind of work they do rather than to know them personally.

The surgeons I know may be the most friendly, kind and sociable persons,and yet do lousy work . And on the other hand, someone whom I have never even met may be doing the best work. Good quality before and after pictures of the results of the surgery show if the cosmetic surgeon is doing good work. The before and after pictures of the work they have done is the most important criteria by which we can tell how good the work they do is.

It is as in sports - as runners say - it is how fast s/he runs that counts. In golf, the score is most important. Nothing else.

How good a cosmetic surgeon is depends on how good the results are. Nothing else.

What are good results? Good results are the most benefit with the least harm. The most beautiful appearance, and the least amount of swelling, bruising, recovery time, and ill effects.

What are good Results ?

As I heard the architect I. M. Pei say "function before form". And that is true of our work too. A face that is beautiful but does not function properly is not acceptable.

To be a good result the result must be completely natural in function and appearance. It is not good to have an attractive nose and not be able to breathe through it. Or big beautiful lips that dont move normally and cause a lisp. Or beautiful eyes that are red and burning from dryness because they wont close at night.

A beautiful result is beautiful to everyone. Not just those in the know. Not just the sophisticated, educated, intelligent people. But everyone from children to the elderly. Everyone of every race creed, culture, ethnic group or country of origin. Just as flowers appeal to everyone, so should a beautiful face.

Another comparison to architecture is the importance of planning. The credit for a beautiful building is given to the architect who conceives it and plans it, rather than the actual builders. The plans tell the builders what to do.

The importance of a goal

So have we found it to be with cosmetic surgery. A good plan leads to a good result. An excellent plan to an excellent result.

The plans that we make for the face are drawings done on the person's pictures. I began drawing and planning in 1965 having heard of this technique from an American Rhinologic Society meeting.

Upon showing drawings Ihad done to the patient, it immediately became clearthat if drawings are done to plan the result of the procedure, the patient is very interested in them and wants to participate and choose what appearance they are going to have.

So by the late 1960s we would make many photocopies of the drawings in progress and give copies to the prospective patients to take home and show to their trusted friends and relatives. They could also study and modify the drawings until from many alternatives the very best drawing could be chosen.

Anyone can do all the drawings themselves without the assistance of the surgeon or his assistants. Some of the finest drawings we have used as a goal have been done by professional artists and art teachers of high schools and colleges. Many are done by the patients and their families and friends.

Drawing on photocopies of the original pictures is easily done in pen or pencil. And more and more people have digital cameras and drawing programs on their computers at home or the office.

Then, with the chosen drawing, the challenge was to see how close to the drawing we could come with the result of surgery.

And so for all the past 30 years, every patient has had drawings that they have chosen. Some of the chosen drawings are shown on this web site. While visiting us in the office in reviewing some of the more than 8,000 photos we have prepared to show, some before and after photos may be chosen at random to see the drawings that were chosen by that person in the photos. And in this way a good, clear estimate of how close we usually come to the drawings with the result can be made.

Although we have had computer imaging since 1985, the final plan drawings were still done with pencil, pen and paper until 1995 because the printing was not of high enough resolution. Since 1995 the printer output has been photo quality. We still do some sketching even on the photo drawings produced by the computer, or on photocopies of them. Fine tuning of drawings and producing variations can be done as fast as one drawing per minute. This can provide many drawings from which to choose.

Cosmetic surgery has certain ethics or rules. A full list of them is under Principles and Ethics section.

"What specifically would be best for me?"

The most common first question of a person who comes to visit is, "What can you do for me?" For each person, the answer is different. To give an accurate and fairly complete answer covering all of the possibilities and reasonable alternatives requires a thorough analysis of that persons face.

After a brief health history and a few questions regarding the person's wishes, we do this analysis routinely in five different ways:

1. Mirror examination.

2. Digital or pen/pencil drawing.

3. Photographic analysis and sketches.

4. Comparisons with other faces, including before and after photos.

5. Physical examination, often with a microscope.

And then there is the explanation and discussion of all of these findings.

Each person isgiven photocopies of all of the drawings and sketches for independent study at home and a copy of the prints of any pictures taken.

From the analysis among all of the possibilities and alternatives explored is a search for:

1. The best appearance that can be accomplished.

2. The most improvement in appearance with the least amount of change.

We want to find for each person the most benefit with the least amount of surgery, and the maximum improvement in appearance. Then in addition to those two things, all the alternatives and possibilities are shown so a goal can be chosen. Ordinarily a person chooses what they like best.

Choosing a goal

The photographic analysis and sketching is the real planning phase. It is approximately equivalent to an architects plan for a building. It is very important because the intention is for the result to look almost exactly like the chosen plan.

Choosing a goal is also very important in that it is a search for the best the person can look - the most beautiful that person can be. No matter how much change is required to get there, it is good to know how good it can be when we look our best. Any drawing that can be improved upon should be. And the final drawing or plan should be un-improvable. It should not be possible to improve on the drawing chosen to be the goal..

Yet the best looking drawing may not be the one that is chosen, because the change may be too great.

We will want to find for each person the best possible result with the least amount of surgery - the "biggest bang for the buck". The best appearance, however, may still be chosen even though more change is required to achieve it.

Learning about the experience

Another great source of information when visiting a doctors office are the photos of other patients who have had procedures done similar to those being considered. Very often I will ask of the after surgery patients if it would please them toshare their results and experiences with anotherperson who is a complete stranger, all the good and the bad.Most say yes.

Even when there is distortion from swelling and bruising and the after surgery patient doesn't feel that anything good can be said about how they feel, the communication is encouraged. It is especially beneficial for the person considering going through the process to see and hear the truth, all the bad as well as the good. The better-informed one is, the less afraid andmore confident they become.

Being left alone with several and sometimes many persons individuallywho are friendly and want to share can be more informative and memorable than any other information that is given. Previous patients can tell all about what the experience was like and also share the experiences of all the others they have met who have been through the same or similar experiences. And they can be asked very open and direct questions that one might feel embarrassed to ask the doctor.

Many patients have met as many as a dozen other patients who shared with them their experiences. Sometimes they have become good friends and shared telephone numbers. Even some of the well-known persons who require more confidentiality and privacy have enjoyed meeting others and sharing their experiences of surgery.

It is like a support group that can be very helpful to many. The expectant mothers meet together ingroups at the hospital and learn from each other. And many others with shared experiences, goals and values become friends in school or church or many other ways. It can be very helpful not only for the one who is seeking information and understanding, but also for the ones who are sharing.

It is highly desirable that the person considering an improvement in appearance is given all the information about all of the alternatives available before the final decisions are made. At stake is not only the persons appearance, but also their health and comfort as well as considerable cost in time and money.

A poorly planned result can be very disappointing and a very good one a joy forever. Let us help you plan a good one!

Contact us at:

William Roy Morgan M.D., F.A.C.S .

1419 Superior Avenue, Suite 2

Newport Beach CA 92663

Phone 949-645-6665

wrm@mail.wrmorganmd.com

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