Posted on February 3, 2012 in Face Lift, Facelift, Facial Plastic Surgery
Wondering what a typical facelift patient looks like in their 50s-60s? This latest blog entry by San Diego face expert, Dr. John Hilinski, highlights a female patient in this particular age range who desired cosmetic face enhancement to turn back the clock. Dr. Hilinski discusses the thought process and evaluation of your typical patient who has these type of concerns. Dr. Hilinski performed a combined facelift, neck lift, eyelid lift and chin implant to provide this patient a more rested, youthful appearance – all without looking like she had a surgical lift! To learn about this type of facial enhancement surgery performed by San Diego facial plastic surgery expert Dr. John Hilinski, use this link here.
Posted on January 26, 2012 in Facial Plastic Surgery, News, Rhinoplasty
Facial Plastic Surgeon in San Diego Discusses Rhinoplasty Recovery
According to the latest statistics from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the most popular cosmetic surgical procedure in 2010 was rhinoplasty, with an average of 54 procedures performed per surgeon. Dr. John Hilinski, a facial plastic surgeon in San Diego who performs well over 100 procedures each year, says because of its popularity, rhinoplasty is subjected to several misconceptions regarding recovery and the surgical process. Dr. Hilinski discusses important factors for patients to consider when weighing the gravity of a surgical procedure such as rhinoplasty in San Diego.
San Diego facial plastic surgeon Dr. John Hilinski says rhinoplasty is the most common procedure he performs at his practice, with an average well over 100 procedures each year. While well above the average, this statistic is reflected in the most recent study from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), which states that an average of 54 procedures were performed per surgeon during 2010.
According to the AAFPRS study, rhinoplasty was the most popular cosmetic surgical procedure performed in 2010, particularly among men where it was nearly twice as popular as any other surgical procedure. Dr. Hilinski says with the popularity of San Diego rhinoplasty comes a number of misconceptions patients need to be cautious of when considering the procedure. Because rhinoplasty affects both the cosmetic appearance of a central point in one’s facial symmetry, as well as essential airway passages and breathing structures, he says patients should be sure to discuss the entire surgical process and recovery with a board-certified facial plastic surgeon before undergoing any nasal reshaping surgery.
While the typical rhinoplasty procedure takes anywhere between an hour and a half to three hours to perform under general anesthesia, Dr. Hilinski says most patients expect the recovery process to be quick. However, because of the intricate nature of rhinoplasty, he says full healing and final shape of the nose may not occur until anywhere between six months to two years after surgery, depending on whether patients undergo an open or closed procedure. Dr. Hiliniski says many patients feel publicly presentable after 10-14 days, but rhinoplasty recovery is an ongoing process and patients need to be prepared for swelling, bruising, and puffiness that may realistically require a significant amount of healing before the final desired results take shape.
“In a majority of open rhinoplasty procedures, nearly 70-80% of the swelling has gone away by 2-3 months out from surgery. That leaves nearly 20-30% of the swelling that still has to go away over the next 1-2 years. This is a point that many rhinoplasty patients often times forget. Even at 9 months out from surgery, when patients think they are looking at the final result, the reality is they still have a decent amount of healing to go before the shape of the nose finally plateaus. In patients who have had a closed rhinoplasty procedure, it may take the final shape as early as 6-9 months out from surgery since there is less swelling involved with this type of rhinoplasty technique. Over this time they should see a progressive trend where the nose is taking on its new shape and size. However, rhinoplasty patients need to keep in mind that there may be periods of time (days to weeks) when the nose looks more swollen or puffy than it did previously.”
Dr. Hilinski says patients considering rhinoplasty must take into account all factors before deciding to undergo a procedure. He stresses the level of commitment patients need to prepare for with such a cosmetic enhancement and recommends talking about the options with an experienced and personal facial plastic surgeon so as to ensure the highest quality results, safety, and patient satisfaction are achieved.
“I think one of the most important things that patients need to realize about rhinoplasty surgery is the healing process can be quite extensive when compared with other plastic surgery procedures (such as breast augmentation or eyelid surgery). Many patients are under the mistaken perception that their nose will be essentially healed 2-4 weeks out from surgery. When someone considers undergoing a rhinoplasty procedure, they are committing themselves to a long-term healing process that can take upwards of 1-2 years before the nose ultimately settles into its final shape and size. This is quite a commitment when it comes to surgical healing and one that needs to be considered very seriously by any potential rhinoplasty patient.”
About John M. Hilinski, MD
Dr. John Hilinski earned his medical degree from Harvard Medical School in Boston, after which he completed a General Surgery Internship followed by a Head and Neck Surgery residency at the University of California, San Diego (UCSD) Medical Center. He also completed a Facial Plastic and Reconstructive Surgery Fellowship at the University of Illinois, Chicago Medical Center and a National Institutes of Health Research Fellowship at the UCSD Cancer Center. Dr. Hilinski has served as a staff surgeon at Sharp Memorial Hospital and Scripps Clinic and Green Hospital, as well as a Clinical Faculty Instructor in Facial Plastic and Reconstructive Surgery at the UCSD Medical Center and Veterans Administration Medical Center. He is board-certified in Facial Plastic and Reconstructive Surgery and Head and Neck Surgery. Dr. Hilinski is also a member of the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Otolaryngology-Head and Neck Surgery, the California Society of Facial Plastic Surgery, and the San Diego County Medical Society, in addition to having been published in several book chapters and medical journals.
Located at 3720 Fourth Avenue in San Diego, CA, Dr. Hilinski’s practice can be reached at (619) 296-3223. He can also be contacted online via the website www.drhilinski.com or www.facebook.com/drhilinski.
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Posted on January 17, 2012 in Facial Plastic Surgery
What is the youngest age when it comes to performing cosmetic rhinoplasty surgery in San Diego, CA? In general, the youngest age for female patients is around 16-17 years old and for males around 17-18 years old. These age ranges are chosen because it is around that point in their development that growth of the nose (inside and out) has begun to stabilize. Because of this, surgical reshaping of the nose can be undertaken through rhinoplasty surgery without a significant risk of disrupting the normal growth pattern. That being said, I have performed rhinoplasty surgery on female patients as young as 15 years old in certain situations. For instance, a young female patient who was only 15 years old had seen me for rhinoplasty reconstruction of the nose because she wanted to have a smaller looking nose. In a scenario such as this where we would be attempting to make the nose smaller, the risk of disrupting further growth of the nose is not as much of a concern. Her rhinoplasty was performed with excellent results that look very natural for her face. But as a rule of thumb, you can consider those age ranges noted above as a guideline for consideration of rhinoplasty surgery in your teens.
Posted on December 13, 2011 in Facial Plastic Surgery, Plastic Surgery
I just wanted to take a moment and wish all of our patients and colleagues a happy 2011 holiday season! We are truly grateful and honored to have such an amazing group of loyal patients and trusted colleagues who motivate me everyday. From the San Diego Face and Neck Specialties family to yours – Merry Christmas!
Posted on November 3, 2011 in Facial Plastic Surgery, News
San Diego Facial Plastic Surgeon on Rhinoplasty and Choosing the Right Practice for a Procedure
According to the latest statistics from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), rhinoplasty was the top procedure performed by facial plastic surgeons in 2010, with an average of 54 procedures performed per surgeon. Dr. John Hilinski, a double board-certified facial plastic surgeon in San Diego, says that because of the difficulty involved in successful rhinoplasty, consulting with the proper physician is essential for achieving the best results. Dr. Hilinski discusses the intricacies and complexities of rhinoplasty as well as specific qualifications to look for in a facial plastic surgeon.
At his San Diego facial plastic surgery practice, Dr. John Hilinski says rhinoplasty is the most common procedure he performs. The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) confirms Dr. Hilinski’s observations, reporting in their latest study that an average of 54 rhinoplasty procedures were performed in 2010 per surgeon, followed by facelift with an average of 50 procedures and eyelid surgery with an average of 49. Because of its popularity, Dr. Hilinski says many doctors are choosing to offer rhinoplasty at their practice, but few have the qualifications and experience needed to perform such a complex and intricate procedure. He says rhinoplasty requires specific surgical attention to both the cosmetic appearance and the physiological detail of the nose’s structure, because it impacts both a person’s breathing and their appearance.
“Cosmetic rhinoplasty is arguably the most complex and challenging plastic surgery procedure performed because the nose is truly the centerpiece of the face and plays such an important role in our facial appearance. And, unlike other cosmetic procedures such as breast augmentation and abdominoplasty, less than ideal surgical results cannot be easily concealed from view. Because the stakes are so high in cosmetic reshaping of the nose, choosing your rhinoplasty surgeon can significantly influence whether or not a successful outcome is achieved.”
Dr. Hilinski says that as with any aesthetic enhancement, patients must be sure to consult with the proper surgeon before undergoing a rhinoplasty or secondary rhinoplasty procedure. He also adds that plastic surgeons with specific focus on the face and nose are far more likely to have the experience and surgical ability to perform the procedure successfully and with the highest quality results. Dr. Hilinski says surgeons who have been certified by the American Board of Facial Plastic and Reconstructive Surgery and also the American Board of Otolaryngology-Head and Neck Surgery are preferred because of their dedication to the specific cosmetic and functional structure of the nose and face. “Those with this additional board certification have established expertise in dealing with the actual function of the nose. Such experience can be vital when reshaping the nose for cosmetic reasons, as form and function are inextricably linked when it comes to rhinoplasty surgery.”
Another distinction to look for in a facial plastic surgeon according to Dr. Hilinski is a detailed and expansive portfolio of before-and-after photographs. He says that a surgeon’s ability to display their work extensively signifies an aptitude and consistency in their surgical technique that comes from having an experienced background in performing rhinoplasty and revision rhinoplasty.
Regardless of whether patients are seeking rhinoplasty in San Diego, or another procedure such as eyelid surgery, Dr. Hilinski recommends putting the time into researching thoroughly all options before undergoing any procedure. “Unless your chosen rhinoplasty surgeon meets these all-important criteria, my recommendation is to keep looking. Given the fact that cosmetic nose reshaping is widely regarded as the most difficult plastic surgery procedure to perform correctly, doing your homework way up front can pay huge dividends in the future.”
About John Hilinski, MD
Dr. John Hilinski received his medical degree from Harvard Medical School. He completed a General Surgery internship and a Head and Neck surgery residency at the University of California, San Diego Medical Center, focusing exclusively on surgery of the face and neck. Dr. Hilinski also received extensive training through a fellowship in Facial Plastic & Reconstructive surgery in Chicago, IL, where he served as a Clinical Instructor in the Division of Facial Plastic and Reconstructive Surgery at the University of Illinois, Chicago College of Medicine. He is double board-certified in Facial Plastic and Reconstructive Surgery as well as Head and Neck Surgery. Dr. Hilinski is a member of the American Academy of Facial Plastic and Reconstructive Surgery and the American Academy of Otolaryngology-Head and Neck Surgery. He has been published in numerous medical journals and book chapters for rhinoplasty and advanced techniques in scar revision.
Located at 3270 Fourth Avenue in San Diego, Dr. Hilinski’s practice can be contacted at (619) 296-3223 or online via the website drhilinski.com or www.facebook.com/drhilinski.
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Posted on October 9, 2011 in Dermal Fillers, Facial Plastic Surgery
Many patients inquire about non-absorbable options for treating unwanted hollowing and volume deficiency of the face. These are patients that have tried temporary injectable fillers, such as Juvederm, Restylane, Perlane and Radiesse, but are unhappy with having to get repeated treatments every year. One alternative is to use liquid silicone injections to achieve a more long-lasting cosmetic enhancement. Silicone injections are considered off-label when used for this type of purpose. They are FDA approved for injection elsewhere in the face, but like Botox and hyaluronic acid fillers, silicone is used off-label (meaning off the FDA label) in other areas for cosmetic treatment of unwanted soft tissue depressions and hollowing. This includes undesirable shadowing around the lower eyelid-cheek junction and loss of facial volume in the mid-cheek region. The patient example below highlights the typical candidate for silicone injection.
Micro Injection of Silicone
This male patient from San Diego felt as if his cheeks were becoming too hollowed and thinned. On examination, he definitely demonstrated evidence of soft tissue atrophy (shrinkage) particularly through the cheek to lower eyelid region. We discussed the various options available to him. Ultimately, he chose to have micro silicone injections to help him achieve a more sustained, long-term cosmetic enhancement. By ‘micro’ what is implied is that the silicone is placed with much smaller volumes of injection distributed over a wide area. This in contrast to injecting the same amount of total volume into one or two confined areas. By distributing the silicone injections over a broader region, the body has greater opportunity to surround the micro droplets of silicone with collagen tissue. Thus, there is a more dramatic, smoother collagen response that translates into an improved cosmetic result with less chance of complications. Following a series of silicone injections spaced apart 6-8 weeks each, the body’s own collagen elicits a controlled response to fill out the treated areas. As you can see in his before and after photos, there has been a notable volume enhancement through the cheek and lower eyelid region that gives him a ‘fuller’ look to his face. And what he sees in terms of a clinical response is there for the long run as silicone injections result in a more permanent outcome.
Posted on October 7, 2011 in Chin Implant, Facial Plastic Surgery
This young female patient from San Diego is a great example of how a chin implant can significantly enhance facial harmony and balance without looking surgically ‘altered’ or ‘done’ as some people fear. This particular patient had what we would describe as facial plastic surgeons was poor chin projection. Meaning, her chin simply too small for her lower face and did not project outward sufficiently to be in balance with the mid to upper face. In most cases, we evaluate chin projection and position by looking at the side view, or profile.This is shown in the adjacent photo diagram of this patient taken prior to chin implant surgery. An imaginary vertical line is typically drawn straight down from where the red and white lip meet. Ideally, the chin in a female patient should project forward to within millimeters of this line on average. As you can see, the most prominent point of her chin, as seen from the side view, sits several millimeters behind what is considered ideal.
Chin Implant For Facial Enhancement
In this case, the patient opted for augmentation of her chin using a chin implant, which is clearly the most common method of chin enhancement in my practice. By going from underneath her chin, I was able to hide the scar quite nicely. In addition, this approach allowed for more accurate placement of the chin implant and less likelihood of her getting an infection (compared with placement done through the mouth). Overall, you can see from her before and after photos that her lower face is now in much better balance and harmony with the mid and upper face regions. Her chin contour has been notably enhanced and she has improved definition of her jawline. Arguably most important is the fact her jaw and chin still look very natural for her facial features. Although we know she has a chin implant, this is not something that is readily picked up by someone walking by her on the streets of San Diego.
Chin Implant Consultation in San Diego
If you have an underdeveloped chin and/or desire enhancement of your chin projection, feel free to contact our San Diego office today for a complimentary consultation for chin implant surgery.
Posted on October 6, 2011 in Brow Lift, Face Lift, Facelift, Facial Plastic Surgery
Many patients inquire about crooked eyebrow position, also known as asymmetric eyebrow positioning, and whether or not a browlift might help. What they are referring to is the actual position and shape of the eyebrows. In a good majority of people, the eyebrows naturally sit differently on both sides of the forehead – one side is usually higher than the other. Most of us are simply born this way. In most social situations and conversational environments, however, this difference in eyebrow position is not really obvious to others. There are definitely patients, though, who are bothered by the fact their eyebrows have a different shape when comparing the two sides. In fact, so much so, they seek out a facial plastic surgeon to help enhance the symmetry in the eyebrows. This particular patient is one such example and is presented here.
Eyebrow Lift Patient Presentation
This patient was unhappy with the fact her left eyebrow was lower and flatter than her right eyebrow. Again, many patients might look at this and not put too much emphasis on this natural difference between the two eyebrows. However, there are a good number of patients who present to us facial plastic surgeons each year seeking correction of crooked eyebrows. One option that is quite common is using botox injections to help create more eyebrow symmetry by lifting the one side. Unfortunately, many patients, like this one, are looking for a more permanent surgical correction. In this particular patient, we recommended an eyebrow lift, which is also known as a brow lift or forehead lift (suspension). This is a cosmetic eyebrow procedure intended to lift the brow region to reposition and reshape the lower forehead. This can be done using what is called an open brow lift approach where incisions are hidden in the hairline to perform the forehead suspension. Alternatively, an endoscopic brow lift can be done (also called an endobrow lift) where limited incisions are made and small surgical telescopes are used to perform the forehead lift. Each one has its own advantages and disadvantages that will be reviewed with your facial plastic surgeon to determine the best choice for your individual case. In this particular patient, she chose to have the open approach brow lift surgery.
Eyebrow Lift Surgery Photos
Her before and after eyebrow lift photos are shown here. As you can appreciate there has been a notable enhancement in her eyebrow position and shape on her left side. This side of her forehead was lifted more preferentially to try and achieve the desired symmetry. Using meticulous surgical technique and permanent sutures, her left eyebrow was lifted and repositioned in a higher location to create a more feminine arch-shaped eyebrow. As is noted in the photo diagrams, her left eyebrow was previously quite flat across as is indicated by the blue line. Following the forehead lift, or brow lift, it was more arched to match her right side as indicated by the red curved line. Certainly some people may look at this and think – subtle change. But in many cases of facial plastic surgery, this is precisely what is desired and needed – a visible cosmetic improvement in an area without looking surgical altered. And in the case of an eyebrow lift, avoiding that unwanted surprised look that so many patients fear.
San Diego Brow Lift Consultation
If you or someone you know is interested in having an eyebrow lift (forehead lift) to enhance the appearance of their brows, please contact our office today to arrange for a complimentary consultation. You can also learn more about cosmetic facial enhancement of the eyebrow region by visiting our comprehensive website at http://www.drhilinski.com. We look forward to meeting you.
Posted on August 30, 2011 in Facial Plastic Surgery, Nose Job, Nose Reshaping, Revision Rhinoplasty, Revision Rhinoplasty Specialist, Rhinoplasty
Dr. John Hilinski and his staff are proud to announce the launch of SanDiegoRhinoplasty.com – a website dedicated to educating potential rhinoplasty and revision rhinoplasty patients. SanDiegoRhinoplasty.com is intended to complement our main website – drhilinski.com – as a specialized online resource for those considering cosmetic nose reshaping. The new site also contains an online rhinoplasty patient primer that is similar but distinct from our current rhinoplasty tutorial. As an authority and regional expert in rhinoplasty and revision rhinoplasty, Dr. Hilinski felt compelled to develop SanDiegoRhinoplasty.com so that those considering plastic surgery of the nose would have a fully dedicated educational and reference guide. We hope you enjoy the new site!
Posted on August 9, 2011 in Facial Plastic Surgery, Scar Revision
Over this past week, I have witnessed several traumatic injuries to the face while watching a number of competitive water polo games in Orange County. Many of these injuries occurred around the eyes and forehead region and involved lacerations (cuts). Unfortunately, I was not equipped to offer my services on the pool deck! Most of these injuries were subsequently seen and treated in the local emergency rooms. Although there is great care provided in a good majority of our community emergency rooms, facial laceration repair is one procedure that commonly needs revision by a plastic surgeon. This is a great example of facial scar revision in a female patient from San Diego, CA who was also initially repaired in an emergency room. 
This particular patient suffered a facial laceration while sledding in the local mountains. The laceration was repaired by staff at a local emergency room without the advise of a plastic surgeon. Unfortunately, the laceration did not heal optimally and she desired scar revision to make it less visible. As you can see in the adjacent photo of her forehead, there is an obvious visible scar that is abnormally shaped running across her mid-forehead. You can also appreciate the fact that the scar has darkened (called hyperpigmentation) and is slightly depressed (sunken in). This latter problem creates unwanted shadowing of the scar and contributes to the scar being much more visible.
The patient elected to undergo facial scar revision with our office to help improve the appearance of the scar. We recommended a technique called excisional scar revision – meaning we planned on cutting out (excising) her old scar and redoing the closure in a more meticulous manner. She underwent the procedure using just local anesthesia to numb the area. We removed her old scar completely then realigned the skin edges in a very strategic fashion. We then let her heal for at least a year, which is about how long it normally takes for scars to mature and evolve to a stable state. In the meantime, she was recommended to use topical healing gels like Mederma and silicone to aid the scar maturation process. Her end results are shown below.
Photos of Facial Scar Revision
As you can see from her before and after scar revision photos, she has a significant improvement in the appearance of the scar. Is it completely invisible? Absolutely not. But the patient and plastic surgeon have to be realistic in terms of what they are trying to achieve with this type of cosmetic enhancement procedure. The goal is to make the scar less visible to the naked eye. It would be completely unrealistic to think that the scar will disappear completely after scar revision. In this particular case, we were able to achieve the goal of making the scar much less visible to the naked eye. The level of the scar is much better and more even with the surrounding skin. The texture and color of the scar have also been enhanced. There has been a clear cosmetic improvement that might be further enhanced by additional techniques like dermabrasion. However, the patient is quite happy with the overall change and is not interested in pursuing any further procedures for the scar. If you are interested in having a scar revised for cosmetic improvement in appearance, please do not hesitate in contacting our San Diego facial plastic surgery office today.
