Archive for the ‘plastic surgeon’ Category

Shloop or Droop? How to protect your breasts 24/7

The idea of wearing a bra to bed is nothing new. I estimate approximately 6% of women already realize the benefit sleeping in a bra either because they were advised to do so by a buxom relative with ample bosom or are clever enough to understand how the laws of physics will affect their breasts in the long run.

Breasts without bras BREASTS WITHOUT BRAS

Breasts are affected by gravity just in the same way that Sir Isaac Newton noted that an apple is. If the apple is not prevented from dropping to the ground, it will do so and often get damaged in the process. During the day, breasts get pulled towards the earth in the same way and if no support is provided to counteract this force, breasts will eventually elongate and narrow complemented often times with downward facing nipples.

After examining thousands of breasts throughout  my 20 years of private practice, I have come to realize that those who sleep in a brassiere generally have perky breasts than those who don’t. Specifically, those who wear a bra during the day and not one at night tend to have breasts which are wider, yet flatter and concave on top with their nipples still point upwards.

Oblique cross-section of breast showing inner anatomy including Cooper's suspensory ligament's.Oblique cross-section of breast showing inner anatomy including Cooper’s suspensory ligament’s.

Apart from being blessed with good genetics to imbue your breasts with strong Cooper’s ligaments, collagen and skin there is nothing one can do to to protect your breasts from drooping except good old fashion commonsense prevention – and that comes in the form of a bra.

There is no muscle in the breasts therefore neither exercise nor yoga positions will help. There’s even poorly conceived research stating that wearing a bra creates more drooping of the breast because “they limit the growth of supporting breast tissue, leaving the breast to wither away and degrade more quickly”! In other words, they imply that the stress of gravity is good for the breast, training it like a muscle. If that were the case, patients could simply gain and lose excessive weight repeatedly in order to” train the skin” so that stretch marks can be avoided. OK…but I then wonder why pregnancy results in abdominal stretch marks…hmmmm?


My job as a plastic surgeon is to not just simply do the surgery and wish my patients all the best as they fade into the sunset. I feel it is my responsibility to also provide an “instruction manual” so to speak on how to manage their aesthetic wellness outside of my clinic and operating room.

For example, after facial surgery I recommend specialized skin care regimens and after body sculpting, certain diet and exercise. However, after breast surgery, few if any plastic surgeons recommend long term breast care except for incision/scar management, implant massage and mammograms. You only have one set of breasts and whether or not you choose to undergo plastic surgery, it is equally important to invest time and not just money in protecting their aesthetic wellness as appropriately early as you can. As soon as a young woman’s breasts are large enough to fall off the side of their chest when they are lying down is the ideal time to prevent them from doing so!

In the same way that gravity exerts an affect on a woman’s breasts when she stands, it also profoundly affects them when she lies down. However, wearing a regular, daytime bra to bed simply did not provide the specialized support that was needed when on one’s back and side. When calling the support specialized, I am referring specifically to secure lateral outside support to keep the breasts from falling off to the side in addition to inner or middle support to prevent the upper breast from falling onto the lower during side sleeping.

There were no bras on the market that addressed these important issues. It is for that reason that I developed NightLift ®. It had to fill three criteria:

1. First and foremost, it had to be comfortable, like a second skin if you will. Despite providing unparalleled support, no underwires exist within this bra.

2. It had to work. 48 prototypes were developed over several years to ensure ultimate support without wire or compression. We call  this technology B.U.S.T. ® (bilateral uplift support technology).

3. It has to be stylish and sexy so a woman not only feels fabulous but also looks great, whether she’s alone or with her partner.

Whether a woman has undergone breast surgery or not, I recommend night list to all of my patients if she is concerned with aesthetic wellness of her breasts. After breast surgery (including breast augmentation, mastopexy or breast reduction) I fit my patients in NL a week after surgery when most swelling has dissipated. Since NL provides incredibly comfortable support without hurtful underwire, patients fall in love with this and it soon becomes a staple within their lingerie collection.


Randal Haworth MD


To learn more, go to

You do not need to look surprised after a BrowLift

Better late than never! This is the second part of a blog I wrote almost one year ago about the upper blepharoplasties and brow lifts. Brow lifts are often confused and considered part of a facelift but they are not. A facelift deals with rejuvenating the areas below the lower eyelids including the midface, jowls, jawline and neck.

I am honored to be giving a talk to my esteemed plastic surgical colleagues at the California Society of Facial Plastic Surgeons annual meeting in Lake Tahoe this March. The purpose of my talk is to share my thoughts not only of brow elevation but also of controlling and creating the ideal brow shape. Ironically, as I write this, I am sitting in my hotel room having just listened to 6 hours’ worth of talks from other plastic surgeons about brow lifts and shaping as part of a meeting for the American Society of Aesthetic Plastic Surgeons. As always, I come back from these meetings with one or two pearls that I am keen to incorporate into my practice to provide the best possible results for my patients.

However, I think that most surgeons miss the point about brow reshaping. We all understand that we want the tail end of the brow to sweep upwards in a glamorous yet subtle arch without creating a surprised or malevolent/samurai look (think Carrot Top or Cruella DeVille). Unfortunately, the techniques to achieve that fall short of their stated goals. Surgeons apply tension through hidden incisions behind the temple hairline in a effort to raise the outside aspect of the eyebrow, but this is soon met with diminishing returns. As in all aspects of plastic surgery, simply applying more tension to a region that is resisting movement will not will not provide long lasting elevation. After a few weeks to months, mother nature wins and the structure (in this case the outside aspect of the brow) will fall down again.

Endoscopic brow lifts are beautifully elegant operations that are performed through 2 cm hidden incisions within the hair which do not involve shaving or cutting out skin. Most surgeons, as I mentioned, will attempt to lift up the outside aspect of the brow by angling the incisions outwards on the side of the head to apply upward tension through them. Unfortunately, much resistance is encountered and the results reflect that. In a counterintuitive move, I have angled the inner incisions towards the midline and have found that I can lift the outer aspect of the brows almost effortlessly with minimal tension. The results are long-lasting and more simulate the appealing eyebrow shape of a young cover girl.

Check out the following 31 year-old patient who underwent a brow lift along with fat transfer, chin implant and a minor rhinoplasty:

I feel that brow lifts are sometimes misunderstood creatures. They are under appreciated and when performed correctly provide extremely beautiful results that not only rejuvenate the forehead, reduce wrinkles, elevate and reshape the brows while rejuvenating the upper eyelids. 70% of patients that come to my office complaining of upper eyelid sagging and all they simply need is a well performed modern endoscopic brow lift.

 slightly weak chin and a subtle bulbous nasal tip

31-year-old female with noticeable facial asymmetry with low-set brows. Of note, she also had slightly weak chin and a subtle bulbous nasal tip

exquisite improvement in brow position and shape

Three month follow-up showing exquisite improvement in brow position and shape. Note how her face and eyes “open up”

Preoperative photograph showing the oblique view

Preoperative photograph showing the oblique view of the same patient.

 three-month follow-up of the same patient demonstrating the chin augmentation as well as the minor change to her nasal tip

A three-month follow-up of the same patient demonstrating the chin augmentation as well as the minor change to her nasal tip. Again, note the improved brow position and shape without any look of surprise.”

Can plastic surgery buy you happiness (especially if you are on Adderall) :)?


“Plastic surgery won’t make you happy, but it can make you happier”

I think most sentient human beings will agree that the world it’s becoming a crazier place in which to live. We are constantly bombarded by negative imagery, negative stories, negative experiences, negative people while reminded that we are not good enough to fit the ideal as embodied by the media’s ambassadorial cadre of celebrities and certain reality stars. In more recent years, I am seeing an uptick in the amount of negative patients in my practice. I have learned to better recognize them and avoid operating on them as best I can.

Why do I do this?

The answer is simple. I avoid operating on them to better serve them . My staff and I at the Haworth Institute adhere to a basic principle of delivering the best service possible in order to maximally satisfy our patients. Yet, even if I perform the most exemplary plastic surgery and the patient is not happy with the results, then I have failed. In other words, the objective assessment of the surgical results does not match the subjective one of the patient. There are reasons for this break from reality, such as body dysmorphic syndrome and a patient’s own internal anger, discontentment, strife or call it what you will. There is much written about body dysmorphia but little is discussed about the latter situation-the angry, malcontent. Many times, these people come to a plastic surgeon seeking out surgical transformation for the wrong reasons, thinking that the surgery itself will bring a positive change in their life. When that doesn’t transpire and the patient realizes that they are still the same unhappy soul, all hell can break loose for both patient and caregiver because of unrealistic expectations. This may become a greater incendiary situation when a patient is taking Adderall or some other amphetamine-related prescription medication. Consequently, plastic surgeons should be aware of this heretofore anecdotal correlation prior to operating on anyone taking Adderall or equivalent since this may be a predictor of both disproportionate patient disappointment and anger.

I now have come up with the following saying within the last month which resonates with both my staff and myself:  “Plastic surgery will not make you happy, but it can make you happier.” In simple terms, this allows me to assess whether a patient is fundamentally happy and balanced prior to operating on them. I’m sure that there will be a few patients that still slip through the cracks, so to speak, but if I can manage to avoid operating on the majority of angry, unhappy patients then I know in my heart that I did serve them well.

Coincidently, this article just came out today about plastic surgery and happiness:

C’mon get happy! Plastic surgery can help :)

Dr. HAWORTH is a board-certified (American Board of Plastic Surgery) plastic surgeon located in Beverly Hills. His specialties include all aspects of aesthetic facial and breast plastic surgery, including rhinoplasty, revision rhinoplasty, facelifts, lip reshaping and breast augmentation. For further information go to

Tattoos and Cancer

Tattoos are meant to be party fun and expressive… Cancer and infections are such a buzz kill!

To each his own, but I have always been rather impartial to tattoos. Unlike a fine wine, I simply don’t think they age very well and they look especially out of place on a doting grandmother or father (unless they’re a member of a famous rock group and had a bank account to go along with it).

Anyway, onto more pressing matters such as how tattoos can kill you.

As a Beverly Hills plastic surgeon board-certified by the American Board of Plastic Surgery, I am always aware I am a doctor first and a plastic surgeon second. It is for this reason I address subjects such as this to inform the public of potentially dangerous trends they embrace. More is written about how tattoos are associated with resistant bacterial infections and skin cancers, especially that the American FDA is applying its investigative microscope to the issue. More ominously, because of hepatitis C transmission, tattoos are associated with liver cancer and the possible necessity of liver transplantation. That is some virulent ink to say the least!

You might read this and think that you’re better off undergoing laser tattoo removal. Unfortunately, while the tattoo might be removed by the laser, blasting away that pigment might release it into the body a second time.

If you’re thinking about getting a tattoo maybe consider using a safer pigment such as InfiniteInk . This does not contain toxins and can be easily removed. It may cost more, but wouldn’t you want a pigment that was developed to color medicines, rather than paints?

To read more about this unsettling topic click here:


R.D. Haworth M.D., F.A.C.S.


Brow Lift or Blepharoplasty? That is the Question

You are complaining of saggy upper eyelids.

You go to your plastic surgeon.The question is: “Brow lift or blepharoplasty? Or both?”


About 70% of patients coming to me requesting rejuvenation of their upper eyelids have no aging problems with their upper eyelids at all. Instead, what they are really manifesting is a pseudo excess of eyelid skin caused by a sagging of their forehead and its associated eyebrows ( brow ptosis). The skin between the eyebrows and the upper eyelashes is now compressed into folds, giving the impression age- related excess eyelid skin.
It is imperative from an aesthetic and functional standpoint that the plastic surgeon makes the correct diagnosis, differentiating brow ptosis from true excess eyelid skin. Sometimes the two conditions can coexist like in Kenny Rogers pre-surgery.

Kenny Roders Before any surgery. Note how he has a combination of heavy brows and excess eyelid skin.

Kenny Rodgers Before any surgery. Note how he has a combination of heavy brows and excess eyelid skin.

The treatment for brow ptosis is an endoscopic Browlift (which I will discuss in a future blog post and how to avoid the “surprised-look”) while that for excess eyelid skin is an upper blepharoplasty. Sometimes strategic fat transfer or filler injection above and into the brow can help reversed brow ptosis to a moderate degree.
I have seen many unfortunate results of upper eyelid surgery or blepharoplasty, stemming not from poorly performed surgery, but simply from a wrong diagnosis. In other words, the wrong surgery was correctly performed for the wrong diagnosis. I have also seen the correct surgery performed but carried out too aggressively such as in the case of Mr Rogers. If you compare his presurgical picture to the post surgical picture, one could see that his eyes are too recessed because too much fat and skin was removed.

Note the overaggressive brow lift and upper blepharoplasty leaving him with unnaturally hollow upper eyelids.

Note the overaggressive brow lift and upper blepharoplasty leaving him with unnaturally hollow upper eyelids.

Unnaturally deep recessed eyes as seen in these male celebrities can result- the upper eyes are bizarrely punched out in a feminized fashion not usually seen in nature. Yes , the upper lids are clean, but they are too sculpted and when placed adjacent to a still sagging brow, they results are just plain unattractively weird.

Wayne Newton before any plastic surgery.

Wayne Newton before any plastic surgery.


Wayne Newton after an overaggressive upper blepharoplasty. He probably would've been best served by a subtle brow lift alone

Wayne Newton after an overaggressive upper blepharoplasty. He probably would’ve been best served by a subtle brow lift alone

Don’t confuse this condition with people who have naturally deep set eyes such as Jeremy Irons.

Jeremy Irons has naturally deep set eyes. This is who he is and it looks completely natural.

Jeremy Irons has naturally deep set eyes. This is who he is and it looks completely natural.

Mr. Irons still has his natural character embedded in his countenance, whereas the aforementioned public figures who have had overly aggressive brow and eyelid surgery seem to had their essence extracted from their face.


For further information or to make a consultation with Dr. Randal Haworth, a Beverly Hills plastic surgeon and specialist in eyelid and browlift surgery,call 310 273 3000 or visit him at

This New Blunt-Tip Needle Screws the Bruise! Dermasculpt

What is Beverly Hills Plastic Surgeon, Dr Randal Haworth’s, latest tool to minimize bruising with injections?

Injection techniques to place filler into the face to correct lines, folds and wrinkles have became even more advanced with the use of blunt tip cannulae, such as Dermasculpt.
These are similar to needles except that they are not sharp and therefore are less prone to cut the tiny diameter blood vessels in and below the skin.


What does this mean for the patient?

-Markedly less bruising
-Generally significant less discomfort
-Greater safety profile

I don’t employ them to treat all areas of the face, since certain anatomical facial features require extremely precise placement of filler not afforded by blunt tip cannulae. They are ideal to inject larger areas which require generalized plumping or filling such as the temples, cheek hollows, brows and jawline.

I have injected most types of filler through them including Juvederm, Restylane, Belotero, Artefill, Aquamid and Radiesse.

Be prepared to hear some minor crackling noise, however, for the first minute or so similar to lettuce being cut!

“The Lifestyle Lift”-LSL . Does that really stand for the long scar lift?


The myths and realities of the Lifestyle Lift

As with any service industry, there are convenience stop businesses and destination businesses. You see that with restaurants (think of McDonald’s or Chili’s versus French Laundry, one of the best restaurants in the United States) and you see this concept applicable to the plastic surgery business. I stress the term business  and not medical field for a reason in this essay. I can safely say that most people that pursue higher education in any country do so to seek a better life, better pay and have more opportunities come their way. Of course, most scrupulous doctors experience immense satisfaction from treating their patients as well and, cynically speaking, are not simply in it for the financial award.

Like all professionals, doctors do seek out (and deserve) a certain financial reward for all the years of dedication, study, stress and life sacrifice they undergo in order to carry out their profession and deliver the best care they can to their patients. However, in this day and age of increasing competition and commoditisation in all aspects of health care including plastic surgery, surgeons are forced to perform more surgeries at lower costs and possibly increased medical risk to patients. This alarming trend can especially be seen in plastic surgery where the end results of a hastily performed surgery are not hidden within a body cavity but are plainly visible on the face. Some of my colleagues brag about the speed at which they perform a surgery citing the many corners that they “cut” during an operation as unnecessary steps (no pun intended). I suppose they feel more akin to a Usain Bolt than that of a gifted watchmaker.

This brings me to the title of this blog post-The Lifestyle Lift. To the unsuspecting public this facelift is heavily marketed as a viable, simpler, safer, faster quality facelift at a fraction of the price. In fact, this facelift is an overly simplified distillation of pre-existing ideas wrapped in a new packaging as something brand-new and revolutionary. The one aspect that is revolutionary about this facelift is that it is one of the first surgeries that has been rebranded and marketed directly to the “consumer”. The company then refers the “consumer’ to one of their participating surgeons in the network to become a patient. Unfortunately, as a Beverly Hills plastic surgeon board-certified by the American Board of plastic surgery, I have seen many results of this “Lifestyle Lift” that reek “cookie-cutter surgery” in which performance is measured in terms of speed and not quality.

I have seen many unacceptable, hideously widened scars most probably stemming from the fact that the surgeon did not perform a wide enough dissection to allow a tension-free closure (which is tantamount to a good scar). I have also consulted with many patients who were dismayed by how the “Lifestyle Lift” failed to meet their expected goals with incomplete treatment of their jowls, neck and midface.

While it is true that all surgeons have their small subset of unhappy patients either because of unrealistic expectations, sub-optimal results or unexpected complications, the large percentage of unhappy patients complaining of their “Lifestyle Lift” is too hard to ignore. For a good article on the subject that appeared in Plastic Surgery Practice.

Traditional Liposuction versus 360 Liposculpture

Dr Haworth, a specialist in Liposuction in Beverly Hills, describes a new technique of Liposuction that improves upon traditional techniques. He calls this 360 liposculpture and delivers unprecedented results in terms of achieving the ideal human body shape. He has performed this procedure on hundreds of patients ranging from Hollywood celebrities to showgirls and housewives

My staff and I are frequently asked why it takes me longer to perform my body contouring procedures compared to other plastic surgeons. This is because most surgeons intensely dislike performing Liposuction  (or suction assisted lipectomy [SAL] as it is known in plastic surgical parlance) and use it simply as a tool to “debulk” or reduce the size of a body part. Little attention is paid to actually contouring the body itself by creating provocative curves and beautiful blends from one anatomical section into the other. This is true body reinvention at its best.

How is 360° liposculpture performed?

With unwavering concentration, with meticulous careful attention to detail, with minute cannulae (the small tubes through which the fat is aspirated), with a intimate familiarity of techniques ranging from conventional tumescent liposuction to laser-assisted  and syringe. Syringe, you may ask? Yes- this low tech technique provides the most control for the surgeon. allowing him to sculpt the most minute of body  contour irregularities- liken the detail provided by actual hand stitching in clothes to machine stitched. Even though the average person may not notice the difference (especially if he or she considers the procedure a commodity), a true connoisseur will appreciate  the exceptional result afforded by  360 liposculpture. This technique is not for the surgeon with a faint of heart- it is extremely exhausting, time-consuming and demanding of one’s most exceptional skills. Of course, a keen eye and appreciation of human form and beauty is a must.

What are some of the benefits of this 360° liposculpture?

A sublime result maximally customized for each individual patient. Some of the added benefits of 360 liposculpture are obtained by creating a youthful midline abdominal groove, enhancing the waist, reducing unsightly “bra strap” fat bulging, reshaping the ankles and calves fabulously from all angles, contouring beautifully elegant knees and sculpting feminine shoulder and arm definition down to and past the elbow, etc, etc..The list goes on.

However, this technique will not improve stretch marks or cellulite (Nor will any other Lipo suction technique for that matter). A high degree of skin contraction will result. A few examples will follow:

Fat waist pre liposuction Note the back rolls, ill defined waist and thick shapeless midsectionAfter 360 Liposculpture of the abdomen and waist After 360 Liposculpture of the abdomen, back and waistBefore Liposuction of the abdomen and waste Note how the three-quarter view shows how the hip roll and back are compressed together in an acute angle. With 360 liposculpture, Dr. HAWORTH is able to elegantly “open up” that acute angle, thereby rendering a far more elegant look to the body. The patient consequently looks taller as well.After 360 liposculpture of the abdomen waist and back With 360 liposculpture, Dr. HAWORTH is able to elegantly “open up” that acute angle, thereby rendering a far more elegant look to the body. The patient consequently looks taller as well.Note the lack of shape in her lower legs. This patient would not wear certain dresses because she was embarrassed by the shape of her lower legs. She felt that they were bulky and lacked shape. They did not ascribe to her ifeminine ideal. Diet and/or exercise would not give her the results she was looking for.360 liposculpture of the calve, knees and ankles Dr RANDAL HAWORTH performed 360 liposculpture of the calves, knees and ankles to create an elegant look in her lower legs which she thought otherwise impossible up to now. Diet or exercise cannot obtain this type of result


For further information, go to or call 310-273-3000 to arrange an appointment with Dr. Randal Haworth, a Beverly Hills plastic surgeon certified by the American Board of Plastic Surgery.

Needle Away your Concerns about Stretch Marks and Sagging Body Parts

Needling treatment also known as CIT (which stands for collagen induction therapy) has actually been around for quite a long while now. It is truly a low-tech device but it has found a new place in my bag of aesthetic tricks.

Why? Simply because it works. It seems to be the most effective procedure in this day and age to reduce stretch marks (striae distensiae), firm and elevate  tissue(knees, elbows, buttocks etc.), reduce scars (including acne ones), reduce hyperpigmentation-all in all it seems to result in a healthy, more youthful appearing skin.

How does it work?

The patient starts applying fat-soluble vitamins A and C antioxidant oils to the skin two weeks prior to the planned procedure date. The fat solubility of these vitamin oils allow them to penetrate human epidermis and dermis far more effectively that many of the other available competing products. These in turn stimulate the skin to produce more collagen and rejuvenate their elastin component. The device (which is basically a roller with approximately 200 needles attached to it perpendicularly) is then utilized to produce tens of thousands of small needle marks penetrating into the dermis. This in turn, induces a cascade of collagen production, the effect of which is amplified by the combined use of the antioxidant vitamins. In a way, the roller is not only producing a controlled injury to the skin but also acting as a very efficient drug delivery system.

I generally recommend a number of treatments to get the most optimal results. Here’s just one example of the fairly dramatic effect one could achieve by this methodology. The woman had undergone myriad laser treatments to reduce her stretch marks, but to no avail. After just two Roller treatments, she achieved the following result.

Abdominal Stretch Marks

This woman had a previous abdominoplasty in order to help reduce her stretch marks. She was dissatisfied with the result and had many laser treatments to reduce her stretch marks. They are still very obvious in width and depth.



After Needling/CIT

She underwent two rounds of Needling/CIT. Note the dramatic reduction in stretch marks both in terms of width and depth.


For further information about CIT, needling therapy, call the office of Dr. Randal Haworth (310 273 3000) located in the Haworth Institute.


Rhinoplasty – “Samurai Nostrils”?

As one of the leading rhinoplasty specialists in the United States, Dr. Randal Haworth continues to challenge himself to be the best he can be. By constantly questioning his results and asking himself how he can do things better, he feels he is subjecting himself to the highest quality assurance and delivering the best possible outcomes in plastic surgery .

Performing rhinoplasties are one of my favorite specialty since the nose place such a central role in the total harmony of the face. Consider it like one of the leading instruments in the orchestra. Though most plastic surgeons and patients alike obsess on nasal humps, wide bones as well as drooping, boxy, pinched and ill-defined tips and, of course, the width of the nostrils, little attention is paid to the actual shape of the nostrils. In other words, a surgeon should not only assess whether the nostrils are wide at their base, but also whether they are arched, pointy, thick or sigmoid in shape.

One of the most common and unflattering nostril shape is that of the “samurai nostril”. Look at the following two photographs and you will see what I mean.

Seven samurai

Another example of these flared nostrils that may look appropriate as a menacing sign but not a flattering one for beautiful woman

Flared nostrils of the nose before a rhinoplasty

A samurai mask manifesting the flared, aggressive shaped nostrils that are unappealing in a woman

There are a few ways to correct this but probably the most reliable is to harvest a “composite” graft from the hidden portion of one’s ear. This detailed surgery involves insinuating this graft between an incision made on the inside of the nose, corresponding to the actual width of the retracted portion of the nostril. This graft is then sutured into place with the skin side facing the actual inside of the nostril to maintain the continuity of it’s lining. One can lower the nostril about 3 to 4 mm with this technique. Of course, some resorption of the graft occurs so it is best to over-correct this.

Other techniques involve strategic V-Y plasties, which are essentially internal tissue rearrangements of the inner aspect of the nostril in order to lower its rim, cartilage grafts in the actual substance of the nostril to help correct pinched tips while lowering the rim and, finally, filler. These latter techniques, though successful to some degree, are not as effective as an ear “composite” graft.

Note the following two cases in which “composite” grafts were taken from the ear and placed within the nostril to lower them. Of note, simultaneous upper lip lifts to further enhance a feminine appearance were performed.

Preoperative transgender patient with retracted nostrils

Transgender patient was retracted nostrils, long upper lip and droopy corners of the lip

Transgender patient after composite grafts to lower the nostril rims and an upper lip lift with DAO release

Dr. HAWORTH performed a modified rhinoplasty by lowering the nasal arched “samurai” rims (nostrils) as well as an upper lip lift and DAO release to lift up the droopy corners of the mouth

Patient with a long upper lip and retracted "Samurai"nostrils after a previous rhinoplasty

Patient with a long upper lip and retracted “Samurai”nostrils after a previous rhinoplasty by  another surgeon

Dr. Haworth performed an upper lip lit along with nostril rim lowering and fat transfer to the lips

Dr. Haworth performed an upper lip lift along with nostril rim lowering via a composite graft from the ear. Fat transfer was also performed into the upper and lower lips. Notice the more feminine harmony