Self-Centered Aesthetics™

Embracing Artistry By Inga Hansen Photography by Cory Sorensen Plastic surgeon Randal Haworth, MD, is taking the next step in his career with the launch of a stylish, comprehensive aesthetic care facility. Randal Haworth, MD, made a name for himself in aesthetics in the early 2000s when he joined Fox television’s reality show, “The Swan.” On the program, he was part of a team of plastic surgeons, stylists and makeup artists who dramatically transformed participants’ appearances, Earlier this year, he transformed his own Beverly Hills, California-based practice when he moved to a new, custom-designed facility that incorporates a full range of aesthetic services—from facials and nutritional services to fillers, lasers and surgical procedures. Dr. Haworth’s design philosophy for the new Haworth Institute was nature meets high-tech. “It’s a beautiful place, and all our services are under one roof—the surgical center, my clinic and our new noninvasive center, Self Centered Aesthetics,” says Dr. Haworth. “Patients always asked us, ‘What else can you do?’ ‘How do I maintain this?’ It just doesn’t make sense nowadays not to offer the full-range of aesthetic treatments.” In addition to laser treatments and injectables performed by Dr. Haworth and his R.N., celebrity esthetician John Tew performs signature facials and naturopathic doctor Matea Polisoto, who goes by “Dr. Matea,” offers IV therapy and nutrition counseling. “Like John, she has a very big following in Beverly Hills and beyond,” says Dr. Haworth. “She is involved with IV therapy, which helps augment the pre- and postoperative surgical experience, and optimizes healing. “The people working with me are just as important as the surgeon—it’s all about having a team,” he says. The Frustrated Artist Born in Los Angeles and educated in England, Dr. Haworth has a somewhat unusual background for a Beverly Hills plastic surgeon. “My dad was English and spent World War Il in London selling bootleg whiskey during the Blitzkrieg. My mother and her family lived in Holland during the German occupation,” he says. Following the war, both of his parents immigrated to the United States seeking opportunities, of which there were few in post-war Europe. “They met, and I was born in Los Angeles. But my dad always wanted me to be in England eventually,” says Dr. Haworth. When he was 9 years old, he and his parents drove to Central America and boarded a cargo ship to England. During his school years in London, Dr. Haworth became enamored with the arts. “l always drew—and I was very good at a young age. In University I joined band. I was really into the arts, and that’s what I wanted to pursue,” he says. “But my parents, being war babies, wanted a doctor in the family and I was their only child.” During a road trip prior to his final year at the university, he shared his goals with his parents. “We were in a VW bus and they said, ‘We’ll disown you if you become an artist. Make your decision’—it was really bizarre,” he says. His mind flashed back to a BBC interview of Kurt Wagner, MD, he had seen when he was 13. “l said, ‘Then I’ll be a plastic surgeon,’ having no idea what was involved in that.” He came back to the U.S. and enrolled in medical school at the University of Southern California. Following graduation, he completed a five-year general surgery residency at Cornell Medical Center in New York. Dr. Haworth made his way back to the West coast for his plastic surgery residency at the University of California, Los Angeles. “After my residency, I had no money so I was anxious to go into practice. I thought, well then I have to goto Beverly Hills because that’s where successful plastic surgeons go,” he says. Another surgeon offered to rent him a space in his clinic’s kitchen, which was housed in one of the most desirable medical buildings in Beverly Hills. “He had a little pocket door in front of the kitchen so I stayed in there,” says Dr. Haworth. “During my clinic days, I would take his diplomas off the walls in the two little exam rooms and put mine up, and that’s how it started. “l look back fondly on those days now, but it was horrible at the time. If I had two surgeries in a month, it was a great month,” he says. Finding His Niche During his UCLA residency, Dr. Haworth won a plastic surgery research prize for his lip surgeries, which provided a unique niche with which to build his practice, More than 20 years later, he has patients from all over the world who travel to the Haworth Institute for their lip surgeries. “You can be the best doctor in the world, but if you don’t have marketing, no one will know about you,” he says. “So I leveraged that award and started getting known for lips, even though my favorite surgeries are noses, mid- facelifts and what I call hyperaesthetic surgeries where we change everything. The lips are what I was known for, and now I get jazzed by that because there’s really no competi- tion in the world for these surgeries.” He offers upper, lower and corner lip lifting procedures as well fat transfer and F.A.T.M.A. (fat transfer & mucosal advancement). “l do many types of lip lifts because it is shape before volume; there are many things that fillers alone cannot do,” he says. Embracing and Investigating New Technologies Despite the limitations of traditional filling techniques, Dr. Haworth has embraced dermal fillers as effective tools to perfect his patients’ lips. In some cases the new, less invasive procedures are even surpassing what he can achieve in the O.R. “Our mouths get wider as we age and our lower teeth become visible,” he says. “People will often just fill the lower lip horizontally, which won’t help with these concerns.” In his surgical center, he performs lower lip V-Y plasty procedures to narrow the mouth, lift the bottom lip and pout out the middle third of the lower lip. But, due to the minimal improvement, he recently became interested in the idea of using vertical filler injections to lift and shape the lower lip. “About three months ago, I started injecting vertically into the lower lip. I place my long cannula or a long needle vertically from the bottom of the prejowl sulcus all the way to where I see the needle blanching on the vermillion on the back of the lower lip on the sides. Then I inject vertically as I pull the needle out,” he says. “l am seeing such dramatic elevation of not just the lower lip but the whole corner of the mouth—the marionette folds are dramatically reduced and the labiomental sulcus opens up.” He is calling this the Caisson technique after Caisson beams in construction. “The patients are three months out now, and the results are far better than what we see with the lower V-Y plasty in hiding the lower teeth,” he says. Dr. Haworth is investigating new ways to augment and lift lips using dermal fillers. “l love doing surgery, but plastic surgery is in some ways a dying field,” he continues. “The future of plastic surgery lies in the lab, not the operating room. Eventually they are going to know how to stop senescence. In the meantime, the future of aesthetics is laying more and more in lasers and newer, better fillers, and I want to stay on the forefront of that.” His biggest challenge is determining which new technologies and procedures live up to the hype—and resisting the urge to bring in every new device about which patients inquire. “Sixty to seventy percent of all new medical cosmetic technologies overpromise and under deliver,” he says. “First it’s a big ‘Wow!’ Then results are ‘operator-dependent,’ then it’s gathering dust, so I vet all these technologies and only offer the ones I believe are proven to work. “What I want to offer my patients with the Haworth Institute and Self Centered Aesthetics is more than one-stop aesthetics, It’s the tools and knowledge to deliver the absolute best treatments for their individual concerns and lifestyles,” continues Dr. Haworth. “We have a turbocharged armamentarium of proven noninvasive treatments to carry on the philosophy that I espouse in my surgeries, which is really detailed aesthetic work.”

Gloria (Croatia) 2017

Dr. HAWORTH is interviewed by Gloria magazine about his life in being a top Beverly Hills plastic surgeon and catering to the aesthetic whims and desires of the rich and famous as well as his charity work. He has heard about Gloria magazine from his ex wife who was Serbian Actress Ana Alexander (Stojanovic).

Follow up: Kim is the Butt of the Jokes

Well… as I originally predicted in a blog post at the time Kim Kardashian’s champagne-glass-bottom graced the cover of Paper magazine, there would be “fall out” to the story. Judging by active reaction to recent un-retouched photographs of Kim’s derrière in the media by both fellow plastic surgeons and public alike, comments have generally been less than flattering. 
Fortunate aftermath of wanton Buttock enlargement without consideration of body proportions and pulchritude
My blog post was essentially a warning to those seeking to “maxi-size” their assets in response to media’s insidiously pervasive influence on the public’s impressionable collective psyche.  A copy of my original blog post is here:
I don’t like comic book butts and I cannot lie
Not to say that the images in question expose overtly ireversible droop of Kim’s buttocks, they do unquestionably reveal the dimpling, pitting and bulging of exaggerated cellulite. Furthermore, there is no way  to predict how these artificially corpulent gluteals will age with further time. Unfortunately in 2017, there is little to be convincingly done to remedy such a situation. Lest this be a caveat for those seeking buttock super-sizing regardless of the method employed. Dr. Haworth 2017

Drastic or Fantastic Plastic Boob Job?

 
Fake pre-pectoral breast implants
Artificially round and hard appearing breasts after an overfilled “above the muscle” breast implant augmentation. The patient desired a more natural and smaller pair of breasts to match her frame
Natural, conservative result after breast implant revision and breast lift perform simultaneously.
Natural result afterexchange of her overfilled implants to memory gel silicone implants “under the muscle” along with a mastopexy (breast lift).
What is wrong with this revision breast implant and lift surgery I performed? According to this patient, apparently everything!     At first, this patient came to me with ostensibly straightforward requests to “make” her breasts smaller and “better-shaped” in accordance with her body frame.  Of note, she had undergone a previous “above the muscle” breast augmentation which, in my humble opinion, left her with a net result of breasts which were too big, too round and too fake. In essence, her breasts did not lend to a pulchritudinous appearance and that is why she sought my expertise in the first place. Indeed, she wanted to get remarried after having children and was seeking “christian boobs” to attract a decent husband. So I did what any self-respecting, honest and aesthetically minded board certified plastic surgeon would do and that was to perform a capsulectomy (remove her collagenous scar capsules),  substitute her overfilled saline implants with smooth Memory Silicone Gel  implants placed “under the muscle” and conclude with a bilateral mastopexy (breast lift). I thought the surgery was an unqualified success and, further punctuated by her exceptional healing vis-à-vis scarring.     So why was she unhappy? I was thoroughly puzzled since we both had extensive discussions prior to the surgery about the usual risks, alternatives and benefits including what she exactly wanted from the surgery. I know she wanted to go smaller (check), she wanted to be natural (check), she wanted to appear more youthful and perky (check) and indeed she conceded that I did achieve these goals. However,she also expected her breasts to be firm and more round  she felt that her result was too natural, both in look and to touch and therefore something went wrong.  
Fake pre-pectoral breast implants
BEFORE: Artificially round and hard appearing breasts after an overfilled “above the muscle” breast implant augmentation. The patient desired a more natural and smaller pair of breasts to match her frame
Natural, conservative result after breast implant revision and breast lift perform simultaneously.
AFTER:Natural result after exchange of her overfilled implants to memory gel silicone implants “under the muscle” along with a mastopexy (breast lift).
Fake pre-pectoral breast implants
BEFORE
Natural, conservative result after breast implant revision and breast lift perform simultaneously.
AFTER
                      But after further, protracted postoperative conversations with her, I realized where the disconnect was. I did not give her what she exactly wanted from the surgery because I gave her what she asked for and not what she wanted. In essence, this was a story of missed and unrealistic expectations.     More and more of these situations arise in a plastic surgery practice simply because unrealistic expectations are instilled in us 24/7 by social media. The main platforms culpable for this insidious brainwashing are the mobile apps Instagram, Snapchat and YouTube with their interminable repository of Photoshopped/FaceTuned manipulated models and instructional contouring videos. Young women come to me wanting cheekbones, buttocks or breasts like Abigail or Jocelyn Instastar simply because they are famous and therefore more popular and loved.    
Social media and Instagram star Abigail Ratchford
Social media and Instagram star Abigail Ratchford
Indeed, one patient requested Bella Hadid’s nose even though, in my opinion her rhinoplasty ended up with an “inverted V” deformity and a somewhat pinched, boxy tip. However, it did not matter to her because she considered Bella her idol andwas willing to accept a possible substandard result with potential nasal obstruction. Ah, the power of celebrity!     Recently, I had the experience of operating on another young woman who had beautifully shaped breasts with a natural cleavage. She wanted to go only slightly bigger yet have a bigger gap between her breasts. The surgery went flawlessly but the patient was dissatisfied. She agreed her breasts were fuller with a wider cleavage but she now voiced that I should have known all along she wanted her breasts to look fake, round and hard! After this perplexing conversation, I sat down and pondered the meaning of what I really do.
Social media and Instagram star, Joselyn Cano.
Social media and Instagram star, Joselyn Cano.
    It is one thing to make abnormalities such as unnatural breasts look natural but it’s  another thing altogether to make natural looking breasts look deliberately unnatural and possibly unappealing. For decades, I have endeavored to create natural results by making the deformed normal and the normal beautiful but now a new aesthetic standard has emerged in our culture and ultimately, it may not have positive consequences.   But who am I to judge?  Fake is the new real.     Randal Haworth MD, FACS

The most obvious tell-tale sign of a facelift

Good plastic surgery is invisible but many people insist that they can always spot anyone who has had plastic surgery. For example, they claim they can always spot a celebrity with a facelift and list those with obviously sad results that garner all the press. You can refer to the three attached photographs as examples of such. (They go on to name others who have not had any plastic surgery and when I in turn correct them, they express bewildered disbelief.)
Joan Rivers with obvious plastic surgery and pixie-ear deformity
Joan Rivers with look-at-me pixie-ear deformity
 
20090328_cob_a72_8941
Bruce Jenner with a plain-as-day pixie-ear deformity after a facelift
Mickey Rourke sporting his obvious Pixie-ear and man-bun on the red carpet
Mickey Rourke sporting his obvious Pixie-ear and man-bun on the red carpet
However, this blog post is not about good plastic surgery, it is about the bad and the ugly. There are many signs that scream “facelift”:

1. Overly pulled face skin with diagonal grooves

2. Altered hairlines such as pulled-back sideburns

3. Widened, non-hair-bearing scars with step-offs in the natural hairline behind the ear

4. Distorted anatomy in front of the ear canal due to effacement of the delicate tragus cartilage and finally…

5.”Pixie ear”.

Most of these aforementioned problems stem from misplaced anchoring of the newly redraped skin flaps resulting in needlessly excessive tension across potentially visible scars. One immutable rule in plastic surgery dictates that such increased tension can create widened scars, hair loss and distorted anatomy. Yet, despite these well-documented problems, I unfortunately still see many patients who seek correction of these stigmata of ill-conceived facelifts.

Correcting these problems is not an easy task. Generally, a secondary facelift needs to be performed to release enough skin so that both scars can be removed and closure achieved in a tension-free matter. If it happens to be a lucky day, scars that were placed in front of the ear can even be moved more posteriorly to within the ear canal as in this example of a facelift I performed in order to not only make her look younger but also remove her telltale signs of past substandard surgery.

Pixie earlobe after a facelift. Note scar in front of the ear
After correction with revision facelift and tension realignment


Pixie ear deformity and tired appearance after previous facelift
Pixie ear deformity and tired appearance after previous facelift
Note correction of pixie-ear deformity after revision facelift. An endoscopic brow lift, fat transfer and upper lip lift along with a lower blepharoplasty were also performed
Note correction of pixie-ear deformity after revision facelift. An endoscopic brow lift, fat transfer, upper lip lift and a lower blepharoplasty were also performed

I don’t like comic-book butts and I cannot lie

Every ethnic group has certain predisposed notions of what ideal beauty is based upon their own genetic make up and cultural ideals. Cultural ideals are influenced by trends and therefore can change over the years (think of the beauties depicted in Ruben’s paintings). In terms of Kim Kardashian‘s genetic make up, she is partly Armenian and represents for many an ideal version of female pulchritude. Unfortunately, she is depicted on the cover of myriad top-tiered magazines as a cartoon representation of bottom-heavy female beauty and sexiness. The cover of Paper is no exception. Here, she has been clearly “Photoshopped” to exaggerate her waist-to-hip ratio and smooth out the buttock cellulite she most certainly possesses. In this case, add oil for good measure to flame some pubescent boy’s fantasy. She may have had one or more fat transfers to accentuate her already full bottom (which may or may not show up on x-ray as microcalcifications) but, who cares? This would all be harmless titillation were it not for the fact that many unsuspecting women will be easily influenced to attain their own version of Kim’s voluminous buttocks. Don’t get me wrong-I am the first to appreciate an hourglass figure and a well-balanced full bottom to complement a woman in-and-out of clothes. But full is different than big which in turn is different from a comic-book-big butt of a centaur. IMG_0239.JPG Often times buttock enhancement procedures may lead to immediate or even long-term disastrous consequences. Buttock augmentation can be performed with silicone implants, fat transfer, or injections with man-made substances ranging from PMMA to free silicone or other illicit compounds found in back alleys or mechanic shops. Buttock augmentation with silicone implants is generally considered a safe procedure but has a higher rate of infection as compared with other implants in the body and the results often feel unnaturally hard. I perform fat transfer which is very safe but the patient must have a enough fat to transfer in order to make the result a meaningful one. I am not a proponent of injecting free silicone or other man-made substances because of their inherent danger in terms of disfigurement and possible death. One must remember that we do not know of the long-term consequences of having such outrageously enhanced buttocks in regards to how they will look and droop as the patient ages. Drooping buttocks is a very difficult problem to treat for the plastic surgeon and the only solution would be a butt lift. Unfortunately, most buttock lifts produce mediocre results with unsightly scars. Contrast this to a breast lift, the result of which is often spectacular with minimal scarring. Those contemplating injections and other forms of untested ways to augment their derrière must do their homework and be prepared to roll dice. One must remember that even though one may not experience immediate complications, one must consider the long-term effects of having an extra 2 to 4 pounds of added junk in your trunk.

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 www.drhaworth.com.

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 midsection


After 360 Liposculpture of the abdomen and waist
After 360 Liposculpture of the abdomen, back and waist


Before 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 drhaworth.com 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.

Tricky Lindsay. How Lohan is changing her looks

People seem to always ask me which celebrity did what and why would they do that. Sometimes that is frustrating.

A close friend of mine who is a fine art photographer tells me she can always spot if someone had plastic surgery to which I reply, “No you can’t”…

That is because good plastic surgery is invisible. Therefore, by logical extension, the only plastic surgery she or anybody can recognise is visible. Most  would concur that visible plastic surgery is less ideal than invisible surgery, but this is not always the case. Think Christy Turlington and her obvious rhinoplasty as a reminder of how visible plastic surgery can elevate a face to another worldly, ethereal level and you  will get my point.

Recently Extra asked me to comment what Lindsay had done to herself based on photographs.

Dr Haworth of beverly hills is a specialist in facial plastic surgery, including  rhinoplasty, fillers and facelifts  
Lindsay Lohan in better days   Lindsay Lohan in less better but recent days
This is similar to expecting a detective to know who committed a crime based solely on showing him some iPhone photos. I can only surmise what Lindsay had done. I feel assured to say she definitely had fillers in the past (just look how her lips and cheeks have changed over the years) and a breast augmentation. But recently, the poor woman has undergone more severe change and not for the better.
She looks swollen and has an obvious “double chin”. This to me is a salient clue –

1. Is she simply bloated from substance abuse or withdrawal?

2. Has she gained weight for any number of reasons (in preparation for playing Elizabeth Taylor in Liz and Dick?)

3. Is she swollen after undergoing some involved facial surgery?

Who knows? I am simply a detective here and would need to visit the crime scene, so to speak. I would need to ask questions and perform an examination!



Dr Haworth has no professional affiliation with Lindsay Lohan

Bristol Palin’s new look

Bristol Palin sports a startling new look, especially around her jawline.

BP after surgery

Bristol Palin looking as if she had too much vertical chin elongation from a sliding genioplasty or a misplaced chin implant

She attributed her change to necessary  “corrective jaw surgery” and not plastic surgery. Firstly, that is hogwash since corrective jaw surgery is a form of orthognathic surgery which lies in the realm of plastic surgery. It was obviously performed partially to change her appearance, most probably via a “sliding genioplasty”. A sliding genioplasty involves sawing the lower aspect of the chin bone away from the actual lower jaw bone and either moving it forward, downward or both at which point it is then stabilized with a screw. It  seems that Bristol had her chin moved both forward and downward to correct skin redundancy around her chin area. I frankly am not enamored with the look since it makes her chin too pointy and distorts her original facial harmony. However, this pointy look is lessened if she looks upwards towards the camera thereby moving the offending outgrowth further away from the lens.

Her pointy look is lessened if she looks upwards towards the camera as demonstrated in this photo

Bristol was actually prettier before the procedure (especially before her weight gain)  and it seemed all she needed was some weight loss, strategic liposuction of her jawline and neck and perhaps a  chin augmentation  with a small implant, positioned in such a way as to not elongate her chin.





Bristol before her surgery, showing better overall facial harmonics

As Mark Twain wrote: ” To not read the newspaper is to be uninformed, but to read the newspaper is to be misinformed”.