Tamara Jaber, the ex-wife of Kyle Sandilands debuted a dramatic new look during an appearance on The Morning Show last week. She has stayed quiet on the subject of cosmetic procedures. Dr. Haworth, a Beverly Hills plastic surgeon believes her changing look may be the result of a little nip and tuck. Haworth told The Daily Mail ‘I believe Miss Jaber has followed what many do when coming to Hollywood in search of change, whether in their personal or professional lives. And that is to seek out the services of a plastic surgeon’
Dr Haworth claimed that Tamara may have had surgery to refine the shape of her nose. ‘It does not take a a hyperaesthetic specialist such as myself to ascertain she has undergone a rhinoplasty,’ Haworth said. Haworth also claimed that her elevated and refined cheeks, fuller lips and noticeably defined jawline have contributed to her overall facial transformation.
The Born To Try singer, Delta Goodrem, may have invested in some cosmetic tweaks over the years. Dr. Haworth told Daily Mail Australia on Monday he has a ‘strong hunch’ that Delta may have undergone a rhinoplasty, and may have also had filler injected into her cheeks and lips. The Beverly Hills plastic surgeon believes the tip of her nose is likely evidence that she has had cosmetic surgery.
Dr. Haworth claimed: ‘Certain angles maybe more revealing than others, but I have a strong hunch she had undergone a rhinoplasty or nose job in the past because the shape of her tip is more demarcated from the rest of her nose while her bridge is noticeably narrowed.’ He also believes she may have indulged in some other non-surgical cosmetic procedures. ‘I find it apparent that both her cheekbones and her lips have been enhanced with a temporary filler, most likely of a hyaluronic acid variety such as Juvéderm or Restylane’ he told Daily Mail Australia.
Elle Macpherson, has been an advocate of natural beauty, crediting an active lifestyle and a plant-based diet as the secrets behind her age-defying appearance. Beverly Hills plastic surgeon Dr Randal Haworth, believes that Elle may have also undergone a few cosmetic procedures to maintain her effortless beauty over the years. Dr Haworth stated: ‘The plan is simple when maintaining the beauty of an already beautiful woman. Elle’s genetic blueprint is flawless, therefore a plastic surgeon would have to follow the plan to a “T”, never veering away from her natural features.’
Dr Haworth believes that Elle may have had a subtle rhinoplasty in her thirties, resulting in ‘a squared nasal tip flanked by vertical grooves extending down to her nostril rims’. Dr Haworth also claims that she may have gone under the needle to enhance her already-striking visage. ‘Her lips are fuller in a subtle way, indicating she may have had them plumped with an off-the-shelf filler such as Juvéderm,’ he claimed. ‘These are some of the type of subtle “tweaks” that may have helped help Elle Macpherson radiate her natural beauty in a casual yet confident manner,’ he surmised.
Elle has made no secret of her laissez-faire approach to beauty and aging, telling This Morning in June that she is proud of her natural look. In 2016, Elle admitted PEOPLE magazine that she had played around with cosmetic procedures to fight wrinkles.
Beverly Hills plastic surgeon Dr. Randal Haworth offers his expert opinion on whether Jennifer Hawkins has gone under the knife. She has been the subject of ongoing surgery speculation due to her changing appearance over the years. Dr. Haworth told Daily Mail Australia on Tuesday: ‘I often see pretty girls like Jennifer wanting to fine-tune their features to enter “supermodel” territory.’
Despite being a household name for 15 years, Jennifer does not appear to have aged a day and is arguably more beautiful now than she was in her early twenties. Dr. Haworth, who has not treated Jennifer himself, stated that the Australian model appears to have invested in some minor improvements to ‘improve facial balance as a whole’. In 2010, Jennifer attributed her drastic change in appearance to healthy eating, exercise and makeup during an interview with The Kyle and Jackie O Show.
While old photos of Jennifer reveal a noticeably thinner pout and fuller face, she has previously brushed off surgery speculation. Jennifer once told The Australian Women’s Weekly that it’s the nature of the fashion industry to be accused of undergoing cosmetic surgery. ‘When someone says “under the knife” I don’t have a reaction,’ she told the magazine.
Dr. Randal Haworth, told Daily Mail Australia on Tuesday that he believes the rapper, could have made additional changes to her facial shape. Haworth, who has not treated Iggy himself, stated that the Australian musician appears to have invested in some ‘subtle‘ and ‘beautiful’ refinements. ‘Iggy is what I would describe as an excellent “canvas” on which a plastic surgeon can reveal his work,’ he says. Iggy Azalea’s striking appearance may be the result of further cosmetic procedures, according to Dr. Haworth.
‘When done right, results can be sublime and indiscernible to a layman’s eye. In the absence of rare complications, less surgical work is needed to create the beautiful, yet subtle, results as exemplified by Ms Azalea – while a less-than-average surgeon could draw unwanted attention to an anatomical “flaw” which only makes things worse.’
In addition to Iggy’s rhinoplasty, which ‘straightened and narrowed her nose’, Dr. Haworth believes she may have undergone ‘a chin augmentation as well as mandibular angle enhancement to give her a more refined, “modelesque” jawline’.
Beverly Hills-based plastic surgeon, Randal Haworth, M.D., says he needs to be comfortable and free to move in order to perform facial and body plastic surgery.
But space can be somewhat limited in an OR inside a boutique plastic surgery practice, he says.
“… so careful planning of the envisioned flow between patient, surgeon, scrub tech, circulating nurse and anesthesia provider must be done,” Dr. Haworth says. “In my case, I had to work with a rectangular operating room, in which case I first had to decide where the anesthesia machine would be situated, since its range of movement would be limited by the oxygen and vacuum hoses tethering it to the ceiling. Consequently, it was important for me to have a 180-degree turning radius for the operating table, so I could position it according to whether I am performing facial or body surgery. Of course, OR lights have to follow suit and must be very mobile and bright. My Trumpf LED [Trumpf Medical] system fits the bill nicely.”
2. A Quality Monitor and Sound System
Having a big monitor with a good sound system for music is not only a luxury but a necessity for the modern plastic surgeon. Having the monitor in constant view is a must, according to Dr. Haworth.
3. Intelligently Designed Cabinetry
Proper cabinetry, design to maximize space and efficiency, is essential, according to Dr. Haworth.
“You can never have too many cabinets from the get-go, since these promote organization and obviate the need for vulgar retrofits in the future,” he says. “When it comes to designing my clinic or the operating room, I think that creating and maximizing the feeling of unrestricted space is important for both the patient’s sense of security and the staffs’ sense of clarity.”
4. Don’t Cut Corners
Don’t cut expenses, when it comes to safety, according to Dr. Cohen.
5. Seek Expertise
Dr. Cohen says cosmetic surgeons should tap experts in designing operating rooms.
“Reach out to architects with experience in both the design and credentialing processes,” Dr. Cohen says. “Ultimately, certain third-party inspections may be required, and you don’t want to be caught off guard.”
Dos and Don’ts for the In-office OR
Erin Metelka, an interior designer with Studio Four Design, offers these design dos and don’ts.
Use a sheet flooring, with heat welded seams and sanitary cove base.
Use bleach cleanable/non-porous products.
Use clean/calming colors.
Provide a variety of adjustable ambient lighting options.
Utilize floor patterns to designate the extents of the sterile zone and care-provider zones.
With the wide variety of procedures that occur in an operating room, often times, the table is moved in order to accommodate the most efficient workflow with the other equipment in the suite. The floor patterns can also be used to dimension the proper location of the table for these various scenarios.
When creating several operating rooms, utilize an identical layout (not mirrored). Often, physicians are moving into adjacent operating rooms for a procedure, while a room is being turned over and sterilized. Having identical layouts increases efficiency and reduces error.
Do not have extraneous items of décor within the suite, such as artwork.
Do not utilize fabric of any kind such as curtains/draperies. If there are windows, create privacy with natural light by using integrated frosted glass. If an upholstery is required for a physician stool or other items, a bleach cleanable vinyl is a suitable alternative, ideally with a Crypton or nano-technology finish applied (these finishes work to prevent moisture penetration to the cushion and function as an antimicrobial).
Do not place any direct down-lighting, with the exception of the surgical boom, directly over the table.
Botox may soon be used to treat psychological depression. We know that it can help alleviate the symptoms of migraines in many.
Dr. Randal Haworth Beverly Hills is an expert specialist in facial plastic surgery including maintenance therapy through fillers and paralytic agents such as Botox®, Dysport® and Xeomen®.
Botulinum toxin A seems to do far more than just block the transmission of acetylcholine (the neurotransmitter chemical released from nerve endings to affect change in muscle, glands etc.).
There is new evidence to suggest that Botulinum toxin type A can be used to treat depression which was first reported in 2006 by two American doctors (Finzi E, Wasserman E “treatment of depression with botulinum toxin A: a case series, Dermatol Surg 2006; 32 (five): 645-649). Based on this small study, a much larger study with careful patient assessment has shown that a single treatment of the glabellar lines (the dreaded “11” frown lines) with botulinum toxin resulted in a significant and sustained benefit for depressed patients (Wollmer MA, de Boer C, Kalak N, et al. “facing depression with botulinum toxin: a randomized controlled trial,” Journal of psychiatric research May 2012; 46 (five): 574-581).
Therefore, one can conclude that Botox®, through control of facial expression, seems to have the ability to control patient mood. However, is this an effect of increased self-confidence on the patient’s part or is this a result of hormone or regulatory peptide secretion as well?
Who knows at this time, but this is intriguing nonetheless. Dr. Haworth of Beverly Hills, however, is still not offering this treatment for depression even though many do say that aesthetic plastic surgery can be surgical psychiatry when performed in properly selected patients! Is this why there are so many ostensibly happy people in Beverly Hills and and its environs? 😉
In order to perform a nose job or rhinoplasty whether in Beverly Hills, Los Angeles or wherever, the plastic surgeon must be physically able to manipulate only two things under the nasal skin-cartilages and bone, Well, the debate rages on and on as to what is the best of the two methods in gaining access to the internal cartilaginous and bony structures of the nose. The two methods are the “closed” and “open” techniques.
The “closed” technique involves creating incisions confined solely to within the actual nose (usually located just within the nostrils proper) whereas the “open” utilizes the same incisions as the “closed” but also incorporates a small additional one across the columella (the fleshy partition separating the left and right nostril at the bottom of the nose).
In this age of less invasive surgery afforded by modern technology through the use of endoscopes, modern radiology, etc. one would think that the “closed” technique represents a newer evolution in rhinoplasty surgery, but surprisingly, the opposite is true. The “closed” technique is the more traditional approach while the “open” evolved and gained in popularity as both patient and surgeons expectations grew. Perhaps unrealistically, patients increasingly expect perfection and in their quest to deliver the acme of results, surgeons need as much control as possible when performing the surgery. Control involves extremely accurate symmetrical suture placement (to reshape cartilage), hemostasis (to minimize bleeding), strategic cartilage graft location and stabilization among other factors. In order to gain the most control as possible, visibility must be maximized and this is where the “open” method far surpasses the”closed”.
Proponents of the “closed” technique cite prolonged swelling and a potentially visible scar across the columella as two distinct disadvantages to the “open”. However, in proper hands these supposed shortcomings can almost always be avoided. I, as a rhinoplasty specialist, used to perform 80% of my rhinoplasties as “closed”, but now I carry out 90% as “open” and I can safely say that over 95% of my rhinoplasty patients are delighted with their new nose by the end of the second week. If the surgery is carefully undertaken, I have seen essentially no difference in swelling between the “closed” and “open” techniques. However, the one difference I have seen are the clearly superior results afforded by the “open” method.
To see many “open” rhinoplasty results, click here and here for revision rhinoplasty.
Dr Randal Haworth can be contacted at 310 273 3000 and Is a Board Certified Plastic Surgeon (American Board of Plastic Surgery) who practices at The Haworth Institute in Beverly Hills.
Dr. Haworth of Beverly Hills gained much of his advanced experience as both a primary and revision rhinoplasty specialist back in the Middle East. He performed literally hundreds of nose jobs there on patients from all walks of life. One of the most common complaints there are boxy and bulbous nasal tips.
What constitutes a bulbous nasal tip?
The bulbous nasal tip is most likely caused by thick alar cartilages (see accompanying diagram)and/or alar cartilages that are splayed out instead of shaped in a neat triangular formation.
This anatomic situation can be exacerbated by a thick layer of oily, sebaceous nasal tip skin. Think of the latter as a sleeping bag as opposed to a thin silk sheet., draped over delicate structures
How does an experienced plastic surgeon correct the thick bulbous nasal tip during a nose job?
In my hands, I prefer performing a rhinoplasty utilizing an “open” approach because it affords me vital binocular vision so I can assess up to half-a-millimeter asymmetries that otherwise I would would be unable to appreciate utilizing a closed approach. The closed approach is one where the incisions are solely confined to the inner rims of the nostril, whereas an open approach utilizes the same aforementioned incisions in addition to a small hidden incision below the columella (that fleshy partition that separate the left and right nostril). The open approach allows me to see both the left and right nasal tip cartilages simultaneously so that any maneuver I would perform on the other can be immediately assessed with its opposite counterpart. Sutures are meticulously placed in a strategic fashion in order to change the shape of the cartilages from a round convex shape into more of a triangular one which, in turn, will translate to a more refined, elegant nasal tip. Think of assembling a ship in a bottle via strings, so to speak. The rhinoplasty surgeon cannot just bend cartridges, he must utilize sutures in order to shape them. This is part of the stock-in-trade of nasal tip/nasal cartilage manipulation.
Of course, some cartilage is removed as the surgeon sees fit. The importance of not being too aggressive cannot be overemphasized since doing so could result in an unsightly “pinched tip”. Finally, it is more often than not necessary to “defat” the under surface of the thick sebaceous nasal skin that would accompany such a bulbous tip. This allows the thick “sleeping bag” to redrape more fluidly over the newly reconstructed nasal cartilages.
Swelling of the nose may take many months to even a couple of years to fully disappear. This does not mean that the patient would not enjoy the effects of a rhinoplasty before then. It is just that the skin can remain slightly swollen for prolonged periods of time. The last area for swelling to dissipate is at the nasal tip area. So even though great of a 95% of my patients love their nose at the 21st day postoperatively, some will say that they would like their nasal tip to become further defined. I may either inject some Cortizone underneath the skin to turbocharge the swelling to go away quicker or just recommend patients. Sometimes that’s the hardest thing for inpatient to digest.
Over the last 3 to 4 years I, as a primary and revision rhinoplasty specialist, have noticed an increasing and disturbing trend being practiced amongst those facial and classic plastic surgeons in my immediate community of Beverly Hills and other cities. This trend revolves around the use of rib grafts for not only revision but also primary rhinoplasty (!) (or in common parlance, nose job).
A good number of rhinoplasties require cartilage in order to achieve exemplary results. Cartilage is used to either build a bridge, fill depressions, augment or support the nasal tip. It is mainly harvested from the septum (that partition that exists in the midline of the nose which separates the left and right nostril) or the ear. Though I am fully trained general surgeon and am comfortable operating in and around the lungs and heart, I rarely employ rid graft as a source of cartilage. For most, it is generally a last resort when absolutely no other cartilage source is available. Admittedly, rib provides a strong support and is generally in plentiful supply. However, a number of downsides arise when rib is harvested: a permanent visible scar is created below the breast. Additionally, significant pain can arise from the harvesting as well as a small chance of creating a pneumothorax (or a collapsed lung) . Finally, rib can be notorious for warping thereby creating a nose that is crooked.
Despite these drawbacks, I will use rib when there is a collapsed nasal septum (or dorsum creating a saddle nose deformity) or when plentiful cartilage is needed while other sources are exhausted.
See the accompanying photos.
A Collapsed Nasal Bridge or Saddle-Nose Deformity
After a Revision Rhinoplasty Utilizing Rib Graft
A Severe Saddle-nose Deformity after Infection
After Rib Graft Reconstruction
I always use cartilage to highlight and augment the nasal tip, however, when there is not enough cartilage present and I only need to build the bridge by a small amount, I do not hesitate to employ some artificial material such as Goretex®. I utilize this only when the chance of infection is remote. When patients are properly selected for utilizing Goretex®, the chance of infection extremely minimal in my experience. Unfortunately, the surgeons who habitually use rib grafts will scare the bejesus out of their patients into choosing the rib graft method by overstating the chance of infection and poor outcome if Goretex® is used.
So if I am writing that rib grafts are over utilized, then why do the rib graft cartel tell their patients otherwise?
I feel it is simply a matter of finance. When a rib graft is harvested, the surgeon can charge a lot more for both his services and the operating room, especially if insurance is billed. Most patients will not question their surgeon’s motivated choices and indeed, feel that they have no choice at all, believing that the rib-graft-mafia method is their only solution.
What is especially unsettling is that these doctors who are members of the rib graft cartel are now utilizing rib grafts for primary rhinoplasties (first time nose jobs). This is very puzzling because there is plenty of prime cartilage graft material available from the septum and ear and there is little to no reason to subject the patient to a rib surgery.
All I can say is that this is a dangerous trend which introduces unnecessary risk and morbidity to the operation.
A good patient is an educated patient and the purpose of my blog is to merely propagate information in the most objective way possible so that patients can make their own decisions as sentient adults. To learn more about primary and revision rhinoplasty , you can click here.