DailyMail – Aug 7, 2018

Rebecca Judd, is known for her glamorous and striking appearance. The Melbourne socialite has always denied plastic surgery rumors, a Beverly Hills plastic surgeon claims her flawless visage is far from natural. Dr. Randal Haworth said before and after photos suggest the Postcards presenter may have had ‘cosmetic fillers’ or a ‘fat transfer’ at some point.

Rebecca Judd Facelift

‘Earlier, her eyes were deep set because they were surrounded by noticeable hollowing,’ Dr. Haworth said referring to photos of Bec from more than 10 years ago. ‘My most age-defying patients who make looking beautiful as effortless as breathing are the ones who work at it the hardest.’ Daily Mail Australia has reached out to Bec for comment. In 2013, the mother-of-four acknowledged that she invests ‘a lot of time, effort and cash’ into her appearance and said she gets ‘shocking eye bags.’ She previously credited Melbourne skin clinic Liberty Belle for her glowing skin and gets everything from exfoliation to laser treatments. In 2008, Bec, who is the wife of former AFL star Chris, denied plastic surgery rumours.

Original Article

Tamara Jaber has transformed her look

Tamara Jaber

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.

Original Article

The cosmetic procedures behind Tammy Hembrow’s Instagram-perfect look

Many social media influencers enlist the help of photo editing apps to sharpen up their picture-perfect public image. Beverly Hills plastic surgeon Dr. Randal Haworth believes that Tammy Hembrow may also rely on cosmetic procedures. According to Dr. Haworth, she may have undergone a nose job, liposuction and dermal fillers to achieve her bombshell look. ‘Miss Hembrow is the quintessential Instagram model for our social media world where fake is the new real,’ Dr. Haworth said.

The celebrity plastic surgeon went on to claim that she strikingly different in recent photos compared to images of her taken several years ago. ‘Based on what I presume to be filtered photos, she has undergone a striking transformation of not only her facial features but also of her facial shape,’ Dr. Haworth claimed. ‘Her jawline is more defined into a “V-line”. I would even venture to say her chin has been shortened and narrowed compared to her teenage years.’ says Dr. Haworth.

Tammy HembrowAccording to Dr. Haworth, Tammy Hembrow’s lips have also almost certainly been enhanced due to their ‘overly plumped’ appearance. He claimed: ‘Like Kylie Jenner, Tammy has been originally inspired by the Angelina Jolie lip variety. Paradoxically, lips oversized for a face can mature the visage beyond its years.’ His claims come after Tammy was stretchered out of Kylie Jenner’s 21st birthday party at celebrity hotspot Delilah in West Hollywood last Thursday night.

Original Article

Has Married At First Sight Star Ashley Irvin Gone Under the Knife?

In an interview with Daily Mail Australia, Dr. Haworth has offered his expert opinion on whether the Married At First Sight star has gone under the knife.

Beverly Hills Plastic Surgeon Dr. Haworth believes Ashley Irvin has had some subtle work done on her face and chest. She sparked rumors about a possible breast enlargement after putting on a busty display at the Logie Awards on Sunday.

Ashley Irvin ‘The faint circular ridge bordering the upper portion of her breast strongly suggests the presence of a breast implant’ he said.

Dr. Haworth also believes that Ashley may have made changes to her face in recent years. Observing the ‘visual harmony’ between her lips and teeth, he suggested that Ashley may have invested in lip fillers or veneers.

Dr. Haworth concluded by saying the aforementioned procedures may not be Ashley’s ‘only foray into the world of plastic surgery’.

Original Article

Kybella ® vs. liposuction for a double chin

While we in the cosmetic industry are getting better and better at delivering the results that patients expect, I still hold fast that 60 to 70% of modern high-tech materials and devices in plastic surgery over promise and under deliver ! Considering that the future of plastic surgery will be less about actual surgery as more more and more technological advances are made in the lab (think genetic engineering, better fillers, better lasers, etc.), this 60-70% statistic is rather disappointing. What makes this all the more egregious is the fact that doctors are forced to pay an arm and a leg for such underperforming technologies (Ulthera ® Thermage®, etc.). In light of the fact you can get a state-of-the-art Tesla  with all the bells and whistles for around $100,000, paying $150,000 or more for a machine that just delivers fuddy-duddy ultrasound technology through a wand to aid in liposuction is frankly outrageous. However, the medical tech companies can’t be solely blamed for this-they are basically governed by the FDA’s policies which, in turn, are a response to precedents extrapolated to an absurd degree by  lawyers. Unfortunately, I have seen it all too many times – a new plastic surgery technology coming out amidst a flurry of media only to fade into relatively rapid obscurity. This is similar to a Billboard chart topper only to turn out to be a one-hit wonder! In my opinion the latest overhyped snakeoil is Kybella® from the big pharma conglomerate Allergan®, proud makers of Latisse®, Botox®, Voluma®, Juvéderm®, etc. I was glad to hear from some of my esteemed colleagues at the recent American Society of Plastic Surgery meeting in Los Angeles that their thoughts on Kybella ® echoed mine.   Taking into account Kybella’s negative points, which include: 1.  relative risk of damaging important facial nerves, 2.  cost (though one treatment is less expensive than liposuction, more often than not multiple treatments are necessary and these, of course, add up), 3.  associated pain, 4.  longer recovery (which, ironically, is worse than surgical liposuction since remarkable swelling can occur after every injection session) and 5.  inferior results to those obtained  with aesthetically and skillfully performed liposuction …there is little to no advantage in utilizing Kybella® for my patients except perhaps for its superior multi-million dollar marketing campaign! Indeed, micro liposuction can provide unprecedented control in removing  fat to treat a double chin while refining the jawline and addressing the jowls as well-all with less downtime and more economically so in the end. Case in point:
Dramatic perioral rejuvenation including improvement of the jowl and chin utilizing a combination micro liposculpture and fat transfer
Dramatic perioral rejuvenation including improvement of the jowl and chin utilizing a combination micro liposculpture and fat transfer. Note the smoother jawline and submental (chin) region all performed with delicate no scar facial surgery without a face or neck lift.
Dramatic perioral rejuvenation including improvement of the jowl and chin utilizing a combination micro liposculpture and fat transfer. Note the smoother jawline and submental (chin) region all performed with delicate no scar facial surgery without a face or neck lift.
After combination micro liposculpture and fat transfer. Note the smoother jawline and submental (chin) region all performed with delicate no scar facial surgery without a face or neck lift.
After combination micro liposculpture and fat transfer. Note the smoother jawline and submental (chin) region all performed with delicate no scar facial surgery without a face or neck lift.

Know your nose job options:

Know your nose job options: knife or needle?

So you had a nose job and you don’t like the result.   Now what are you going to do?   You can always do nothing and live with the result. That’s OK. That’s your decision.   You can go back to the original surgeon or to a new one (of course, one who is board certified by the American Board of Plastic Surgery). This plastic surgeon may feel you’re a good candidate and give you two options: surgery (secondary or revision rhinoplasty) or non-surgery. In essence, the knife or the needle. Before your meeting with the plastic surgeon, you may think your only option at this point is a revision rhinoplasty with its attendant cost and recovery. However, this plastic surgeon rhinoplasty expert whom you chose to get a secondary opinion with, surprised you with his honesty, suggesting an altogether different approach to your nagging problem. He offered you a solution that involves less recovery, costs a good deal less and fixes your main concern…

  …and it doesn’t involve surgery.

  Your new plastic surgeon offered to inject filler into your nose to camouflage the irregularities, smooth and even out your bridge and even give you more of a chic tip. From the front view, by strategically injecting the filler to alter the light reflex and  control shadows your deviated nose can even be made to appear straight. He/she offers you a temporary or permanent filler. The temporary ones can serve as a dress rehearsal, so to speak, if you are unsure as to whether this is a good idea or not. Temporary ones such as hyaluronic acid  (e.g., Juvederm ®, Restylane ®, Voluma ®) or calcium hydroxyapatite (Radiesse ®)are good choices. Permanent ones such as Bellafill ®, Aquamid ® (not FDA approved) or fat transfer (a living transplant from your own body) are all excellent fillers in my opinion. You decide to go for it but you must be counseled to have realistic expectations. Fillers definitely cost less and involve less recovery (a few days of swelling and perhaps minor bruising at worst). However, the filler solution will: 1.  Neither help breathing problems 2.  Nor  will they treat all forms of aesthetic deformities such as this:
distorted medial crura of the alar cartilages
Significantly distorted medial crura of the alar cartilages
So the next time you’re considering altering the shape of your nose with a rhinoplasty of some sort, you may ask your plastic surgeon (hopefully,  board certified by the American Board of Plastic Surgery) about the filler option. Albeit,  it cannot match the power of an actual surgical rhinoplasty, the non-surgical, filler rhinoplasty can be an excellent alternative to actual scalpel- based surgery in many select circumstances. In these cases, the needle can be more powerful than the knife as one can see below:
Bellafill injectable , non-surgical rhinoplasty
This lady had a distorted nose after a previous rhinoplasty. Her cartilages were visible through her extremely thin skin and were twisted. After Bellafill ® Treatment.
Bellafill injectable , non-surgical rhinoplasty
Note the improvement of her inverted V deformity and how the nose appears straighter
OLYMPUS DIGITAL CAMERA
Note how her nasal rims have been dramatically lowered with the off-the-shelf filler. Of course, individual results may vary.

The Fallacy of “Stem Cell Facelifts”-the Verdict

In addition to  facial rejuvenation, buttock  and breast augmentation, stem cell marketing has reached such peaks that one may posit that they harbor the solution for global warming.

Postulated uses of stem cells
Postulated uses of stem cells
A recent study came out in our esteemed, peer-reviewed journal Plastic and Reconstructive Surgery addressing stem cell enriched fat transfer versus “regular” fat transfer  (PRS Journal: stem cell rich fat transfer). In essence, this study showed there was no difference in the effects of a fat transfer whether it was enriched with stem cells or not. This was essentially the same conclusion of a blog post I wrote a few years back. However, what makes this news different is that it comes from  a well-designed, randomized prospective study.

You may then ask yourself why are there so many doctors promoting  stem cell facelifts and fat transfers as being the chalice of youth or life’s elixir to immortality and aging. The simple answer is finance and marketing. By promoting your fat transfer as being different, labeling it with the trendy buzz prefix of “stem cell”, prospective patients will naturally think they are getting something better, longer-lasting and more natural.

You may then ask yourself why their before-and-after photos are impressive. The simple answer is that for every before-and-after photo of a stem cell-enriched fat transfer there are 10 equally-as-impressive before-and-after results from regular fat transfers. The bottom line is that one can achieve equivalent results from a regular, well-performed fat transfer-specifically, one in which the fat is appropriately harvested, cleaned and transferred by the physician with precision and artistry. Fat is basically serving as a filler, but one that is extraordinary. Extraordinary because it is not only permanent but is actually living as well-consequently it can grow or shrink depending if the patient gains or loses weight, respectively.

Stem cell embryonicStem cell science is in its infancy and we have much to learn. Indeed, many stem cell scientists now believe that the byproducts  of stem cells (cytokines, etc)  play a  far more important role in healing than the actual stem cells themselves.Fat is a rich source of stem cells but to assume that the stem cells, when transplanted into the face, can miraculously know how to uniquely reverse aging is pipe-dreaming at best.



Randal Haworth M.D., F.A.C.S.
Beverly Hills

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.

Fat transfer to the lower eyelid hollows/dark circles

Fat transfer is a brilliant way in order to fill up the lower eyelid circles which gradually appear with age as the mid facial fat sags southwards. Though one can inject any number of temporary and permanent fillers into the area with magnification (such as Juvederm®, Restylane®, Artefill®, Belotero®, etc.), one must remember that fat is an excellent solution. By filling out this dark circle/hollow, a smooth beautiful interface is created between the lower eyelid and the upper portion of the cheek. The harsh defining ledge of the lower bony orbit is smoothed out.

Here is a classic example of a strategic fat transfer to the lower lid. The results are permanent and natural appearing.

Note the harsh shadowing around the lower eyelid interface with her upper portion of her cheek. This is called the “tear trough” and worsens with age.
Note the smooth result that was obtained by softening the shadowing and ledge that defined her lower eyelid hollow. Fat transfer was performed in order to obtain this result.


Obviously, as we continue to age, the cheeks descends further thereby widening the “tear trough” or lower eyelid Hollow/dark circle. The fat that worked perfectly to bridge the gap is now inadequate since the gap has widened. The results of fat transfer should be permanent, however, as long as the surgeon adheres to proper fat harvest and transfer techniques.

For further information into how Dr. Randal Haworth of Beverly Hills(Certified by the American Board of Plastic Surgery), Call 310-273-3000  

Botox® for Depression?

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? 😉

For further information click on this link to body language.net
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