Face Optimization

No two faces are the same, and in fact yours and mine are two amongst 4 billion on the planet. So it stands to reason that a surgery fashioned for you or for me should be equally unique. As a concept, Dr. Rad’s FaceOps™ is not “à la carte” style surgery where “cookie cutter” procedures are done without special nuance, but rather bespoke customization. Amongst the infinite variations in anatomy and aesthetic possibilities, Dr. Rad relies on his artistic eye and deep experience to customize surgery for each patient. Drawing on his depth of knowledge of facial anatomy and the most modern surgical techniques to modify it, from porous polyethylene structural bone implants to correct deficient midfacial and jaw bone structure, to deep plane face and neck lift with deep sculpting to take decades off your face, to fat grafting to restore natural youthful volume and to rejuvenate your skin, to endoscopic brow and eyelid lifts and shaping. Dr. Rad studies your anatomy and tailors your perfect result along with you all with your specific goals in mind. Aesthetics are fundamentally about powerful emotions and nuanced harmony, concepts that transcend time back in history to greats such as Michaelangelo, Monet. Computer simulations can never capture the aesthetic nuance and stunning synergy for which Dr. Rad’s results are known.

First, a consultation through which Dr. Rad understands your aesthetic vision, areas of focus and, combined with his expert analyses of your bone structure and soft tissue, he formulates a highly specific, customized surgical plan designed solely for you. This often requires a combination of procedures, each one intended to correct subtle signs of imbalance. But keep in mind that the art lies in the hands performing the procedures, not the procedures themselves. Knowing how much change, to what magnitude, direction and type (ie, fat or muscle or fascia or biocompatible prosthetic) is the 6th sense that gifted surgeons possess. Just as a beautiful piano concerto, on a page, stands in its own beauty. But it’s the pianist who brings it to life, some so much better than others, and the most gifted pianists have the ability to move their listeners in a deeply emotional way.

Likewise, surgeons have different skill levels and aesthetic nuance, and bring to life the best results to varying degrees of ability. The level of artistry required to achieve natural, beautiful and long lasting results requires tremendous nuance. As Dr. Rad frequently says, “millimeter changes throughout the face can synergize beautifully into stunning yet natural results.” Put simply the devil is in the details. These details are reflected in surgeons’ before/after photographs which is why you must evaluate these with an aesthetic eye. But you need not understand every technical nuance — it’s an overall feeling, your “gut instinct” that hits you in a split second that tells you what you need to know. You have only one face and so, in addition to how the surgeon focuses on safety, listen to your instincts when you evaluate surgeons’ results. Dr. Rad has built his reputation on delivering striking yet natural results that resonate deeply with his patients.

Safety is always Dr. Rad’s top priority, and achieving exceptional results is a close second place. Therefore, every aspect of Dr. Rad’s care has safety at the core. Safety breaks down into two categories: delivery of care by experts, and your health related risk factors. With regard to delivery of surgical and anesthesia care, experience is everything. Dr. Rad has performed tens of thousands of facial procedures and has guided many thousands of patients to safe outcomes. He ensures that the environment and team are optimized for safety which is why he works with expert anesthesia and nursing teams at DC’s top hospital-based surgery centers (George Washington University Hospital and Johns Hopkins Sibley Memorial Hospital). Even “general anesthesia” is focused on patient comfort and safety, to ensure that the airway is protected and with the minimum amount of anesthesia necessary.

Think of the various depths of anesthesia as like different depths of the ocean – from surface to the bottom could be miles deep. Open-heart surgery is like the “bottom of the ocean” depth of anesthesia whereas requires only “under the surface of the water”. This makes facelifting very safe from an anesthesia standpoint and the length of time for surgery, oftentimes from 5-8 hours depending on the complexity of surgery, is less of a material concern.

In Dr. Rad’s and his team’s hands, facial optimization surgery entails low risk and safety is always top of mind. Dr. Rad’s innate familiarity with facial anatomy, knowledge of safe navigation of the delicate nerves, muscles and blood vessels, and working with expert anesthesia and nursing teams, all translate to keeping patients safe. Patients must have medical clearances with their primary care doctors as well as specialist physicians if they have histories of heart, lung, kidney or metabolic disorders. Dr. Rad wants your entire care team to be on board with the plan for anesthesia and, if there is medical concern, then Dr. Rad advises holding off from elective surgery until appropriate steps have been taken to optimize medical conditions.

Care post-surgery is important for both your recovery and results whether at your home or at a hotel. For your safety, as you’ll be somewhat sleepy, you will need a responsible adult to stay with you for at least the first night. If you’re interested in having an experienced private duty nurse, we can help facilitate this care. Once home or in a hotel, you will mostly rest, although you should be able to perform “activities of daily living,” meaning being up and about and doing basic self care. Since your head will be wrapped, you’ll defer showering until your first post-op appointment with Dr. Rad 1-2 days after surgery.

During the daytime you should walk 10-15 minutes each hour and should not be on bed rest. Pain is relatively mild and most patients need a mild pain medicine to help them sleep. Tissues react with swelling and bruising that distorts facial appearance and causes facial muscles not to work normally, but this is normal and temporary. Cold compresses and head elevation helps with comfort and swelling.

Since nausea is not uncommon after anesthesia, no matter how light the anesthesia given, nausea prevention is essential and straightforward by taking an anti-nausea medicine such as Zofran (Ondansetron). Nausea side effects typically wear off in 24-48 hours. Other side effects of anesthesia include feeling a bit groggy or “out of it”, but this is relatively mild and wears off quickly. Dr. Rad recommends not planning important work-related activities or phone calls as you will not feel your sharpest.

Drinking liquids is most important to maintain hydration. Dr. Rad recommends Gatorade, or Drip Drop and Liquid IV electrolyte replacement powders mixed in water. If neck lift has been done then patients often feel some neck tightness that is normal, common and temporary. You will see Dr. Rad within the first few days to check on your early healing.

Your vision for your results will emerge through detailed consultation with Dr. Rad, meticulous examination of your anatomy, and careful pre-surgical planning. While Dr. Rad’s surgical approach is unique for each patient, the goal of naturalness remains constant.

Over the course of 2-6 weeks post surgery, results will continue to develop with long-term recovery experienced around 6 to 12 months after the procedure. By this point, the majority of swelling and bruising should have resolved, and you should start seeing the full results of your facial masculinization surgery. However, it’s important to note that individual healing rates can vary, and it may take several months for all swelling to completely dissipate and the final outcome to be evident.

To enhance your results and “protect your investment”, Dr. Rad recommends consulting with Dr. Sherber for laser resurfacing, injectable neuromodulators such as Botox or Daxxify, a results-oriented skincare and sun protection regimen, and non-invasive skin tightening with Thermage FLX. Just like regular tune-ups or oil changes to keep your car running well for many miles, you can maximize the “mileage” you gain from your facial masculinization surgery through these maintenance treatments under Dr. Sherber’s care.

To see Before & After results, visit our gallery page.