When there’s something we don’t like about our facial features, we tend to focus on it. But in order to fix those things, we should be examining the entire face—which is exactly what Washington University Facial Plastic Surgery Center docs Gregory Branham and Mark Checcone do.
“Patients don’t realize that a much more complex process is going on,” says Branham. Sagging skin is related to loss of volume; tired-looking eyes may be traced to a drooping brow; and the shape of the nose can be softened by the shape of the chin. So how do we know what we need? Enter cosmetic surgery experts like Branham and Checcone.
With a combined 25 years of experience in the field, the two operate at several St. Louis locations in association with Barnes-Jewish Hospital. Branham has been listed in America’s Top Doctors and Best Doctors in America since 2002. They report that patients often come in asking for one thing, but actually needing another. With rhinoplasty procedures, for example, people often focus on what’s wrong with their nose. “But it’s important for patients to understand that when we evaluate for a cosmetic rhinoplasty, we’re not only looking at the nose,” Checcone says. “It’s our job to look at the nose on the entire face and steer them in the right direction with any complementary procedures.”
In many instances, the size of the nose is out of proportion with the chin, in which case the doctors may insert a chin implant, Checcone explains. And rhinoplasty is not always about nose size, adds Branham. They often end up changing the shape of the tip or the bridge, narrowing the nostril span or altering the angle between the nose and upper lip. Their practice also specializes in ‘revision rhinoplasty,’ re-working previous nose surgeries that patients were unhappy with.
“Hopefully you don’t need more than one rhinoplasty,” Branham says. “But there are things that you don’t have control over; there are things in the healing process that can throw you a curve.” If the original rhinoplasty removed or damaged the nose’s cartilage structures, Checcone notes, rib cartilage grafting may be required, a procedure he specializes in.
Another surgery that requires ‘patient education’ is the brow lift. “The brow lift is a very underutilized operation in terms of rejuvenation of the eye area,” Branham says. “People tend to think of an eyelid tuck, taking the extra skin out of the eyelid. But as you age, the whole forehead and brow descend, and it causes you to have a tired look.”
Checcone and Branham say this ‘down season’ is a good time to consider cosmetic procedures in St. Louis. “It’s winter, and you can sort of hibernate a little,” says Checcone. “You’re simply not out as much. I see patients doing more facial rejuvenation, peels and that sort of thing.”
When considering cosmetic work, Drs. Branham and Checcone suggest researching safety issues in advance on a Web site like Injectablesafety.org, which is created by a coalition of professional medical societies. Branham mentions a patient who frequently traveled between St. Louis and the West Coast, where she attended a party in somebody’s home at which a nurse was doing injectable fillers and Botox. “If something were to happen, you’d at least want to be in a doctor’s office so you could get the proper care,” he says.
“A good question patients can ask is, ‘If there is a bad outcome, can the doctor take care of it?’” adds Checcone. “Check that they’re licensed and board-certified with a reputable certifying organization.” Those include the American Board of Dermatology, the American Board of Plastic Surgery and the American Board of Facial Plastic and Reconstructive Surgery.
“Another thing that I will always recommend to patients who have a big decision about a procedure is that they get multiple opinions,” Checcone says. “If the doctor seems pushy or offended, I think patients need to let that help guide their decision-making.”
Drs. Branham and Checcone address common issues on their newly revamped Web site, http://facialplasticsurgery.wustl.edu">facialplasticsurgery.wustl.edu. The site provides information on what to expect from a variety of procedures, includes a photo gallery of former patients, and lists special discounts. Patients can also e-mail the doctors directly or try the ‘Face Touch-Up’ program, which allows you to upload your own photo and see what a rhinoplasty might look like on you.
ON THE COVER
Drs. Gregory Branham and Mark Checcone bring a combined 25 years experience to their practice at Washington University Facial Plastic Surgery Center, 605 Old Ballas Road, Ste. 100, Creve Coeur. They perform minimally invasive office procedures and a range of surgeries, including rhinoplasty, revision rhinoplasty, facelifts, brow lifts and others. Call 432-7760 or visit http://www.facialplasticsurgery.wustl.edu">www.facialplasticsurgery.wustl.edu for more information. Pictured on the cover: Drs. Mark Checcone and Gregory Branham | cover design by Noah Palone | photo by Jason Mueller