Medesthetics

OCT 2017

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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medestheticsmagazine.com | OCTOBER 2017 55 his way back to the West coast for his plastic surgery resi- dency 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 go to Bev- erly 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. "I look back fondly on those days now, but it was hor- rible 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). "I do many types of lip lifts because it is shape before volume; there are many things that fi llers alone cannot do," he says. Embracing and Investigating New Technologies Despite the limitations of traditional fi lling techniques, Dr. Haworth has embraced dermal fi llers as effective tools to perfect his patients' lips. In some cases the new, less inva- sive 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 fi ll the low- er 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 fi ller 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 verti- cally as I pull the needle out," he says. "I am seeing such dramatic elevation of not just that lower lip but the whole corner of the mouth—the marionette folds are dramati- cally 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. "I love doing surgery, but plastic surgery is in some ways a dying fi eld," he continues. "The future of plastic surgery lies in the lab, not the operating room. Eventually they are Dr. Haworth is investigating new ways to augment and lift lips using dermal fi llers.

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