4765 Carmel Mountain Rd. Suite 201 San Diego CA, 92130
April 21st, 2009 Dr. Karam
The mid facelift is designed to lift the upper cheek upward. As we age, our cheeks begin to descend and this leaves our cheeks looking like they are sagging and flattened. A variety of approaches to the mid facelifting our available. Most require an incision under the eye or along the temporal hairline. 
Regardless of the approach, the end result is the malar fat pad is lifted into a more rejuvenated and ideal position. This helps to reverse the long tired look that so many patients complain about.
Dr. Amir Karam
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April 21st, 2009 Dr. Karam
Short scar facelift- a modern approach
Every surgeon has been trained differently on how to perform a facelift. In the end, it is the final result that counts. One of the most important components about the final results is how the incision will finally look. The short-scar incision tries to create the same excellent result as a conventional facelift by with a shorter scar.
Although, it is technically more difficult to perform, I believe the end result justifies the extra effort. One major advantage is that the individual is free to wear their hair back in a pony tail without any scars behind the ears. People love this freedom.
Further, it reduces the risk of complications with scars such as hypertrophic scaring and keloids. The incision starts below the temporal hairline then goes down in front of the ears (along natural creases) and ends at the base of the earlobe. That’s it. It is about ¼ the length of a full incision. This approach is an advance over previous incision styles.
Dr. Amir Karam
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April 21st, 2009 Dr. Karam
Each surgeon has their favorite incision style when it comes to facelifts. They are not all the same and the final result can be affected by incision choice. In the conventional face and neck lift, incision are long. They usually start up within the temple and course down the front of the ear, go behind the ear and then U-turn back down into the scalp hair.
The problem with these incisions are that they leave potential scars behind the ear. Also, they can shift the hairline both in front of and behind the ears. This tips people off that a facelift was done. Most people don’t mind telling others that they had a facelift, however they don’t want to look like they have had one.
So when considering a facelift, speak frankly with your surgeon about the different types of incisions and ask to see how they look once they are healed.
Dr. Amir Karam
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March 13th, 2009 Dr. Karam
Most patients don’t want to loose their ethnic identity. Each ethnic group has features throughout their face that are unique tot that particular ethnicity.
During the surgical planning, the ethnic features of the face need to be matched with the new nasal features created through rhinoplasty. Otherwise there will be a mismatch and the face will look odd or over-operated. This is clearly not the goal of a well-done rhinoplasty. So, lets start with some basic general principles. Asian and African-American patients most often need augmentation to the dorsum (bridge) while many Hispanic and Middle Eastern patients most often need reduction of the hump (bridge). There are also important differences in the skin thickness and tip shape and configuration. Compared to a Caucasian patient, the importance of maintaining the strength and structure of the nose through conservative cartilage removal and more aggressive cartilage preserving/shaping techniques. In the end, these noses will look more natural and will hold up through the healing process which often collapses poorly supported noses.
A major part of my practice is performing rhinoplasties on individuals from different ethnicities. Choosing a surgeon with experience is an important prerequisite.
Dr. Amir Karam
Posted in Home, Rhinoplasty(Nose Job) | 1 Comment »
March 4th, 2009 Dr. Karam
Is a Mini Facelift an effective rejuvenation procedure?
The mini facelift has many different definitions. Some use the term to indicate a shorter incision followed by the removal of small amount of loose skin. These skin only procedures are not effective in terms of producing long-term change. In these cases, the results return to their baseline within 3 to 6 months, which often disappoint the patient. The goal of a facelift is to enhance the contour of the jaw line and neck. To achieve this, the deeper muscle layer needs to be repositioned into a more youthful configuration. When the deeper layer is treated, an effective long-term improvement is seen. So, in these cases, a “real” facelift can be performed using a smaller or “mini” incision. This is the only mini facelift that should be performed. Though this advanced procedure is technically more difficult to perform, patients love the results.
Dr. Amir Karam
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March 2nd, 2009 Dr. Karam
Not all facelifts are the same. A real facelift, the only type that anyone should subject themselves to is one in which the SMAS (or muscle layer) is fundamentally treated. When the skin is lifted without this step, the results are short lived and long term irregularities can show up.
The goal of a facelift is to re-contour and rejuvenate the lower face (jawline and neck). Several modern innovations have been introduced which have allowed facelift patients to get excellent results with less down time, risk, and even without the need for general anesthesia. These procedures are done with short incision lengths, which allow for better long-term scar outcomes. If you would like to learn more about the contemporary facelift approach, please feel free to state your questions. I would love to discuss this with you further.
Dr. Amir Karam
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March 2nd, 2009 Dr. Karam
The really interesting part of being a rhinoplasty surgeon is that every case is different. That is because every nose is different, even for individuals from the same ethnic background. They are even more different for individuals from different ethnicities. Take for example, the obvious differences between the Caucasian nose and the African American, Hispanic, Asian, and Middle Eastern nose.
So, it doesn’t make sense to treat all these noses the same. In fact, when a surgeon who is not experienced in dealing with ethnic noses performs the surgery, the results are often less than ideal. This is because most text books on rhinoplasty are based on the “ideal” North American White nose. The problem is if you use this “ideal” when shaping an Asian or Persian nose for example, the results end up looking unnatural. This is because the entire face is different, not just the nose. Most patients want to enhance there natural beauty, not change their ethnic identity. In my practice, I perform Hispanic rhinoplasty, African American rhinoplasty , Asian rhinoplasty, and Middle Eastern rhinoplasty (Persian, Iranian, and other Arab countries). I would be more than happy to discuss this topic further or answer any specific questions you may have.
Dr. Amir Karam
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February 25th, 2009 Dr. Karam
Rhinoplasty (or nose job) is one of the most difficult procedures to perform in facial plastic surgery. Noses literally come in all shapes and sizes. So the surgeon needs to have a wide range of skills in order to handle this diversity. So, who should perform your rhinoplasty? The simple answer is, a well-trained and experienced rhinoplasty surgeon. So what does this mean? There are essentially only 2 specialties that are fundamentally trained to perform rhinoplasty. These are surgeons that are certified by the American Board of Otolaryngology-Head and Neck Surgery and the American Board of Plastic and Reconstructive Surgery. Surgeons that choose to focus on cosmetic and reconstructive surgery of the face and neck will often complete a Fellowship in Facial Plastic and Reconstructive Surgery. This highly coveted Fellowship is offered to 40 surgeons per year. Once, you’ve found a surgeon who meets the above criteria, you need to evaluate their surgical outcomes and determine if you like the surgeons aesthetic style. After all, a picture is worth a thousand words. Please feel free to post your comments or questions. I would love to discuss this with you further.
Dr. Amir Karam
Posted in Rhinoplasty(Nose Job) | 1 Comment »
February 25th, 2009 Dr. Karam
Rhinoplasty (or nosejob) is one of the most difficult procedures to perform in facial plastic surgery. Relative to any other procedures, a well done rhinoplasty can, however, have the greatest impact on enhancing your facial appearance. The simple removal of a large hump or narrowing a wide tip can serve to bring the entire face into an ideal balance.
From a patient’s point of view, the first step towards achieving a great rhinoplasty outcome is defining your specific desire. Next is finding a well-trained experienced rhinoplasty surgeon. Next, and perhaps most importantly, you need to communicate exactly what you are hoping to achieve following your rhinoplasty. This will insure that you and your surgeon are on the same page. Next, it is on surgeon to guide you to a realistic expectation and deliver a technically sound result. Rhinoplasty patients are often the most satisfied and happy patients as long as the above criteria are adhered to. 
Dr. Amir Karam
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February 20th, 2009 Dr. Karam
Otoplasty is an operation designed to treat over projecting ears. Ears that stick out too far from the head are often a point of embarrassment. Too often, especially during elementary school, it becomes a topic of jokes and teasing. Several studies have been done to help identify the ideal age to perform an Otoplasty. It turns out that the age of 5 or 6 is ideal. Since the child’s ears grow to near full adult size by this age and the child is just starting school, this age strikes the right balance. What is most damaging is the effects on the child’s self perception and self esteem. This is what we are actually treating when the procedure is done at a young age. Now, of course there are many adults that miss this window and get the procedure done to enhance their cosmetic appearance. Either way, the operation is highly effective and in trained hands, the results are so natural-appearing that no one can tell surgery was done.
If you would like to discuss this further, please feel free to post your thoughts and questions.
Dr Amir Karam
Director of Carmel Valley Facial Plastic Surgery, Amir M. Karam, M.D. is a San Diego facial plastic surgeon who is board certified by the American Board of Otolaryngology (ABOto) and fellowship trained in facial plastic and reconstructive surgery. Our skilled San Diego facial specialist offers procedures such as Botox ® injections, face lift (facelift) surgery, nose surgery, rhinoplasty revision, eyelid surgery, and browlift surgery at his practice. We encourage you to view our San Diego plastic surgeon’s photo gallery, as well as schedule a complimentary consultation with Dr. Karam today. Dr. Karam offers facial plastic surgery in San Diego County including San Diego, Del Mar, Carlsbad, Carmel Valley, Encinitas, Rancho Bernardo and La Jolla in Southern California
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