- Aesthetic Injectables
- Facial Implants
- Revision Rhinoplasty
- Micro-Mini Lift™
Dr. Michael S. Godin has been in practice for 22 years and focuses solely on facial cosmetic procedures—two facts that provide his patients with confidence in their outcomes. At his AAAHC-accredited facility, he takes a personal approach when consulting with patients to understand not only their desired results, but also the concerns and motivations behind them. “I spend time with my patients and get to know them,” Dr. Godin say...
Dr. Michael S. Godin has been in practice for 22 years and focuses solely on facial cosmetic procedures—two facts that provide his patients with confidence in their outcomes. At his AAAHC-accredited facility, he takes a personal approach when consulting with patients to understand not only their desired results, but also the concerns and motivations behind them. “I spend time with my patients and get to know them,” Dr. Godin says. “That way, I have a thorough understanding of their ultimate goals and they can understand what I can offer them.” Dr. Godin is an internationally recognized expert in facelift surgery and is also the author of the successful textbook Rhinoplasty: Cases and Techniques.
I have a calm, deliberate style. I'm very focused on what I'm doing, but I'm also relaxed because I really get into it. I lose track of time and distractions. It's not a tense situation I'm composed.
I don't take unnecessary risks with patients. I do only procedures that I know are going to be reliable, that work well and that will improve the patient with very little risk. My in-office surgery suite is AAAHC accredited, and the anesthesia we use there is sedation, not general, and is given only by board-certified anesthesiologists.
I customize what I do for each individual patient. I take time to really listen to what they would like to achieve. Then I try to give them a range of options from less invasive to more invasive treatments. At the end of the day, the plan has to fit their goals, and they have to be happy with it.
I get so many compliments on my office staff! We put a high value on getting it right for each patient and providing them with a very high level of service. I am very fortunate to have such detail-oriented, friendly and talented people working with me. They like what they do, and it shows.
A small-incision procedure to firm the jawline and improve drooping in the neck.
Because the incisions are smaller than a standard facelift or even a facial or neck tuck-up, it is a mini-lift. “Micro” describes the surgeon’s mindset—an almost microscopic attention to detail.
Patients with early jowling and looseness in the neck. Generally, they are in their 40s or early 50s.
Yes, it is individualized in every case. For example, the deeper layer (SMAS) may simply be tightened or partially removed and repositioned, depending on tissue looseness and thickness.
I do sculpture. I have worked in wood, metal and clay. I've always enjoyed looking at something and trying to improve it in a creative way. Having an aesthetic sense helps me in the operating room. You can't do this type of work very well if you don't have it.
What I like most is creating positive changes in people's lives. Patients are happy and appreciative when you do this, and you can see it when they come back for follow-ups. They just light up. It's nice to be able to do something that makes people happy that way.
For the last 17 years, I've been doing pro bono work through the national domestic violence project of the American Academy of Facial Plastic and Reconstructive Surgery, which provides free surgery to victims of domestic abuse. I've met some really extraordinary, courageous women who had some bad circumstances that are better now. Repairing the injuries they suffered to the face is sometimes their last step in moving past what happened.
Unhappy with the jowling in her lower face and skin laxity, this 46-year-old patient sought a less invasive solution. “Through years of work, I have developed a modification of the facelift, called the Micro-Mini Lift* (MML), which is appropriate for patients with a small amount of excess skin in the jawline and/or minor looseness of the neck,” Dr. Godin says. Shown 16 days after a MML with neck liposuction, the patient looks noticeably more youthful.
*The Micro-Mini Lift (MML) is a trademark of Michael S. Godin, MD, PLC
Dr. Godin uses a variety of facial fillers to get the improvements that patients are looking for. He prefers using a more substantial and long-lasting filler for contouring the face. “Radiesse® is terrific for this because it provides bulk where you need it and lasts about a year,” he says. “My patients like the effect and the longevity. For me it is a very creative process—like adding small amounts of clay in a very precise way to the sculpture you’re enhancing.”
Because reshaping the nose is one of the most complex of all facial procedures, Dr. Godin says he could never get bored doing it. “It’s endlessly fascinating to me. It is also the most unforgiving of all cosmetic procedures, so you must go to someone who knows what he’s doing and has enough experience,” he says. The challenging nature of rhinoplasty has led Dr. Godin to his current project, a major new textbook, Rhinoplasty: Cases and Techniques (left), written for surgeons. The book has just been published and contains case studies from him and other surgeons from around the world. “For me this is a labor of love,” he says.
After a rhinoplasty, there is short-term healing and long-term healing. In short-term healing, most patients can return to work, comfortable and presentable, in about 10 days. I normally schedule the procedure midweek so patients are back a week from Monday. In long-term healing, patients will see their final nose after one year yet subtle changes may still continue. While most swelling should subside within 10 days, fluid remaining in the nasal tissue for an extended period results in what’s commonly referred to as the shrink-wrap effect. The skin and soft tissue envelope adhere to underlying cartilage and bone causing these subtle changes over time.
For an accurate diagnosis, you need an experienced professional. If there is brow ptosis or a low brow, and an eyelid surgery is performed, you are decreasing the distance between the eyelashes and the eyebrow causing the patient to look permanently angry and tired when they are not. You want to do the right procedure and surgeons should be able to help you make those choices. Having said that, there are nonsurgical options. We use long-term, off label fillers for the tear trough area and along the orbital rim. We may also use an off-label neurotoxin to help the eye area as well.
The neurotoxin changes the way the muscles function in the brow and crow’s-feet areas. It decreases arching. When frowning causes the brow to be pulled in and down an FDA approved injection, such as Botox or one of the equivalents, Xeomin or Dysport, can help relax those muscles. This "chemical browlift" may actually cause the brow and surrounding muscles to float up slightly.
If a patient is dissatisfied with their results, revision is a certainly possible. As one of the most interesting and challenging parts of my practice, revision rhinoplasty requires extreme care and a lot of respect for support and structure. I believe people get into trouble with revision rhinoplasty when there is prior weakening and additional surgery only weakens the area further. With the retractile forces of healing, a real deformity may occur so multiple revisions only worsen the issue. Therefore, I highly recommend seeing an extremely experienced doctor, especially with revision rhinoplasty, and giving a great deal of attention to the structure.
Breathing issues may be caused by nasal destruction from a deviated septum or blockage but may also be due to other factors such as allergies or environmental factors. A qualified doctor should be able to determine the cause. Also with rhinoplasty, form most often follows function. We are essentially performing functional and cosmetic operation simultaneously allowing the patient to not only breathe better but also look better.
To ensure the nose matches all other features, a doctor must take the patient's entire physical appearance into account. This includes observing the width of the face, length of the face, and even a patient’s stature. One feature that may alter facial harmony is the chin. For example, if a patient has a short chin and fairly strong nose, a chin implant can restore balance.
This is biggest part of my practice. I do more facelift than any other procedure. When determining which procedure is best, I advise speaking with an expert in facial plastic surgery. Because the patients will have desires and see specific things they want to improve, it is our job to go to the problem area and make it better. If it is the neck that is drooping, but the jaw line is firm, then we may perform a necklift rather than a neck tuck or a full facelift. If there is jowling but the neck is firm, we may do a facial tuck up. If there is very early jowling and drooping in the neck, we would perform a procedure I trademarked as the Micro Mini Lift. This modification of the facelift is ideal for patients in their early 40s to mid 50s.
These operations are really intended to direct specific problems. You have to have a full range of tools in your tool kit or arrows in your quiver. We assess patients individually to determine which lift fits their specific needs. We try to choose the procedure that gives the best results with the least risk and the least amount of downtime. If we can get away with a smaller incision and still get an excellent effect, then we will do it.
Botox, Dysport, and Xeomin essentially treat the same thing. The important thing to understand is that the same basic molecule interacts with the muscle but is delivered in slightly different ways. Botox and Dysport are complexes with proteins. The size of these proteins and how the body detaches them from the botulinum toxin molecule gives them different properties. Xeomin is a pure botulinum toxin so it does not have those attached proteins and acts slightly different. In general, all three have similar duration and effect. It is nice to have three different treatment options because some patients may do slightly better with one than the other.
There are a variety of mini-facelifts. The incision for a Micro Mini-Lift resembles a comma around the earlobe which then extends up the back of the ear and slightly hooks back into the hairline. This incision allows access to the upper neck and jawline. A surgeon’s attention to detail must be almost microscopic in mindset, paying close attention to adequate elevation during this procedure. A novice surgeon may find this operation difficult, as the same areas assessed in a traditional facelift are to be assessed with smaller incision. A more experienced surgeon would be more comfortable with the anatomy with the micro mini lift. Unlike the traditional procedure, recovery is only about a week.
Neck and face procedures should be combined when both significant sagging and significant jowling, exist concurrently. This would be when the jawline appears wider from the front and side views, the jawline crease is visible, and tissue sags just below it.
When chin and neck become one, a patient may need liposuction. Because neck and jawlines differ among patients, we as facial plastic surgeons must first evaluate each patient individually and then optimize them. This means different things for different patients.
A "liquid facelift" is not a true facelift. A true facelift moves tissue to a more youthful position whereas a “liquid facelift” uses injectables to fill spaces, sagging areas and furrows and to relieve some of the bunching that leads to unsightly lines and wrinkles. A “liquid facelift” can be very helpful for a patient who isn’t ready for surgery or wants to wait for surgery yet still wants to look good in the near term. Also, for someone younger and not quite ready for a surgical procedure, a “liquid facelift” or one of the components of it can be very helpful. My Micro Mini-Lift qualifies as a mini-facelift. This small-incision lift targets less neck sagging and jowling than the traditional facelift.