Jorge L. Menendez, MD, FACS

Plastic Surgeon

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PHILOSOPHY

Keeping close ties with his past has helped Dr. Jorge L. Menendez create a better future for himself and his patients. He immigrated to the United States from Cuba in 1968, when he was just 10 years old. Drawing from that experience has helped him offer great comfort and understanding to everyone he meets. At the Aesthetic Plastic Surgery Center, Dr. Menendez uses his life experience to foster better results in his work and more productive relati...

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Keeping close ties with his past has helped Dr. Jorge L. Menendez create a better future for himself and his patients. He immigrated to the United States from Cuba in 1968, when he was just 10 years old. Drawing from that experience has helped him offer great comfort and understanding to everyone he meets. At the Aesthetic Plastic Surgery Center, Dr. Menendez uses his life experience to foster better results in his work and more productive relati...

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FAQ's

Q. How can I tell if I need a breast lift, a breast lift and breast implants or just implants? Is there some easy formula?

What our experts say:

If you measure the distance from your sternum to the nipple areola complex that's the measurement we use to determine where the breast needs to be. For the layperson, if you consider under your breast crease, if the nipple areola complex is way below that, say _ to1 inch below that, it may be a indication that you need a breast lift or a lift and breast augmentation.

Q. Is there something I can do in my 30s and 40s that could or should help me age well or am I heading just where nature intended me to be?

What our experts say:

Sure, I think the public has become more accepting to doing procedures earlier to maintain your appearance versus how it used to be 15, 20 years ago, when women would wait until their 60s and 70s and then have these massive overly done procedures which disconnected their head and neck with their body. So now we know that you can do modified things in your late 30s, early 40s, then as you get a little older you can go have a little traction on the neck. So yes you can do things that can ameliorate that acute change.

Q. My mother has the classic turkey wattle below her chin, and I can see my skin getting a little loose, so I worry that I'm going to have the same. Do I get a neck lift early or wait until it gets bad?

What our experts say:

I would do something early because the likelihood is you will have the same. Let's say you're 30 and you have a little fullness there you can simply do a neck liposuction and you'll get enough contraction of the skin because you're young and you have good collagen and then as you move into the next decade when the issue becomes the skin's really falling, then you'll need that lifted.

Q. What do I do about cellulite? Is there a good cellulite treatment?

What our experts say:

Not much. They're working on some techniques. Every few months some machine will come out that says this result or that result, it's more the exposure of the camera taking the picture than the machine. We have yet to see anything that can address that issue.

Q. What’s a nonsurgical nose job?

What our experts say:

Nonsurgical nose jobs were born out of the use of fillers such as Juvederm to correct the deformities of the nasal pyramid. Either by putting a little bit on the tip, deformities, like concavity on the sides of the nasal pyramid, can be helped a little bit. It's not a rhinoplasty, it's a camouflage procedure that will last about 12 months and then you'll have to repeat it. Juvederm on the average lasts nine to 12 months depending on the patient. Your body will absorb it over time.

Q. When you do a facelift with a fat transfer you use fat instead of a filler but is it a major procedure to remove the fat from another part of the body?

What our experts say:

The fat is usually harvested from the inner or outer thigh sometimes from the tummy right below the belly button. It's processed in a centerfuge which spins it then it separates the fat cells from the oil. The oil is discarded and the fat cells are then transferred to injection syringes, it's just small volumes. The area that usually needs volume is the cheek or the area of the periorbital with dark circles. So that's what it's used for and it does a beautiful job in providing volume to the face. That was the problem with facelifts many years ago, it was a procedure that was taking too much away and now we know that the face needs to have volume restored. We harvest it by hand because liposuction would destroy the fat cells.

Q. When you do an eyelift is it in conjunction with a facelift or at the same time?

What our experts say:

Ninety percent of the time, at the time of a facelift, an upper lower blepharoplasty is done, or even just a lower or just an upper. Ninety percent of the time they are done together as a pretty routine procedure.

Q. Why would I get a mid facelift v. a traditional facelift?

What our experts say:

It's confusion in terms. So-called mini facelifts or lunch time facelifts were popularized by non board-certified plastic surgeons such as ENT (ears, nose, throat doctors) adding these procedures, which they do in the office under local anesthesia by pulling a little skin. You see all these advertisements for a quick lift, those are all marketing modalities to do a procedure that is not really appropriate. There is not really a short cut to the real thing. However, if you're young and you have minimal issues you can do a minimal procedure. But a 55 or 60 year old who has laxity or looseness of the neck skin and the tissues and the jowls around the mid-face, generally the best result is doing a standard facelift which addresses just those issues. And then the blepharoplasty and a browlift in addition to that. There's confusion that a facelift means eyes and brows. It's not true.

Q. Why would someone get a tummy tuck and not liposuction?

What our experts say:

It's the laxity of the skin, or redundancy of the skin, that determines that.

Q. What is the most reasonable outcome for surgery to correct dark under-eye circles/bags (genetic)?

What our experts say:

Surgical correction is very difficult. There are some treatments with lightening creams that are very helpful but it's very problematic area. One of the things that can be done if the lower eyelid is discolored is fat grafts to the area and increase the volume and thus bring light to the area and have a slight improvement. But otherwise, surgically, there's no clear procedure that can treat that.

Q. Are there alternative nonsurgical methods of fat removal?

What our experts say:

If your skin is good and you don't have many stretchmarks and you have relatively good form but the issue is you just have fat deposits in areas you can just do standard liposuction and that does pretty well. You wear a garment for four to six weeks and you get a fairly good result. Some of the things like lipolysis and these injections are not considered standard of care by the American Board of Plastic Surgery, things you hear about in spas or in France where they inject you with this liquid that dissolves fat, the term is lipo dissolve. Those have proven to be problematic and are usually done in nonsurgical settings by a medical spa or someplace that is just not qualified to do that.

Q. How can I keep a natural looking brow as I age? And prevent the need for other types of face procedures?

What our experts say:

One of the simplest nonsurgical ways to do that is by using Botox to decrease the pull of the brow by the muscles in the periorbital area. So if you treat the forehead and the crow's-feet it allows the crow's-feet forehead muscle to lift the brow a little bit.

Q. How is a body lift like or different from a mommy makeover?

What our experts say:

A body lift encompasses from the neck down several issues that occur either with significant weight loss or with significant aging and child bearing. You address the breasts if you have breast ptosis, or the normal term is sagging breasts, or volume loss of the breasts. If you address that first you'd get a breast lift or you may need a breast lift with a breast augmentation to restore the position of the breast and the volume to the breast. As you move down, laxity to the tissue of the abdomen either from child bearing, life, or significant weight loss, the procedure would be an abdominoplasty. If you progress south, if you had significant weight loss, where you more commonly see it is sagging of the buttocks, the medial thigh, the tissues of the thigh, there are procedures such as thigh lift and buttock lift. You don't do all of those procedures at once. You do them in sequence because it's too much surgery.

Q. Is a PDF plate in the nose preferable to your own fat or filler?

What our experts say:

Basically it's augmenting the nose with a synthetic material. And there are these little silastic that can be placed to give the tip or the nose more projection. There is a long term consequence of putting a plastic or foreign device in the nose is that sometimes they break through and come out. For aesthetic rhinoplasty you should be evaluated by a board-certified plastic surgeon and try to use the tissues that are native to you in the procedure.

Q. When you do a blepharoplasty is it only surgical or can it include fillers to complete the eye rejuvenation?

What our experts say:

You can augment the lateral brow by filling it with Juvederm or fat after a blepharoplasty or before. I like to do it when the patient is awake and sitting up in the office under local anesthesia or a little cream because you're more accurate. Blepharoplasty is done outpatient as a surgical procedure not in the office under a local.

Q. Whose choice is it whether I get saline breast implants or silicone breast implants?

What our experts say:

The choice between saline and silicone can be a personal choice of the patient but more accurately it depends on the volume of the breast. If you have very thin breasts in terms of support, a saline implant can be more palpable than a silicone implant. The decision when you're doing a breast lift whether you need an implant to provide more volume is one that is determined between the doctor and the patient.

Q. Should I have a browlift or an upper eyelift? What will give me a more rejuvenated look?

What our experts say:

You have to differentiate between a blepharoplasty and a browlift. The misconception is that by removing the skin of the upper eyelid you address the descent of the brow. They are two different entities so you have to examine the patient to determine if they have browtosis or a lower brow, which contributes skin to the upper lid or do they have isolated skin to the upper lid. You have to differentiate those two because they're different procedures. Or the patient may need a combination of browlift and upper blepharoplasty. But you have to determine that by examination.

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