What can be done with cosmetic surgery?
Another way of asking
the same question is
"What results can be expected from cosmetic surgery?"
And what most of us are interested in eventually, is
not just what has been done for someone else, but
“What can be done for me?”
This web site is for
the answer to these questions. What can be done is
shown in pictures and explained in words. What can
be done for each person can be imagined by seeing
what has been done for others. But a more specific
answer is shown in drawings of each persons face.
And anyone can do the drawings.
We want to know in
advance as clearly as possible what is going to
happen to us and what the result will be. What we
fear most is the unknown. Here we want to share all
the experience we have had in more than thirty years
of cosmetic surgery, and to explain how to find out
and know as clearly as possible what the results of
doing something cosmetic would be like.
We have chosen the
to mean all the consequences of surgery both good
Can anything be done
for my face that would be safe, easy and painless
and would not change my appearance except for the
improvement, and have enough improvement in
appearance that would be visible to and look good to
everyone who sees me, that would be completely
natural with no scars and
of little cost and great benefit? The answer
Let us explain and
show in this web site as clearly as we can how that
can be pre-determined so that it is much less a
matter of taking a chance.
See what has been done in photographs
Instead of explaining
only in words, it is faster and easier to see
results. The quickest way to see results is with
good quality photographs. If we can see the good
quality before and after results of the doctor’s
work, then we know what can be done. Or at least
what can be done by that doctor.
It is very good if
one knows in advance what changes are to be made,
how much improvement, how soon the recovery, and all
the good and the bad as clearly as possible so that
there is much known and little left to the unknown.
And this is why we show a lot of pictures and do a
lot of planning with drawings.
To say in words that
the results can be from bad to excellent is worth
much less than seeing them for yourself. The
quickest, easiest way to see and study results is
Digital photographs and retouching
But let us beware of
digital photographs as shown on the internet.
Retouching of photographs dates back more than 100
years. Most of the glamour photos of movie stars
were retouched extensively. The most famous
photographers such as Ansel Adams retouched and
enhanced their photographs.
And now with digital
technology, every magazine cover is digitized before
it is printed. Even of the most famous and beautiful
models gracing the ads and covers on the newsstands,
everything of face and body are retouched routinely.
They are scanned photographs at 35Mb or greater
size, and each of the 35 million or more pixels can
be changed individually with the most subtle (and
sometimes not so subtle at all) beneficial changes
which no one can tell and no one will ever know. All
internet pictures are digital.
This is a danger for
the observer of cosmetic surgery results on the
internet. Any or all of the surgery results in the
before and after pictures can be enhanced either by
making the before look worse or the after better.
And sometimes both are retouched.
All of the
photographs we show you here and in the office of
the more than 200,000 available are from film, and
not digital. You are very welcome to see the
negatives and slides from which they are made -
dates and everything.
In this site no
retouching of any surgery results has been done.
Everyone is invited to see the slides and negatives
of the befores and the afters shown. Almost all the
pictures, except the drawings, are from film and
were not originally digital. The slides are
dated by the developer. And the negatives are in
strips with other photos taken on the same dates.
And this should be required of all results shown on
the internet or in the surgeon’s office. When
visiting us in the office, we hope you will ask to
see the original slides and negatives of random
choices if the results photographs look
exceptionally good. We will not only NOT be
offended, but pleased that you are interested.
The Scales of Balance
Since the word
has been chosen to include all of the effects of
surgery, both the good and the bad, the results can be
expressed as scales of balance with the good on one
side and the bad on the other. In cosmetic surgery
the good should far outweigh the bad or the surgery
should not be done. In the visit with a cosmetic
surgeon a prediction or estimation of all the good
and bad effects of each procedure and change in
appearance that is contemplated can be given to the
person who is considering having the work done.
What can be done with
cosmetic surgery can be shown with photographs. To
be believed the photographs of work done of the face
should be on film and not just digital. The
lighting, camera settings, makeup, position, and
expression of the subject should be the same in the
before and after so they can be compared for what
the surgery has accomplished.
The stages of
progress from one day after surgery until the person
is looking and feeling well can also be clearly seen
in pictures. See samples of day-by-day recovery
under the Nose and
Face sections of the
The importance of photographs
If someone asks me if
I know a good surgeon they could go to in New York,
Miami or Berlin, the answer is “Yes”, I know some
surgeons there. And some of them are very nice, very
pleasant to see at meetings, and good friends. Some
I know quite well having seen them and known them
for years. But I would not go by just that. It would
be much better if I could see before and after
photographs of the work they have done and to know
what kind of work they do rather than to know them
The surgeons I know
may be the most friendly, kind and sociable
persons, and yet do lousy work . And on the other
hand, someone whom I have never even met may be
doing the best work. Good quality before and after
pictures of the results of the surgery show if the
cosmetic surgeon is doing good work. The before and
after pictures of the work they have done is the
most important criteria by which we can tell how
good the work they do is.
It is as in sports -
as runners say - it is how fast s/he runs that
counts. In golf, the score is most important.
How good a cosmetic
surgeon is depends on how good the results are.
What are good
results? Good results are the most benefit with the
least harm. The most beautiful appearance, and the
least amount of swelling, bruising, recovery time,
and ill effects.
What are good
As I heard the
architect I. M. Pei say "function before form". And
that is true of our work too. A face that is
beautiful but does not function properly is not
To be a good result
the result must be completely natural in function
and appearance. It is not good to have an attractive
nose and not be able to breathe through it. Or big
beautiful lips that don’t move normally and cause a
lisp. Or beautiful eyes that are red and burning
from dryness because they won’t close at night.
A beautiful result is
beautiful to everyone. Not just those in the know.
Not just the sophisticated, educated, intelligent
people. But everyone from children to the elderly.
Everyone of every race creed, culture, ethnic group
or country of origin. Just as flowers appeal to
everyone, so should a beautiful face.
Another comparison to
architecture is the importance of planning. The
credit for a beautiful building is given to the
architect who conceives it and plans it, rather than
the actual builders. The plans tell the builders
what to do.
The importance of a goal
So have we found it
to be with cosmetic surgery. A good plan leads to a
good result. An excellent plan to an excellent
The plans that we
make for the face are drawings done on the person's
pictures. I began drawing and planning in 1965
having heard of this technique from an American
Rhinologic Society meeting.
Upon showing drawings
I had done to the patient, it immediately became
clear that if drawings are done to plan the result
of the procedure, the patient is very interested in
them and wants to participate and choose what
appearance they are going to have.
So by the late 1960s
we would make many photocopies of the drawings in
progress and give copies to the prospective patients
to take home and show to their trusted friends and
relatives. They could also study and modify the
drawings until from many alternatives the very best
drawing could be chosen.
Anyone can do all the
drawings themselves without the assistance of the
surgeon or his assistants. Some of the finest
drawings we have used as a goal have been done by
professional artists and art teachers of high
schools and colleges. Many are done by the patients
and their families and friends.
photocopies of the original pictures is easily done
in pen or pencil. And more and more people have
digital cameras and drawing programs on their
computers at home or the office.
Then, with the chosen
drawing, the challenge was to see how close to the
drawing we could come with the result of surgery.
And so for all the
past 30 years, every patient has had drawings that
they have chosen. Some of the chosen drawings are
shown on this web site. While visiting us in the
office in reviewing some of the more than 8,000
photos we have prepared to show, some before and
after photos may be chosen at random to see the
drawings that were chosen by that person in the
photos. And in this way a good, clear estimate of
how close we usually come to the drawings with the
result can be made.
Although we have had
computer imaging since 1985, the final plan drawings
were still done with pencil, pen and paper until
1995 because the printing was not of high enough
resolution. Since 1995 the printer output has been
photo quality. We still do some sketching even on
the photo drawings produced by the computer, or on
photocopies of them. Fine tuning of drawings and
producing variations can be done as fast as one
drawing per minute. This can provide many drawings
from which to choose.
Cosmetic surgery has
certain ethics or rules. A full list of them is
under Principles and Ethics section.
"What specifically would be best for me?"
The most common first
question of a person who comes to visit is, "What
can you do for me?" For each person, the answer is
different. To give an accurate and fairly complete
answer covering all of the possibilities and
reasonable alternatives requires a thorough analysis
of that person’s face.
After a brief health
history and a few questions regarding the person's
wishes, we do this analysis routinely in five
2. Digital or
analysis and sketches.
4. Comparisons with
other faces, including before and after photos.
examination, often with a microscope.
And then there is the
explanation and discussion of all of these
Each person is given
photocopies of all of the drawings and sketches for
independent study at home and a copy of the prints
of any pictures taken.
From the analysis
among all of the possibilities and alternatives
explored is a search for:
1. The best
appearance that can be accomplished.
2. The most
improvement in appearance with the least amount of
We want to find for
each person the most benefit with the least amount
of surgery, and the maximum improvement in
appearance. Then in addition to those two things,
all the alternatives and possibilities are shown so
a goal can be chosen. Ordinarily a person chooses
what they like best.
Choosing a goal
analysis and sketching is the real planning phase.
It is approximately equivalent to an architect’s
plan for a building. It is very important because
the intention is for the result to look almost
exactly like the chosen plan.
Choosing a goal is
also very important in that it is a search for the
best the person can look - the most beautiful that
person can be. No matter how much change is required
to get there, it is good to know how good it can be
when we look our best. Any drawing that can be
improved upon should be. And the final drawing or
plan should be “un-improvable”. It should not be
possible to improve on the drawing chosen to be the
Yet the best looking
drawing may not be the one that is chosen, because
the change may be too great.
We will want to find
for each person the best possible result with the
least amount of surgery - the "biggest bang for the
buck". The best appearance, however, may still be
chosen even though more change is required to
Learning about the experience
Another great source
of information when visiting a doctor’s office are
the photos of other patients who have had procedures
done similar to those being considered. Very often I
will ask of the after surgery patients if it would
please them to share their results and experiences
with another person who is a complete stranger, all
the good and the bad. Most say yes.
Even when there is
distortion from swelling and bruising and the after
surgery patient doesn't feel that anything good can
be said about how they feel, the communication is
encouraged. It is especially beneficial for the
person considering going through the process to see
and hear the truth, all the bad as well as the good.
The better-informed one is, the less afraid and more
confident they become.
Being left alone with
several and sometimes many persons individually who
are friendly and want to share can be more
informative and memorable than any other information
that is given. Previous patients can tell all about
what the experience was like and also share the
experiences of all the others they have met who have
been through the same or similar experiences. And
they can be asked very open and direct questions
that one might feel embarrassed to ask the doctor.
Many patients have
met as many as a dozen other patients who shared
with them their experiences. Sometimes they have
become good friends and shared telephone numbers.
Even some of the well-known persons who require more
confidentiality and privacy have enjoyed meeting
others and sharing their experiences of surgery.
It is like a support
group that can be very helpful to many. The
expectant mothers meet together in groups at the
hospital and learn from each other. And many others
with shared experiences, goals and values become
friends in school or church or many other ways.
It can be very helpful not only for the one who is
seeking information and understanding, but also for
the ones who are sharing.
It is highly
desirable that the person considering an improvement
in appearance is given all the information about all
of the alternatives available before the final
decisions are made. At stake is not only the persons
appearance, but also their health and comfort as
well as considerable cost in time and money.
A poorly planned
result can be very disappointing and a very good one
a joy forever. Let us help you plan a good one!
Letter to a Patient
Asking and questioning, is what we all should constantly be doing. It is the basic starting point for the search for truth. What we should most be skeptical of, is ourselves. Is this good? Right? True? etc of all science, philosophy, knowledge, wisdom and especially politics.
We all need help with some of the most important decisions. Friends who are informed and have been through the same thing and who care about you are most important. Many others such as relatives may be completely opposed.
The search for wisdom can be simplified into the pros on one side of a page and the cons on the other and this can be helpful. But when the choices are so many and varied, it can take many pages and we begin to find that we need more knowledge coming from lots of research before we even know where to begin. Many judgments come to us best after a good nights sleep.
I had rather see the results of a doctor's work and speak with his patients about their experiences than to meet the doctor.
Of course whether or not we like the doctor makes a big difference, but even more important is - does he seem to like us.
And yet, if I know I am going to get the best result from one doctor, that is a better result than any other I have seen, then overwhelmingly the better result is the choice that is best for me.
As if we were purchasing a work of art, that work is what we take home and not the artist.
And in this case of the face, the actual appearance or looks is most important.
Whereas in art, whose work it is can be the deciding factor, along with artist's fame. And this factor is not true here. For example a Picasso may be most unattractive and still much more valuable than a work of great beauty by an unknown.
For cosmetic surgery we want the most beautiful, natural result, in safety and comfort with the quickest recovery and return to normal.
At our website http://www.wrmorganmd.org/ under the "Index of Information" in the left column, all of the items from " The Question" down to the "Contact Us" part are items to consider in choosing what to do and how to make the right choice.
If my sister in New York asked me who her very best friend should see and what should she do, these are the things I would explain to her. All of those words are meant to be the unbiased truth, explaining all I know that will be most beneficial to her friend.
It is an important decision that has a lifelong effect. If done well, it will make a person look better always, to themselves and everyone else who sees them.
It is very nice of any knowledgeable, experienced friend to share with you. And maybe there are other friends and acquaintances who will too.
Before we do a persons face, we want to know that the goal chosen is what all persons agree is unsurpassable or unbeatable beauty that will be with them forever. Also that it is achievable with a safe, comfortable experience, without pain and a quick recovery as is shown on our website.
The safety record of the chosen doctor should be perfect, There should have been no infections or serious negative consequences. These should be facts and there should be no salesmanship or advice. The doctor should just explain all the options and choices, and share their wisdom and knowledge.
The best persons to speak with are those who are best informed, and who care only about you and who get no other reward, except the reward we all feel when we have done something for someone else. August 27, 2012
S:\wrm web\Letter to Patient web.doc
William Roy Morgan M.D., F.A.C.S.
1419 Superior Avenue, Suite 2
Newport Beach CA 92663