Aviva Plastic Surgery & Aesthetics

Not every neck needs the big guns.

A deep plane, structural neck lift can be an incredibly powerful operation, but excellent facial plastic surgery isn’t about choosing the biggest operation. It’s about choosing the right operation for the anatomy of each individual patient.

This lovely 30-year-old woman had favorable anatomy, good underlying skin quality, and very localized and unwanted fullness beneath her chin and along her jawline. Rather than a surgical neck lift, we chose a less invasive approach: carefully performed liposuction to remove unwanted fat and refine her neck contour, combined with radiofrequency-driven tissue tightening to help the skin contract and redrape smoothly over her new shape.

She’s shown in our standardized photos just 2 months after treatment, with a cleaner jawline and a more defined chin-to-neck transition; and her result should continue to mature over the next several months (check out the gorgeous contours in her wedding photo, taken approximately 6 months after treatment!).

Sometimes we need the big guns. Sometimes the lesser gun is exactly the right one.

The art is knowing the difference.

Every incision creates a scar, and we work very, very hard to make surgical scars as fine, soft, well-blended, and ultimately as imperceptible as possible.

How a scar heals depends on many things: genetics, age, skin type, incision location and tension, surgical technique, sun exposure, ni****ne use, and postoperative care. Meticulous surgery gives a scar its best possible start, but scar optimization continues for months afterward.

At our practice, our approach may include careful incision care with plain Vaseline and hypochlorous acid, timely suture and staple removal, silicone gel or sheets, and diligent sun protection. For scars that need a little more help, we have an expanded toolbox: Kenalog and 5-fluorouracil injections for raised or thickened scars; CO₂ laser, microneedling, or radiofrequency treatments for texture; vascular lasers for persistent redness; and nanofat for selected depressed or acne scars.

For select surgical patients, we may also recommend hyperbaric oxygen therapy before and after surgery to increase tissue oxygenation and support a favorable environment for wound healing. And when a scar ultimately heals too wide, depressed, or irregular, surgical scar revision may offer another opportunity for improvement.

Sometimes optimization is about camouflage and restoration rather than changing the scar itself. For mature hypopigmented scars or scars involving the eyebrow, we may refer to talented colleagues for medical-grade tattooing (also called micropigmentation). When a scar has caused permanent hair loss, hair transplantation may help restore hair to the eyebrow, hairline, scalp, or beard-bearing skin.

Most importantly, scars need time. A pink or firm scar at six weeks can look remarkably different at six months—and different again at a year.

At Aviva, we think of scar care not as one treatment, but as a thoughtful process of scar optimization and modulation: the right intervention, for the right scar, at the right stage of healing. 🤍

Lip lift: early healing 🤍

This beautiful 39-year-old patient is shown 6 weeks after a subnasal upper lip lift + corner lip lift.

At this early stage, we can already see some of the changes we wanted to create: a shorter philtrum/ distance between the nose and upper lip, greater show of the pink portion of the upper lip, and a more balanced relationship between the upper and lower lips, all without adding additional filler.

These photos also highlight something important: our patient’s scars are still pink. And at 6 weeks, that is expected.

Surgical healing happens in stages. Early scars can be pink, red, firm, raised, or simply more noticeable before they gradually soften, flatten, and fade. Scar remodeling continues for many months, and we generally tell our patients that most surgical results can take up to a full year to completely mature.

That’s one of the hardest parts of plastic surgery: patience. 🤍

We live in a world of instant before-and-afters, but surgery and post-surgical healing are not instant. At 6 weeks, we’re looking at the direction we’re heading, and not yet judging the final outcome.

Over the coming months, we expect these incisions to continue softening and their pink color to fade as the scars mature. Her lip will continue to refine in shape and definition as well.

Good surgery is a process, and proper healing takes time. Beautiful, natural results begin with thoughtful planning of the treatment approach, careful surgical technique, and thorough counseling about recovery and realistic expectations at every stage of healing.

This is an early result we’re delighted to share, and one we’re excited to watch continue to evolve over the next 6–12 months.

This young woman and confident business owner had always been bothered by ears that felt a bit too prominent and slightly asymmetric. While others rarely noticed, it was something she saw every day, and something that quietly affected her confidence.

Seven months after otoplasty, her ears are naturally balanced, beautifully proportioned, and still unmistakably hers. The incisions are carefully concealed within the natural creases behind the ears, allowing the focus to remain on the result, not the surgery.

Otoplasty, or ear-shaping surgery, doesn’t change who someone is. It simply allows a feature that has long drawn unwanted attention to fade quietly into the background, so the eyes, smile, and face can take center stage.

The best facial plastic surgery often isn’t about creating a new look. It’s about restoring confidence so that patients no longer think about the feature that once bothered them.

Beautiful results begin long before surgery.

One of our patients’ most common questions is, “What can I do to heal better?”

The answer isn’t found in a single supplement, peptide, or treatment. It begins with building the healthiest possible foundation before surgery.

At Aviva, we believe preoperative optimization is one of the most important, and often overlooked, parts of achieving beautiful, predictable results.

That means:
✨ Building strength through regular exercise
🥗 Eating a balanced, protein-rich diet
😴 Prioritizing restorative sleep
🚭 Avoiding ni****ne and limiting alcohol
💊 Reviewing medications and supplements thoughtfully
🩺 Optimizing your overall health with your primary care physician when appropriate
❤️ Surrounding yourself with a strong, supportive recovery team

Many patients also ask about peptides and other emerging therapies. While the science continues to evolve, high-quality evidence supporting their routine use before or after elective cosmetic surgery remains limited. We continue to follow the research closely and incorporate new therapies when they are shown to be both safe and effective.

Surgery is just one day.

Healing is a process.

The healthiest patients are often the ones who enjoy the smoothest recoveries—not because they’re lucky, but because they’ve prepared thoughtfully.

Exceptional results begin long before the first incision.

“Will a lip lift make my nostrils look wider?”

This is a common question we hear during lip lift consultations, and it’s an important one.

A subnasal lip lift is performed immediately beneath the base of the nose, and changes in the appearance of the nostrils or nasal base are a recognized consideration of the procedure. In the early days after surgery, swelling can temporarily make the nostrils appear more open and distorted or the nasal base look wider. This is completely expected and gradually improves as healing progresses.

Our patient’s photos tell that story beautifully.

At 4 days after surgery, swelling is still present, and the nostrils appear more open than they ultimately will. By 4 months, the swelling has resolved, the nostril shape and width have returned to their natural appearance, and the scar is carefully concealed within the natural contour beneath the nose.

Minimizing nasal distortion begins long before the first incision. Avoiding long-term distortion of nasal anatomy depends on thoughtful patient selection, meticulous surgical design, and careful handling of the tissues during surgery. One of our goals is to create a stable repair by securing the upper lip to strong, supportive tissues at the base of the nose while preserving the natural architecture of the nostril sill whenever possible. We also generally avoid combining rhinoplasty and lip lift surgery during the same operation, allowing each procedure to heal without competing forces on the nasal base.

Equally important is the healing process itself. Careful scar management, minimizing tension during the early weeks of recovery, and closely following postoperative instructions all contribute to a beautiful long-term result.

A successful lip lift should highlight a more balanced facial appearance, not draw attention to the nose or any other facial feature.

Every patient is unique. Individual results will vary.

Revision otoplasty is often more challenging than performing ear surgery for the first time, but it can also be incredibly rewarding.

Unlike primary otoplasty, revision surgery must work around changes from a previous operation. Scar tissue, altered cartilage, changes in anatomy, and the loss of normal tissue planes can all make surgery more technically demanding. In many cases, the goal is not simply to “do the surgery again,” but to understand why the original result fell short and develop a thoughtful plan to improve it.

This patient came to us after a prior otoplasty elsewhere. While his first surgery had improved the prominence of his ears, he still felt the final contour did not reflect the natural and “more contoured” appearance he had envisioned.

Our approach to revision otoplasty begins with listening. We carefully evaluate the existing anatomy, discuss what is realistically achievable, and tailor the surgical plan to each patient. Often small, precise refinements can make for a meaningful difference in facial harmony.

Revision surgery requires experience, patience, and an appreciation for both anatomy and aesthetics. While no revision can erase every sign of prior surgery, thoughtful reconstruction can often achieve a more balanced, natural-looking result.

Swipe to see this patient’s transformation.

Every patient is unique. Individual results will vary.

Healing after surgery is a carefully orchestrated process, influenced by countless biological factors working together to restore healthy tissue. We believe that thoughtful recovery is just as important as thoughtful surgery, and that exceptional results begin with exceptional healing.

Hyperbaric oxygen therapy (HBOT) is a medical treatment in which a patient relaxes inside a pressurized chamber while breathing nearly 100% oxygen. Under these conditions, oxygen dissolves into the bloodstream at much higher levels than it can under normal atmospheric pressure, allowing more oxygen to reach healing tissues throughout the body.

Why does this matter after surgery?

Oxygen is essential for many of the body’s healing processes, including collagen synthesis, new blood vessel formation (a process called angiogenesis), and tissue repair. These are all critical components of recovery following facial plastic surgery.

For many patients undergoing facial rejuvenation procedures, including deep plane facelift and neck lift surgery, we recommend hyperbaric oxygen therapy beginning before surgery and continuing through the early postoperative period as part of our comprehensive recovery protocol.
(Photo by Ron Lach)

A beautiful result is about more than the technical aspects of surgery; it’s about thoughtful planning and the healing journey that follows.

This lovely, health-conscious patient came to us with a deep understanding of facial aesthetics and a clear goal: to address an elongated philtrum, improve the visibility of her upper lip, and elevate downward-turning corners of the mouth that made her face appear more tense.

Her treatment included a central upper lip lift (bullhorn lip lift) and bilateral corner lip lifts.

Swipe through to see her journey:
• Before surgery
• Immediately after surgery
• Six weeks after surgery, immediately following CO2 laser resurfacing to further refine her scars
• Six months after surgery, with a nearly fully healed result

She loves that her lips and face now feel more balanced, relaxed, and more “at ease.” Her elevated mouth corners are further complemented by ongoing Dysport treatment to the DAO muscles (the muscles that pull the corners of the mouth downward).

As part of carefully planned and customized perioral rejuvenation, a lip lift procedure restores balance, improves lip show, and enhances the harmony of the entire lower face.

Healing takes time, and beautiful results continue to evolve for many months after surgery.