The Importance of Surgical Safety

Smith Cosmetic Surgery Surgical Safety Smith Cosmetic Surgery goes to great lengths to ensure the well-being of their patients

You may be surprised to hear that there’s no mandatory U.S. accreditation for plastic surgeons or plastic surgery offices. Therefore, patients need to be extra careful when selecting a doctor to perform a facelift or other plastic surgery procedure on the face or body.

You should be asking these surgical safety questions:

Does the office keep regular business hours or are they operating at all hours of the night?

Do staff members have the proper certifications and training?

Does the surgeon perform plastic surgery on the face specifically or on all areas of the body?

How many facelifts has the surgeon performed before yours?

Where’s the accreditation certificate in the office?

Unsavory answers to any of the above should raise some serious red flags.

Today we’ll highlight two significant considerations to keep in mind when interviewing a plastic surgeon to perform a medical procedure on you: accreditation and specialization. Let’s start with accreditation.

Accreditation keeps us accountable

While there’s no formal standard that plastic surgeons are held to once they open a private practice, there is a voluntary accreditation program that’s highly valued and sought after in the industry: AAAHC. It’s considered the leading stamp of approval in plastic surgery, among other healthcare professions.

AAAHC stands for Accreditation Association for Ambulatory Health Care, Inc. This non-profit organization, which has been operating since 1979, is designed “to assist ambulatory health care organizations in improving the quality of care provided to patients,” according to the official AAAHC website.

A certificate of accreditation from AAAHC means you can rest assured that the plastic surgery practice is undergoing regular, thorough external reviews to certify that it’s delivering safe, high-quality patient care. The third-party organization measures against nationally accepted standards, as well as its own policies, procedures, processes and outcomes.

The accreditation includes an extensive, on-site survey by AAAHC health care professionals. Smith Cosmetic Surgery’s staff describes the process as “looking at us under a microscope.” AAAHC evaluates everything from how sanitary plastic surgery operating rooms are, to whether proper anesthesia practices are followed, to how clinical teams communicate and follow up with patients during recovery.

Additionally, each practice monitored by AAAHC is required to participate in quality-improvement studies: on-going self-evaluation, peer review and education to continuously better care and services. Likewise, AAAHC is constantly establishing, reviewing and revising standards to continue to create medical practices where patients can feel safe. 

The process is extensive, both for review and for a practice to maintain the standards AAACH expects going forward. It requires a significant amount of time and resources to stay current, but Dr. Brent J. Smith is a firm believer in going the extra mile to attach this independent seal of approval to the Smith Cosmetic Surgery brand.   

Specialization is the secret sauce

While accreditation is critical, so is your plastic surgeon’s focus, dedication and experience in operating on a particular part of the body. Specialization in plastic surgery is just as important as in every other field of medicine. You likely wouldn’t have a family-medicine doctor perform your hip replacement – is a breast and tummy surgeon the best choice for your facelift?

While we believe accreditation is critically important, we also think there are significant advantages to finding a plastic surgeon that is fully focused, dedicated and experienced on one particular body part or area.  Think of it this way – just as your family doctor isn’t the best choice to perform your knee replacement, a breast or tummy specialist may not be the best consideration when it comes to your facial procedure.   You want a specialist. Surgical doctors go to school to learn about a specific region of the body; so do the best plastic surgeons. Doctors performing elective surgical procedures have gone through extensive schooling and training to become experts in not just their field, but also their chosen area of focus and expertise. 

And, Dr. Smith is a great example of that. He chose the face because it’s the physical body’s special way of “expressing outwardly the unique qualities we all have inside,” he says. A perfectionist, Dr. Smith has built a 25-year career around crafting beautiful, natural-looking faces that make patients smile for years to come. He specializes in facial plastic surgery and performs as many as 200 facelifts each year. 

It took some hard work and dedication on Dr. Smith’s part to achieve a sub-specialization in the facial region. Following graduation from Stanford, Dr. Smith went on to Indiana University School of Medicine and residency at University of Cincinnati College of Medicine in the Department of Otolaryngology and Maxillofacial Surgery. A fellowship followed with Devinder S. Mangat, MD, FACS, of The Facial Plastic and Cosmetic Surgery Center in Kentucky.

Dr. Smith is also uniquely double board certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology/Head & Neck Surgery. A fellow of the American College of Surgeons, he is a member of six state and national academies and boards dedicated to furthering best practices in plastic surgery.

Dr. Smith also continues to further his education and outreach through leading and participating in professional courses on new and improved surgical techniques, nasal and facial anatomy and the latest laser techniques. Additionally he attends seminars on medical ethics and law, and frequently contributes to publications and makes media appearances on behalf of the facial plastic surgery specialization. 

The reasons accreditation and specialization matter are clear: This is your face we’re talking about. You want to be absolutely certain you have found someone you can trust—who will take legitimate responsibility for your wellbeing and has a track record proving a commitment to education and ethics in facial plastic surgery.

Don’t discount the importance of either of these concerns when making the choice about your facelift. Trust is essential to a positive experience and outcome in facial plastic surgery.

Have more questions about Smith Cosmetic Surgery’s accreditation and Dr. Smith’s specialization? Our dedicated staff is here to help.

The realities of recovering from a mini facelift

mini facelift denver There is a reason that year after year people continue to consider, explore and schedule facelifts: They work wonders! However cosmetic plastic surgery is still surgery and requires thoughtful and realistic consideration.

The concept of a “lunchtime facelift” is unrealistic.  The advanced mini facelifts that Dr. Brent Smith performs are medical procedures that require manipulating skin tissue and muscle. There’s no way around that reality if you want the natural-looking, long-term results that specialty facial plastic surgery doctors like Dr. Smith create. Continue reading “The realities of recovering from a mini facelift”

Is there a good age to have a cheek/neck lift?

What's the Best Age for A Cheek or Neck Lift?The answer to the age-old question of when to have a mini facelift is entirely personal. There’s no right or wrong time to schedule a cosmetic surgery procedure during your lifetime, because everyone reaches acceptance at a different moment.

For example, a woman in her 60s, who is experiencing a combination of aging skin around the jowl and loss of contour in the cheeks, may sound like a likely candidate for a cheek and neck lift. However Dr. Brent J. Smith regularly consults with patients well outside the “norm.”

This could include a twenty-something who inherited a genetic trait that they feel negatively affects their face (and subsequently lifestyle, relationships, career, etc.) to a 75-year-old who is finally ready to turn back time and live the remainder of life with newfound confidence.

At Smith Cosmetic Surgery, we don’t subscribe to a standard age for our facelift patients. Our goal is simply to help guide people in choosing facial plastic surgery for the right reasons, rather than just focusing on the right time. In fact, in most cases we find that people have already come to the decision to have a mini cheek and neck lift and just need some support to take the next step.

Some cosmetic surgery patients have struggled with body image and confidence issues all their life; while others have undergone a significant life change or transition that led to the decision; and still others come in with a loved one to support a choice they’ve wanted to make for a very long time. Every time the decision is different; and every time it is personal.

It’s our job at Smith Cosmetic Surgery to set realistic expectations and make a custom plan for each facelift—and every person. The more stories we can share about the very different types of people—at very different stages of life—that Dr. Smith has treated, the more we find that others considering plastic surgery can relate and uncover their own courage to come in for a complimentary consultation.

Looking the part when you’re just starting out

One scenario that may sound surprising, but is more common than people realize is someone younger, perhaps even in his or her late 20s, who comes in to discuss facelift options. Often these young patients, due to no fault of their own, are endowed with unwanted facial features, such as a mouth that appears to frown even in a resting state.

As you can imagine, such a perpetual negative appearance may have started to affect self-confidence, especially in a professional setting. For example, if you’re building a career in sales, a position that requires a majority of face-to-face work, having a facial structure that pulls the mouth into a frown could be highly detrimental to communication.

Not only is it personally frustrating to have to hide the look of a heavy jowl area and not be able to express adequately how you feel on the inside, but also an unwanted scowl may start to weigh on your entire professional life.

And while it’s easy to judge someone in his or her 20s as too young for a facelift, we know that’s unfair in the practice of facial plastic surgery. If any individual is struggling in life due to outward appearance, we want to alleviate that burden by crafting a custom mini lift to draw up an undesirable pout while highlighting all angles of the patient’s youthful characteristics.

Midlife and a time of transitions

In another scenario that happens quite often these days, men and women are finding themselves back on the dating scene in the middle of their life. This can put a new emphasis on appearance that may have fallen by the wayside in the routine of family or professional life.

Additionally, with the proliferation of online matchmaking, where a profile photo often makes the first impression, more middle-aged people than ever are considering the clear benefits of a facelift. There’s no denying that dating these days, at any time in life, has become visually driven. In fact, you might not get the chance to even meet a potential partner in person if you can’t get past the profile page.

So while it’s not a decision to take too lightly, there is certainly something to be said for finally being able to stop “Photoshopping” your™ picture and just come in to Dr. Smith to achieve your desired results. Cosmetic surgery patients who do just that usually find themselves projecting a whole new look (and confidence) in as little as two weeks, not to mention on their next big date.

Never too old for a facelift

We also love stories of people, even into their 70s, who opt for a mini lift on the face. While this is past the typical age for a facelift, women in their 70s sometimes make the empowering move to commit to a mini cheek and neck lift. Why?

Well often they’ve experienced the prolonged effects of estrogen loss and other signs of aging that show up in a sagging face. Mature people, many who remain active and social, are now permitting themselves to age more gracefully—and look as young and healthy as possible for their golden years. And we couldn’t agree more.

For all mini cheek and neck lifts at Smith Cosmetic Surgery, regardless of a patient’s age, we address the underlying muscles and tissues, bringing everything from orbital bone under eye down to clavicle, back up where it belongs.

While Dr. Smith can’t “break the clock,” he has certainly turned back time with exceptionally natural-looking plastic surgery work. In most cases for older adults, he can help patients achieve a look at least 10 years younger upon healing from a mini lift. And that’s not temporary, but rather an outcome that seniors can maintain for the rest of their lives.

So no matter your age, really there are no rules for when you should or should not have a mini facelift. Everyone’s motivation is different. Your plastic surgeon should understand both your impetus for a facelift, as well as how to help you achieve a desired yet realistic outcome.

Remember, sometimes genetics come into play. Or maybe midlife circumstances changed in an unexpected way. Or perhaps you finally found the courage much later in life to do something you’ve always wanted to. The opportune time for a mini cheek and neck lift is … whenever you are ready.

Interested in discussing your circumstances and desire for a facelift? We are here for you and invite you into our office for a free consultation with Dr. Smith. Our computerized imaging program will generate a before-and-after model so you can feel great about your choice to commit to a facelift. Give us a call today.

Caring for Your Skin During the Winter

protecting your skin

It’s not uncommon to forget about your skin a bit when cold weather sets in. After all, in winter we’re not exposed to as much sun, we may be doing more indoors, and we all get busy and involved with holiday schedules and numerous events.

Unfortunately our skin and faces often get neglected during the colder months, which can lead to all sorts of unsightly issues.

  • Dangerous rays that shine even through winter doldrums inadvertently damage unprotected skin.
  • Cheeks crack and get inflamed through exposure to a combination of cold, wind and sun.
  • New and existing wrinkles tend to look even more dramatic on winter-parched skin.

In Colorado, Dr. Brent J. Smith’s patients are even more exposed to the elements. Not only does the sun shine about 300 days a year here, but also the state sits at an elevation that’s closer to harmful UV rays. Additionally, much of the population in Colorado and many western states is active, pursuing outdoor activities that further expose our sensitive skin to sun and wind burn during a day on the ski slopes, for example.

Of course, during winter being indoors for extended periods of time can be as harmful as heading out into the frigid elements. Our faces have to contend with the dry, dirty forced air from overworked heaters. There’s little fresh air to clean contaminants or humidity to save our skin. Wood-burning fireplaces are beautiful in winter, but also add smoke and carcinogens to our already full plate of indoor issues.

And it doesn’t help that during the chilly season we tend to slowly lose our summer glow. Fading complexions and undernourished skin begins to read dull, flaky and flat. This new winter “mask” does us no favors in the beauty department.

So what’s winter skin to do?

Instead of ignoring the face (and body) for the season, we encourage all Smith Cosmetic Surgery patients to think of winter as a time to “baby” skin even more. Whether you are trying to protect your youthful appearance before it shows additional signs of aging or need to learn a healthy routine to help maintain the youthful glow you just received from a mini facelift, there’s no better time to put your face first than right now.

3 tips for keeping skin healthy all winter long

1| The sunscreen routine.

Sometimes it sounds counter-intuitive, but we should all be wearing sunscreen year-round—especially in sunny, arid, high-altitude climates. One easy way to stay in the sunscreen routine is to find a daily moisturizer with sunscreen built right in.

And remember, don’t neglect those other exposed areas—ears, necks, lips, hands—on days where you’ll be spending time outside. People often forget that the neck area is truly an extension of the face—and we want those regions to complement one another! So don’t stop application at the jaw line; make sure you apply sunscreen and moisturizer liberally to the neck region, even onto the chest.

And, don’t forget those lips—one of the most exposed and deserted areas of the face. When lips are dry, cracked and sunburned they make the rest of the face look overworked as well. Consider keeping some small containers of sunscreen in convenient places, such as your car console or desk, where you can reapply throughout the day.

2| Moisturizer made for me.

Finding the right moisturizer can be tricky. Every individual face is a complex organism that combines a unique medley of genetic variants, age-related strains, and exposures from environmental and lifestyle choices.

A professional 65-year-old female who just had her first facelift may require a different application than an active 35-year-old male who’s struggling with the effects of adult acne. We’re all different people and we require (and deserve) special products designed to protect our precious faces.

At Smith Cosmetic Surgery, we introduce every patient to professional-grade skincare lines made for aging skin, as well as the healing power of lasers and oxygen technologies through Dr. Smith’s original Rapid Recovery.

We know that surgery is just the first step in creating a new look. How you care for your skin, particularly in a uniform way throughout the year, is critical to maintaining new, more youthful contours. Our skilled nurses will walk you through all the steps for protecting and enhancing healing skin following a facial plastic surgery procedure.

For those who have yet to opt for surgery, there are some over-the-counter and prescription-strength moisturizers that can prolong a more youthful look until you’re ready to consider the long-term benefits of cosmetic surgery on the face. Some of today’s most effective topical solutions contain powerful retinol and antioxidants to penetrate deeper and help rebuild healthy skin while creating a smoother, more vibrant look.

3| Healing from the inside out.

One of the biggest drags on our skin is dehydration. It’s like taking a grape and drying it into a raisin. Without water—internally the form of diet or externally as humidity—we go from plump and radiant to slack and dull.

In the winter, the need for water is amplified. We’re indoors in dry environments; we’re outdoors in cold climates. And, often the lure of comfort food in winter means we’re not getting enough hydration from a good glass of water or through fresh fruits and vegetables.

In fact, there’s a great misconception that we hydrate from the outside in. In fact, the opposite is true. Our skin desperately needs replenishing moisture and nutrients from the foods we eat and liquids we drink. A common quick fix for dry winter skin is to pile on the moisturizer when instead we should be taking in more fluids and eating healthier, water- and nutrient-dense foods.

For those who really need a “restart” in winter, a laser resurfacing procedure can be a great choice for kick starting a healthy new you. The advanced CO2 lasers at Smith Cosmetic Surgery gently strip away old, winter-weary layers of skin to reveal a fresh foundation.

It’s like starting with a clean slate—one you can continue to maintain with skincare products and healthy lifestyle choices. In fact, many of our patients enjoy the challenge of building a healthy routine to support their glowing new appearance. It can be a great confidence booster and mood enhancer during the busy holiday time.

Are you ready for a fresh look this winter? Dr. Smith and the skin care professionals at Smith Cosmetic Surgery are here to help. We invite you in for a complimentary evaluation to see how you can rejuvenate your look this season.



Fight Fine Lines, Aging Skin with Laser Skin Resurfacing

laser skin resurfacing Oftentimes, people are judged by the appearance of their skin. It’s just human nature. We draw inferences about others by the way they look up-close, especially if they have saggy, sun-damaged skin.

As supportive skin structures like collagen and elastin fibers break down, skin tone and firmness weaken naturally over time. Laser skin resurfacing can help restore that younger-looking evenness and effervescence everyone wants to recapture.

The beauty of laser skin resurfacing is that it can work either in combination with a facelift or by itself in a series of treatments designed to refine the skin’s outer appearance. Instead of judging, people will be left wondering about your true age.

At Smith Cosmetic Surgery, we often refer to laser resurfacing as the “icing on the cake.” Laser treatment performed during or even after a facelift surgery, is how the most dramatic effect is created. Laser skin rejuvenation is truly the refinement that can give your skin the healthy “glow” of youth.

So what is laser skin resurfacing, exactly?

Laser skin resurfacing is an easy, outpatient procedure in which a laser light beam is applied to the face in a strength and concentration calculated for your needs. The type we use at Smith Cosmetic Surgery is a carbon dioxide (CO2)-based laser, one of the most advanced and sought after in the field of cosmetic surgery.

This type of laser treatment not only gently erases away old layers of skin to reveal new, healthy layers, but also stimulates the growth of collagen, a critical component in keeping a youthful look intact as we age.

Typically performed in a series, laser skin resurfacing is effective for reducing the appearance of:

  • sun damage
  • hereditary skin disorders
  • acne scars
  • fine lines & wrinkles
  • other vascular issues like visible blood vessels
  • pre cancerous cells


The laser procedure is highly effective in conjunction with or even following a facelift. Laser resurfacing functions as a complement to improve the texture on the surface of your skin after you’ve committed to having work done to elevate underlying muscle and tissue.

Lasers penetrate deep enough to remove layers of flaky skin and to refresh and rebuild underlying collagen.  Although, laser procedures alone cannot lift and tighten the way a surgical facelift can. Only surgery can address the underlying weaknesses in the face, and that’s why we show patients how mini facelifts and laser truly go hand in hand—addressing both the inner and outer structures of the face.

Dr. Smith often reminds patients that skin has no shape of its own—and that’s true. Our faces need a supporting framework—either held up by the natural collagen of youth or muscular manipulation through cosmetic surgery—in order to look their best. If we don’t have a good foundation, it shows.

What’s the science behind laser technology?

While often referred to as a fast and flawless procedure, laser skin resurfacing comes in different strengths. The newest CO2 laser powers range from “fractional,” which delivers continuous “ultra pulses” to remove a thin top layer of skin with minimal heat damage, to “ablative,” which penetrates deeper to take off the entire top layer.

Based on patients’ needs, Dr. Smith uses an advanced laser technology suite to control the precise depth of treatment. Having a computer-guided system rather than a manual procedure allows for a new level of precision. With more science, comes more control.

What can I expect during the procedure?

After a complimentary consultation with Dr. Brent J. Smith to determine your skin condition and needs, we will recommend a laser skin resurfacing plan customized for your individual skin issues or that which will best compliment your facelift.

During the outpatient laser procedure, Dr. Smith will set the laser to a precise strength and guide it over your face to gently remove the top “dead” layers of skin and allow new collagen to reproduce, creating a lasting, youthful glow. To patients, the laser appears as a light directed onto the face in concentrated, pulsating beams.

A topical anesthesia will be applied as needed for your ultimate comfort. The procedure generally is not considered painful, but you should prepare for some healing time and will need to limit exposure to the sun as your face continues to “grow” brand-new skin.

What’s the recovery time like?

The powerful, results-oriented fractional laser used at Smith Cosmetic Surgery delivers beautifying effects that become more obvious over the healing days following a procedure. Full recovery for fractional laser work can be about three to five days. Because the ablative laser goes another layer deeper, it may require up to two weeks to see full results with this type of treatment.

Dr. Smith and his staff will instruct you about everything you need to know during recovery time, including what to expect, topical aids for treated skin, realistic results and when to come in for your next laser treatment.

Scheduling a laser procedure later in the work week, such as a Friday, is a good way to give your body extra time to renew over the weekend. Holiday breaks are also a smart time to book a laser resurfacing treatment, especially if it’s your first time and you want time to monitor how your skin reacts and heals.

If you are having laser skin resurfacing with a facelift, you may want to utilize Dr. Smith’s Rapid Recovery program. Our healing system combines the latest in “supercharging” hyperbaric oxygen, laser and LED-light treatments to get you back to your life routine as soon as possible.

Why choose laser skin resurfacing over other treatments?

Because there are so many different skin-enhancing procedures on the market, it can be very confusing for consumers to sort out which treatment will work the best. A top-quality cosmetic surgeon, especially one who specializes in the facial region, will quickly be able to guide you down the right path.

Every treatment we offer at Smith Cosmetic Surgery is carefully chosen to provide the quality and results our patients deserve. We only select the most proven, advanced technologies to help achieve your desired results.

While there are plenty of great surgical and non-surgical procedures to treat specific areas of the face, laser skin resurfacing is one of the most exciting on the market today because of its ability to produce more supple, uniform and youthful-looking skin in as little as one session. We’re pretty sure anyone would sign up for that!

What if I have concerns about the treatment?

Dr. Smith is in the facial cosmetic surgery business because he truly appreciates the transformation, both externally and internally, that takes place during what can only be described as a deeply personal experience. If you have questions about why you’re making the choice, your complimentary consultation is the best time to talk through any concerns.

First, we’ll ensure that you are a good candidate for this laser skin resurfacing. While laser skin resurfacing works for a variety of skin types and conditions, there are typically a few skin types that are not a great fit: skin with active acne, very dark skin and skin with stretch marks.

We want you to know that we’re here to listen and to help guide you through making this decision that you can feel great about now—and in the future. If you’re ready to schedule a complimentary consultation to see if laser skin resurfacing is a good fit for you, please reach out today.

Causes of facial aging

Plus a three-pronged approach for revitalizing skin

Causes of Aging Do you really know how or why your face ages? At Smith Cosmetic Surgery, we find that this is one of the most commonly misunderstood processes. In fact, this confusion often leads unsuspecting adults to choose the wrong things to try to turn back time.

Usually one of two things happen: Either people notice a distinct sign of aging and try a series of topical products that are marketed as beauty “cures.” When they see no effect from the application of a serum on your already aged face, they move on to the next product. Or, patients try more invasive treatments that are not yet properly tested or approved by the FDA, only to be left with unwanted, unnatural looking results.

The first thing that Dr. Brent J. Smith does during the complimentary consultation he extends to each and every Smith Cosmetic Surgery patient is to cover some quick facts about how and why our skin ages. While there are certainly some big environmental factors, such as sun exposure, that can lead to premature aging there are also some very personal genetic factors that are exclusive to each and every individual. In fact the combination of dynamics behind aging skin are truly as unique as every face we see.

Common causes of aging skin

So let’s address some of the biggest culprits of naturally or prematurely aging skin.

Genetics: This is your mother’s skin. When patients inquire about the one thing they can do to prevent wrinkled, sagging skin, Dr. Smith always responds: “Choose your parents appropriately.” All joking aside, there is not much humans can do to change their genetic makeup. So if your parents had tricky skin—acne, fair skin, freckles/dark spots, early wrinkles, expression lines, etc.—there is a decent chance you may experience some of these issues as well.

Similarly, we inherit genetic codes for producing special enzymes that act as antioxidants to help correct damage to individual DNA. Our personal degree of age-fighting cellular power also comes from our parents. That said, you are in control of some environmental and many lifestyle factors that can exacerbate these genetic tendencies, leading to dulling, and sometimes, drooping facial features.

Environment: Especially in Colorado, where Dr. Smith sees patients who may see the sun more than 300 days a year, exposure to dangerous UV rays is a serious concern in our state and many others around the country. The dryness of the air at altitude only adds to the parched look and feel of skin in this part of the U.S. However, wherever you live there are a variety environmental factors that can play a part in prematurely aging facial skin.

There’s exhaust, smog and poor air quality in urban centers. Even people who live in rural communities can be exposed to airborne toxins on farms and ranchlands, or smoke from wood-burning stoves. And in warm climates, people constantly vacillate between skin-tricking air conditioning, outdoor humidity and forced-air heat in the winter. All of these external aspects can contribute to the general health of our skin.

Lifestyle: Of course, many of the things that affect our skin most directly can be attributed to the lifestyle choices we make. Smoking is by far the most destructive. It’s easy to pick out a smoker’s face from a non-smoker’s. It usually includes a combination of distinct pucker lines, under-eye bags, discolored skin and deep wrinkles. Additionally, smoking creates free radicals that reduce the elasticity and collagen that keeps facial skin firm.

Other lifestyle habits, such as not getting enough regular sleep or eating a diet poor in protein, fruits and vegetables, can also lead to skin that ages more rapidly. Likewise, perpetual stress should not be overlooked as a contributing factor for aging skin.

How the face ages naturally

Now that you know that genetic, environmental and lifestyle factors can play a part in how your skin ages and looks during your lifetime, it’s also important to set some expectations around how all faces will age naturally over time. Everyone in the world will show somewhat similar signs of getting older if they do not take preventative or surgical measures to slow or erase the visual effects of time.

We start losing our “baby” faces around age 35. Generally, between age 35 and 45 our faces take on a more sculptured look as we lose more fat in and around our eyes, cheeks and mouths. After that mid-life period, our faces start to look a little more gaunt, and wrinkles that may have already existed start to appear more prominent.

Over a lifetime, it is natural for the muscle and tissues of the face, jawline and neck to relax, descend and deflate as we lose fat in our faces. And, of course, depending on the range and severity of exposure, all the variables we discussed above only contribute to the overall look of an aging face.

A three-pronged approach to revitalizing skin

Understanding the ways our faces age naturally and vary in genetic predisposition helps patients think sensibly about cosmetic surgery.  Having a plan for the right procedure, the right time to institute a long-term solution and the right methods for maintaining a healthy new look results in aesthetic harmony.

In many ways being educated about what you can control—and what is handed to you when you’re born—is really helpful when setting expectations around what a face lift can achieve versus a non-surgical treatment like a laser or peel.

One of the first things we must alert patients to is the fact that simply no product, injection, treatment or device on the market today can actually tighten the facial muscles that have relaxed over time. This must be done manually through a surgical procedure customized for each individual face.

To help facelift candidates understand just how Dr. Smith achieves that naturally supple look of youth, we explain surgery as a three-pronged approach: elevating, adding and enhancing.

Elevate: During each facelift, Dr. Smith makes hidden incisions to allow for the manipulation of skin, tissue and, most effectively, muscle. This is what draws a sagging face back to a more youthful position. Yet lifting muscles and the overlying skin upward is only the first step. We haven’t yet added any fat back to fill the voids that are so common in aged features.

Add: Next Dr. Smith can actually take fat from another area of your body where you don’t need it and add it to where you do: your face. This injection of natural body fat to the face essentially uses a natural compound already existing in our bodies to create fresh volume and support lifted muscles in the features that have become most depleted over time.

Enhance: Once Dr. Smith has helped a patient achieve both a more naturally elevated and volumized look, we finish the job with a laser treatment to further enhance the new look. Surprisingly, sometimes this final step is what makes the most remarkable difference. Once you have achieved more volume and balance, a laser treatment, which Dr. Smith adjusts for the requirements of each patient, can create that youthful glow we’re all looking for. Lasering surface imperfections or damage and allowing new skin to regenerate, actually compliments new musculature and facial accents.

One of the most important aspects of our jobs at Smith Cosmetic Surgery is education. We want our patients to truly understand the science and art behind a facelift. If you are starting to confront unwanted signs of aging, we invite you to come in for a free consultation. Remember, most of these effects—wrinkles, muscle deflation, fat loss—are not your fault. They are genetic. And environmental. And perhaps the result of a happy life lived outdoors. But luckily there is something you can do right now to turn back time.


Chins Are In: Chin Implants

“Selfies” and self-esteem are tied to mentoplasty procedures

Chin implant surgery Denver The chin is all about harmony. A well-defined chin gives both structure and balance to the face and helps define the facial profile. It’s also one of the most overlooked areas of the face when it comes to considering the right plastic surgery procedure.

When most people look in the mirror, they tend to focus on obvious wrinkling or prominent features that look “off,” rather than the more subtle structure and effect of the chin area. It’s easy to see hooded eyes, large creases in the skin or a nose that’s out of proportion. It’s a lot harder to notice how much a “weak” or recessed chin can affect your appearance—and even how others perceive you.

Just as different physical traits in different cultures around the world are tied to how men and women are perceived and treated, in America defined chins have come to symbolize strength and power. Without a naturally demarcated chin and contoured jaw, people are often perceived as being weak, whether the outward appearance matches the inner psychology or not.

Chins central to the “selfie”

Chins have also become a central topic in the social fabric of our lives. A modern-day ritual for both young and old, the “selfie” has put our chins front and center—often from not-so-flattering angles. How we hold the camera, tilt our heads and capture the light on our profiles all have to do with how our close-ups look. And those defining moments, often captured and posted for all to see and comment on, put an increasingly frenzied focus on the chin. Sadly, few people understand how much the reverse camera angle required for the everyday selfie actually distorts reality, in more ways than one.

If it’s not noticed during a routine selfie, an undefined chin is often ignored or not truly identified until a patient comes in for a rhinoplasty consult for surgery on the nose. At this point the size and shape of the chin becomes a serious consideration when discussing how to balance the proportions and dimensions of the nose. A weak or depressed chin can actually make the nose appear more prominent, over-projecting or overshadowing the lower half of the face. Quite often the two plastic surgeries go hand-in-hand to create the most complementary outcome possible.

Another common time people consider chin augmentation, reduction or sculpting, also known as mentoplasty, is later in life when gravity has taken its toll over time and the chin in effect pulls the face downward, creating the illusion of a weak chin and jawline. If you were born with a weaker chin, time is definitely not on your side. The games gravity plays with the lower half of our faces in the second half of our lives are not fun ones.

How does mentoplasty work?

This minor plastic surgery procedure on the chin “props up” the parts we like; sculpts skin around the parts we don’t; and even exposes the natural beauty of a jawline that has become hidden under sagging skin and folds. The chin implant procedure is a relatively straightforward form of facial plastic surgery that can dramatically enhance the look of an aged face and make a significant difference in the appearance of older adults.

To augment the chin, Dr. Smith first makes a few tiny incisions, typically at the chin’s natural crease line, and gently inserts a soft, synthetic implant that feels similar to natural tissue in the face. Because modern implants come in a wide variety of sizes and shapes, Dr. Smith can follow a careful outline to create the most custom fit and natural result.

After implantation, nearly invisible sutures are used to close the incision, and healing time makes any minor scarring unnoticeable. In chin reduction surgery, a surgeon initiates the procedure with similar incisions and carefully sculpts the chin bones to a more proportionate size.

As with all the procedures at Smith Cosmetic Surgery, chin implant patients are given access to and instructions for how to take advantage of Dr. Smith’s exclusive Rapid Recovery program. The advanced, in-house healing routine includes a combination of “supercharging” hyperbaric oxygen, laser and LED-light treatments and specially formulated skincare products.

Getting to know you

Just as all faces—noses, lips, brows, cheeks—are unique, so are the challenges that come with individual chins. Each person brings a different scenario to the table, and for Dr. Brent J. Smith that’s all part of the art of cosmetic surgery. He has perfected this precise craft over nearly three decades in the business of operating on faces, and faces alone. A double Board-certified surgeon, who understands not just the art but also the real science behind the structure of the face, this is where Dr. Smith shines.

Each complimentary consultation for chin implants, as well as the nose, neck and cheek areas that often go with chin surgery, includes:

  1. In-depth, in-person interview and evaluation with Dr. Smith
  2. Advanced computer imaging with a simulated preview of your personal surgical results (with free printout to take home)
  3. Review of testimonials and “before and after” photos of Smith Cosmetic Surgery patients

Getting Rid of Crow’s Feet

crow's feet facial surgery Eyes are such a focal point of the face. As we age, these “windows to the soul” can wrinkle and droop, often changing our facial expressions significantly—and possibly sending a message we don’t want to send.

Eyes have an uncanny ability to “say” things for us before we speak. As author Tarjei Vesaas said in The Boat in the Evening, “Almost nothing need be said when you have eyes.” A “twinkle” of the eye can convey vast amounts of non-verbal information, so it’s only natural to want these special facial features to maintain an appearance that expresses our distinct personalities, emotions and thoughts.

It may come as no surprise, then, that Dr. Brent J. Smith is fascinated with plastic surgery on the eye area. With more than 25 years in the business, and countless hours perfecting his skills in surgical facial procedures with the most effective technology-enhanced trends, Dr. Smith considers his work on the all-important eye region a true art form—and so do his satisfied patients.

Not only is every pair of eyes different, but so is how each set complements a face, as well as what specific signs of aging those eyes are actually showing over time. Every face is as distinct as a fingerprint and we must treat it as such, with great dignity. Because eyes are so prominent on the face what doctors do to them surgically affects all other areas of the face. That’s why it’s nearly impossible to request a “packaged” eyelift and expect to see natural results. In fact, this is part of a large misconception we regularly address at Smith Cosmetic Surgery.

Crow’s Feet 

One of the top complaints about wrinkling eyes is linked to those tiny, bunched, stubborn lines that accumulate at the corners of the eyes after years of making repetitive expressions. While they might not make you very happy, crow’s feet are commonly referred to as “happy lines”—those creases that develop during the billions of tiny muscle movements your eyes make over a lifetime. However what many people think are crow’s feet are not actually wrinkles from squinting or smiling, but rather lines created by folding skin that naturally begins to sag as it loses collagen.

Crow’s feet, on the other hand, are largely genetic—a frustrating side effect that compounds over time in people with a specific type of musculature makeup. That means if your parents struggled with this type of wrinkling, you may as well. For example, people in their 60s have come into Smith Cosmetic Surgery with deep crow’s feet, but no other visible horizontal lines on their brow. On the flipside, some women in their 20s may show no crow’s feet yet can make an accordion with their brow line. It’s just the way the face moves uniquely for each person.

What’s commonly mistaken for crow’s feet may actually be creasing on the upper eyelid, also known as “hooding,” which happens gradually and naturally as skin around the eyes begins to relax. While the loosening of skin over the eyes can lead to a wrinkling effect near the corners of the eyes, it is not the typically inherited condition known as crow’s feet. Likewise age-amplified fat pockets that show up under the eyes can accentuate existing smile lines around our eyes, but this, too, is a slightly different sign of aging and therefore needs to be treated with a custom approach with upper or lower eyelid surgery.

Distinguishing between these two common eye issues is the first thing we must address with new patients. Knowing what has actually caused the wrinkling helps Dr. Smith determine which approach will work best to treat the condition, such as an eyelift in combination with enhancements on the upper third of the face, often alongside a mini facelift.

How do I Know I Have Crow’s Feet?

Women often start to notice hooding when their eye makeup begins to smear. That morning mascara applied in the far upper reaches of the eyelashes somehow transfers down onto the eyelid and gets smudged with other makeup. It can be a daily struggle as simple as makeup application that sends someone into our surgery center. Men often notice crow’s feet in the summer after a round of golf without enough sunscreen. Suddenly a burned or tanned face reveals something unsavory: bright white “squint” lines inside those crow’s feet that were hidden the day before.

Whatever triggers an initial decision to consider plastic surgery on the eyes and face, there is almost always an effective solution for every patient who comes through our door. Here are some of the top procedures for enhancing the eyes:


Also known as blepharoplasty, the eyelift is one of the most commonly requested procedures at plastic surgery clinics nationwide. This form of facial cosmetic surgery is designed to treat the upper or lower portion of the eye—or both, depending on needs.

While eyelid surgery is not a “cure” for hereditary crow’s feet, it can dramatically impact the look of aging eyes, especially when performed in tandem with a mini facelift or complementary procedure on the browline and cheeks.

On the lower half of the eye blepharoplasty can alleviate “hallowing,” a sunken look created by a loss of fat under the eye, or the opposite under-eye issue—bags, which happen when older fat deposits actually expand over time.

On the upper eyes, blepharoplasty can address the drooping skin that sags over the eyelid and can interfere with vision. An eyelift on the upper lid works to tighten both the musculature and skin around the eyes. A supplementary “browlift” is also a common counterpart to an eyelift, because it can effectively reduce “hooding” on the upper eyelids and those forehead lines that can add age to the eyes.


One the most popular prescription-strength injectable facial fillers, Botox was recently approved by the FDA for use on crow’s feet. While it has been used for years as an off-label procedure to treat the eyes, the proven injectable is now enticing more women and men who may have shied away from the product in the past.

By inhibiting the strength by which you can crease the tiny muscles around the eyes, Botox can help younger people prevent the lines from forming in the first place or older adults from adding to the damage. In addition to crow’s feet, this injectable enhancement, which typically lasts four to six months, works well on forehead lines, making it a helpful companion in the fight against wrinkles on the upper third of the face.


Laser resurfacing is a non-surgical procedure that works much deeper than a chemical peel to refine the look of facial skin. While it’s not a permanent fix for wrinkles around the eyes such as crow’s feet, laser resurfacing using a powerful fractional CO2 laser can significantly change the appearance of skin on the face, making features appear brighter and more youthful.

Administered in a series of three procedures at six- to eight-week intervals, each laser resurfacing process builds on the last, carefully stripping away old, dry and damaged layers while stimulating the body to “grow” new skin during the healing process. When used in conjunction with prescription-strength eye creams and Botox injections, this minimal-downtime procedure can work as a formidable non-surgical alternative for reducing the appearance of wrinkles around the eyes.

Our eyes are our individual signature. That’s why every cosmetic surgical or non-surgical facial procedure is designed around your needs. Whether you’re noticing crow’s feet for the first time or drooping eyelids that are affecting vision and confidence, Dr. Smith can create a custom treatment that will enhance the beauty of your natural eyes. Come see for yourself.




Are You Tired of Your Turkey Neck?

turkey neck A Mini Facelift Can Eliminate Your Turkey Neck

The phrase “turkey neck” refers to loosening and folding skin under the chin. Often associated with the double chin, it is one of the top issues aging men and women inquire about at Smith Cosmetic Surgery.

Our staff often hears men and women complain that their faces have become rounder, fuller or squarer than they’d like, and they’re developing a double chin even though their general weight and lifestyle hasn’t changed over the years. Other times individuals come in because genetics are starting to catch up to them, and they’re noticing more significant signs of a slack neckline that, unfortunately, just runs in the family.

Just like a crooked nose, visible scarring, or deep wrinkles around the eyes or brow, turkey neck can cause undue stress, anxiety and self-consciousness. As you weigh your options for eliminating the look of turkey neck, here are a few questions to consider.

How did I get turkey neck?

When a patient books a complimentary evaluation with Dr. Brent Smith to discuss options for getting rid of turkey neck, we ask questions to better understand and guide each individual patient. Have you always been the same weight but your face has become fuller, independent of your body? Does the double chin run in your family? Does your lifestyle include smoking, exercise, extensive computer work, sun exposure, etc.?

How can I get rid of turkey neck?

If you are young enough, following smart lifestyle practices can help ward off the advancement of this condition. These include monitoring the angle of your neck during “device” time; maintaining a consistent weight and healthy body fat; staying hydrated; and using sunscreen every day, even on the neck. However the only long-term strategy for dealing with turkey neck is a surgical procedure that will enhance the look of both the neck and face uniformly, tightening skin and muscle and ensuring that the double chin is gone for good.

What procedure works best on turkey neck?

One common misconception in facial plastic surgery is that you can “spot correct” the neck without touching anything else. Unfortunately this Band-Aid approach doesn’t work. You must consider the whole lower face rather than just the neck when addressing turkey neck. Today, top surgeons like Dr. Smith use a revolutionary procedure called the “mini facelift”, a customizable, less invasive technique, requiring fewer and more precise incisions.

If you’re tired of wearing scarves or ties to hide your neck, now’s the time consider a mini facelift to improve your sagging muscles and skin. To see how Dr. Smith can alleviate the anxiety you feel about your turkey neck, give Smith Cosmetic Surgery a call for a free consultation. We look forward to discussing your options with you!


Common Misconceptions About Dermal Fillers

Facial Injectables Injectables are one of the most misunderstood products in modern cosmetic enhancements for the face. Because we field so many questions and dispel so many myths about injectables during consultations at Smith Cosmetic Surgery, we think it’s essential that anyone considering either a mini facelift or routine injectables in the near future should know the facts.

One of the most helpful things Dr. Brent J. Smith can do as a respected veteran in the facial plastic surgery industry is to set the record straight. The more informed our prospective patients are about the differences in the results related to injectables versus surgery, as well as how these procedures can complement one another, the more positive and realistic the outcome will be for all. So let’s address a few of the most common misconceptions out there about the use and effectiveness of facial cosmetic injectables.

I can use a dermal filler to permanently change the look of my cheeks. 

One of the biggest misconceptions is that a dermal filler or volumizing injectable such as Juvederm can take the place of cosmetic surgery on the delicate cheek area. While these types of plumping products can work wonderfully to maintain a recent facelift, the fact is that fillers cannot actually reverse the biological process of losing collagen over a lifetime.

Around age 45 to 50, many people start to notice more significant “deflation” in their facial features, specifically in the cheek area. This is a perfectly natural sign of aging skin. As collagen inherently breaks down, the support system holding up the cheeks is weakened and can no longer maintain the taught apple-cheek look of youth. Because this is a structural effect linked directly to muscle and fibers in the face, injectables cannot penetrate deep enough to halt this biological breakdown. A facelift, however, can address this issue more specifically, and injectables are an excellent choice to maintain the more youthful look you’ve achieved following a mini facelift.

I can use Botox to treat any area I want.

While Botox is a prevalent and proven treatment, it’s important not to confuse this injectable with other volumizing products such as Juvederm. Botox is short for botulinum toxin, which sounds scary, but really isn’t. The FDA approves of it and so do we. When injected at a facial site where muscle contractions commonly cause wrinkles, this highly effective solution temporarily “paralyzes” the muscle tissue so the body’s naturally occurring expressions don’t continue to create deeper lines.

Now try to imagine using Botox to limit the movement of your lips, for example. Not so pretty. Botox is exclusively used for the upper third of the face to treat forehead wrinkles and crow’s feet around the eyes. A filler like Juvederm, on the other hand, is used to treat loss and lines on the bottom two-thirds of the face. This volumizer works differently than Botox to temporarily “plump” cheeks, smooth lines and folds around the mouth, and even add a natural fullness to thinning lips. In fact, at Smith Cosmetic Surgery, we often recommend using both types of injectables as a dynamic duo for masking the signs of aging in both the upper and lower portions of the face.

When it comes to lips, the more I inject the better.

Limp, diminishing lips are one of the first things that patients request Dr. Smith’s Nurse Injector, Glenda Rainold, RN MSN to  address with injectables. This isn’t a bad idea; in fact, injectable products have proven to work very well to create a more youthful pout—but only when undertaken conservatively. Too much filler not injected carefully at the right sites can quickly lead to, well, the stuff we see regularly on reality TV. Dr. Smith won’t use injectables in this manner; his goal (and it must be the patient’s shared objective as well) is to use the wonders of injectable technology to create the most natural and youthful-looking mouth for each individual patient.

It’s all in the technique, and when delivered well, injecting fillers properly for the lips is really an art form. The ultimate test for Glenda, as an expert Nurse Injector at Smith Cosmetic Surgery, is to make the injectable nearly unnoticeable. It should blend with and subtly enhance the face you were given. Imagine if you were really worried about thinning lips and you chose only to have your lip line enhanced, without touching the rest of your aging face. Sadly we see these consequences all the time: oversized, unnatural-looking lips sitting right in the middle of an aging face. Instead of the lips complementing a facelift, for example, they now stand out prominently against a backdrop of wrinkles and drooping skin.

Injectables are for old people.

While Smith Cosmetic Surgery doesn’t advocate starting any injectable or facial cosmetic procedure until a patient is mature and responsible enough to understand the risks and benefits of such undertakings, injectables are becoming more common for younger men and women, typically in their 20s and up.

Why? Well, because a temporary but effective non-invasive infusion like Botox can act as a wrinkle preventer. If the brow cannot contract as freely in a repetitive, creasing motion, it’s harder to develop expression-related wrinkles in the first place. That’s not to say a Botox injection will “freeze” a youthful brow or eye area in an unnatural way. The outcome depends on how much injectable is applied—and where. Again, when added to the muscle with finesse and constraint, an injectable can be a valuable preventative cosmetic routine—before those age-related wrinkles start to appear. Young (and older) bodies also do amazing things following routine injectables: They start to create their own restoration process. Having a regular filler around the lip area, for example, actually stimulates natural cell regeneration at the site, which means the more you get it the better job your body does to preserve your lips on its own.

Injectables are going to make me look fake.  

Again, there’s a right way to inject fillers and volumizers, and a wrong way. As an industry, facial cosmetic surgery has come a long way. Plastic surgery offices dedicated to the practice of injectables, either as a preventative measure or as a complement to facial surgery, are more astute in their understanding of how—and how much—injectable solutions should be applied for different faces and structural makeups. That’s why Smith Cosmetic Surgery requires a complimentary upfront consultation. Everyone’s genetic makeup is different, and that’s what makes our faces beautifully unique.

Before ever injecting an industry-standard dose of Juvederm, Smith Cosmetic Surgery first measures how much is truly appropriate for each patient, depending on age, skin condition, structural integrity, and lifestyle expectations. If we were treating the lip area, we would need to look at what kind of outline your natural lips have in order to preserve the curvature. Have you always had straight lips and now want them plump and curvy? That’s probably not a realistic expectation with an injectable, and this would be discussed with you.

We’ve examined some of the most common misconceptions around popular injectables such as Botox and Juvederm, but Smith Cosmetic Surgery uses several other exceptionally effective FDA-approved products to create the realistic results our patients desire. Give us a call to discuss which product lines or procedures might be the smartest choice for your face—and your future.