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.

What’s Best For You: Surgical or Non-Surgical Procedures?

Non-Surgical Procedures

Every day people come to Smith Cosmetic Surgery wondering how to fix problem areas on their neck, face and brow.  With the abundance of information in media and print many first-time patients come to us seriously misinformed about the achievable results related to popular non-surgical procedures and surgical options such as a mini facelift.

By surveying confused and frustrated patients, long-time facial plastic surgeon Dr. Brent J. Smith and staff members in Denver have learned a lot about half-truths floating around—and where they’re coming from. We hope we can set the record straight about common questions regarding the health of the body’s most beautiful and prominent feature: the face.


Landmines of mixed messages. 

We know there’s a matrix of misinformation on the Internet, which is one of the first places most people privately research information on a variety of lifestyle choices, including plastic surgery. Undocumented articles and advice are prevalent on the Web, and sadly far too many people take this written information at face value—as fact. This is a great disservice to qualified facial cosmetic surgeons and patients alike.

Additionally, Smith Cosmetic Surgery regularly consults with new patients who come in asking for the same procedure that a friend or family member raved about. With such enthusiasm come very high expectations that a similar procedure, whether a surgical facelift or non-surgical injectable or filler, will produce the same effects on a completely different and individual face. This mindset creates a conundrum, as we must quickly dispel the myth that cosmetic surgery techniques are universal. In fact, the opposite is true. Dr. Smith customizes each surgery to ensure that patients simply look like a refreshed and younger version of themselves—rather than refining a face to mimic another.


Dispelling more myths—from the neck up

So how does the average person wade through all of this information from so many different sources? They don’t. That’s what we’re here for. When you come in for a complimentary consultation with Dr. Smith he will evaluate your concerns and long-term goals to help you make the most informed decision possible based on your individual face and future.

Even with over 25 years of experience operating exclusively on the face, Dr. Smith cannot give advice about whether a surgical or non-surgical procedure is optimal for an individual without an in-person meeting. These important decisions are always case-by-case, and there’s never a universal surgical or non-surgical solution that works perfectly for every person. Part of our job as professionals in the plastic surgery and skincare industry is to educate our clients, and we take that charge very seriously at Smith Cosmetic Surgery.

By far the No. 1 issue patients inquire about is an unattractive neck. This could be a natural loosening of skin under the chin caused by waning elasticity, creating a “turkey neck”; other times it’s a genetic double chin that’s become more prominent over the years. The neck is a common area of concern, and we certainly understand why.

Many who are unhappy with the look of their aging jowls and neck ask Smith Cosmetic Surgery about non-surgical neck-sculpting procedures they’ve heard or read about that are claiming dramatic results.   Smith Cosmetic Surgery certainly doesn’t de-value non-surgical procedures, such as the popular Botox and Juvederm products, and other laser-based skin resurfacing procedures.  We offer many of these advanced non-invasive offerings for good reason.  Our goal as cosmetic experts is to set reasonable expectations around all non-surgical methodologies.

It all starts with educating patients about the real aging process. It may be surprising, but most prospective patients trying to make a decision about surgical and non-surgical options are not clear about how the body—and specifically the skin on and around the face—actually ages. Once they are informed about how all skin loses elasticity and collagen over time, resulting in hallowed cheeks, sunken eyes and/or a sagging forehead, it’s much easier to discuss the most appropriate procedure or combination of techniques.


Surgical and non-surgical work together

Generally, Smith Cosmetic Surgery considers its non-surgical offerings—fillers, injectables, laser-based resurfacing, skincare lines—preventative or maintenance procedures. That means when started early enough, regular resurfacing or effective fillers, for example, can make a big difference in how you look as you age. We consider these smart preventative measures leading up to a mini facelift or full facelift in the future.

Likewise, non-surgical aids work very well to help maintain a previous surgical procedure, in effect extending the fresh, youthful look created by a well-crafted, natural-looking mini facelift. These simple, outpatient procedures can work wonders to fill in those emerging wrinkles, reverse the surface appearance of sun-damaged skin and create the illusion of a tighter, more radiant face.

However, what non-surgical approaches cannot do is change the muscle structure in any part of the face. The reality is no professional-grade skin cream, injectable or laser-sculpting device can elevate the brow or reduce sagging skin around the neck. Once the deep musculature of the face has relaxed and shifted due to the inevitable aging processes, some form of surgery will be required to achieve a younger-looking face.

When it comes to sorting through the non-surgical “miracle” cures on the market, our advice is simple: If it seems too good to be true, think twice. There is no magic solution. Before you spend your money on a procedure, get informed with a free consultation with Dr. Smith.

We’re here to help answer all of your pressing questions—and truly make the face you’ve always wanted (or didn’t even know was possible) a reality. We listen and support you through your entire cosmetic surgery journey.​ Dr. Smith’s national reputation and 25 years of experience operating exclusively on the face should assure you that you’re in capable hands. Let’s start the conversation today.




‘Rapid Recovery’ is Paramount to Cosmetic Surgery Results

Rapid Recovery Recovery concerns and timing are some of the top reasons people put off a facelift—even when they’re ready for the exciting and dramatic lifestyle change that facial plastic surgery can create. At Smith Cosmetic Surgery, we want to remind men and women who are considering a facelift that when the procedure is performed by a trusted facial plastic surgeon, recovery should not be a deterrent. Advanced mini facelift sculpting tools and recovery methods have now significantly reduced post-operative downtime.


Despite these facts, prospective patients often wonder about many things related to recovery, such as:

How long does facelift recovery take?

What can I expect after facelift surgery?

How will healing time affect my work and family?

When will I start to look like the “new” me?

What steps should I take to ensure the best results?

You may have similar questions, and that’s why we’d like to put your mind at ease and explain what you can expect in terms of the recovery process at our practice.  For example, at Smith Cosmetic Surgery our specially trained facial plastic surgeon, highly qualified staff and sophisticated medical center are all available and designed to support patients through every step of a facelift and introduce our valued guests to an entirely new way to heal faster, healthier and happier. In the past, a lengthy period of downtime was expected with any plastic surgery procedure, but today’s modern mini facelift techniques allow for less invasive incisions and subsequently shorter healing time. Additionally, Smith Cosmetic Surgery has created Rapid Recovery, one of the most state-of-the-art, multifaceted recovery methods in the field of facial plastic surgery.

At top-caliber facial plastic surgery centers, your care and comfort should be top priority. From years in the business, we know that no one has time for an extensive recovery period, and post-operative downtime shouldn’t prevent anyone from enjoying the benefits of a refreshed, younger-looking appearance. We have jobs, families and plenty of other priorities that just can’t wait while we heal.

Reasons a recovery plan matters

As you begin to compare mini facelift experiences at various medical facilities and with different doctors around the Denver Metro area, make sure you ask about the planned patient care and recovery process. If there isn’t one besides sending you home on your own, sans ongoing support and resources, look elsewhere.

Patients need to know that they will be cared for and listened to not just in the beginning of the facelift process—when the anticipation of a new look is heightened—but also when the procedure is complete.  The best facelift doctors specialize in plastic surgery of the facial region only, and have a comprehensive recovery process, customizable for each and every patient.

To put you at ease, here’s a little more about how recovery works at Smith Cosmetic Surgery:

It’s all about setting expectations

We never sugarcoat the reality of recovering from a facelift. The truth is every patient will experience some form of post-operative discomfort. Of course this varies by patient, depending on factors such as age, skin type and pain tolerance, but for the most part, facelift patients should expect some degree of bruising and/or swelling following a procedure performed on such a delicate part of the body.

Our goal at Smith Cosmetic Surgery is never to ignore, minimize or explain away what’s considered normal after even minimally invasive plastic surgery. Rather, to build in these expectations to the conversation we have with each prospective patient by addressing how our caring doctor and staff are more than prepared—and our facility is more than equipped—to make facelift recovery as smooth as possible.

Recovery is built right in

We never “hard sell” our plastic surgery services, only to leave recovery primarily in the hands of the patient. Dr. Brent J. Smith is extensively educated and trained in plastic surgery, which he has exclusively performed on faces for more than 25 years. Dr. Smith’s special focus on this complex area of the body, coupled with our Rapid Recovery process is an important part of every facelift procedure performed at Smith Cosmetic Surgery.

In fact, you won’t leave our office until you know the critical first week’s plan for recovery, and we invite you to return each day following your procedure to speed your restoration with dedicated healing treatments designed just for your face.

Procedures with precision

Dr. Smith has been performing facial plastic surgery for more than two decades and has earned international recognition for his fine-tuned techniques. The preciseness with which he creates incisions to enhance—never stretch—the natural contours of the face are well known in Denver and around the country.

But while smaller, more accurate incisions during a facelift make for a more beautiful result, they are also designed to facilitate faster healing. How a mini facelift is performed can make a significant difference in recovery time and pace. During each complimentary consultation, Dr. Smith will walk patients through exactly how both facelift surgery and our exclusive Rapid Recovery program work together.

Rapid Recovery 101

Dr. Smith’s custom recovery process starts the day after your surgery and includes five “super-oxygenation” sessions in our in-house hyperbaric unit—the only one of its kind in a plastic surgery practice in Colorado. Recharging healing skin with extra oxygen has been shown to decrease the amount of bruising and swelling by up to 35%. Coming in every day for hyperbaric treatments also allows a Smith Cosmetic Surgery staff member to check your progress and eliminates the chance of any patient being at home alone worrying about what may or may not be “normal.”

The full Rapid Recovery system includes hyperbaric healing, as well as a routine of precise laser applications at incision sites to reduce redness and decrease inflammation; LED light treatments that help regenerate new skin tissue faster; and a 30-day supply of professional-grade skincare supplements to continue a healing routine at home.

Now that you know recovery isn’t a barrier to making one of the most inspiring decisions of your life, what’s stopping you? In fact, there’s no better time than winter, when we’re already indoors, to schedule this confidence-boosting procedure. Need some more inspiration? Explore some of our recent before and after photos at Smith Cosmetic Surgery.

Refresh Your Facial Appearance for a New You in 2016

December is the perfect time to schedule a facial rejuvenation procedure. There’s nothing more invigorating than greeting the New Year head on with a more youthful appearance. Sometimes just knowing we’re presenting a bright and refreshed look can actually make us feel and act more refreshed! Let your face take center stage as you look forward to the promise of all that’s to come in 2016.

As we’ve detailed over the year, Smith Cosmetic Surgery offers a variety of facial rejuvenation procedures, from surgical options like mini-facelifts to non-surgical techniques such as laser resurfacing and microdermabrasion. To help inspire you, here’s a recap on some of our most popular facial rejuvenation procedures. You can book one of these right now to make sure you head into 2016 with the healthy look you desire—and the self-confidence you deserve.

Cheek/neck lift

Part of the ever-popular mini facelift, a customized cheek and neck lift can address sagging or loose skin while elevating the muscles of the lower face and neck. Say goodbye to that age-related double chin and those hallowed cheekbones staring back at you in the mirror. Dr. Brent J. Smith, who has worked exclusively on faces for more than 25 years, has perfected the art of rejuvenating facial contours in the most natural-looking way. Dr. Smith’s mini-facelift surgical technique focuses specifically on tightening skin-supporting muscles around the cheeks and neck, resulting in less swelling and shorter healing time, with effects that last for years. In fact, when you make the decision to have a cheek/neck lift now, you will reap the youthful results for years to come.


Often the most beautiful expressions we make with our eyes lead to some of the most distinct and frustrating age-related wrinkle marks, namely those pesky crow’s feet at the corners of our eyes. In addition to aging, other eye-related issues, including under-eye bags, dark circles and sunken-looking eye cavities, may be more related to stress, sleeplessness or genetics. Dr. Smith handles many of these common complaints with blepharoplasty, a form of facial cosmetic surgery designed to treat upper, lower or both parts of the eye. This specialized eyelift technique works by tightening both the skin and tiny musculature around the eyes, even counteracting drooping skin above the eye.

Brow lift

A brow lift is commonly performed to further compliment an eyelift or blepharoplasty. A brow lift can help with sagging skin on the upper portion of the face; deep forehead lines that add age to the eyes; and “hooding” of the upper eyelids, which can interfere with vision. A smoother, youthful-looking brow has a beautiful way of framing the eyes and face, and Dr. Brent J. Smith uses years of experience sculpting this area to complement your natural features. His careful, precise style of facial plastic surgery—never over-lifting to the point of paralysis—allows for full expression. We want you to look like you—only better!

Laser resurfacing

Fine lines, wrinkles, brown spots, rough patches and acne scars… “Be gone!”  Fast, flawless laser resurfacing is a highly effective in-office procedure that requires minimal downtime. This breakthrough skin-enhancement method is quickly becoming one of the most popular procedures at Smith Cosmetic Surgery. Why? Well, in as little as an hour, a directed laser beam gently strips away old layers of skin to reveal new skin and repair years of damage from sun, stress, acne and more. Dr. Smith employs some of the most advanced lasers on the market to regenerate new skin, smooth fine lines and quickly create a softer, younger-looking face.


While not a cure-all for all aging skin, microdermabrasion is an increasingly popular and effective treatment for maintaining a youthful appearance, as well as preparing for other procedures such as chemical peels. Because microdermabrasion rids the face’s outer layer of dead skin cells and provides more circulation to the skin, it creates a fresh “glow” while also helping chemical peels penetrate deeper.


Everyone gets wrinkles as they age, but as skin-supporting collagen breaks down over time people also lose that resilient, full look, especially in the lower portion of the face. Liposculpture, sometimes referred to as fat grafting, is Dr. Brent J. Smith’s process of harvesting a patient’s own natural body fat from the abdomen or hips and transferring it to the face to sculpt areas where skin has lost elasticity and fullness. Research has shown that during this process stem cells convert into collagen elastin fiber, helping with key production of new collagen. In effect, transferring natural fats through liposculpture can provide a fresh foundation for a more youthful look.

These are just a few of the procedures that can help patients look and feel more rejuvenated in 2016. Call Smith Cosmetic Surgery to schedule a complimentary skin consultation to review your options for the New Year—and the new you!

Happy Holidays from Smith Cosmetic Surgery

Happy Holidays

The month of December always holds a special place in my heart as it is a time when I get to reflect on the past year. And, 2015 has definitely been one for the books!   Not only have I been able to perform a myriad of procedures, but I have also had the opportunity to meet hundreds of “new faces” along the way!   I am blessed with patients who feel comfortable enough to sit across from me and let me into their lives.  Receiving their “Thank-You’s” and hearing how plastic surgery has enhanced their lives is my greatest reward.

I want to take this opportunity to thank you, my patients. I get to do what I do because of you. I come to work each morning feeling honored that you have chosen me and my wonderful staff to guide you in this journey. As 2015 comes to a close, I celebrate my family, my practice, my staff and my patients and am excited to see all that the New Year will offer!

Have a wonderful holiday season and cherish all you’ve been blessed with!


Brent J. Smith, MD

The Wonders of Winter Skin Care

While skin deserves preserving treatments year-round, there’s no better time to give your face total TLC than during the winter months. The approaching cold season brings so many elements—frigid temperatures, brutal winds and extreme dryness—that can strip skin of its natural protectants. And in places like Colorado, where living at high altitude exposes skin to intense sun and unrelenting dry climate, caring for the sensitive face becomes an essential part of an everyday routine.

During winter, we’re also typically indoors more often and therefore exposed to plenty of dehydrating heat sources, from wood-burning fireplaces to electric forced air. Heat does our precious skin no additional favors. Faces can quickly become dry, tight, flakey, itchy, cracked, raw and red. In some cases skin is so inflamed by harsh winter elements (indoor and out) that it develops eczema, a tender condition that’s trickier to get rid of than dry skin.

Luckily, individuals have many options for consulting skincare professionals such as Denver’s Smith Cosmetic Surgery staff. Our skin technicians guide people of all ages with all different skin types through smart and effective skin-preserving routines. Typically our recommendations combine advanced, medical-grade skincare products; lifestyle skin-protection practices (i.e., wearing the right sunscreen and learning how to carefully clean and moisturize the face); and regular non-surgical rejuvenation procedures such as microdermabrasion and chemical peels. As you consider how best to safeguard yourself from the elements this winter, here are a few helpful ideas from Dr. Brent J. Smith, Denver’s foremost facial plastic surgeon.

Drink more water. Hydrating our bodies (including our faces!) from the inside out is crucial for maintaining healthy skin, head to toe. When we drink plenty of fluids, our bodies naturally flush toxins and replenish parched skin cells through natural biological systems. So rather than slathering on more moisturizer to make up for extra-dry winter skin, start by trying to drink an adequate amount of water (and eating as healthy as possible). One thing that’s tricky about water consumption in winter is it often doesn’t sound very inviting to drink cold filtered or tap water when we’re chilled. Instead, consider some creative ways to drink more water in the chilly season: heat up a mug of water and add a purifying lemon slice; add a splash of fruit juice like pomegranate, which is also a wonderful antioxidant; order an herbal tea instead of coffee at the drive-thru; or purchase an encouraging new hot-and-cold water container—and fill it before every car ride.

Encourage cell turnover. In the summer we sweat more, which helps initiate regular skin cell turnover. In the winter, we don’t sweat as much. When cells don’t turn over as often, skin becomes duller quicker and needs assistance to encourage cell renewal. This rejuvenation process in the epidermis layer of the skin also slows down as we age, which means older people get hit doubly hard in the winter. Fighting this process requires stimulating facial skin cells and manually removing “dead” layers, especially in the winter. In-office, non-surgical procedures such as laser resurfacing, chemical peels and microdermabrasion can be an ideal way to regularly retain that fresh, youthful look.

Up your antioxidants. There have been a lot of studies recently proving the effectiveness of antioxidants in preserving healthy skin over a lifetime. Much like vitamins, antioxidants are amazing supplements, many occurring naturally in “super foods” such as green tea and blueberries. When it comes to our skin, antioxidants work to combat free radicals that are known to damage our bodies and speed up the signs of aging. Antioxidants also help sunscreen to more effectively prevent damage from exposure during the day, and can promote cellular repair and healing when applied topically over night. One analogy for this process is the natural degradation of stainless steel. If you leave stainless steel out in the elements with no protection it will rust. But if you add a protective layer it doesn’t oxidize. That’s the magic of anti-oxidant!

Remember your retinol. If there is one external skincare product routinely recommended by facial plastic surgeons, dermatologists and skincare professionals, it’s the special antioxidant-rich, anti-aging retinol. This ingredient comes in different concentrations in over-the-counter products and prescription-strength applications, and is especially effective when used around the eyes to slow the advance of wrinkles. Smith Cosmetic Surgery has tested a wide range of cosmetic skincare lines and has selected specific medical-grade brands that deliver retinol in proper strengths to plump collagen-depleted skin and reduce the appearance of pore size. Retinol can be applied during and after non-surgical procedures such as microdermabrasion, which works to remove dead skin, exfoliate the face and motivate healthy new cells.

Are you prepared to face winter head on? Reach out to Smith Cosmetic Surgery with any questions related to skincare products and procedures that can help you look and feel healthier this season.