Plastic Surgery Photos | Before and Afters

Dr. Durboraw commonly addresses problems of the eyelids with surgery, from excess eyelid skin and drooping eyelids to malpositions of the eyelids. Skin cancer of the eyelids and surrounding area can become a complex reconstructive undertaking and there is no one more qualified than Dr. Durboraw in the surrounding region.

Ptosis is a condition where the eyelid margin has descended and is obscuring the pupil of your eye and your peripheral vision. People often describe their eyes as looking “half mast” when they are trying to fully open their eyes. Sometimes this is combined with excess eyelid skin which can be addressed simultaneously. If your peripheral vision is significantly obstructed, your insurance company will pay for the surgical repair of this condition. Make an appointment for evaluation.

Aging of the lower lids can often make patients feel they appear tired or “drawn”. Usually the problem involves a combination of excess eyelid skin and bulging fat pockets of the lower lid which accentuate the tear trough and exacerbate the appearance of dark circles. Although this is not considered medically necessary and will not be covered by your insurance, these problems can often be corrected through surgery. Make an appointment for evaluation.

Dr. Durboraw maintains offices in Idaho Falls, and Sun Valley, Idaho, along with Jackson Hole, Wyoming. Contact the main office of The Center for Aesthetics in Idaho Falls and a staff member will set up an appointment in the office closest to you.

Dr. Durboraw graduated with highest honors and second in her class from The University of Tennessee, Memphis. She was elected to the Alpha Omega Alpha medical honor society. It was during her years in medical school that she was introduced to the sub-specialty of ophthalmic plastic and reconstructive surgery and her passion for this field was ignited.
Residency During Dr. Durboraw’s residency in Ophthalmology at the University of Tennessee, Memphis she demonstrated her leadership ability and interest in academic advancement. During her four years in training she published and produced several scientific articles and instructional videos on surgical technique and orbital trauma and disease. She spent her final year in residency as chief resident. The busy surgical volume at UT, Memphis gave her a unique surgical “hands on” experience.
In 1998 Dr. Durboraw completed her fellowship and opened her private practice in Idaho Falls, Idaho. Dr. Durboraw always had a personal interest in aesthetic medicine and surgery. Her practice grew rapidly and particularly in the direction of aesthetic medicine. After several years in practice she renamed her practice The Center for Aesthetics, reflecting her commitment and focus on providing an unparalleled level of competency and technology in this area of medicine. The Center for Aesthetics has grown to serve a large portion of the state of Idaho as well as western Wyoming. She has had a satellite practices in Jackson, Wyoming for 9 years and in Sun Valley, Idaho for 8 years. Last year she recruited Dr. Mark Freeman to become her partner in The Center for Aesthetics – a fellowship trained cosmetic plastic surgeon of distinguished training and background. With the arrival of Dr. Mark Freeman, The Center for Aesthetics now offers the complete array of surgical and non-surgical treatments in aesthetic medicine. She has continued to demonstrate her leadership ability and is currently serving as the Chief of the Department of Surgery at Eastern Idaho Regional Medical Center.

Call Dr. Durboraw’s office today at 208-542-1050 or 800-575-8337 to schedule a consultation, or you can request an appointment online. Dr. Durboraw practices at The Center for Aesthetics, serving Pocatello, Jackson Hole, and other communities in Idaho. Plastic surgeon Dr. Catherine E. Durboraw would welcome the opportunity to speak with you further about plastic surgery and to answer any of your questions concerning facial rejuvenation.

Facelift surgical technique has gone from extremely simple in the early years, to far too complex, and now is returning to a happy middle ground of just right. There is still attention to the skin , fat, and muscles of the face, and the results are excellent with the less invasive and quicker to heal technique. I am certainly not referring to the advertised noontime lifts that take less than an hour and are quite frankly nonsense. I am talking about a real facelift of the highest quality. Operating time varies from 3 to 4 hours, depending on age and work required for perfection. This facelift of 2010 can be done under local anesthesia but quite frankly, when I have my facelift, I will prefer the comfort and added security of general anesthesia and a MD anesthesiologist in attendance. I never compromise safety for my patients. Think long and hard before entering into any surgical procedure without an MD anesthesiologist by your side. The anesthesiologist affords you comfort and supreme safety. An anesthesiologist in attendance allows me to concentrate totally on your facelift surgery and obtain the very best results for you.

Before a plastic surgeon can embark on a surgical procedure about the eyelids, there must be a clear definition of what will constitute beauty in each specific patient. Eyelids differ in men , women, different races, different ages, different facial types, etc. Let us undertake first a thought process of what should be attained in the 55 plus or minus year old female of general non Asian eyelid anatomy. Later we will discuss Asian patients, males, and on and on. We will discuss in this essay only upper eyelids to be more specific because it is the upper eyelids that differ most between the mentioned groups. Upper eyelids in the non Asian female of 55 tears or so must have the following characteristics. The upper lids ideally should have a open natural alert look. The upper eyelid crease should be about 10 mm from the lash line. The crease should display a beautiful flowing natural curve from the inner canthal area to 10 mm to 13 mm beyond the lateral canthal area. Ideally no puffiness is noted in this upper lid at any point along its length. On the other hand it is preferable that the lid not have a too deep hollow look. The surgeon must be prudent in his removal of fat, In fact great thought must always be given to the removal of any fat about the eyelid area because of possible hollowness later. The upper eyelid ideally rests above the pupil but below the upper border of the iris. The upper lid closes easily in a blink or at rest or sleep. The function must always be normal and function must be a foremost consideration of the plastic surgeon. An enhancement of the beautiful upper eyelid as well as the lower eyelid is the presence of long attractive eyelashes. Latisse, an eyelash enhancer made by Allergan is a product that really works and works consistently and extremely well for nearly everyone. To attain the above beautiful eyelid the surgeon must have extensive training and exert great thought and planning. A surgeon that is boarded by the American Board of Plastic Surgery is ideal. Just the perfect amount of skin must be excised in exactly the perfect incision. The orbicularis oculi muscle must be examined and properly adjusted. The fat must be assessed and properly adjusted. A beautiful flowing subcuticular suture must be used for closure that can be removed by a single pull out effort. The sutures should be removed by the 5th day. The procedure should be quite easy and a joy for the patient. Return to work or play should be possibly after a week. A desire for significant confidentiality can make this 2 weeks. This factor varies.. In my next essay session I will discuss the lower eye in all ages, and races, and sexes, because the lower lid is somewhat more universal in its nature. Nevertheless there are difference that must be addressed and the different looks possible must be discussed with the patient.

Again and again I hear patients mention that they would have considered a plastic surgery procedure years earlier had they know it could be done with such reasonable pain control. We all fear pain. I do not want to be hurt! Do you? Of course not. A little thought and planning gos a long way in minimizing pain in procedures such as the facelift, rhinoplasty, breast augmentation, breast reduction, abdominoplasty, liposuction, otoplasty, forehead lift, and eyelid lift. The surgeon must plan to minimize pain and discuss these plans with patients and then patients must cooperate to keep all discomfort at the minimum. What are the ingredients or menu of less pain in plastic surgery or any surgery for that matter. The list of factors that are important for less pain include discussion and understanding between surgeon and patient, cooperation, adequate pain medicine that actually agrees with you, anti nausea medication that facilitates taking pain medication, sedation for sleep, bupiveracaine (marcaine), pain pumps placed within the surgical site, a firm concept of the fact the the wound at rest heals best, ice and cool packs, adequate help after surgery, and an attentive surgeon readily available if pain becomes a factor. There are many types of pain medications but clearly the narcotic medications works the best in the early post operative period. Percocet gives good relief with minimal nausea. Remember however that all narcotic medication can stimulate nausea. Some patients prefer no narcotics and this may work well. Patient and doctor need to discuss the types of medication that may have worked in the patients past experiences. Anti nausea medications help prevent dreaded feelings of upset stomach and the finest anti nausea medication is Ondansitron (Zofran). Call Maximart Pharmacy in Palo Alto because they offer this wonderful medication at a great price. The best form of Ondansatron is the 8 mg sublingual tablet taken every 4 hours if needed under the tongue. Rectal suppositories of Phenergan work but who wants a rectal suppository, no one. Sedation at bedtime helps pain medicine do its work and I think patients do well with Ambien. Ambien has been cleared for climbers on Mt Everest so its very safe. The Marcaine pain pumps come with various names including Pain Buster and such and work extremely well for abdominoplasty surgery and sometimes other procedures. No tummy tuck should ever be done without a Marcaine pain device. Good old fashioned coolness and ice especially is still one of the great pain remedies. While selected steady activity after surgery helps prevent pneumonia and thrombophlebitis, nevertheless the wound at rest heals best and hurts less so be sensible. Discuss pain with you Plastic Surgeon in great detail. Doctors are generally kind souls who are merciful and do not want you to hurt unnecessarily. Get a great plan that you feel comfortable with. Lastly prepare yourself and your home and care team so all is easy for you after surgery. You do not want to be running to you local store for the milk and soup you should have purchased pre operation. Regarding soup, get low salt. Salt (Sodium) causes swelling or at least makes it worse and swelling hurts so avoid salt. Low salt means less than 1500 mg a day. Lastly, remember there is a correlation with more bruising and more pain. Remember to avoid substances that interfere with blood clotting 2 weeks before and after surgery. These include aspirin, ibupropfen, fish oil, Vitamin E, and many Herbs to name a few. Get the advoidance list from your Plastic Surgeon before surgery. Does arnica montana reduce bruising. There is absolutely no proof that it does but if you feel better taking it please do so because it will not harm you beyond its cost of a few dollars. So you are now ready for you minimally painfully Plastic Surgery experience

Before a plastic surgeon can embark on a surgical procedure about the eyelids, there must be a clear definition of what will constitute beauty in each specific patient. Eyelids differ in men , women, different races, different ages, different facial types, etc. Let us undertake first a thought process of what should be attained in the 55 plus or minus year old female of general non Asian eyelid anatomy. Later we will discuss Asian patients, males, and on and on. We will discuss in this essay only upper eyelids to be more specific because it is the upper eyelids that differ most between the mentioned groups. Upper eyelids in the non Asian female of 55 tears or so must have the following characteristics. The upper lids ideally should have a open natural alert look. The upper eyelid crease should be about 10 mm from the lash line. The crease should display a beautiful flowing natural curve from the inner canthal area to 10 mm to 13 mm beyond the lateral canthal area. Ideally no puffiness is noted in this upper lid at any point along its length. On the other hand it is preferable that the lid not have a too deep hollow look. The surgeon must be prudent in his removal of fat, In fact great thought must always be given to the removal of any fat about the eyelid area because of possible hollowness later. The upper eyelid ideally rests above the pupil but below the upper border of the iris. The upper lid closes easily in a blink or at rest or sleep. The function must always be normal and function must be a foremost consideration of the plastic surgeon. An enhancement of the beautiful upper eyelid as well as the lower eyelid is the presence of long attractive eyelashes. Latisse, an eyelash enhancer made by Allergan is a product that really works and works consistently and extremely well for nearly everyone. To attain the above beautiful eyelid the surgeon must have extensive training and exert great thought and planning. A surgeon that is boarded by the American Board of Plastic Surgery is ideal. Just the perfect amount of skin must be excised in exactly the perfect incision. The orbicularis oculi muscle must be examined and properly adjusted. The fat must be assessed and properly adjusted. A beautiful flowing subcuticular suture must be used for closure that can be removed by a single pull out effort. The sutures should be removed by the 5th day. The procedure should be quite easy and a joy for the patient. Return to work or play should be possibly after a week. A desire for significant confidentiality can make this 2 weeks. This factor varies.. In my next essay session I will discuss the lower eye in all ages, and races, and sexes, because the lower lid is somewhat more universal in its nature. Nevertheless there are difference that must be addressed and the different looks possible must be discussed with the patient.

I hear some patients say they fear they are too old to have cosmetic surgery. This is simply not a valid fear. We humans build false fears about so many things. The fact is that if you are healthy and desire to have cosmetic plastic surgery it is just fine as long as you are reasonably healthy. Certainly I am very detailed about checking health issues in all patients and in the 60 to 90 plus group little things pop up that need sorted out before elective surgery can occur. I have done breast augmentations in patients in their early 80s with great success and happiness. My oldest facelift patient was an 89 year old lady having her second facelift and she did fine. I might add that this lady worked full time 5 days a week. And then there was an 86 year old lady who had a facelift because she liked to go on cruises and dance. As she aged she was unfortunately not getting asked to dance much. After her facelift she was frequently asked to dance and looked just great. My oldest liposuction patient was 79, and yes skin will contract just fine at that age. I have done many injured noses in people in their 70s and 80s but my oldest elective rhinoplasty was 76. This was a male patient physician who never liked the hump on his nose, so I removed it and he was delighted. My oldest setback of very prominent ears was also on a male that was 77 and had always disliked his ears since childhood. I set his ears back and he was very pleased. Older people often get a little tummy distention that can be corrected with a simple moderate abdominoplasty. Baggy eyelids can be corrected as well as hooded eyelids well into the 90s. So this gos on and on. I have many wonderful patients in their 60s , 70s, and 89, and occasionally 90s that are made very happy by looking the way they wish. And then there are Botox and Juvederm and Obagi creams and peels which can be done safely in any age person.

Complications in Plastic Surgery are something few care to discuss. In fact serious complications are quite rare. Nevertheless occasionally problems do arise. A largely preventable problem is that of blood clots (thromboembolism) that may originate in the calves and travel to the lungs. Once in the lungs this is called pulmonary embolism and is a threat. The pulmonary embolism problem can be successfully treated but the best course is prevention. The old advice of stay healthy by not getting sick never shined brighter. In over 25 years of practice none of my patients have ever had this blood clot – pulmonary embolism problem. I attribute this partly to good fortune but generally we make our own good fortune. I have always treated my patients premptively with every prevention method known. These preventions include the use of sequential compression devices on 100% of surgery patients during surgery to prevent blood stagnating in the calf area. These devices squeeze the lower legs gently and help keep blood moving. This works. Close cooperation with our MD anesthesiologist also greatly helps in preparing patients for surgery and picking safe candidates and procedures selected and tailored for each candidate. During surgery the anesthesiologist constantly safeguards positioning of the patient to assure the lower extremities are in good position, are moved from time to time, and have no obstructive encumbrances. I work closely with our anesthesiologists to assure safe dressing and garments that do not obstruct lower extremities. The SCDs are continued in recovery and also in the hospital if hospitalization is selected. Patients are ambulated the evening of surgery and frequent short walks are encouraged the day after surgery. In liposuction cases I will start ibuprofen or a similar NSAID for its anti coagulating effect. This combination of effort for all of my patients has been 100% successful.

Botox is the simplest and least costly treatment that quickly generates happiness for all patients. There are nearly no complications and when the little issues come up they quickly dissipate. Botox is used to treat wrinkles of the forehead, frown, mouth area, crows feet, sweating underarms,hands and feet, headaches, and more. Ice is applied prior to injection and little if any pain is experienced. Patients desiring zero pain can apply Emla 1 hour prior to injection. The injections are made with a tiny 30 gauge needle and take but a few minutes. Botox is available in Dr Commons office at the very reasonable price of $11 a unit, This translates into around 150 to 200 dollars for a frown area. Large male frowns take a little more. Appointments can be made by calling 650 328 4570. Dr Commons does 100% of all treatments. Results are seen in 24 hours and are completed within 5 to 7 days. This is definitely a noon time treatment. After the treatment you can easily return to work. For BOTOX in San Jose area contact Dr. Commons

Rhytidectomy or more commonly known as a face lift, is a surgical procedure used to rejuvenate and improve the appearance of the face

The best candidates for this procedure are men and women whose face and neck have begun to sag but who still have some elasticity and whose bone structure is strong and well-defined. A face lift can make you look younger and may enhance your self-confidence.

he vast majority of men and women do not experience any of these complications. You need to discuss these issues with Dr. Windle prior to your surgery to be sure you completely understand the basic risks along with any other special risks that may be involved.

At your initial consultation, Dr. Windle will evaluate your general health, examine your face, condition of your skin, your underlying bone structure, and explain the procedure to you along with the risks of the procedure. In addition, your doctor will give you different options based on your particular situation. After meeting with Dr. Windle, he will tell you what he thinks is a realistic expectation for your situation. Photographs will be taken and possible alterations can be made on the computer screen to give you an idea of what changes you can expect to see as a result of your facelift.

The recovery period following a face lift will consist of some numbness, swelling, and bruising in the face. Your drainage tubes will be removed 2-3 days after surgery when your drainage has slowed down. You will need to keep your head elevated for a couple of weeks. You will have some scars from your facelift but the majority will be hidden in your hair and the rest will be placed in the natural creases of your face and ears. In time, they will fade and be scarcely visible.