The following dialogue is excerpted from an interview with Dr. Jerry Graff of the KFMB radio show “The Health Hour.” What you should know about Cosmetic Plastic Surgery of the face. Ask the expert.

My biggest concern is about having a facelift look natural. What should I know?
Not all surgeons are created equal. You need to be aware of the surgeon's technique and artistic sense. See examples of their work, not computer art. I prefer a composite facelift approach with double layer support. The same as double layer stitching on a quality shirt, it will look better and last longer. This deep layer approach allows preservation of the hairline and reshaping the tissues in the appropriate direction; both are critical in achieving an outstanding natural appearing result.

What is the recovery time for a complete facelift and is there a preferred age?
There are two stages of recovery. Two weeks for reliable social commitments (although many patients are very comfortable being out and about with in one week) and three to 6 months for more full settling and final result. With regard to when is the right time, I treat the face, not the clock. There are forty year-olds who could benefit and sixty year- olds who don’t need a facelift. We are treating the high cheeks, smile creases, marionette lines, jowls, and neck; these are the areas that make the difference. The composite face and necklift addresses each of these areas in natural balance with the other.

How long does a facelift usually last until I have to have another one done?
A composite facelift procedure is a permanent change. You will always look better than you otherwise would. While you do continue to age, this occurs slower because of the double-layer support. Whether or not someone seeks further treatment in the future is a personal preference. When you feel healthy and vital, you want to continue to reflect that in your appearance. While a well done facelift will stand the test of time, there are several lesser refinements which can compliment your improved look short of a repeat facelift.

I know people who love the way Botox takes away the frown wrinkle between their eyes, but the cost and inconvenience of repeated treatments is a problem, what are the alternatives?
An exciting alternative to repeated botox treatments is SEWS(Selective Endoscopic Wrinkle Treatment). Here, we use a scope as in knee cartilage surgery to visualize the over- active muscles and thin them out. This can soften the appearance of glabella (between the eyes) lines and bulges with minimal downtime (7-10 days). The result can last 5-15 years. How you use botox depends on your goals. While some people seek treatment every 3-4 months to maintain immobility of certain facial areas, others prefer a more subtle weakening of expression wrinkles. The visual improvement of botox can last long after it’s weakening has worn off. Thus, some people treat every 6-9 months. Using botox is like hitting the reset button. This way, we can hold aging at bay.

What is Restylane?
Restylane is a safe and natural cosmetic dermal filler that restores volume and fullness to the skin to correct moderate to severe facial wrinkles and folds, such as nasolabial folds.

What is Restylane made of?
Restylane is the first and only cosmetic dermal filler made of non-animal-based hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin.

Is Restylane safe?
Yes. Restylane has been used safely by dermatologists and plastic surgeons since 1996 worldwide. Because Restylane is non-animal-based and fully biocompatible, allergy testing is not required. There is virtually no risk of animal based disease transmission or allergic reaction. The most commonly reported side effects were temporary redness and swelling at the injection site. These effects typically resolve within two to three days.

More men than ever are interested in cosmetic surgery. What about men with thinning hair who are nevertheless concerned with aging of their eyes and forehead. What are their options?

Yes, many men are staying fit, and it is not a sin to want to look your best. For these patients, I developed the SMART LIFT (simplified muscle access, release, and temporal lift).

This approach allows me to naturally rejuvenate the eyes, brow, and forehead, all through a discrete upper eyelid incision.

What separates one doctor from another in performing these procedures? These are four critical factors to achieving extraordinary results.
1) Training: Board Certification by the American Board of Plastic Surgery denotes a background and commitment you want in your plastic surgeon.

2) Technique: You want a surgeon with a focus to their practice. Additional training beyond the “bare minimum” reflects commitment, experience, and expertise in your area of concern. I attained advanced training with on of the masters in Cosmetic Plastic Surgery because I love helping people look their best. I have a focus and dedication to Facial Rejuvenation and to Cosmetic Plastic Surgery of the breast, and body. From the cleft lip patients on medical missions to my aesthetic/cosmetic surgery patients, this is my focus and my goal.

3) Artistry: As Michaelangelo said, “Details are no Trifle.” Many surgeons are technically adept but artistically lacking. Their patients heal, but do not look their best. Other surgeons have an “eye” for aesthetics, balance, and beauty.The patient and surgeon must agree on what looks good! If they do not agree, they are healed in different directions and the chance of mutual satisfaction is slim.

4) Compassion: Francis Peabody, a physician and philosopher said, “The secret of care of the patient is caring for the patient.” In order to achieve excellence, we have to care enough to do our very best.

When it comes to cosmetic plastic surgery, Dr. Scott Miller understands that you don’t work on patients, you work with them.

“Each patient is an individual,” says Dr. Miller, who is certified by the American Board of Plastic Surgery and specializes in cosmetic surgery of the face, breast and body. “You need to take the time to get to know them—time to discuss their goals and how to best achieve them.”

To allow for this strong focus on communication, cooperation and personalized planning, Dr. Miller chooses to work with a limited clientele. There’s a boutique quality to the practice. You walk into the elegant Scripps La Jolla office, and you know you’re going to be listened to, cared for and respected throughout the entire process.

“Our work doesn’t start with the operation; it starts with the consultation,” says Dr. Miller. “It’s important to plan carefully and work meticulously, so you get results that are both natural-looking and long-lasting.”

“There is no one else with his combination of artistry and technique,” says patient Sharon Ferro. “I look and feel better than ever.”

Dr. Miller strives for a harmonious result, a face that’s youthful and balanced. Rather than approach cosmetic and reconstructive procedures as a set of unrelated maneuvers aimed at segments of the face, Dr. Miller utilizes the deeper muscle layers to carry the upper and lower face as a single unit. This approach repositions the cheek, jawline and neck, and avoids additional procedures as well as the distorted, “pulled” look of older techniques.

Dr. Miller, an award-winning artist in his youth, says his task is not to cover a blank canvas but to recognize the beauty that is there and give it renewed expression. “The gold standard in this job is not to create beauty,” he says, “but to reveal it.”

The word “facelift” conjures up the image of someone looking tight and unnatural. However, under the care of the right surgeon today's facelift can be more effective and natural looking than ever. Patients look refreshed, rested, healthy, and younger. By tightening up the underlying tissue as well as removing excess skin, facelifts now last longer that ever before, without looking tight or pulled.

After a facelift, most of our patients have minimal discomfort, and very little swelling and bruising. Most of them feel that they can return to a relatively normal routine very quickly and begin all activities, including exercise, four weeks after surgery. The results are dramatic but very natural looking. The scar are usually difficult to see and typically there is no significant alterations in the hairline.

With the new, deeper lifts, the patient undergoing a facelift should be able to achieve a striking result that will last for many years. We welcome prospective patients to see the appealing results that our physician has been able to accomplish.

In just a few years, lasers have become more precise, more comfortable, and less invasive. Lasers have revolutionized skin resurfacing and have become one of the mainstays in improving, reducing, and sometimes eliminating fine lines and wrinkles that appear on the cheeks, forehead, around the eye and lips. Beautiful, youthful, healthy skin is available with shorter recovery time, less redness, and fewer complications.

Using the UltraPulse Co2 Laser, Dr. Miller removes the outer layers of damaged skin and allow newer, smoother skin to appear.

The Blue Peel is a safe, fast, and virtually painless way to have smooth, silky skin on your face, neck, and hands.With a buffered TCA solution, surface cells are removed and every skin type can be rejuvenated. The Blue Peel is superior to the results of most other non-laser treatments.

Teens love how it improves their acne scars, oily skin, and uneven skin tone. Pores look smaller and blackheads disappear.

Adults find that fine lines, wrinkles, hyperpigmentation, sun damage and aging skin can often be treated without much time away from work or social activities.