• Perma Facial Implant, January 2009
• Thermage, March 2008
• Modus, Jan. 2008
• Face Forward, Nov. 2007
• Dr. Gorman, Oct. 2007

Face Forward, Nov. 2007

Put Your Best Face Forward, Facial Cosmetic and Reconstructive Plastic Surgery

Austin Woman, November 2007

Story by Darline Turner-Lee
Photos Courtesy of Dr. Edward Buckingham and Dr. Robert Clement of Austin Plastic Surgery Institute

Every morning we each wake up and shuffle sleepily into the bathroom. Wiping the sleep residue from our eyes, we gaze at our faces in the mirror. What do we see? Most of us take in the big picture – an overall exhausted look from long hours of work, or, maybe, a look of generalized congestion, complete with red eyes and runny, red nose (courtesy of our allergy-promoting Austin climate). How about an overall splotchy face –perhaps the result of crying over a lost love or from the margaritas downed in an effort to wash away the pain? No matter what the look, the vast majority of us will shower, dress and do that thing we do with hair and makeup to “put our best face forward” and prepare to face the world. For some women, no amount of grooming or makeup can hide what they believe are glaring imperfections in their faces. 

“Even fully made-up, I look tired,” laments one woman. “I was having the best day and someone walked up to me and asked me if I was tired. It’s maddening.” 

Whether it’s a persistent droopiness around the eyes, the ever-present family heirloom hump along the nose or an increasingly sloping chin and neck, these individual imperfections make it impossible for some people to see the big picture when it comes to their appearance. And many feel that these imperfections detract from other people seeing them for who they really are. Some people have suffered their worst fears as reality – passed over for promotions or stuck in career deadends only to learn it’s because they are perceived as old, not cuttingedge or too tired to be able to handle demanding new tasks. Social interactions may dwindle. Relationships may suffer. When personal perception and self-esteem are affected, it’s time to take action. “Do something or have something done when an imperfection bothers you every day,” says William Gorman, MD, plastic surgeon and partner at Austin Plastic Surgery Institute. His partner, Robert Clement, MD agrees and adds, “When you’re willing to take the risks associated with plastic surgery – or any surgery – then you’re ready to do something about your problem.” 

At age 30, Janet swore she’d never have plastic surgery. But at age 55, the former sun worshipper was very unhappy with the deep creases across her forehead, her sagging double chin and what she calls ‘turkey neck.’ In her early 50’s, she had begun to contemplate plastic surgery but didn’t think she could go through with it. Two years ago, a friend convinced her to attend an open house at Austin Plastic Surgery Institute. She continued to contemplate plastic surgery before she booked a consultation. After meeting with Dr. Clement, Janet felt so confident that plastic surgery could help her, that she went forward with surgery two weeks later.

“I had a lower facelift (for my chin and sagging neck), brow lift and blepheroplasty (eyelid tuck). The surgery was pretty extensive and lasted 5 hours. I stayed in the hospital (Austin Surgical Hospital) overnight, and I am really glad that I did. I was pretty wiped out afterwards and was on pain meds for two days. Once the stitches and staples were out, I felt a lot better. I am thrilled with the results. I look brighter and cheerier.” The five physicians of Austin Plastic Surgery institute perform a wide variety of cosmetic surgeries from facelifts to body contouring and dermatologic procedures. “If we can help people feel better about themselves, we do it,” says Fred Wilder, MD. “However, if a patient really needs to take better care of themselves, lose weight and stop other bad habits, we tell them that as well and won’t operate.” 

NJA had a lower face lift, brow lift eyelid tuck and autonomous fat transfer to her under eye area in May 2006 by Dr. Edward Buckingham. A chemical peel completed her makeover. “To be perfectly honest, the photos don’t fully tell my story. Dr. Buckingham is truly remarkable, a real architect of the face. Some surgeons give you a new face, one that looks nothing like the old you, but Dr. Buckingham takes what you’ve got and makes it look better. Even though I look better, I still look like me.” Edward Buckingham, MD is the medical director at Buckingham Center for Facial Plastic Surgery. Trained as an otolaryngologist (ears, nose and throat specialist) Buckingham also completed fellowship training in facial plastic and reconstructive surgery. “I really enjoy head and neck anatomy,” says Buckingham. Not only does Buckingham perform elective plastic and reconstructive surgery, but he is also one of very few plastic surgeons in Central Texas who perform skin cancer reconstruction. His practice is half facial cosmetic plastic surgery and half facial reconstructive surgery – mainly post cancer treatment. “Because of our warm, sunny, southern climate here in Central Texas, there is lots of sun exposure, and, consequently, lots of skin cancer. Dermatologists remove skin cancers, then I fill in the holes left after the cancer is removed and restore a natural look to the face.”


That is the hallmark of plastic surgery – to restore to a (presumed) natural appearance. Plastic surgery as a specialty developed around cleft lip palate repair and restoring the faces of infants and children born with the deformity to a normal, natural look. The surgeons at Austin Plastic Surgery Institute were all classically trained in plastic surgery which included a lot of cleft lip repair. When they came together as a group in 1987, they decided to continue the foundational work of plastic surgery and cofounded Austin Smiles, a non-profit organization that provides cleft lip repairs to children and adults in need but unable to pay. Dr. Clement describes how the organization evolved and how the practice became involved. “We all did some mission work during our training and we wanted to continue to do that. We originally took the call money we received from Brackenridge and put it in a fund that we used to travel to Mexico, Central and South America. We used the money to pay for staff expenses and to pay for the necessary equipment. Now we have a nonprofit organization and we raise funds for the mission trips. 

Each year, a team of 35-to-40 clinical staff members travels to an underserved area and performs 75-to-100 cleft palate repairs a week. It’s really amazing to hear people’s stories. Some families travel for days – walking, taking the bus, doing whatever it takes to get their children’s faces repaired. It’s truly remarkable.” 

“But Austin Smiles also takes care of Austin as well,” adds Dr. Wilder. “We correct cleft palates in children in Austin and Central Texas, to shelter clients and uninsured musicians as needed at a reduced (or free) rate.”
Patients who decide to have facial plastic surgery – whether it is elective for cosmetic reasons or recommended for medical reasons – must strongly consider all of the risks and benefits of surgery before they proceed. As NJA quickly advised, “Don’t take anything at face value. Interview several surgeons and be sure that your surgeon’s personality and philosophy aligns with yours. They should listen to what you want and not try to force
other procedures on you.”  

The surgeons at Austin Plastic Surgery Institute added, “It’s not our job to sell you on surgery. You as a patient have to know what you want. We won’t tell you what you need.”  

Janet summed it up this way, “In the end, you have to do it for yourself.”