About the Consultation
Consultations are scheduled later in the day throughout the week and typically run to ninety minutes or more.
The best preparation for the consultation is time spent on the website. In fact, one of the key motivations for developing the website was to facilitate (and concentrate) the consultation process in Dr. Little’s office. The better the prospective patient understands Dr. Little’s overall philosophies and techniques in facial rejuvenation, the sooner the consultation can focus on the specifics of her particular situation. It may be helpful to note down the reference numbers of certain patient results from the website…both those that one especially admired and, more importantly, those that one did not.
Bring Young, Non-smiling Pictures
It is important that prospective patients bring with them photographs from their early years (twenties and thirties), preferably without smiling. Some patients wonder why such early pictures are reviewed; nobody wants to look twenty again. Of course nobody can look twenty again, and any attempt to create such a degree of change would be foolish. But Dr. Little finds great benefit in understanding each patient’s youthful facial personality, as it was before the aging process set in (for reasons that become clear during the consultation). Some patients complain that all of their pictures present full smiles. Smiling pictures are better than no pictures, but non-smiling pictures are better. Many over-looked sources of early pictures include college or high-school yearbooks, sorority or fraternity books, sports team photos, wedding photos, and early passports or driver’s licenses.
Learn about Facial Aging
The consultation is in part an educational experience, and most patients come away with new insights and understanding into what really matters in facial aging (and what does not). A range of before-and-after results (beyond that available on the website) in patients of similar age and facial type may be reviewed, including standard side-by-side matched views of the face and neck from multiple angles. Dr. Little also presents his results as “superimposed faded” images, whereby matched pre- and post-operative views are stacked one on top of the other and then faded from one to the other (a highly informative means of comparison recently developed by California plastic surgeon Val Lambros, M.D.). This specialized presentation of results allows one to follow precisely subtle shifts between the “before” and “after” appearances, so that multiple nuances of change can be appreciated that would otherwise be overlooked (few plastic surgeons present results in this manner, however, as the preparation is labor-intensive). Finally, multiple results are viewed in animation, with before-and-after video images shown side-by-side while talking, smiling, frowning, etc. (frowning, for example, is not included in the website examples). Such animated results (also rare in facelift consultations) provide the ultimate reassurance about the naturalness of any facelift result.
In fact, in many of these moving pictures the post-operative patient appears more “natural” than the pre-operative one (even when there has been no previous surgery). This is a theme that runs throughout the consultation, confirmed by result after result: well-conceived facial rejuvenation surgery typically yields an appearance that is more natural than many patients’ aged appearance before surgery. Said another way, while facial aging is a natural and progressive aspect of any life, its outward effects on some individuals are decidedly unnatural. While many patients worry that the price of any surgical manipulation of the face includes at least a subtle tradeoff in unnaturalness, such is not the case. Also, such “truer-to-life” moving pictures (captured in available light) reveal the improvements of volume-added rejuvenation far better than still photographs taken with “flash.” During the consultation, Dr. Little will indicate precisely which surgical steps a particular patient embraced (and equally important, which steps she did not) in arriving at this, that, or the other result–both for results presented on the website (each of the more than 250 before-and-after, side-by-side photographic pairs is accompanied by a reference number), as well as for those that can only be reviewed in the privacy of the office.
Comparing Now and Then
The patient’s early photographs from youth are then compared to current photographs taken at the consultation (these do not remain at the office, but go home with the patient). Any architectural or shape-based change that Dr. Little then recommends will likely be directed toward the architecture evident in these early pictures…not to try to have the patient appear twenty or thirty, of course, but to return toward an earlier appearance that is buried deep within an inner sense of self and body image. There is an exception to this general rule, however: the occasional patient who never liked her appearance in youth, typified by the 15% of women who had a round face throughout their youth and young adulthood. In such cases the early facial architecture may instead be ignored in pursuing a look the patient might have preferred, such as an “inverted-cone-of-youth,” with a sleeker lower face and jawline.
A Serious Dialog
Also during the consultation Dr. Little will review the temporary and permanent potential disappointments and complications of the contemplated procedure…not only the rare major ones, but also the minor ones that are more vexing than harmful. He discusses his personal experience (if any) with each and sends this tabulation home with the patient, as well. Do not expect wine and cheese at the consultation, as this is a serious scientific and artistic dialog about a complex subject that is too often over-simplified. An initial consultation fee is due and payable at the time of the consultation; there is no such fee for second consultations or beyond.