Rhinoplasty in Santa Barbara by Dr. Terry Perkins

Rhinoplasty – commonly referred to as a “nose job” – is a cosmetic surgery procedure that is usually done to improve the appearance of the nose. A rhinoplasty nasal surgery involves reshaping the nose by reducing it in size or shape or enhancing it. Last year, rhinoplasty was the second most popular cosmetic surgery* with over 221,000 surgeries performed (breast augmentation was the first, with over 290,000 done).

Is rhinoplasty nasal surgery the only way to reshape a nose? A few decades ago the answer would have been yes, but nowadays we can use dermal fillers to slightly alter the nose without undergoing surgery. Dermal fillers (such as Restylane/Perlane, Juvederm, and Radiesse) are used to replace volume, and fill wrinkles and folds in the face. Using a bit of filler in the nose area can make a bump or hump in the nose disappear. The results are immediate and can last up to a year or more (depending on the type of filler used). This is a great way for people to “preview” what can be if they do elect to have rhinoplasty done.

Rhinoplasty Patient of Dr. Perkins

Rhinoplasty cosmetic surgery can be done to fix small to large nasal irregularities. For some people, rhinoplasty is also done to help breathing function. Dr. Perkins can change the shape of a nose by altering bone, cartilage, and soft tissue. A crooked nose can be straightened, a bulbous tip can be refined, and a widened nose can be narrowed. Dr. Perkins pays close attention to the nose/chin connection so facial proportion is balanced and the result looks “natural”.

Whether you are having rhinoplasty to bring balance to your features, improve your look and confidence, or alleviate breathing problems, it is important that you speak candidly about your expectations with your doctor. Dr. Perkins takes the time to listen to his patients, educate them on their options, and help them make a decision that best suits their needs. When the doctor and patient have this sort of understanding, the patient is usually very pleased with the outcome.

Santa Barbara cosmetic surgeon Dr. Terry Perkins is an expert in facial cosmetic surgeries, including Rhinoplasty Nasal Surgery. Call Cosmetic Surgery Center at 805-563-0000 to schedule a consultation with him. 

* Cosmetic surgery statistics from the American Society of Plastic Surgeons “2013 Plastic Surgery Statistics Report“.

Sagging Neckline: Neck Lift Surgery or Skin Tightening Treatment?

Santa Barbara cosmetic surgeon Dr. Terry Perkins is an expert in facial cosmetic surgery and extremely knowledgeable in skin tightening procedures. He runs a Santa Barbara cosmetic surgery practice and plays an active role in Evolutions Medical & Day Spa, of which he is the founder and Medical Director. So when people come to see him because they are bothered by loose skin in their neck area, he can offer more choices than just plastic surgery. Dr. Perkins answers questions about skin tightening and neck lift surgery in this blog post:

How is Skin Tightening done?
Dr. Perkins: For Evolutions, I developed a protocol called Total Tightening that combines two of the top non-invasive skin tightening procedures, ReFirme and Titan, into one treatment. ReFirme uses Bi-Polar Radio Frequency and infrared light energies to heat the dermal tissue in the target area which reduces wrinkles and lifts sagging skin. Skin also becomes smoother and toned. Titan is a safe infrared light that heats the dermis which is well below the skin’s surface. The heat contracts existing collagen and stimulates new collagen to be produced. The epidermis -the top of the skin’s surface – is protected through a cooling device on the Titan handpiece. Each treatment will work to tighten existing collagen and promote new collagen growth. The result is a firmer, fresher look. 
Does Total Tightening work for the neck area?
Dr. Perkins: Yes! ReFirme is safe and effective and can treat a number of areas including the face, abdomen, upper arms, knees, and neck. With Titan, we have seen exceptionally good results on the jawline, under the chin / neck area, and the abdomen. So using Total Tightening to firm up the neck area is definitely an option. 
How many Total Tightening treatments are needed? 
Dr. Perkins: We typically recommend four treatments and many clients see results after just one treatment. Results are cumulative so we urge people to continue with their series even if they are seeing results after the first session.

Are the Total Tightening treatments painful and is there downtime after the treatment?
Dr. Perkins: Most clients consider it comfortable and a topical numbing cream is usually not needed, but available for someone who is more sensitive. There may be some redness or swelling directly after the treatment that usually subsides within a few hours. Otherwise there is no downtime.

Who is a good candidate for Total Tightening?
Dr. Perkins: Total Tightening is good for those who have minimal looseness in the neck area. The new collagen that is stimulated from this treatment not only lends itself to tightening of the area, but will also create smoother skin. Clients are very happy with this result.

“Before” and “After”
Neck Lift Surgery by Dr. Perkins

How is Neck Lift surgery done?
Dr. Perkins: Incisions are made behind the ears and a small incision is made under the chin. Then I tie the muscles to create a sling effect to better support the neck area and a suspension suture may be used to give more long-lasting support. If necessary, excess skin will be removed. This is a surgical procedure so the patient will have a combination of local anesthesia, oral and intravenous sedation to provide relaxation and lack of awareness throughout the procedure. General anesthesia is not used. There is downtime for this procedure. People usually take 7 to 10 days off work for recuperation.

Who is a good candidate for Neck Lift surgery?
Dr. Perkins: In general, a person who has moderate to severe skin laxity in the neck area is a good candidate for Neck Lift surgery. Neck Lift surgery can really redefine the lower half of a person’s face. More definition in the neck and jawline can take years off a person’s appearance.

Any additional advice?
Dr. Perkins: Whether you have neck lift surgery or a skin tightening or no treatment at all, I always remind people that they can help to stave off wrinkles and sagging skin by treating their neck area as they treat their face. The delicate skin needs to be cared for through proper cleansing, moisturizing, and, of course, daily application of an SPF broad spectrum sunscreen.

If your saggy neckline is in need of help, contact Dr. Perkins. Call Cosmetic Surgery Center in Santa Barbara at 805-563-0000 for a consultation

Santa Barbara Neck Lift Surgery by Dr. Perkins

Botox and dermal fillers are a great way to “defy” the aging process on your face but your neck may be giving away your “true” age. Unfortunately our necks are also susceptible to loss of collagen and the effects of gravity, which may leave you with a “turkey waddle” that certainly doesn’t match the rest of your look.

If this is the case, you may want to consider Neck Lift surgery by Santa Barbara cosmetic surgeon Dr. Terry Perkins. When the neck area has succumbed to the aging process, three issues may be involved: sagging skin, muscle banding and local fat accumulation. Dr. Perkins will address each of these problems in order to make the neck contour what it once was. This can be done using incisions behind the ears and a small incision under the chin. If necessary, Dr. Perkins will tie the muscles together to create a “sling effect” for even better support.

Is there anything you can do to stave off aging of the neck? If your neck isn’t quite at the point where a Neck Lift surgery is necessary than consider yourself lucky to be reading this post! Keep your neck area looking young by giving it the same treatment as your face. When you are cleansing, applying moisturizer, antioxidants, serum, or sunscreen, remember to feather it down your neck. Although your neck has fewer oil glands than your face, it is still exposed to the same elements so proper skincare and protection will do it a world of good – and may give you ten more years before a Neck Lift is necessary.

Schedule a cosmetic surgery consultation with Dr. Perkins by calling Cosmetic Surgery Center in Santa Barbara at 805-563-0000.

Santa Barbara Cosmetic Surgery Highlight: Chin Augmentation with Rhinoplasty

When people think of facial cosmetic surgery, they are usually envisioning face lifts and nose jobs (rhinoplasty), not chin augmentation. Perhaps it is because most people believe that a face lift or nose job surgery has the most impact in improving an appearance. While we agree that having a face lift or rhinoplasty can enhance a face, chin augmentation should not be dismissed.

People who are looking to balance their profile by refining their nose (whether it is reducing a bump, defining a bridge, or narrowing the tip) should also consider their chin and it’s overall affect on their profile. In fact, it is the neck, chin, and nose that work together to make an “aesthetically proportionate” face. So if a person has a nose job to reduce a bump and straighten a nose, but they still have a “weak” chin, then the likelihood of reaching the best aesthetic result is less than if they had augmented the chin as well.  Likewise, if the chin is too big, a person’s profile can also be disproportionate. 
How can a chin be augmented? For a “weak” chin, a small implant can be added that fits the point of the jaw. Dr. Perkins will use a soft-solid alloplastic implant so that it can be customized to distinctly fit the person it is being used on. The soft silastic material of the implant is well-tolerated, will not leak, and, if desired, can be removed. For a prominent chin, bone or soft tissue can be removed to make it proportionate with the nose and the neck. 
If you decide to have both a chin augmentation and rhinoplasty, it can be done simultaneously. You may save money (one procedure instead of two) and will only have one recovery time.
Schedule an appointment with Santa Barbara cosmetic surgeon Dr. Terry Perkins by calling 805-563-0000. 

Neck Lifts in Santa Barbara: Cosmetic Surgery Highlight

The neck can be a “spoiler” for some people by revealing their “true” age or even making them look older than they really are. While many of us take extra special care of our faces to prevent signs of aging by using Botox or fillers and having routine appointments at Evolutions Medical Spa for Laser Facials and peels, there are not many preventative steps you can take to make your neck look younger, or keep it young. Cleansing, exfoliating, moisturizing, and using sunscreen diligently on the neck area helps, but what can you do when the skin begins to look crepey and/or begins to hang, blurring the line between your jaw and your neckline?

The best answer to that question is to have Neck Lift surgery. By surgically removing extra fat and tightening the skin, a person can regain the neck contour that they once had. Santa Barbara cosmetic surgeon Dr. Terry Perkins performs neck lift surgery by tying the muscles to create a “sling effect” for better support and a suspension suture is often used to give more long-lasting support to the neck area. Incisions are behind the ears and a small one is also placed under the chin.

Dr. Perkins also performs a minimally-invasive neck lift surgery using special support sutures and limited undermining behind the ears. This is a good option for those who are looking for less dramatic results (or who may not need a full neck lift at the time) but the results do not usually last as long. View more before-and-after neck lift surgery pictures on Dr. Perkins’ website.

Actual Patient of Dr. Perkins: Neck Lift Surgery Santa Barbara

For a neck lift surgery consultation with Dr. Perkins, contact his office at 805-563-0000. Cosmetic Surgery Center is located in Santa Barbara, just a few blocks from Cottage Hospital. 

New Facelift Information: How Long Do Facelifts Last?

A facelift in Santa Barbara by cosmetic surgeon Dr. Terry Perkins is an investment. It will take years off your appearance and may halt, or at very least, slow down, your aging process for a number of years. Of course results always vary from person to person and so there is a degree of difficulty involved when a prospective facelift candidate asks the doctor, “How long will my facelift last?”

The good news is there is new information from a study in the December issue of Plastic and Reconstructive Surgery about the longevity of a facelift procedure. The study evaluated the long-term results of 50 facelift patients. The researchers of the study found that “76 percent of patients will still look younger five and a half years after a facelift than they did prior to the facelift”. They further stated that there was “no significant objective or subjective sign of continued aging or ‘relapse’ in any area except for the neck” and that the “vast majority of patients will continue to look better several years after surgery than they did before.”

From the data in the study, it is safe to say that three-quarters of patients who have facelift surgery will see nice, long term results. If you are looking to rejuvenate your appearance with a natural, “non-operated” and rested look, call Dr. Perkins’ office for a cosmetic surgery appointment to discuss your aging face concerns and Santa Barbara facelift options – 805-563-0000.

Cosmetic Surgery in Santa Barbara with Dr. Terry Perkins

Santa Barbara cosmetic surgeon Dr. Terry Perkins has always made education a priority for himself and his patients.  Throughout his practice, Dr. Perkins is continuously researching and implementing the latest surgical techniques and using the most advanced technology.  Along the same lines, he believes in educating his patients so that they feel comfortable and confident in their decision to have plastic surgery and/or non-invasive treatments like Botox or fillers.

During a cosmetic surgery consultation with Dr. Perkins he will ask you what your main concerns are. Dr. Perkins will then offer his opinion about what may best correct the issue. He firmly believes that there is always more than one way to solve a problem, so he will most likely offer a few options and will help you make an educated decision on what would give you the best result.  Dr. Perkins may also offer solutions that extend beyond the operating room. As the founder and Medical Director of a Santa Barbara medical spa, Evolutions, Dr. Perkins may refer a patient to Evolutions for pre-operative care to prepare the skin for surgery and post-operative care to help expedite the healing process.

Dr. Perkins is a specialist in facial rejuvenation cosmetic surgery such as facelifts, rhinoplasty nasal surgery, forehead lifts, eye lift surgery and more.  He also specializes in body sculpting through liposuction and was the first specialist in the Santa Barbara-Ventura area to offer the liposuction surgical procedure.

“Meet” Dr. Perkins in this informative video:

Schedule a cosmetic surgery consultation with Dr. Perkins by calling 805-563-0000.

Rhinoplasty Nose Surgery in Santa Barbara: Cosmetic Surgery Highlight

Rhinoplasty (nasal surgery) is one of the most popular cosmetic surgeries done.  Rhinoplasty can dramatically change the appearance of the face (from a frontal view as well as the profile) and can change the function of the nose. People seek rhinoplasty for various reasons: to refine a bulbous tip, narrow a wide now, straighten a crooked nose, and/or remove an unwanted bump. If necessary, Dr. Perkins can also correct obstructive airway problems, such as a deviated septum or bone spurs, at the same time.

How is rhinoplasty done?
Nasal surgery can be performed as an open or closed procedure.  The open procedure will leave a small external scar.  At Cosmetic Surgery Center, the majority of surgeries that Dr. Perkins performs are the closed technique which allow incisions to be hidden inside the nose.

What is a good age for rhinoplasty?
Surgery on the nose is best when a person is in their late teens (or older) as the nose has likely finished its growing phase by then.  This leads to a more desirable result.

Is rhinoplasty done under general anesthesia?
A combination of local anesthesia, oral, and intravenous sedation keeps the patient comfortable and unaware.  General anesthesia is not needed.

What happens after a rhinoplasty surgery?
Immediately after surgery there will be minimal pain that is controlled with oral medication.  Some stuffiness is also experienced, similar to a mild cold. There is seldom a need for nasal packing, but an external dressing is in place for the first week.

How much recovery time is there after the nose surgery?
Patients of Dr. Perkins usually return to work at 7 to 10 days post surgery.  Light walking, stationary bicycle and treadmill are allowed after a few days.  Aerobic exercising may be gradually resumed after three weeks.  The majority of the swelling subsides within the first two months, but the final results will take about a year to be fully realized.

See more before-and-after pictures of rhinoplasty nasal surgery patients by on the Cosmetic Surgery Center website.  All pictures are actual patients of Dr. Perkins.


Santa Barbara cosmetic surgeon Terry J. Perkins, MD, specializes in facial cosmetic surgery and liposuction. Contact his office at 805-563-0000. 

Abdominal Liposuction and Tummy Tucks are Slimming and Satisfying

Santa Barbara cosmetic surgeon Dr. Terry Perkins has been performing cosmetic surgery for over 30 years. People see Dr. Perkins for facelifts, rhinoplasty, neck lift surgery, and also for body contouring through liposuction.  Many of those who seek liposuction from Dr. Perkins are women who have had one or more children and cannot shed stubborn stomach and flank fat, regardless of leading a healthy lifestyle and steadily exercising.

For many women, one or more pregnancies can really affect the abdominal area. After the beautiful baby is born, the stretched stomach skin may never return to it’s pre-pregnancy tautness. Additionally, sometimes the abdominal muscles become separated, which can affect the ability to re-firm the stomach area through exercise. It can be very disheartening to shed the pregnancy weight but be left with a pooch that looks like the beginning of another pregnancy!

It is usually at this point that women seek the help of a cosmetic surgeon for abdominal liposuction or a tummy tuck to reclaim the belly they once had.  Abdominolplasty, commonly known as a “tummy tuck”, can address either the full abdomen or the lower abdomen below the belly button. When the full abdomen is treated, an incision is made that is slightly longer than a C-section to allow the doctor to tighten the abdominal muscles and liposuction out excess fat.  The belly button is detached and repositioned and excess skin is removed. The end result is usually more definition of the waist and a flatter, tighter abdomen.  A “mini tummy tuck” involves the lower abdomen where muscle tightening may be done if the excess is limited to below the belly button. Excess skin is removed and this procedure is done with a shorter incision.

Dr. Perkins has observed that his patients who underwent abdominal liposuction and/or a tummy tuck are thrilled with their result. With a flatter stomach and more accentuated waistline, overall body appearance can change dramatically – allowing clothes to fit better – and giving the person a more positive body image. In fact, it’s not only Dr. Perkins’ patients who feel this boost.  The April issue of Plastic and Reconstructive Surgery studied the self-esteem of patients who had cosmetic liposuction and/or tummy tuck surgery. The average age of the patients was 42 and the self-esteem assessment was taken four months after the surgery. Overall, 86% reported an improved sense of self-esteem post procedure and about 70% reported improved quality of life. So it seems that women who get abdominal surgery end up with a slimmer waist and a more satisfied sense of self.  Not a bad deal!

If you are interested in scheduling an abdominal liposuction and/or a tummy tuck consultation, contact Dr. Perkins at 805-563-0000.

Getting Rid of Excess Skin After Pregnancy or Weight Loss

Santa Barbara cosmetic surgeon, Dr. Terry Perkins, gets lots of inquiries about how to tighten skin after pregnancy or a significant weight loss.  While there are lots of claims on the internet that certain lotions and potions can “firm and tighten”, the reality is that most of these products don’t offer the results that people are truly seeking.

Excessive weight gain, whether it is through pregnancy or accumulated over the years, can significantly stretch the skin. Once the weight is lost (or the baby is born and the rest of the pregnancy weight is shed), the skin may not be as taut as it once was.  The best way to get rid of excess, sagging skin is through surgery.  Skin excision surgery is common and may be done in combination with liposuction.

Removing excess skin can be done in many places on the body:

Arm Lift and Arm Liposuction: Many people (even those who have not gained extra weight) suffer from excess skin in the upper arms (“bat wings”).  If fat is the main issue, liposuction can be done and the skin may contract without the need for skin removal.  For those with too much loose skin, removal is done so that the scar is placed inside the arm (against the body), above the elbow, so it is not visible from the front or back. If there is only a small amount of loose skin, the skin removal can often be confined to or near the armpit.

Abdomen Surgery / Tummy Tuck: Dr. Perkins can remove skin in the abdominal area in a “mini tummy tuck” procedure.  The incision is done at the upper edge of the pubic hair line so it can be hidden. If need be, the incision can be extended far to the sides (a “tummy tuck”) to avoid a “dog ear” pooch of the skin and the abdominal muscles are sewn together to further flatten the lower abdomen.

Leg Liposuction / Thigh Lift: Loose skin on the legs most often occurs in the inner thigh area. Liposuction can be done to remove any excess fat (as the inner thigh can be a “trouble” spot and some may prefer to have liposuction along with skin removal) and the skin removal is done through incisions in the groin and upper thigh area that can be hidden with underwear or a bathing suit.

Getting rid of excess skin is a great way to give a person a new shape – or re-store an old one!

Make an appointment to see Dr. Perkins in Santa Barbara at Cosmetic Surgery Center by calling 805.563.0000.