By Kenneth D. Steinsapir, M.D.
This week plastic surgery speculation before and after pictures of Renee Zellweger are everywhere on the Internet with headlines like: “Renee Zellweger is now completely unrecognizable.” I must say that this is not breathy hyperbole. Renee’s cosmetic services have wrecked her brand. Unfortunately, for almost all of our actresses this risk is very real. In an effort to maintain relevance, they are just one bad surgery away from being forced to retire from their screen presence. Examples abound: Jennifer Gray and her rhinoplasty and Meg Ryan and her catastrophic facial surgery. The reality is that for actors, so much of the brand is the recognizable face.
Colleagues in the press have speculated what she may have done. To my eye it is all too clear. First she has had a bad upper blepharoplasty. Before this surgery she had a beautifully natural full sub-brow area. Her surgery removed all of this tissue. This heavy and essential fold stimulated her frontalis muscle of the forehead to lift her eyebrows. With this tissue removed, the eyebrows relax reducing the space between the eyebrows and the eye lashes. This is made worse by the use of Botox in the forehead creating a flat, atrophic forehead (I am so Marcia Crossed over this look). This is the most dramatic change. Let me stress, that is it not necessary to have a such a dreadful upper blepharoplasty. The essence of eyelid surgery is that less is more.
Before Plastic Surgery
Before surgery she had a very well defined lower eyelid with a natural orbicularis roll. This area of fullness in the lower eyelid has been removed by eyelid surgery. Although she had a very good lower eyelid surgery, this procedure was entirely not needed and has effaced important lower eyelid volume just below the lower eyelid lashes that provided character.
Perhaps the biggest change is the effect of fillers in the lower cheek. Before surgery, Renee had a heart shapes face that was full just below the pupils. Cheek fillers have radically changed the shape of her cheek. Her low cheek mass has been tripled in size. While this might be great for her surgeon’s pocketbook, the low volume has shifted the center of gravity of the cheek and rob the face of its heart shape. This is what Jonathan Van Meter called the “New New Face.”
My Message to Ms. Zellweger
Here is my message to Ms. Zellweger and to anyone out there with this misfortune: There is help. For Ms. Zellweger, the key is restoring the shape and volume of the face. Remarkably this can be done with nonsurgical methods. The first step is removing the hyaluronic acid filler in her cheeks. This can be done using the enzyme hyaluronidase which causes immediate breakdown of the ridiculous low cheek volume that is distorting her face. Within days, she will have the lower half of her face back. For the forehead, the current botulinum toxin treatment makes her look locked in. Nothing is moving up there. This is completely unnatural and the treatment totally flattens her brow. I would initially superimpose my patented microdroplet botulinum toxin forehead lift that places microdroplets of botulinum toxin treatment along the eyebrows and leaves the forehead untreated. Initially there will be slight lift but as the old treatment wears off, the effect of the new treatment will reshape and lift the eyebrows. The next challenge is addressing the horrible blepharoplasty result. Was the surgery bad? In fairness, it is just mediocre. Unfortunately it happens to fall on the face of one of our formally most recognizable actors. Restoring the wonderful sub-brow fullness is just never going to happen. However, Restylane, a hyaluronic acid filler can be used to revolumize the upper eyelid folds. This would completely restore them, but it will make a profound difference and solidly help her together with the BOTOX microdroplet forehead lift to look much more like her old self. The filler can also be used at the top of the cheek to restore the changes from the lower eyelid surgery as well. The filler services will last on the order of 10 to 12 months, possibly longer. Botulinum toxin treatment will last about 4 to 6 months for most. The good news is that these are office services that can be comfortably performed with minimal downtime.
There is hope and help for Ms. Zellweger. Using nonsurgical methods, it is possible to restore her face to what it was like 10 years ago. This is a good example of what Nora Ephron understood in her essay “I Feel Bad About My Neck.” Just because a surgeon is famous does not mean they know what you need aesthetically. Ageless beauty is much better than age indeterminate beauty. There is help for these types of situations. That is what I do in my practice everyday.
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
To learn more about procedures and treatments performed by Plastic Surgeon, Dr. Kenneth Steinsapir, contact us at 310-274-7422.