u/AvivaPlasticSurgery

A lot of people think prominent ears are a “small thing.”
But for the person living with them, they often shape self-image for years. Many of my patients, both children and adults, describe a history of teasing or self-consciousness around their ears.

This 24-year-old woman came to see me because she had long felt bothered by the projection and shape of her ears. She wanted them to appear softer, less prominent, and more balanced—without looking pinned back or surgically “done.”

I treated her with bilateral/ both-sided otoplasty to reshape and reposition her ears into a more natural position relative to her face. My patient had her surgery in the comfort of my office, awake and relaxed with the help of by-mouth relaxing medications, and with injected numbing medicine. She is shown here 5 months after surgery, with a softer contour and improved facial harmony, while still looking entirely like herself.

For many patients, otoplasty is less about dramatic change and more about quiet relief—wearing hair up comfortably, not thinking about ear position in photos, or simply feeling more at ease.

I see otoplasty one of the more underappreciated procedures in facial plastic surgery. When done thoughtfully and conservatively, the impact is significant—not because people notice the ears, but because they stop noticing them.

I welcome your questions!

A lot of people think prominent ears are a “small thing.”
But for the person living with them, they often shape self-image for years. Many of my patients, both children and adults, describe a history of teasing or self-consciousness around their ears.

This 24-year-old woman came to see me because she had long felt bothered by the projection and shape of her ears. She wanted them to appear softer, less prominent, and more balanced—without looking pinned back or surgically “done.”

I treated her with bilateral/ both-sided otoplasty to reshape and reposition her ears into a more natural position relative to her face. My patient had her surgery in the comfort of my office, awake and relaxed with the help of by-mouth relaxing medications, and with injected numbing medicine. She is shown here 5 months after surgery, with a softer contour and improved facial harmony, while still looking entirely like herself.

For many patients, otoplasty is less about dramatic change and more about quiet relief—wearing hair up comfortably, not thinking about ear position in photos, or simply feeling more at ease.

I see otoplasty one of the more underappreciated procedures in facial plastic surgery. When done thoughtfully and conservatively, the impact is significant—not because people notice the ears, but because they stop noticing them.

I welcome your questions!

A lot of people think prominent ears are a “small thing.”
But for the person living with them, they often shape self-image for years. Many of my patients, both children and adults, describe a history of teasing or self-consciousness around their ears.

This 24-year-old woman came to see me because she had long felt bothered by the projection and shape of her ears. She wanted them to appear softer, less prominent, and more balanced—without looking pinned back or surgically “done.”

I treated her with bilateral/ both-sided otoplasty to reshape and reposition her ears into a more natural position relative to her face. My patient had her surgery in the comfort of my office, awake and relaxed with the help of by-mouth relaxing medications, and with injected numbing medicine. She is shown here 5 months after surgery, with a softer contour and improved facial harmony, while still looking entirely like herself.

For many patients, otoplasty is less about dramatic change and more about quiet relief—wearing hair up comfortably, not thinking about ear position in photos, or simply feeling more at ease.

I see otoplasty one of the more underappreciated procedures in facial plastic surgery. When done thoughtfully and conservatively, the impact is significant—not because people notice the ears, but because they stop noticing them.

I welcome your questions!

This patient came to see me because she had always felt her upper lip was “too long” and that it hid too much of her smile. She wanted a brighter, more balanced appearance without looking overfilled or unnatural.

Instead of adding more volume, I performed a conservative surgical upper lip lift (“bullhorn” lip lift). The procedure shortens the philtrum, or distance between the nose and upper lip, allowing more of the pink lip to show and improving upper tooth show with smiling.

One thing I think is important to understand about lip lifts is that they are really a structural procedure, not just a “bigger lips” procedure. In the right patient, they can:

• improve smile balance
• reduce an elongated upper lip appearance
• create better harmony between upper and lower lip
• enhance lip shape without relying on filler

This patient is shown 7 months after surgery. Her scar has healed beautifully and sits discreetly along the natural contours beneath the nose. The goal was never to make her look “done” — only more refreshed and balanced.

I think lip lifts are one of the most powerful but also most misunderstood procedures in facial plastic surgery. In the wrong patient, they can look exaggerated very quickly. But in carefully selected patients with a long philtrum and limited upper tooth show, the change can be subtle, elegant, and incredibly impactful.

I welcome your questions and comments!

-Inessa Fishman, MD.

This patient came to see me because she had always felt her upper lip was “too long” and that it hid too much of her smile. She wanted a brighter, more balanced appearance without looking overfilled or unnatural.

Instead of adding more volume, I performed a conservative surgical upper lip lift (“bullhorn” lip lift). The procedure shortens the philtrum, or distance between the nose and upper lip, allowing more of the pink lip to show and improving upper tooth show with smiling.

One thing I think is important to understand about lip lifts is that they are really a structural procedure, not just a “bigger lips” procedure. In the right patient, they can:

• improve smile balance
• reduce an elongated upper lip appearance
• create better harmony between upper and lower lip
• enhance lip shape without relying on filler

This patient is shown 7 months after surgery. Her scar has healed beautifully and sits discreetly along the natural contours beneath the nose. The goal was never to make her look “done” — only more refreshed and balanced.

I think lip lifts are one of the most powerful but also most misunderstood procedures in facial plastic surgery. In the wrong patient, they can look exaggerated very quickly. But in carefully selected patients with a long philtrum and limited upper tooth show, the change can be subtle, elegant, and incredibly impactful.

I welcome your questions and comments!

-Inessa Fishman, MD.