When movie stars, rockstars, models, playboy playmates, and politicians need plastic surgery, one top surgeon that is often requested is Dr. Frank Ryan. Most recently, Dr. Ryan was in the news for performing a couple cosmetic surgery makeover on KISS lead singer Gene Simmons and his wife Shannon Tweed and having the surgery filmed for their TV reality show “Family Jewels”. Dr. Ryan also helped America’s Next Top Model winner Adrienne Curry get a breast augmentation to fix her breast asymmetry, as well as scores of other celebrities such as Janice Dickinson and Motley Crue lead singer Vince Neil. Make Me Heal spoke with Dr. Ryan, who offered a rare glimpse into the celebrity plastic surgery world and why stars get plastic surgery, as well as share with us his views on the best techniques for breast augmentation, what injection fillers work best, and how he performs his trademark facelift.
Make Me Heal: You seem to be the plastic surgeon of choice for hard rock stars like Gene Simmons of Kiss and Vince Neil of Motley Crue. Why do you think rock stars and other celebrities come to you?
Dr. Ryan: The real “insiders” in the entertainment industry know who’s who in the field of plastic surgery. These celebrities, agents, manager and publicists can all identify Los Angeles’ best doctors, dentists, trainers, hairstylists, etc. In my particular case, it has been word-of-mouth among this Hollywood crowd that has generated my following. Since I have been performing surgery on patients from the entertainment industry for almost fifteen years now, positive word-of-mouth has led me to become known as one of the “go-to” guys in Hollywood.
Interestingly, these celebrities are typically not particularly impressed when a plastic surgeon is featured on television or in a magazine. Since these celebrities all have publicists themselves, they know that all it takes for someone to appear on television or in a magazine is a good publicist. Therefore, they rely strongly on word-of-mouth from people they trust.
Make Me Heal: In your opinion, what is the primary reason celebrities make that decision to go under the knife?
Dr. Ryan: Because we as a society are so youth and beauty conscious, people feel compelled to undergo plastic surgery. Since celebrities make their living off their looks, they are under even more pressure to look good. There have been hundreds and hundreds of unflattering tabloid photos of celebrities over the years where the caption reads, “What happened to [fill in the blank]?” Usually, the photos just demonstrate the typical signs of aging, such as a sagging neck or love handles. In other words, it’s apparently OK for the readers of the tabloids to have sagging necks and love handles, but the celebrities shouldn’t!
Since my practice is made up largely of celebrities, my patients are under more of a microscope than the patients of most other plastic surgeons. Unlike patients from Extreme Makeover or The Swan, who go back to their hometowns after their makeovers, never to be heard from again, my patients are constantly being photographed throughout their lives. In many cases, the celebrities are caught in a position that is less than flattering. For example, Janice Dickinson once had me inject her lips with Restylane just moments before she was about to tape a segment for her reality show, The Janice Dickinson Modeling Agency. That same day, she went on to tape Entertainment Tonight followed by an episode of America’s Next Top Model, all with bruised swollen lips! To make matters worse, she – being Janice — made a face to a paparazzo later that day where she stuck her lips out at him, making her already-swollen lips look simply enormous! Of course, that photo ended up in The Globe with the caption under the photo describing how Janice has really gone way overboard with her new, grotesquely-enlarged lips.
In reality, of course, once the swelling went down, Janice’s lips looked incredible, but the damage was already done: countless photographs of Janice with enormous lips began circulating in the press and on the Internet.
In my experience, another group that is undergoing cosmetic surgery is politicians. However, politics is probably one of the last fields where cosmetic surgery is kept under wraps – unless you include in that category Mary Carey, the adult film actress who ran against Arnold for California governor a few years ago!
Make Me Heal: Can you tell us more about Gene Simmons and Shannon Tweed’s surgeries? What did they have done and why they decided to have it done?
Dr. Ryan: Gene Simmons, like many people in the public eye, is scrutinized more than the average person. That is part of the deal when you are a rock icon.
Also, since Kiss’ music appeals to people of all ages, thousands of Gene’s fans weren’t even born when Kiss started out in the 1970’s. These younger fans can more easily relate to their rock star heroes if they look young and fit.
Gene underwent multiple facial procedures, including a facelift, forehead lift, eyelid surgery and fat injections. Anatomically, Gene was a very difficult surgical candidate, with very thick skin, very heavy jowls and extremely deep laugh lines (nasolabial folds). Gene also underwent liposuction of the chest, abdomen and flanks. Liposuction of the male chest is actually much more common than people realize. Many men tend to deposit fat in the chest area, as well as the abdomen and flanks, so liposuction in men over 35 or 40 often includes the abdomen, flanks and chest.
Shannon underwent multiple facial procedures as well, including a facelift, rhinoplasty, fillers and laser resurfacing.
Make Me Heal: How many surgeries did you perform on Vince Neil? Is he happy with the results?
Dr. Ryan: Motley Crue’s Vince Neil underwent a forehead lift, eyelid surgery, facelift, cheek augmentation, rhinoplasty and laser resurfacing. Vince is ecstatic with the results, since he just looks like a refreshed, slightly younger version of himself. Like many of my male patients, they do not want to look too pulled or too artificial, like several other male celebrities who have undergone facial surgery.
Make Me Heal: What about Heidi Montag? Rumors say you reshaped her nose and improved her breast appearance. Can you confirm?
Dr. Ryan: Heidi has neither confirmed nor denied that she has had plastic surgery.
Make Me Heal: Name celebrities that you think had great breast augmentations and celebrities that you think had bad breast augmentations?
Dr. Ryan: No comment…(smile).
Make Me Heal: As a doctor who’s been practicing for over 20 years, what are the major innovations in plastic surgery that you have seen? Is your technique different today than say a decade ago?
Dr. Ryan: The biggest change that I have seen in plastic surgery over the years is the trend for more minimally-invasive procedures, along with the tremendous rise in popularity of injectables, such as BOTOX. The sheer number of fillers out there now is amazing, especially since collagen-based fillers were the only game in town for many years.
The use of lasers in plastic surgery has exploded over the past fifteen years. Although we have been treating fine lines and wrinkles, acne scars, broken blood vessels, brown spots and tattoos for quite some time now, lasers are being used for new applications every day. The skin-tightening lasers are one example. Although these lasers have a somewhat spotty track record so far, I feel that they will become more and more popular as the technology is perfected.
In terms of breast augmentation, the biggest development I have seen in the last fifteen years is the November 2006 FDA approval of silicone gel breast implants. Although saline implants are certainly acceptable, both patients and surgeons have been clamoring for the approval of silicone implants for the past fifteen years.
Another trend in breast augmentation is a trend toward bigger and bigger implants. Fifteen years ago, the average patient rarely requested a D cup. Today, a full C cup or small D cup is the most requested size.
Make Me Heal: You have an extensive experience in breast augmentations. Have you started using silicone implants since the FDA approved their use?
Dr. Ryan: Since November 2006, I have not used a single saline implant. During the consultation process, I explain everything to the patient in great detail and give her the option of saline or silicone, but everyone seems to be opting for silicone.
Make Me Heal: Do you think silicone implants present any health risks if the implant ruptured and silicone leaked to other parts of the body?
Dr. Ryan: In 1992, a moratorium was placed on the use of silicone implants for cosmetic purposes. At that time, there was speculation in some circles that silicone implants could be linked to autoimmune diseases like lupus and scleroderma. However, after 15 years of extensive scientific research, absolutely no link was found, clearing the way for the FDA to re-approve the devices for widespread use.
Make Me Heal: If you do not believe that there are any safety downsides to using silicone implants, are there any remaining advantages to getting saline implants now that the FDA approved silicone implants?
Dr. Ryan: I personally feel that silicone implants are preferable for almost all patients. In fact, I can’t think of many – if any – scenarios where I would recommend saline over silicone. However, I ultimately give my patients the choice of saline or silicone after I give them an exhaustive overview of the pros and cons of each type of implant.
Make Me Heal: Do you feel silicone implants look aesthetically better and more natural relative to saline implants?
Dr. Ryan: Most people would agree that silicone gel breast implants look and feel more natural than saline. I think there is very little debate about this.
Make Me Heal: Do silicone implants feel more “real” to the touch compared to saline implants?
Dr. Ryan: Yes!
Make Me Heal: What is your most favored technique for performing a breast augmentation (discuss incision type, i.e. areola, armpit, transumbilical, implant placement over/under muscle, etc.)? Is there a particular incision that is likely to carry the risk of loss of nipple sensation?
Dr. Ryan: In my practice, the peri-areolar incision (around the nipple) is the most commonly-requested incision, followed closely by the inframammary (under the breast) incision. I rarely use the trans-axillary (underarm) approach, because it can be difficult to place the implants in the proper position. Quite often, when a patient comes to see me and tells me that her implants were placed too high, they were almost always placed via the trans-axillary approach.
The trans-umbilical approach never really caught on with mainstream plastic surgeons. In many cases, the technique was used simply as a marketing tool by many plastic surgeons who would say to patients, “You don’t want a scar on your breast, do you? If not, then we should put the implants in through the belly-button.” With the recent approval of silicone gel implants, the trans-umbilical approach will probably fade from the scene. That’s because only saline – not silicone — implants can be placed through such a tiny incision so far away from the breast. Since saline implants are inflated only after they are placed through the incision, they can be placed through a smaller incision. Silicone implants, on the other hand, are pre-filled, so a larger incision must be used and it is simply impossible to get a silicone implant through a tiny umbilical incision.
I personally prefer to place the implants under the muscle (subpectoral), when possible. This usually results in a more natural result, makes mammography easier and may lower the risk of scar tissue formation (capsular contracture).
In terms of nipple sensation, I tell my patients that although it is possible that they may lose some sensation, it is highly unlikely. Surprisingly, the choice of incision doesn’t make a difference, although most patients assume that the peri-areolar incision is more likely to result in decreased sensation. The cause of decreased nipple sensation is damage to the nerve deep inside the breast, as the nerve comes off the ribs. Therefore, it doesn’t matter if the incision is peri-areolar, inframammary or trans-axillary, the nerve is equally at risk with all three incisions.
Make Me Heal: What recovery products do you suggest to use following a breast augmentation (i.e. compression garments, Arnica Montana, Bromelain, Silicone scar cream, Cold/Hot Compress)?
Dr. Ryan: Every surgeon has his or her own postoperative routine. For example, following breast augmentation, my patients are placed in a surgical bra. Some surgeons tell their patients specifically to not wear a bra. My patients are also given homeopathic remedies that help diminish the bruising and swelling and they are given post-surgical multi-vitamins. They are also given silicone gel ointment that helps minimize scarring.
Make Me Heal: You have pioneered a face lift technique that you call the “Ribbon Lift”. Please describe the goals of this technique, as well as how the Ribbon Lift is performed as far as incisions, anesthesia, how the fat is harvested, and other technical details.
Dr. Ryan: The Ribbon Lift is a procedure that is in keeping with the trend for minimal procedures and minimal downtime. The Ribbon Lift involves making a small, one inch incision under the sideburn. Through this incision, the small, dissolvable ribbon device is inserted and slid down to the jowl region. Miniscule soft spikes on one end of the ribbon are pressed gently onto the jowl tissue. When the ribbon is pulled up toward the sideburn, the jowls are pulled up with the ribbon. The other end of the ribbon is sewed to the tissue above the sideburn and a few stitches are placed in the skin incision. The procedure takes 30 to 45 minutes, is performed under local anesthesia, and is associated with minimal recovery. The ribbon dissolves after several weeks. The skin stitches are removed in a week.
Make Me Heal: What is the ideal profile of a candidate for the Ribbon Lift (please discuss age range, facial structures, degree of sagging, etc.)?
Dr. Ryan: The Ribbon Lift can be used in patients of all ages. It is perfect for young people, who have a small amount of facial laxity, but it is also perfect for older people with more significant laxity, but who don’t want a facelift. I find the Ribbon Lift especially helpful for patients with heavy jowls who need more help with the jowls than a conventional facelift has to offer. The ribbon provides an extra edge that these patients with stubborn jowls need in order to achieve a smooth jaw line.
Make Me Heal: How long the results should last? Should a patient return for a second face lift after a certain number of years have passed?
Dr. Ryan: Many people confuse the Ribbon Lift with other techniques like the thread lift. However, they couldn’t be more different – they just share a similar name. The ribbon lift is based on well-established surgical principles and the benefits of the procedure should last several years. It is best for people who have stubborn jowling that don’t want a full facelift. Because the Ribbon Lift is based on sound surgical principles, it should last for several years, not unlike a mini-facelift. Since the aging process continues after surgery, patient who want to maintain their looks often return for a secondary facelift seven or more years after the first facelift.
Make Me Heal: What procedures (i.e. brow lift, blepharoplasty) do you often combine with a facelift? When naming a procedure please explain which issues the procedure addresses.
Dr. Ryan: I rarely perform a facelift by itself, since all parts of the face undergo the aging process simultaneously, including the eyes, forehead, cheeks, lips, nose, chin, neck and ears. I have been doing what I call comprehensive facial rejuvenation since I went into practice in 1993. Comprehensive facial rejuvenation refers to a combination of procedures that rejuvenate the entire face, instead of a more piecemeal rejuvenation. For example, in Gene and Shannon’s case, I addressed the forehead, upper eyelids, lower eyelids, cheeks, nose, chin, lower face and neck all at the same time. To improve the skin, I did a chemical peel for Gene and a light laser resurfacing for Shannon.
Make Me Heal: You have an extensive experience in Fillers. Do you have a preference for say Botox over Restylane, or Perlane or Juvederm? Please describe which filler is best for a particular issue. Which one do you think is better as far as results achieved with your patients?
Dr. Ryan: When it comes to fillers, I feel that a multifaceted approach is the way to go. I will often do BOTOX for the forehead lines, frown lines and crow’s feet, for the rabbit lines of the nose, for the down-turned corners of the mouth and for dimpling of the chin. I also sometimes use BOTOX for the smoker’s lines of the upper lip and for the cords of the neck. I frequently perform a “BOTOX Browlift”, where the BOTOX is injected in such a way that the eyebrows are raised, simulating a browlift.
The filler I use most commonly is Juvederm, which is virtually identical to the other hyaluronic-based filler, Restylane. I use Juvederm for any area on the face that needs to be filled. The groove under the lower eyelids (the nasojugal groove), the smile lines (the nasolabial folds), the lips, the marionette lines and the groove that is just lateral to the chin (the labiomandibular groove) are areas that I commonly filled with Juvederm. Juvederm can be used to augment the chin, the jaw line, the cheeks, the cheek hollow, the temporal hollow and anywhere else that needs volume. I also use Radiesse quite a bit and have started using Arte-Fill, recently approved by the FDA, as well.
I tend to use another filler, Sculptra, for large surface areas, like the cheeks and the hollow below the cheeks, especially in very in thin individuals who do not have any fat to harvest.
Other fillers that I commonly use are Cosmoplast and Cosmoderm, which are derived from human collagen. These fillers have been on the market for several years already.
In general, I feel that there is a role for all of these filers and I use every one of them, depending on the situation. There is no perfect filler, and each one has its plusses and minuses.
Make Me Heal: At the Bony Pony Ranch, you remove tattoos from gang members to help them leave gangs and their world of violence. Can you tell us more about this particular foundation?
Dr. Ryan: I started my nonprofit Bony Pony Ranch Foundation in 1993 when I was doing my aesthetic surgery fellowship at UCLA. I began my nonprofit work at UCLA by removing gang-related tattoos. Since that time, I have removed thousands of tattoos. In 2001, I expanded my activities and began taking groups of inner-city kids up to the Ranch for equestrian therapy, mentoring, athletic activities and art activities and, most importantly for a good old-fashioned day of fun in the country. While at the Ranch, the kids get to interact with horses, mini-horses, mini-donkeys, buffalo, longhorn steer, potbellied pigs, pygmy goats, alpacas, dogs, cats and an ostrich.
Bony Pony Ranch Foundation honorary board members include Eva Longoria, Oscar de la Hoya, Nicolette Sheridan, Renee Zellweger and many, many more.
Dr. Frank Ryan is Board Certified by the American Board of Plastic Surgery. He graduated from the University of Michigan in 1982 and from the Ohio State University College of Medicine in 1986. He then completed eight years of post-graduate surgical training at Cedars- Sinai Medical Center, the University of Missouri and UCLA Medical Center. Dr. Ryan has also participated in numerous fellowships, the first of which was a burn reconstruction fellowship at Shriners Hospital for Children. In 1990, he completed a UCLA Division of Plastic Surgery Research Fellowship that focused exclusively on breast augmentation. While at the UCLA Medical Center, Dr. Ryan was chosen for the UCLA Division of Plastic Surgery’s Aesthetic Fellowship. He is one of only three people in the world to have completed this prestigious fellowship.
Beverly Hills California CA Breast Surgeon, Dr. Frank H. Ryan, achieves artistic excellence in his practice of Breast Augmentation, Breast Implants, Breast Enhancement and Breast Reduction surgery! You will be pleased to know that breast augmentation and breast implants are primary procedures performed in the Beverly Hills California CA practice of Dr. Frank H. Ryan.
Visit Dr. Frank Ryan’s website at: www.drfrankryan.com
The Bony Pony Ranch Foundation
Founded by Dr. Ryan, this non-profit organization helps underprivileged and at-risk youth excel beyond their current situations. The Foundation has created an atmosphere where young people can maximize their talents and achieve new goals in life by being exposed to new role models and mentors who can provide a positive influence. Among the Foundation’s Board Members include Eva Longoria, Madonna, Renee Zellweger, Nicolette Sheridan, Paris Hilton, Heidi Montag, Calista Flockhart, Lisa Ling, and other celebrities.
Visit the Foundation website at: www.bonyponyranch.com
Tags: celebrity, plastic, surgery