Do your lips make you look old? [Ricardo Rodriguez, MD, Baltimore]

Eva Sheie (00:00):
My guest today is Ricardo Rodriguez, and I understand that you're both a plastic surgeon, a professional wrestler, and a professional soccer player. Is that correct?

Dr. Rodriguez (00:11):
No. No, only a plastic surgeon.

Eva Sheie (00:15):
Alright, so

Dr. Rodriguez (00:15):
I did wrestle in high school.

Eva Sheie (00:17):
Oh, you did? Okay. Little known fact about you already. Is there something procedure wise or treatment wise that you're known for now that you've been there in Baltimore area for a while?

Dr. Rodriguez (00:32):
Yeah, there's two or three things that sort of stand out in my practice now. One is lip lifting. I started doing lip lifts in 2002, and it seems like it should be an easy procedure, but there's a lot of subtleties into it. And then there's also understanding the whys and the hows of it. There's been many interesting studies looking at what they call eye saccades, which is how the eyes look at a face or look at anything really. And the eyes really shift back and forth very quickly to create an image. And they've tracked how following those eye movements, how people look at faces. And as it turns out, what they're looking at is this inverted triangle that goes from the eyes, if that were the base of the triangle to the mouth, if that was the apex of the triangle. And that's really where people focus at when they're looking at you, which is really funny because when people go to the plastic surgeon and they want a facelift or something, they're looking at their jowls and the neckline and other people don't really look at that.

Dr. Rodriguez (01:50):
A very common thing I do with my patients is after I'm explaining all these same things I'm talking about with you, and then I'll put my hand over my chin and I'll ask him, do I have lines in my neck? And I clearly do. You can see them here, but nobody in 15 years has been able to tell me if I have lines in my neck. And then I'll cover my eyes and I'll say, you know, what color are my eyes? And you can see on the camera, I have narrow slits for eyes and that they all say brown. So they know right away. And the reason is that when we're looking at a face, we're trying to communicate and we're looking at the two things that matter a lot, the eyes. We want to see if they're sincere or whatever. And then we're also looking at the mouth.

Dr. Rodriguez (02:33):
What are they saying? We use it as a cue. And so that forms my whole approach to the rejuvenation of the face. Those are the areas I focus on rather than the neck and the jowls and all of that. I'll do the same thing and doing with you. And they answer and they say, so what do you want me to fix now? And of course, then their focus changes. But anyways, what happens with the mouth is that it's a round muscle that surrounds the mouth and a sphincter really. And with age, with talking, gesticulating, chewing, whatever, that circular sling underneath the nose sort of gets stretched and it goes down and to the side. So the mouth, the lip looks longer and wider. And so that was one of the first things I started noticing when I started doing lip lifts was that the people look younger, even though the procedure was so small.

Dr. Rodriguez (03:33):
And it's because it's one of those key areas that people are always looking at. And most people that are doing the lip lifts, now they're lifting in a straight vertical vector because it's a lip lift. But really to get the complete rejuvenation, you have to also centralize a lip lift. And so I do it not only lifting, but bringing it more towards the middle. So that makes the lip less wide. And on top of that, the upper lip acquires a better relation to the lower lip than regular people, because most people, as they age, the upper lip will tend to look wider than the lower lip. And so by centralizing those, it gives the lip also more of a sense of volume. It tends to look flatter as you get older. So anyways, the procedure has a little scar underneath the nose, which although it's visible, it's not perceptible and there's a difference, right?

Dr. Rodriguez (04:39):
So you might see it or it might show on a photograph, but when somebody's looking at it, they're not perceiving it because it is a natural boundary. And people don't tend to notice natural boundary lines. So the scar tends to be very well hidden even though it's right in the middle of the face. So that's something that people don't quite appreciate and they're fearful. And many surgeons are fearful of doing the procedure because of that scar. And the final thing that's important in the lip lift is that you have to tie it to something stable because the structures of the nose also move. So if you do a lip lift and you're just tying it superficially to the skin of the nose, it'll move the nose. And so some people, when they get a lip lift, they'll say, oh, my nose got longer, or my nostrils got wider. And it's because of the pulling effect of the skin of the shortened lip because it still has to do the same things it did before. So I anchor my lip repair to deeper structures on the nose and to the septum. You could say, oh, this is talk, and every surgeon will say, this is talk. But the best thing I going for me is I get very good reviews on RealSelf, and I am not asking for those people are just putting them up spontaneously. So that's where I get a lot of my referrals.

Eva Sheie (06:08):
Interesting. If we're listening today and want to find out more about you, your website is cosmeticsurg.net. Is there an Instagram? Is there somewhere else you can point us?

Dr. Rodriguez (06:19):
Yeah, there's an Instagram cosmeticsurg. I'm not that active on it, I used to be. I'm not that active now. It's the website. But the best thing is experiencing the whole office from the office staff to me and all of that.

Eva Sheie (06:34):
On this podcast, we bring you directly to the doctors who are where before meets after Links to our guest's website and contact info are in your show notes. Follow us on Instagram @wherebeforemeetsafter. If you're a board certified plastic surgeon and would like to be a guest or a sponsor of the show, go to wherebeforemeetsafter.com for more information. Where Before Meets After is a production of The Axis, the podcast agency for Aesthetics, theaxis.io.