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Dr. Richard Fleming, Dr. Toby Mayer listed as top 2 Hollywood plastic surgeons


Dr. Richard Fleming and Dr. Toby Mayer were ranked by thecelebworth.com as the No. 1 and No. 2 plastic surgeons in Hollywood, respectively. Dr. Fleming and Dr. Mayer ranked at the top of the list based on their vast experience performing plastic surgery in Beverly Hills and the surrounding areas. Also factored in to their top rankings is their multiple board certifications and the formal education they received.

The Beverly Hills Institute of Aesthetic and Reconstructive Surgery is proud to have its two board certified plastic surgeons listed not only among Beverly Hills’ elite plastic surgeons, but at the top of the list. Below is the excerpt from thecelebworth.com for both Dr. Fleming and Dr. Mayer.

Improving the Fiveheads


In this forum we frequently talk about beauty and facial proportions first described by Da Vinci. The frontal hairline, which helps to frame the face in both men and women, will influence facial balance. In men we are all aware of the common problem of male pattern baldness and the medical and surgical alternatives to treat this condition.

The majority of women have normal forehead height which is 1/3rd of the face. If that is a normal forehead, many years ago the term “fivehead” was coined to describe a bigger forehead. I’ve not heard that term for a long time but recently I’ve seen it twice; tmz.com had a piece on this last month and Tyra Banks is producing an autobiographical comedy called Fiveheads. There are many examples of beautiful women with fiveheads such as Beyonce, Vanessa Williams, and Angelina Jolie but many women do not like this feature which is distracting and will limit their hair styles. That is why we continue to see women from all over the world to have our hairline lowering procedure, which we described many years ago.

In this technique we lower the hairline and shorten the forehead , bury hair follicles which produce hair that will grow through and in front of the incision so it will not be seen after healing is complete.

We thank TMZ and Tyra Banks for reminding us about this innovative description of the unwanted physical characteristic of a “Fivehead” which can be eliminated.

16th Annual Hollywood’s Hottest Looks Survey


With the evolution of techniques in aesthetic surgery some things are constant. Patients still look to Hollywood for standards of beauty. Over the years we have kept track of the celebrities patients reference when they describe physical features they admire. The results of our 16th Annual Hollywood’s Hottest Looks Survey will be released this week. You can participate in the survey by going to our Hollywood’s Hottest Looks Survey.

Rejuvenating the Upper-Third of the Face in Aging Patients.



2. CUTTING THE WRINKLE MUSCLES TO PREVENT AND LESSEN WRINKLES WITHOUT BOTOX–The muscles are carefully divided at the same surgery.

3. FOREHEAD LIFTING WITH THE IRREGULAR TRICHOPHYTIC FOREHEAD LIFT–This is a procedure that we developed to raise the brows and feminize and make a younger look WITHOUT removing any hair. The hair grows thru, not behind, the scar.

4l HAIRLINE LOWERING— The hairline can be lowered at the same time depending on the looseness of the scalp. If the scalp is tight, we use the Fleming-Mayer Tissue Expander to lower it up to 1-2 inches.

5. BALDING TREATMENT — men or women with frontal balding can have the Fleming-Mayer Flap to give natural density without texture change to give a full head of hair.

We create a natural, youthful look to a previous sad, tired and angry face. Look at the photos and videos of patients done this way.

Schedule a Consultation today to see if any of these procedure might be right for you.

Fleming-Mayer Melashade Antioxidant Sunblock Featured on Bungalux as Summer Must-Have!


Bungalux declares Fleming-Mayer Melashade SPF 30 a must for summer 2012

The Beverly Hills Institute is turning heads in Hollywood again this year – but this time it’s for products rather than our surgical results. LA-based real-estate, lifestyle, and design-savvy site Bungalux chose our Melashade SPF 30 Antioxidant Sunblock as a must-have item for beaching and playing this summer.

We’re a little biased, but in the skincare room we’ve long loved this sunblock for its matte finish, silk texture, and golden tint. We love it even more for what it’s missing…. no fragrance, no preservatives, no white cast, and no greasy feel. Men and women of any age finally can enjoy putting on their obligatory SPF!

We’re so thrilled to see our favorite product find its way out of the office and onto the beach.

Melashade SPF 30 Antioxidant Sunblock ($50) is available for purchase by calling the office of The Beverly Hills Institute at 800-854-8823.

Hairline Lowering by Dr. Richard W. Fleming and Dr. Toby G. Mayer


Look at Kim Kardashian and you see the ideal hairline. Her hair frames her face perfectly, no matter what hair style she selects. She is among the fortunate few. Other women struggle with high hairlines that distract from their facial beauty. Many women have a large forehead secondary to an inherited high hairline; other women unfortunately find themselves with a high hairline following cosmetic surgery. A high hairline gives women a balding, masculine appearance , so they spend a lot of time and money finding ways to style their hair in a way that disguises a high forehead to give them their desired look.

Therefore, we developed a new hairline lowering procedure using an Irregular Trichophytic Hairline Incision to bring the proportions of the face into proper balance. The hairline lowering can be performed as an isolated procedure or at the same time as forehead brow lift. With this technique an incision is made within the fine hairs of the hairline and the scalp is brought forward. The appropriate amount of bald forehead skin below the existing hairline is removed. Hair follicles are buried under the skin closure at the completion of the operation, so hair will grow through and in front of that line, giving patients total freedom of hair styling.

This hairline lowering technique is used to enhance or maintain facial proportion and beauty.

Evolution of Modern Natural Rhinoplasty


Rhinoplasty surgery, the most common cosmetic operation in the world, has changed dramatically over the past 35+ years. Previously, the main goal was to reduce the size of the large nose which frequently resulted in the scooped out profile and a pinched, turned up tip.. As patients we should demand and expect more than this surgical appearance. After surgery, nobody should know that you had an operation.

Fortunately, nasal aesthetics have been refined while we preserve normal anatomy and function. There has been a concerted effort to improve results. Today we understand the anatomy and complexity of the nose. Every change we make in one part will affect other structures and the whole nose. Function, including breathing and humidification of the air, is now an important consideration.

Aesthetic tastes have changed; in one word we can describe the ideal result – it must be natural. We strive for a strong well defined nose that is proportional to the surrounding facial features. There is no such thing as a standard procedure. Every nose is done differently; we individualize every rhinoplasty operation. For example a nose is very different in a small, thin, 5’ tall lady than it is in a tall, statuesque woman with stronger physical features. While technical skills are important, aesthetic judgment is critical. The most important work is done preoperatively; that is, the planning of the operation. Make sure that your surgeon shares your aesthetic tastes and you understand exactly what will be changed during your surgery.

With the improvement in techniques, anesthesia, and aesthetics, results continue to improve but unfortunately, over 50% of our rhinoplasty practice still involves revisions of unsatisfactory results in patients who had surgery before they were seen in our clinic..

We will save the discussion of specific rhinoplasty techniques for other blogs. For example, we recently discussed open vs closed rhinoplasties in a previous blog. If you’re not on our website right now, it is another source of information on rhinoplasties and other facial cosmetic procedures.

Beverly Hills Institute Consumer Guide to Successful Cosmetic Surgery By Dr. Toby G. Mayer and Dr. Richard W. Fleming

There has been an explosion of doctors and paramedical personnel entering the lucrative world of cosmetic surgery. Unfortunately, consumers are paying the price in the form of bad results and deadly complications. Most of these are preventable if the consumer takes a few steps to prevent this. As evidenced by the recent death of Donda West, the mother of singer Kanye West, prospective patients are asking the question, “What can I do to prevent something like this from happening to me?”
With this in mind, these are my suggestions, based on 30 years of experience, to guide the consumer through to a successful cosmetic surgery outcome.
  1. Have a complete physical examination by your family doctor or an internist prior to any surgical procedure. He is the one to make sure you are healthy enough to have the surgery you are contemplating.
  2. Have realistic expectations as to the usual results from the surgery. Faces are not made of clay to be molded to perfection. Each person heals and forms scar tissue differently and slight imperfections are to be expected.
  3. Only have surgery to please yourself, not a spouse, mother, or other person who wants you to have surgery for them! Also, remember that surgery won’t solve problems in your life such as a wandering mate, a job that you want, etc.
  4. Pick out the type of result you want in magazines — the general type of surgical result you like. This doesn’t mean you want a specific star’s nose, etc., but rather the type of results you do or do not want.
  5. Please yourself — not the surgeon — with the type of result you choose. You are the one who will look at this face for the rest of your life — not the surgeon! Choose a surgeon who specializes in a few procedures, has a good reputation in the community, and has been practicing for several years.
  6. Don’t pick a “TV doctor,” even if it is me. Television wants to entertain you — not make sure its doctors are board certified and competent.
  7. You get what you pay for. Excellent accredited facilities and medical support cost money and this is not the place to cut corners.
  8. Take time in deciding when and with whom to have your surgery. See the doctor more than once. If you are not comfortable with the first doctor, see another. This is elective surgery and you should not be rushed into surgery.
  9. Have a full discussion of the various ways to “fix” your problem, including the advantages and disadvantages of each. That way you can decide for yourself which procedure seems right for you. Even though I may feel a browlift will give the patient a better result, she may prefer eyelid surgery instead.
  10. It is the responsibility of a good surgeon to inform the patient as to the most common and most serious complications that can occur with the proposed surgery. Though with most facial cosmetic procedures these are rare, this is not true with tummy tucks and body contouring surgery, which can result in death.
  11. The anesthesia you will be given and by whom is most important. It should be a well-trained anesthetist or anesthesiologist in an accredited facility with the latest equipment.
  12. Where one goes after surgery and who will take care of them is equally important. For patients having major cosmetic procedures, we recommend that they go to a recovery center with trained personnel who can evaluate any potential problem and take appropriate action. For lesser surgical procedures such as nose, chin, and eyelid surgery, this is not necessary. However, we insist someone picks them up, takes them home, and stay with them until the next day.
  13. Plan for one to two weeks of downtime depending on the amount of bruising. Good surgeons are mainly worried about what patients do to themselves after surgery, not the surgery itself (falling, getting hit in the face accidently, etc.). Beware of claims of “minimally invasive” or “weekend” facelifts, or any other promoted procedure that appears to cut corners. There is a reason that only a few surgeons recommend these — if it sounds to good to be true, it probably is.
  14. Beware of “simple,” “easy,” or “quick” procedures. They don’t represent the total picture. As for computer imaging, my son can make a great nose or face on a computer screen but knows nothing about cosmetic surgery. Good results on live patients are the best proof of competence.
  15. Pick a surgeon that has your same aesthetics. If you and your surgeon like the “Joan Rivers look” then you have a match. But if you like a more natural look (i.e., not a “pulled” look), then select a surgeon who actually makes that look.
  16. Finally, on the day of surgery, have the doctor draw what he is going to do on your face and show it to you. He should not change his operative plan that the two of you have discussed.
In summary, the patient must be an informed “shopper”regarding plastic surgery. It’s like shopping for a new car, but this is your face! A natural look after plastic surgery with very low risk is possible if you do your homework. Good luck!

Dr. Toby’s Chat Room | Rhinoplasty – Open or Closed Technique

Dr. Toby Mayer

Dr. Toby Mayer, M.D., F.A.C.S.

I am frequently asked what is the difference between an open vs. closed rhinoplasty. When I was in training, all noses were done closed, meaning all of the incisions were made inside the nose. I did my first open rhinoplasty in 1975. The only difference was, I connected the internal incisions to an external incision between the nostrils. This allowed me to “lift up the hood” and see exactly what the problems were that I needed to change to get the desired nose. (In those days I was a “heretic” and today I am a pioneer.) There were only 2 other surgeons besides myself and my partner, Dr. Richard Fleming doing open noses in the US.

The advantages of the open is that it allows excellent access and the ability to suture grafts, etc in place. The disadvantage most often cited in those days was the scar–which is the easiest part of the rhinoplasty, and I have never had to revise one. Its only real disadvantage is that it takes a little longer for the swelling in the tip to go down.

The closed nose has less swelling, but is not as good in some noses for correct diagnosis of the problem. There are many good surgeons who do primarily closed rhinoplasty and many who do primarily open rhinoplasty. About 50 percent of my rhinoplasty surgery is revisions from other surgeons, and I do most open and some closed, depending on what the problem is. Choose your surgeon based on results and experience, not technique!

Are there options for permanent Lip Augmentation?


While temporary lip injections like Juvederm can last a few months, it is not uncommon for lip augmentation patients to seek a more permanent solution. Temporary fillers are just that… temporary. They require repeated treatments which can lead to additional recovery time and swelling. The market has a number of permanent solutions for patients that are happy with the result of lip augmentation, but just want to eliminate the need to continually have injections.

While there are a number of implants on the market to permanently augment lips, the “gold standard” and preferred treatment involves using a patient’s own fat to create a fuller appearance. For younger patients, the goal is often to increase the “lip pout,” as with older patients, lip injections are used to increase lip volume and treat the vertical skin creases which occur secondary to the aging process. Regardless of the reason for having the procedure, using a patient’s fat offers a much softer, more natural appearance to the lips. Implants can often become firm and can look surgically altered.

With over 70 years of combined experience doing lip augmentations, Dr. Fleming and Dr. Mayer have used a number of implants and fillers to augment lips and strongly recommend a “fat grafting procedure” to create natural, long-lasting results.

Is it common to get turned away when considering rhinoplasty?


Here is a question that isn’t asked as frequently, but it can be an interesting one to discuss. In some cases, plastic surgeons may decide that you are not a good candidate for the procedure that you are looking to have performed. While uncommon, some plastic surgeons may even turn down a patients request for a procedure simply based upon a lack of aesthetic need. Meaning, a surgeon may decide that the issue you are attempting to treat does not warrant the risk of the procedure. There are a few reasons why you might be denied a procedure, as your overall health is always a priority for any surgeon.

The most common reason for denying a rhinoplasty would be that the patient has already had multiple procedures on the nose. Multiple procedures on the nose can increase impaired nasal circulation, increasing the risk of severe complications (Michael Jackson is a prime example). This could also be a sign that a patient may never be satisfied with the appearance of their nose. Patients may also be requesting the procedure for all the wrong reasons ( i.e. surgery to get a better job). Lastly, patients may have unrealistic expectations for their procedure, and will undoubtedly be displeased with the results.

At the end of the day, a patient’s health and safety will always take priority over a plastic surgery procedure. Since rhinoplasty is a procedure that delivers long-lasting results, it is crucial that the procedure be done for the right reasons, and that all factors are taken into account prior to performing the procedure. While it is rare for plastic surgeons to turn down potential procedures, it is done for the health, well-being and overall happiness of the patient.