Before & After Photos

David A. Hidalgo MD | Before & After Photos | Manhattan | New York City (NYC)

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*The gallery of images is intended only to provide examples of achievable results. Some sections contain nudity and may not be suitable for all visitors.

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Nov 25

Neck lifts are part of every facelift. The results

Neck lifts are part of every facelift. The results are more dramatic from the side even though patients are more concerned about the front view. We have several options to optimize results. One is adding a chin implant to lengthen the line from the side. It does not take much to accomplish this, only the smallest of implants, about the size of an almond (next screen). The “stage” of necklift here is arbitrary and refers to the chin implant option. On Friday our post will show Stage II, sculpting a new neck shape, and on Saturday will be “ Stage III” showing a recent patient having both radical neck sculpting and a chin implant. Wait until you see that one!

For the surgeons: the simple curvilinear type without the wings in extra small size is usually all that is needed, just like a rhinoplasty.

#faceliftsurgery #rhytidectomy #smaslifting #necklift #chinimplant

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Nov 21

The seven surviving chief residents out of 24 inte

The seven surviving chief residents out of 24 interns starting 5 years previously. 110 hours a week back in the day but the clock meant nothing. We lived instead by what the disease timeline dictated as we took care of our patients. We saw everything imaginable and by the time this picture was taken there was NOTHING we did not feel comfortable taking care of ourselves. Dr. Frank Spencer in the foreground was a pioneer in cardiac surgery and our chief. A fearsome figure in our lives!

#nyu #bellevuehospital #generalsurgery #lifechanging #besttraining

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Nov 20

Blepharoplasty surgery is effective and properly d

Blepharoplasty surgery is effective and properly done does not change eye shape, a common concern. Recovery is two weeks and discomfort minimal. While a brow lift could have been included most patients do not want a radical change.

For the surgeons: partial corrugator excision at the same time can be helpful but has proven less effective than BOTOX.

#upperblepharoplasty #lowerblepharoplasty #blepharoplasty #lookyourbest #nomoretired

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Nov 17

Chemical peels smooth out lower eyelid wrinkles an

Chemical peels smooth out lower eyelid wrinkles and treat discoloration. It is painted on the skin and the frosting reaction reflects the strength of application. The patient on the next screen had only a TCA peel of the lower eyelids, no surgery. See the difference it made! TCA stands for trichloroacetic acid.

#acidpeel #eyewrinkles

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Nov 16

A heartfelt note is the best gift but we got spect

A heartfelt note is the best gift but we got spectacular orchids too! Such a privilege and pleasure to help our patients!

#ilovemyjob #faceliftsurgery #smas #smaslifting #rhytidectomy

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Nov 14

The original internet stock image (next screen) re

The original internet stock image (next screen) required reworking of the composition. The small hands are not enough weight in the center to balance the large heads at the periphery. The image was cut up to create a tighter angle on the arms and move the heads closer inward. More of the head and body are added on the edges to push the twins more to the center as a unit. Additionally, a famous artist once told me that pictures should have a certain “rectitude” to them, meaning not just good composition but having the optimal vertical and horizontal dimensions and overall scale so the picture just “looks right”. This image works best as a carefully proportioned rectangle with overall size 30” x 41”. About 8 months to complete!

#charcoaldrawing #visualartist #photorealism

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Nov 13

Eyelid surgery is precise and predictable enough t

Eyelid surgery is precise and predictable enough that aging changes do not have to be advanced to qualify, like our patient shown here. Modern techniques coupled with good judgment can turn back the clock without leaving fingerprints!
#upperblepharoplasty #lowerblepharoplasty #blepharoplasty #eyelidsurgery #lookyourbest #plasticsurgeonnyc

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Nov 10

Our very elegant and statuesque (6’!) patient is

Our very elegant and statuesque (6’!) patient is shown after a very conservative breast reduction. While looking good beforehand (next screen) she wanted more slender proportions and is thrilled with the outcome. Scar patterns can be reduced in these cases to make it a good trade for a conservative size change.

For the surgeons: 200gm per side. The NAC is usually a normal diameter and at the right height in these cases. Therefore the superior periareolar incision component can be deleted to end up with a “Y” scar pattern, which makes a difference. In those with perfect shape and no element of ptosis a reduction can be accomplished using a 7 cm inframammary incision alone!

#breastreduction #macromastia #worthit. #plasticsurgeonnyc

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Nov 9

Our patient had two previous rhinoplasties elsewhe $Our patient had two previous rhinoplasties elsewhere and just wanted to look normal. These cases become more challenging each time a previous attempt fails. Most entail intricate reconstruction of the underlying framework using proven methods, but often also require unique artistic solutions off the beaten track to be successful. You cannot plan how long it will take to finish one of these projects - 5 hours in this case! For the surgeons: pretty much everything. SMR for grafts + MTF, infracture, tip shaping sutures, medial crura resection to deproject, columellar strut to stabilize, two tip grafts and one over the dorsum, upper lats OK, no alar rim grafts. #openrhinoplasty #nosejob #rhinoplastysurgeon #somuchbetter #naturalresults$

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Nov 6

The latest quarterly newsletter from our national

The latest quarterly newsletter from our national organization, the American Society for Aesthetic Plastic Surgery, has one of our drawings on the cover! They solicit artwork from the membership and we are thrilled to have been selected for this issue.

“All In”, 2020. Charcoal pencil 34” x 41”

#charcoaldrawing #photorealism #ASAPS

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Nov 5

Immediate result in the operating room today! A f

Immediate result in the operating room today! A facelift was done to address the common problem areas indicated. Smoothing of the lower cheek is achieved by tightening the deep (SMAS) layer from the side of the face whereas tightening the neck muscles is done from the front under the chin. Most patients become candidates in the early to mid fifties, far less commonly before age 50.

#facelifting #SMAS #platysmaplasty

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Nov 4

A sculpture by Michelangelo, painter of the Sistin

A sculpture by Michelangelo, painter of the Sistine Chapel ceiling and one of the greatest artists of all time. Amazing that he had a blind spot, in this case, sculpting the female breast. I noticed when I saw them for the first time how they were just distorted afterthoughts. We know he could do it, he apparently was not interested! How else to explain? They actually resemble the distortion seen with breast implant capsules that occur in a small percentage of women (example on second screen). Fortunately, these can be fixed (third screen). The sculpture though, not so much. It has been 500 years and going on forever!

#michelangelo #GOAT #breastaugmentation #breastimplants

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Nov 2

Tummy-tuck navels are sometimes a tell-tale sign t

Tummy-tuck navels are sometimes a tell-tale sign that the surgery was done. The navel is the procedure finale after all of the “heavy lifting” has been completed. The surgeon has to focus on this delicate artistic element to get it right. There are many techniques that work well and each surgeon has their favorite. Thin patients with no fat cannot achieve an “innie” like shown in this 6 week “after” image. A certain amount of fat thickness is necessary to achieve a natural looking result like this.

For the surgeons: regardless of your preferred method making the skin opening slightly lower than the stalk position creates natural hooding. #abdominoplasty #tummytuck #flatabs #getitback #worthit

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Oct 31

My Italian-American wife was excited to be appoint

My Italian-American wife was excited to be appointed to Governor Cuomo’s @nygovcuomo commission to create a memorial to America’s first Catholic saint, Mother Cabrini. The end result is a perfect tribute to this great lady who did so much for immigrants in the early 20th century. The statue shows her both as a young girl and an adult with the boy representing the thousands of children she helped. The statue has a direct line of sight to the Statue of Liberty. Mother Cabrini founded 67 orphanages, schools, and hospitals! The governor’s commission picked the artist and the location. The statue was unveiled on Columbus Day.

#mothercabrini #italianamerican #helpingothers #saints #newyorkcity

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Oct 30

In the old days surgeons simply removed those pesk

In the old days surgeons simply removed those pesky bags, accessing them through the back of the eyelid. The problem was the eyelids often looked hollow. Today we remove only some of the excess fat and reposition the rest to obliterate the “circles” below the bags. If it’s just the bags it is 1 hour and 10 days to look normal! Glasses hide the early swelling nicely.

For the surgeons: 30%TCA peel too, a great adjunct.

#lowerblepharoplasty #blepharoplasty #eyelidsurgery #dontlooktired

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Oct 29

Due to the vagaries of wound healing, and sometime

Due to the vagaries of wound healing, and sometimes unrealistic expectations, a perfect effort in the operating room sometimes may not yield a perfect result. A touch-up procedure can turn 90% satisfaction to 100%. They are quick and have virtually no recovery. Less than 5% are candidates. BTW, like some other things in life, this is something that everybody does and nobody talks about!
#makeitperfect #keepthemhappy

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Oct 28

It was a great honor to serve our #1 journal for e

It was a great honor to serve our #1 journal for eight years, reviewing over 900 articles, writing article discussions, and occasional editorials. Thanks to Dr. Rod Rohrich @rod.rohrich, Dr. James Stuzin, Aaron Weinstein and the rest of the fantastic PRS staff @plasticreconstructivesurgery for maintaining the highest standards for our journal. I learned a lot and am a better surgeon for it!

#giveback #prsglobalopen #prs #americansocietyofplasticsurgeons

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Oct 26

Our beautiful patient is seen here only two weeks

Our beautiful patient is seen here only two weeks after breast augmentation. She asked for something conservative to compliment her curves and that is what we did!

For the surgeons: Very petite with small base diameter. 215 cc just right.

#breastaugmentation #breastimplants #siliconeimplants #underthemuscle #looking good #naturalresults

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Oct 24

Long ago facelifts were done by just pulling on th

Long ago facelifts were done by just pulling on the skin. They did not last very long and cheek distortion was common. Today the skin is lifted to expose the deep (SMAS) layer which is a stronger vehicle for moving the overlying skin. The first patient image shows how tightening this deep layer smooths the lower face while passively carrying the skin upward with it. The tightening effect is stronger without causing cheek distortion because the skin is not doing the work!

“Deep plane” and “SMAS lift” are two names for the same deep layer tightening concept.

#facelifting #SMASlifting #naturalresults

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Oct 22

That says it all! This is the immediate view at s

That says it all! This is the immediate view at surgery. Rhinoplasty is so sophisticated today. We make a lot of counterbalancing changes to the framework underneath to end up with a subtle but refined outside appearance.

#openrhinoplasty #rhinoplastysurgeon #nosejob #newnose #lookinggreat #naturalresult

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Oct 21

Our patient is in her 50s and lost over 50 pounds!

Our patient is in her 50s and lost over 50 pounds! There was no abdominal muscle weakness from previous pregnancies so only skin had to be removed. Recovery is far easier in this setting. She also had an inner thigh lift, a much less commonly done procedure. It is reserved for more severe cases due to the scars required. She is thrilled with the outcome! #abdominoplasty #tummytuck #flatabs #worthit #thighlift #thigh

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Oct 19

We are thrilled to have Meghan join our team today

We are thrilled to have Meghan join our team today! She is a 2019 Villanova grad and spent her first year at NYU hospital: all great preparation. We already know we picked a future star!

#rnpower #plasticsurgerynurse #nursesrock #nursesrule

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Oct 17

Our lovely patient graciously allowed us to adapt

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Oct 15

This lovely former patient returned to us years la

This lovely former patient returned to us years later now interested in facial rejuvenation. A facelift was done today to improve her lower face and neck. Neck muscles were tightened in the front and from the sides, a very small chin implant added, and the cheeks tightened in two layers. This is the immediate result in the operating room!

For the surgeons: “witches chin” direct subcutaneous excision too.

#facelifting #faceliftbeforeandafter #smaslifting #platysmaplasty #lookyourbest

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Oct 14

Quick sketches with a model are great training for

Quick sketches with a model are great training for getting proportions, foreshortening, and anatomical shapes correct. It’s a relaxing counterbalance to focusing on minute details all day long in surgery!

#ilovedrawing #iloveanatomy #ilovesurgery

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Oct 13

Breast augmentation can look great at any age when

Breast augmentation can look great at any age when done tastefully. This super-fit mother of two just wanted to look as good on the outside as she felt on the inside. Implants should always be placed under the pectoral muscles to create a smooth slope on the top and to make mammograms easier to read.

#breastaugmentation #breastimplants #siliconeimplants #underthemuscle #lookinggood

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Oct 12

Our patient is gorgeous and only the nose did not

Our patient is gorgeous and only the nose did not fit with the rest of the picture. Rhinoplasty in our older patients is just as effective as in our teenagers!

#openrhinoplasty #rhinoplastysurgeon #nosejobbeforeandafter #lookinggreat #naturalresults

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Oct 9

Ashley is the tip of the spear at our practice and

Ashley is the tip of the spear at our practice and she is the glue that holds us all together. She is a natural ray of sunshine, uplifting patients and staff alike every day. Moreover, she has an indefatigable work ethic that keeps our office humming. We are thrilled to have her with us 11 years so far!

#candoitall #ourfoundation #teamleader

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Oct 9

This lovely young patient has a tiny waist and fin

This lovely young patient has a tiny waist and fine bone structure. She wanted something elegant, not overpowering. See our video Story posted today discussing how size was selected in her case. She was also self conscious about the visible rib structure. Notice how muted they appear in the “after” image.

#breastaugmentation #looknatural #notfake

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Oct 7

Eyelid aging changes occur earliest and often beco

Eyelid aging changes occur earliest and often become disproportionate by the 40s. Removing hooded upper eyelid skin is straightforward. Lower eyelid bags and circles can be treated without a visible incision. The excess fat is partially removed and the rest of it used to fill in the deep circles from behind. Typically little discomfort and a two week recovery.

#upperblepharoplasty #lowerblepharoplasty #beautifuleyes #eyebags #hoodedeyes

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Oct 6

Some of our patients seeking a “tummy tuck” no

Some of our patients seeking a “tummy tuck” not only have the bulging abdomen but also a “swayback” spine. The front will normally parallel the back in these individuals because there has to be room for all the internal organs in between. Therefore it is challenging (and sometimes not possible) to get the front completely flat when the back has such a deep indentation. In this case it worked out great!

For the surgeons: Thin patients who have markedly protuberant abdomens (i.e. not an excess intra-abdominal fat issue) should always be checked behind for deep lordosis. Not recognizing this can lead to disappointment later. This patient required three rows of vertical plication and a major transverse plication to get the abdominal wall flat. Keep in mind compartment syndrome in these situations!

#tummytuck #abdominoplasty #flatabs #ouch #worthit #getitback

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Oct 2

Many patients say “I just want my neck done, I d

Many patients say “I just want my neck done, I don’t want a facelift.” Actually, a facelift only treats the lower face and neck, not the whole face. It also corrects the jowls and provides a more powerful neck lift because the cheek and neck are rotated both upward and backward thereby creating more neck movement. A neck lift alone, in contrast, pulls in only one direction that is less effective by itself: straight back. Notice the improvement in the jowl area in this patient. The downward lines at the mouth are eliminated which enhances the rejuvenating effect of the neck lift.

For the surgeons: that’s not a chin implant, just a jaw thrust effect from the other side as we took the airway out and snapped the picture! Platysmal plication and subplatysmal fat excision.

#facelift #nevertoolate #naturalresults

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Oct 1

Our lovely patient sent us this photo 4 years afte

Our lovely patient sent us this photo 4 years after her rhinoplasty. I am thrilled that she thought of us to express her delight with the outcome!
#closedrhinoplasty #rhinoplastysurgeon #lookinggood

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Sep 30

Lip lifts are a popular fad now but overutilized.

Lip lifts are a popular fad now but overutilized. The best candidates are over 60 and typically exhibit a thinning upper lip and elongating distance between the bottom of the nose and the lip itself, both natural aging changes. Removing a strip of skin just below the nose and partially hiding the scar within the nostrils both shortens the distance to the lip as well as rolls it out so it appears thicker. This patient is a vibrant woman in her 70s who desired to have this aging sign corrected. The stitches have been blurred in the “after” picture taken at surgery today. Doing this procedure in young patients often leaves more noticeable red scars that can take many months to resolve. Also, proper judgement is required to avoid over-shortening the lip!

For the surgeons: A vertical measurement over 19 mm or so usually indicates a good candidate provided the anticipated change does not throw off the balance within the lower 1/3 of the face.
#bettersmile #lusciouslips #liplift #lips #plasticsurgerybeforeandafter #plasticsurgery #plasticsurgeonnyc

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Sep 29

Like the recent similar post this patient also had

Like the recent similar post this patient also had a rhinoplasty elsewhere and liked everything except the tip. I love these cases! They are interesting puzzles. While having a good idea from the outside what needs to be done, there are always hidden surprises within. Cartilages are often more weakened and deformed than surmised. Rearranging and rebuilding, typically borrowing cartilage from other sites, is the order of the day.

For the surgeons: left spreader, caudal septum extension graft, columellar strut after resecting medial crura 3 mm, resect redundant left lateral crura, alar rim grafts. Septum + MTF sources

#openrhinoplasty #rhinoplastysurgeon #nosejob #nasalreconstruction #lookinggreat #muchbetternow

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Sep 28

Christopher, our ace Practice Manager, popped the

Christopher, our ace Practice Manager, popped the question to now fiancé Rea in Central Park this weekend. He put huge thought and preparation into this and his 655 Park fam are thrilled to hear it was a great success. We are not sure who is luckier but know for sure she has a brilliant, sensitive, and highly organized partner for the next 50 years!

#soulmates #bestdecisionever

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Sep 25

Abi leaves her daytime family at 655 Park to furth

Abi leaves her daytime family at 655 Park to further evolve as a super mom, wife, part time athlete, and much more. She has set and impeccably maintained the highest standards for our operating room since the day she arrived. Abi has an iron work ethic and always treated the practice as her own. So many fun and tough spots together, with her will and equanimity key factors in always achieving the best outcome. You will be missed but we are all thankful for the large part of your life you devoted to us and wish you an exciting and happy future!

#superstar #rolemodel #GOAT

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Sep 24

Minor asymmetries are magnified with enlargement a

Minor asymmetries are magnified with enlargement and often become noticeable for the first time. As a surgeon it can drive you crazy trying to get everything perfect. Fortunately, such differences are barely visible when you look at the gestalt of the final result.

PS: She has enough breast tissue to conceal saline implants well. This allowed use of a small armpit incision. Saline implants typically last longer and do not require MRI scans for future monitoring.

For the surgeons: Dingman dissector only, no endoscope!

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Sep 23

Lower eyelid surgery takes about an hour, causes g

Lower eyelid surgery takes about an hour, causes generally mild discomfort only, and looks good at 10-14 days. It can be done by itself or included with upper eyelid surgery or any other procedure.

#eyelidsurgery #eyebags #eyecircles #blepharoplasty

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Sep 22

Our patient had breast implants placed ten years a

Our patient had breast implants placed ten years ago elsewhere and came to us for repair. The right side had hardened and the left side slipped downward. The former condition occurs randomly in about 5% and the latter is extremely uncommon. Here she is after correction and new implant placement.

For the surgeons: In a case like this do the capsulectomy side first and then match the capsulorrhaphy side crease position to the same height.

#breastaugmentation #breastlift #backtonormal

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Sep 19

Drawing the desired result adds clarity to goals o

Drawing the desired result adds clarity to goals only verbalized previously. The added study of individual patient anatomy during the process also helps me better achieve those goals at surgery.

#rhinoplastydesign #rhinoplastysurgeon #lookbetterfeelbetter

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Sep 19

It’s Friday afternoon at 3. All patients have be

It’s Friday afternoon at 3. All patients have been seen and all calls returned. The office is quiet. It’s time to indulge in the pure joy of performing the last surgery of the week. The immense trust placed in surgeons is both humbling and inspiring to get it right every time!

#rhinoplasty #openrhinoplasty #rhinoplastysurgeon #lookbetterfeelbetter

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Sep 12

Our beautiful patient had it all there - we just a

Our beautiful patient had it all there - we just adjusted one feature. These rhinoplasty selfies are taken 11 months after surgery. Not that she needed it but she is in the beauty business herself!@balayage_courtney

For the surgeons: L-shaped strut on right as both spreader and to support weak anterior septum, normal spreader left, columellar strut, transdomal and interdomal sutures, lateral crura repositioned inferiorly (after Sheen), minor trim left medial crura, Pitanguy ligament repair.

#openrhinoplasty #newnose #lookinggreat #naturalresults #crookednose

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Sep 10

Our patient today is fit, near ideal weight, and h

Our patient today is fit, near ideal weight, and has tight skin without cellulite. She also exhibits the classic areas of fullness largely resistant to nonsurgical measures. Liposuction is the most effective one step treatment for this with only modest discomfort and rapid recovery typical.

#liposuction #bettershape #lookbetter

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Sep 10

About half of our breast implant patients seek to

About half of our breast implant patients seek to restore their original look before multiple pregnancies rather than primarily for size enhancement. Implants do this much better than lifts because the implant insertion scars are largely inconsequential. Silicone is the preferred choice in this group because the tissues have thinned out too much from breast feeding to be compatible with saline implants. Silicone implants must be changed every ten years but our young patients accept the trade off. Moreover, there are other options down the road to mitigate this requirement.

#breastaugmentation #breastlift #breastimplants #siliconeimplants #getitback #notoverdone

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Sep 8

There is a precise amount of upper eyelid skin to

There is a precise amount of upper eyelid skin to remove for the best result. While the drawing may look random the instrument allows accurate measurements at intervals before finalizing the lines.

For the surgeons: using the Green forceps to grab the lower line drawn, simulate minimal lagophthalmos and holding the pen tip over the end of the forceps at that point, pull the lid down on tension and place a dot on the skin at that same point, and repeat at intervals. This will determine the proper course of the top line of the design. Extra-fine Sharpie pens make the thinnest line that will not bleed!

#upperblepharoplasty #eyelidsurgery #beautifuleyes

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Sep 7

This drawing I am working on today will be part of

This drawing I am working on today will be part of the new website. It will introduce the breast procedure section. Welcome to our 655 Park family joining us today!

#labordayweekend #rest #falliscoming

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Sep 5

I painted this 5’ x 6’ oil painting in college

I painted this 5’ x 6’ oil painting in college and it hangs in my garage today. It was done when photorealism was at its height in the art world and took 6 months to do. I was inspired after taking my then girlfriend on a date to the Watkins Glen races. She married me anyway! LOL

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Sep 4

“Tummy tuck”! All of the skin within the patte

“Tummy tuck”! All of the skin within the pattern will be removed. The top of the design and lower portion are then joined together after the underlying muscles are tightened. The navel will be preserved and stays in its original location. Very effective surgery but long scar (it’s a trade) and 1st week recovery challenging.

For the surgeons: A pinch test with the back at 45 degrees accurately identifies the top of the design so that incision is safe to make at the start. There are 4 tiny dots marking that point on the video and the design is slightly lower as you move laterally. Marking at no more than 45 degrees builds in some leeway for further elevation if needed for closure.
#tummytuck #abdominoplasty #flatabs #ouch #worthit #getitback #rectusdiastasis

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Sep 2

Individual plastic surgery procedures are most pop

Individual plastic surgery procedures are most popular at different times of the year. Summertime “rhinoplasty season” is winding down as the school year starts. The fall “facelift season” is now starting in earnest, an early start facilitated by the quarantine and mask wearing. I love the change in procedures that these transitions bring, just like the change in the seasons themselves!

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