Insight Into the Motivations of the Facial Plastic Surgery Patient: A Surgeon's View

When I was a first-year medical student, I fell in love with the field of Facial Plastic and Reconstructive Surgery.

At the time, it wasn’t a particularly popular specialty, and few outside the field truly understood its potential. But for me, it combined everything I loved about medicine: hands-on creativity, technical excellence, and the ability to make a profound impact on someone’s life. I saw surgery as the most immediate way to help people, and the face, as our most expressive feature, offered the highest stakes and the greatest reward.

What I didn’t yet know then—but would come to learn through years of training and thousands of patient conversations—is the deep emotional motivation that drives someone to pursue facial plastic surgery.

Facial Rejuvenation Is About More Than Looks

Over the years, I’ve made it my mission to listen—really listen—to my patients. Why are they here? What bothers them? What do they hope to feel—not just look—after surgery?

A few patterns have become crystal clear:

First, cosmetic surgery is rarely, if ever, a superficial decision. My patients aren’t vain—they’re thoughtful. They’ve often lived with the concern for years, and it’s emotionally significant enough to affect their confidence and quality of life.
Second, most patients know exactly what bothers them. Whether it’s sagging along the jawline, a heavy neck, or tired-looking eyes, they come in with a clear vision of what they want to address.
Third, and perhaps most importantly, every single patient worries about looking unnatural. “I just want to look like myself,” they tell me—“just younger, fresher, and more like I feel inside.”

This last point is the reason I created Vertical Restore®.

Carmel Valley Plastic Surgery - Dr. Karam Banner media

The Real Motivation: “I Feel Younger Than I Look”

Time and again, patients tell me the same thing: “I still feel young—but I don’t recognize the face in the mirror anymore.”

This disconnect between how we feel and how we appear is the true root of why people seek facial rejuvenation. And it’s more than skin deep. It affects how we engage in relationships, how we show up professionally, and how we feel about ourselves in photos, on Zoom calls, or walking into a room.

One of the most vivid examples came from my own mother-in-law. A vibrant, confident woman in great health, she found herself avoiding mirrors—not because of a lack of self-esteem, but because the face looking back no longer matched how she felt inside. After undergoing surgery, she told me she felt like herself again. That shift in self-perception translated to renewed energy, positivity, and joy.

Why I Developed Vertical Restore®

Traditional facelifts were never designed to fully correct the aging face. They primarily pull skin horizontally, addressing the jawline alone. But aging doesn’t happen in isolation or in one direction—it’s a global, vertical process that impacts the outer brow, midface, jawline, and neck in tandem.

I created Vertical Restore® to be a comprehensive, anatomically correct solution that treats the full face—not just one part of it—by lifting it vertically and restoring the structure to its original, youthful position.

For example:

Vertical Restore® releases and repositions the facial ligaments, allowing the tissues to return to their natural placement without tension or distortion
The procedure addresses the full aging pattern from temple to neck, rejuvenating the outer brow, midface, jawline, and neck in one seamless, harmonious lift
It avoids the “pulled” or “overdone” look and instead restores the face with balance, softness, and longevity—results that last 10 to 15 years

And most importantly? It helps people recognize themselves again.

Let’s Talk About the Fear

Despite the motivation to feel better, the fear of looking unnatural holds many patients back. I hear it every day in consultations:

“I don’t want to look tight”
“I don’t want to look different”
“I don’t want anyone to know I had surgery”

These are valid concerns! But here’s the truth:

Bad plastic surgery isn’t about the surgery, it’s about the surgeon
Unnatural results happen when the anatomy is distorted, not when it’s properly restored
Well-done facial rejuvenation should be invisible; people may notice the change, but they shouldn’t know why

Changing Lives, Not Just Faces

I feel incredibly fortunate to do this work every day. I see transformations—not just of appearance, but of self-image and spirit. My patients are among the most grateful, thoughtful, and courageous individuals I’ve ever met. Their decision to pursue facial rejuvenation is never made lightly, but when they do, the reward is profound.

If your reflection no longer aligns with how you feel inside, know that there is a path back—one that’s safe, natural, and true to you. It would be my honor to walk that path with you.

Reviews

Francine M.

I had a vertical restore at age 65 with Dr Amir Karam. It has been a little over a year and I am delighted with the results. Some of my friends have not even noticed - I just look rested. Dr Karam will provide you with all the information and supplements that you need to make the procedure and the recovery time as comfortable as possible. I usually bruise very easily but with the supplements that were given to me prior to my procedure and afterwards, my bruises were gone within a week.

I highly recommend Dr. Karam and would go back to him for anything I might want done in the future. I totally trust his approach and recommendations. You won't be disappointed!

Kris R.

I'm one month out from a Vertical Restore with Dr Karam. Dr Karam is an incredibly talented Surgeon. I can barely see my scars already. I also did a laser peel, within 8 days I was wearing makeup and admiring my new jawline and neck. I'm 65 this month and so happy I chose him. He is the best there is. His staff are fun, caring and kind. They made my entire experience so easy. I would not hesitate or even think about going anywhere else. Check out his Instagram account. He does all his content himself. Extremely informative, with many before and after photos. I decided on Dr Karam after researching his Instagram and had made my decision before we had even met.

Janice S.

Dr Karam is a great surgeon, a true artist and a wonderful human being. He has done 2 procedures on me over the last 3 years. Both with excellent results. His fat transfer and his lip lift technique are extraordinary. I wouldn't think of going to anyone else and I would highly recommend him to anyone who is looking for the best.