When renowned plastic surgeon Dr. Bernard L. Markowitz moved to Los Angeles 23 years ago, he hardly had performing elective enhancements and surgeries in mind. Throughout his 14-year tenure at UCLA Medical Center, Dr. Markowitz gained notoriety for his expert facial trauma work on adults and the treatment of congenital abnormalities in infants and children. In 2001 he opened his current practice, specializing in facial rejuvenation. His highly effective technique relies on his surgical acumen rather than trendy new technologies and leaves patients looking revived, and most important, as if they’ve never had any work done.

LOS ANGELES CONFIDENTIAL: How did you get into cosmetic plastic surgery?
DR. BERNARD L. MARKOWITZ: I used to do a lot of pediatric plastic surgery—cleft lips and palates, moving jaws around. I did most of the major head and neck cancer reconstruction at UCLA. Over the course of 10 to15 years, I started seeing cosmetic surgery patients, those who weren’t happy with their primary surgery.

LAC: How did you develop your technique?
BLM: Many of the patients I saw had very tight skin, but they still had issues with jowls, loose necks and, to a lesser extent, deep nasolabial folds. It was because the deeper tissues weren’t tightened. So I would elevate the skin, reposition the fallen facial fat and superficial muscles in the face and neck. This gets results.

LAC: Does this approach differ from most?
BLM: If you just elevate the skin and pull it tight [a common practice], you don’t have a predictable, reproducible way to do things. Aging is not just skin getting loose and wrinkly; it’s facial fat atrophy and descent. I put a lot of tension on the deeper stuff, which pulls the facial fat back, and the skin goes with it.

LAC: What’s your take on noninvasive technology?
BLM: I’m a surgeon; I like to operate. If somebody has a youthful face with some wrinkles and hyperpigmentation, they’ll do better with one of the alternate technologies. But when they have changes of skin, subcutaneous fat and superficial muscles, the only way to address that is with surgery.

LAC: What makes someone a good candidate?
BLM: When somebody comes in, I ask what they’re not happy with and would like to change. If I see what they see, then we proceed. I tend not to perform surgery on people looking to be somebody else. I try to stay away from the patient population that wants to be anything but a better version of themselves.