Face Procedures
Rhinoplasty (Nose Surgery)

Some nasal conditions such as humps or a crooked shape occur as a result of trauma. Other features such as a bulbous tip, a long nose, or excessively broad nose are gifts from our parents.
The best candidates for rhinoplasty are those with fairly stable personalities and realistic expectations. A rhinoplasty will not cure depression, bad relationships, or an overall poor self image. The best candidates can be very specific about what they want different in their nose (please get rid of the hump) as opposed to non specific (I don’t know, I just have never liked my nose.) Be sure to tell the doctor about any breathing problems related to your nose, as rhinoplasty might have an effect on them. The procedure can be done under general anesthesia or under local anesthesia with sedation.
Eyelid Surgery (Blepharoplasty)

Restoring the proper position of the brow, removing excess lid skin, or tightening skin with removal or a laser, perhaps even a filler, can be as dramatically rejuvenating as anything we do.
Removal of excess skin and fat from the upper and lower lids is called blepharoplasty. This takes away the heavy, tired look from the eyes and can also improve vision if the skin is obstructing the eye. In some cases, insurance coverage is available for this procedure. Incisions are hidden in the natural folds of the eyes and are rarely visible. Laser resurfacing is often a very useful addition to these procedures.
Forehead Lift (Browlift)

If the brows are sagging down over the eyelids, or have a sad appearance, elevating the brows can really lighten a person’s look. This procedure is usually done with an endoscope for milder cases, or an incision at the hairline when skin removal is required. Both tend to heal quickly and make an immediate impact. This is often combined with upper lid skin excision (blepharoplasty) to obtain the sharpest, cleanest result. These procedures are most commonly done with sedation and local anesthesia, so recovery from the anesthetic is minimal.
Ear Surgery (Otoplasty)

Most ear surgery is done for prominent ears-ears that stick out. This happens for two reasons-either the bowl of the ear is too big and too deep, or the outer fold of the ear doesn’t form properly. Sometimes both are present. Prominent ears can be corrected by recreating the outer fold of the ear, and reducing the size of the bowl of the ear.
How is it done?
Incisions are made, usually on the back of the ear, sometimes just inside of the bowl of the ear, where they are not typically visible. Stitches are used to recreate the cartilage folds, and also to hold the ear back against the head. Sometimes excess cartilage in the bowl (concha) is removed. This procedure can be done under either local anesthesia with sedation, or with general anesthesia.
How about recovery?
We will ask you to wear some surgical earmuffs for a week or so to protect the tender ears. You may remove them to shower the next day. The ears are swollen for a week to 10 days, and the swelling isn’t really totally gone for a few months, so don’t worry if your ears seem a little big. Exercise is OK if contact is avoided.
Scar Revision

There are many surgical methods of scar revision, only some of which may be appropriate for a particular type of scar or its location. These include surgical excision, skin grafts, flap surgery and Z-plasty (repositioning a scar so that it aligns with the face and is less noticeable). The effectiveness of scar reduction depends on a number of factors, including the nature of the injury, your body’s healing mechanism, the size and depth of the wound, how much blood supplies the area and the thickness and color of your skin.
Laser Resurfacing
Before & After:
Halo
RESTORE YOUR GLOW WITH HALO™
Over time, your skin can lose its youthful glow due to sun exposure. Previous lasers couldn’t effectively remove this sun damage because they were either too shallow or went too deep. Halo eliminates years of sun damage by precisely targeting the right depth. Halo restores the luminous glow you had when you were younger.
GREAT RESULTS WITH MINIMAL DOWNTIME
In the past, you had to choose between a procedure that offers really great results but a lengthy recovery, or a procedure with a fast recovery but marginal results. Now with Halo you get the best of both worlds: great results with minimal downtime.
Halo combines deep dermal rejuvenation with epidermal renewal for a combined synergistic effect you can’t get with any other treatment. Halo creates beautiful results without the downtime of more aggressive treatments.
BE YOUR OWN KIND OF BEAUTIFUL
Everyone’s skin is different. Everyone’s needs are different. Halo allows your clinician to customize your treatment to the downtime you have available and the results you want. Need to be back at work tomorrow? A light treatment creates silky smooth, vibrant skin that’s ready for makeup the next day. Want to wow them? A more aggressive treatment will give your skin a deep youthful glow with just a few days of downtime. Ask your clinician today about Halo and restore your glow.
Halo precisely targets years of damage to your skin, including:
- Discoloration
- Sun damage
- Visible signs of aging
- Uneven skin tone
- Enlarged pores
- Poor texture
- Fine lines*
- Scar revision*
*only with Halo Hybrid Treatments
RESULTS YOU WANT WITHOUT THE DOWNTIME YOU WOULD EXPECT.
BBL
Acne Treatments
Forever Young BBL
CAN FOREVER YOUNG BBL REALLY STOP THE CLOCK ON THE APPEARANCE OF AGING SKIN?
Yes! It was proven in a long-term clinical study. Patients received regular BBL treatments over the course of a decade. At the end of the study, doctors judged the patients to appear 11 years younger than their actual age. In other words, they looked younger than when the study began.
WHAT AREAS CAN BE TREATED?
Any area of your body can be treated. The most common areas are those most exposed to the damaging effects of sunlight. Most people ask for treatments on the face, neck, back of the hands, chest and shoulders.
HOW MANY TREATMENTS WILL I NEED?
The number of treatments needed varies from patient to patient, and your clinician will personalize a plan based on the level of improvement you desire. Your clinician may also combine your treatment with other popular aesthetic procedures to optimize your results.
Remember that regular treatments—at least once a year—were proven to make patients look ten years younger than when they first started Forever Young BBL treatments.
AM I A GOOD CANDIDATE FOR FOREVER YOUNG BBL?
Your clinician can fine tune Forever Young BBL for your skin type and for your ideal results. The long term effects have been proven in most skin types, including people with olive to darker skin. Men, women, fair, dark…almost anyone can enjoy the benefits of For ever Young BBL.
AT WHAT AGE SHOULD I START BBL TREATMENTS?
Forever Young BBL isn’t just a beauty treatment. It’s a preventive regimen — possibly the best investment anyone can make in his or her skin. Both men and women with almost any skin type can protect themselves against the sun and environmental damage that adds up over time. In fact, the best time to think about the effects of aging is before they appear. Since the ten-year study shows that regular Forever Young BBL treatments stop the skin’s appearance of aging…why wait?
WHAT WILL HAPPEN DURING THE PROCEDURE?
Your eyes will be protected with safety shields or glasses. Typically, there is no need for a topical anesthetic, however your clinician may choose to use one on more sensitive areas.
You may feel a quick, warm sensation as the light is absorbed by the targeted areas. Your procedure may take a few minutes to half an hour, depending on the size of the area to be treated and the type of procedure performed.
HOW LONG WILL IT TAKE TO RECOVER?
This is a noninvasive and gentle procedure with virtually no downtime. In most cases, you are able to apply makeup, return to work and resume most of your activities immediately.
WHAT SHOULD I EXPECT AFTER THE TREATMENT?
You may experience some redness that should resolve within a few hours. For some pigmented lesions, you will see a darkening of the treated area followed by fading and flaking off at a later stage. Your treated skin will feel smoother, pores will be less noticeable, and sunspots or uneven pigmentation will fade. Results depend on your condition, the number of treatments, and the area treated. Your clinician will provide you with complete information about the post treatment care and results.
WHAT AFTERCARE PLAN DO I NEED?
It is important to follow your clinician’s treatment plan. You may be given skin care products and instructions on how to use them. You will be sensitive to ultraviolet light and you must avoid direct sun exposure until completely healed. Fully cover your treated skin or use a good sunscreen whenever you go outdoors.
Pigmented Lesions
Results
Rosacea/Vascular Conditions
Results
Hair Removal
Results
“My skin now feels like it did back in high school. It is so smooth and luminous and I feel like I can’t see the pores on my face anymore. I don’t need to use as much makeup and the makeup I do use is so easy to put on.”
Tiffany L.“The best part of my Halo treatment was how easy it was! I have done a few laser and light treatments in the past, but nothing came close. To be able to have a treatment with minimal discomfort, be able to go out the next day and still get results was amazing!”
Jason F.“I have always been very self-conscious about my pores. I felt like every time I was in public people would stare at my skin. After my Halo treatment, I don’t feel that way anymore, people actually compliment my skin now. I’ve never looked better.”
Brianna B.LASER TREATMENTS – FREQUENTLY ASKED QUESTIONS
What results can I expect?
How many treatments do you need?
What happens during the treatment?
What does Halo feel like?
Can I return to normal activities after my treatment?
When will I see results?
How long will my results last?
I couldn’t be happier with my Forever Young BBL treatment program – my skin looks better today than it did a decade ago!
KathyWow! This is the best investment I could ever make in my appearance. I am 53 and when I tell people I have children that are almost 30, they wonder how much cosmetic surgery I’ve had done. The answer is none – just Forever Young!
EricaSince starting Forever Young BBL sessions, my face and neck are brighter and tighter and I continue to receive compliments on my skin. I am so excited to have discovered this treatment.
JessicaSkin Care
At Billings Plastic Surgery we believe skin care is important and we offer a variety of skin care and make up.
The Skincare brands we carry are:
- Nerium International, SkinCeuticals, LaRoche Posay, Skin Script, Omni Bioceuticals, RevitaLash, ReGenesis Hair Care, and EltaMD
The Makeup brands we carry are:
- Oxygenetix, Colorescience, and Glominerals
Micro needling
The Rejuvapen automatic therapy system utilizes 9 precisely spaced micro needles in a small cartridge to create invisible, vertical, micro perforations into the epidermis and the top layer of the dermis. As a result, the skin shift’s it’s natural repair mechanism into high gear and starts producing collagen and elastin to repair these micro-perforations. The self-repairing property of the skin is a 100% natural form of skin renewal from the inside out.
Benefits from a micro needling treatment include:
Minimized pore size
Fine lines and wrinkles are reduced
Improvement in the appearance of scars, acne scarring, and stretch marks.
We recommend that patients have a series of 3 treatments on face and neck to improve fine lines and wrinkles. Treatment for scarring and stretch marks can require 6 to 8 treatments.
Chemical Peel
A Chemical Peel is a quick and effective treatment that can be used on all skin types to improved many skin conditions. We recommend that our patients plan to have a series of three chemical peels to for the best result. A chemical peel will:
Eliminate skin conditions such as acne, melasma, and hyperpigmentation
Reverse the signs of aging, age spots and sun damage
Erase acne scarring and blemishes
Lighten and brighten your skin
Reduce pore size and soften fine lines and wrinkles
Stimulate collagen production resulting in firmer skin
Improve overall tone and texture of your skin
The Peel we use is called the Perfect Derma Peel
Facials
Billings Plastic Surgery features seasonally-based facials. For Fall, we’re proud to offer a Ginger Vanilla Enzyme facial. All of our facials can be customized to treat skin types such as dry or oily. Our facials can also be added on as an extra treatment to some of the services we offer. All of our facials include we use natural fruit enzymes, antioxidants, natural brighteners, and exfoliants to treat acne, melasma, pigment, rosacea, and dry or oily skin.
DermaPlaning
Dermaplaning is a method of exfoliation that consists of using a 10 gauge scalpel to gently scrape off the top layer of dulling dead skin cells in order to reveal a smoother, brighter complexion. Dermaplaning is a favorite in the entertainment industry, specifically among models and actresses. Why? It also eliminates that annoying peach fuzz that cakes up in makeup and can be enhanced by harsh production lighting and high-definition cameras. “Dermaplaning removes all the dead skin cells and also the facial hair, leaving the surface very smooth. Dermaplaning also allows for greater penetration of skincare products and creates a flawless canvas for makeup to glide on smoothly. In fact, cosmetic dermatologists often use dermaplaning to help prepare skin for more intrusive procedures such as laser treatments and chemical peels.
WHO IS IT FOR?
Dermaplaning is recommended for all skin types except those with acneic skin. If you have deep cystic acne, wait until breakouts are clear before trying this treatment. As always, also discuss any allergies or skin sensitivities before starting a treatment.
This is a great treatment if you are pregnant or nursing and want exfoliation without the risk of harsh chemicals absorbing into the blood stream and potentially harming your baby.
WHAT DOES THE TREATMENT FEEL LIKE?
Dermaplaning is a painless procedure and can be compared to the sensation of shaving your legs, but in this case, it’s on your face.
First, the aesthetician will cleanse and thoroughly dry your skin. Next, she’ll pull an area of your skin taut with one hand, and hold a sterile 10 gauge blade at a 45 degree angle in the other hand and use short, swift strokes to scrape off dead skin cells and peach fuzz.
HOW LONG DOES IT TAKE?
About 30 minutes
ARE THERE IMMEDIATE SIDE EFFECTS?
There are no side effects and zero downtime. After the treatment, your skin will be highly sensitive to sun exposure and may already look very pink, so be sure to wear a broad-spectrum sunscreen with SPF 30 or higher to reduce the risk of hyperpigmentation.
WHAT ARE ANTICIPATED RESULTS?
You’ll immediately look more radiant with a more even skin tone and texture. All of your peach fuzz will be gone, which is why first-timers say their skin has never felt so soft before.
RECOMMENDED COURSE FOR OPTIMAL RESULTS?
Dermaplaning removes 21 days worth of dead skin cells, so it’s best to allow the skin to complete its rejuvenation cycle before your next treatment approximately 6-8 weeks.
WHO SHOULD GIVE ME THIS TREATMENT?
Dermaplaning should be administered by a board certified dermatologist or licensed aesthetician who specializes in this procedure. “An aesthetician has to be licensed in the state she is practicing in. There are several different schools you can attend, but ultimately you have to pass a state administered written and practical exam to get your license,” explains Wright. It’s always a good idea to ask how long they’ve been administering dermaplaning to know their level of experience—there’s a very sharp blade involved!
TCA Cross Peel
The TCA Cross Peel does not treat the full face. The TCA is placed in specific area of acne scarring. The peel may need to be repeated 2-3 times and the results can be impressive. The TCA Cross Peel can also be given before a pro fractional or resurfacing laser to improve acne scarring.
FOREHEAD
- Botox & Dysport
MOUTH FROWN
- Restylane or JUVÉDERM®
MATIONETTE LINES
- Restylane or JUVÉDERM®
- JUVÉDERM® Volbella
LIP BORDER
- Restylane Silk
LIP VOLUME
- Restylane or JUVÉDERM®
- JUVÉDERM® Volbella
CHEEK DEFINITION
- Sculptra, Restylane Lyft or Voluma
CROW’S FEET
- Botox or Dysport
BROW
- Dysport or Botox
Nasolabial Folds
- Vollure
Billings Plastic Surgery is the only Diamond Level with Allergan account in Montana. We are proud of this accomplishment and also proud of the highly experienced injectors in our practice. Our injectors continue to receive ongoing training throughout the year to remain up-to-date on the latest techniques and newest products in the industry.
FOREHEAD
- Botox & Dysport
MOUTH FROWN
- Restylane or JUVÉDERM®
MATIONETTE LINES
- Restylane or JUVÉDERM®
- JUVÉDERM® Volbella
LIP BORDER
- Restylane Silk
LIP VOLUME
- Restylane or JUVÉDERM®
- JUVÉDERM® Volbella
CHEEK DEFINITION
- Sculptra, Restylane Lyft or Voluma
CROW'S FEET
- Botox or Dysport
BROW
- Dysport or Botox
NASOLABIAL FOLDS
- Vollure
Botox & Fillers
BOTOX® Cosmetic
BOTOX® Cosmetic is commonly used to reduce or eliminate the appearance of facial wrinkles. It is injected under the skin into areas surrounding the eyes, forehead and mouth to smooth crow’s feet, frown and worry lines, and lines on the neck. Made from a purified protein, BOTOX® relaxes wrinkles and gives the face a rejuvenated look. BOTOX® may also be useful for migraine headaches, excessive sweating, and eye and neck muscle spasms.
Dysport
Dysport treats moderate to severe frown lines between the eyebrows by reducing specific muscle activity. Wrinkles are caused by repeated movements and muscle contractions, which means they can even develop in younger adults. One injection into each of 5 points between and above the eyebrows temporarily prevents muscle contractions that cause frown lines, leaving the rest of your face to move naturally.
JUVÉDERM® Injectable Gel
JUVÉDERM® is an injectable gel that gently reverses many signs of aging in the face, including fine lines and wrinkles, crow’s feet, thinning lips and loosening skin. It can also “plump up” the lips, sculpt the cheeks, and restore a youthful oval shape to the face. It is made with hyaluronic acid, a natural substance found in the body that works with collagen and elastin to give volume and support to the skin. Because it is non-animal-based and highly biocompatible, no pre-treatment testing is needed. JUVÉDERM comes in three formulas optimized for the depth of the area being treated. Results last about 6-9 months and can be made to last even longer with a simple follow-up treatment a few weeks after the initial injection.


JUVÉDERM® Volbella
JUVÉDERM® Volbella is the newest filler in the Juvederm family of fillers from Allergan. Volbella is specifically designed for the lips to create smooth natural looking volume and shape. Lines around the lip area can also be softened with Volbella. With long lasting results of up to one year.
JUVÉDERM® Voluma
JUVÉDERM VOLUMA™ XC injectable gel is the first and only filler FDA-approved to instantly add volume to the cheek area. It gives you a subtle lift, helping to restore contour and a more youthful
profile, for up to 2 years, in patients over the age of 21. It’s different than JUVÉDERM® XC and works
on a different area of the face. JUVÉDERM® XC smoothes out moderate to severe wrinkles and folds around the nose and mouth, like parentheses. JUVÉDERM VOLUMA™ XC, however, adds volume to the cheek area.


Vollure
Allergan, the pharmaceutical company that owns Juvéderm, just announced its newest hyaluronic acid dermal filler, Juvéderm Vollure XC, which has been approved for the correction of “moderate to severe facial wrinkles and folds, such as nasolabial folds,” according to a statement made by the company. What’s more is that this filler, made for those over 21, is said to last as long as 18 months — a full year longer than other injectables on the market.
In a clinical trial for the injectable, 59 percent of participants saw improvement in smile lines around the mouth for up to 18 months, and at the same time, 82 percent of patients said they were satisfied with results at six months, while 68 percent were still pleased at eight months .
Juvéderm Vollure XC uses special technology, known as Vycross — which is also used in Juvéderm Voluma XC and Juvéderm Volbella XC — to hold the hyaluronic acid together into a cohesive gel, which keeps it intact after it’s injected into the skin. “Vollure XC’s Vycross technology links both high and low molecular-weight hyaluronic acid, while Juvederm’s Hylacross technology uses various degrees of cross-linking of mainly high molecular weight hyaluronic acid.” Another major difference between Juvéderm and the new Juvéderm Vollure XC is that the new formula produces minimal swelling, which means shorter recovery time.
Restylane®
Restylane is a clear gel formulation of hyaluronic acid that is specifically formulated to act like your body’s own naturally produced hyaluronic acid, helping to visibly correct moderate to severe facial wrinkles and folds, including the lines from your nose to the corners of your mouth (nasolabial folds or laugh lines), the corners of the mouth and marionette lines — the area that extends downward from the corners of the mouth to the jawline.
The Restylane family of products includes Restylane®, Restylane® Lyft Restylane® Silk.
Restylane can be used for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds.
Restylane and Restylane Silk can be used for lip augmentation or for the correction of lip wrinkles
Restylane Lyft can be used for cheek augmentation and the nasolabial folds.
Restylane® Lyft
Restylane Lyft is just one member of the full Restylane family of products. Each treatment is a clear gel formulation of hyaluronic acid. They are specifically formulated to act like your body’s own naturally produced hyaluronic acid in patients 21 years of age and older.
As we age and our faces lose volume, some of us begin to look for ways to regain more definition in our cheeks without surgery. Restylane Lyft, formerly known as Perlane-L®, is an injectable hyaluronic acid gel used to correct volume loss and treat wrinkles in the face.
Restylane Lyft is the first and only FDA-approved filler indicated to provide lift to cheeks and add volume to correct and smooth smile lines (nasolabial folds).
Restylane® Refyne & Defyne
There’s a new filler in town (actually, two new fillers) and they’re billed as the next big thing in the fight against laugh lines. Galderma, the pharmaceutical company behind injectables like Restylane, Sculptra, and Dysport, has just announced FDA approval of two new fillers: Restylane Refyne and Defyne. The first was approved to treat moderate wrinkles and folds from the nose to mouth, while the latter is meant to plump and fill deep-set lines.
Courtesy of Galderma
While there are other fillers on the market that can plump wrinkles, Refyne and Defyne are meant to give a more natural-looking result than previously thought possible. Galderma claims results can last up to 12 months, which means you’ll likely need to get pricked twice a year to keep things looking smooth. But it’s the new type of hyaluronic acid in the filler gel that’s the real news here. The new technology is called XpresHAn—which is pronounced like a French person trying to say the word expression—and it allows the hyaluronic acid gel to flex within the skin as you move your face. So whether you’re smiling, frowning, or wrinkling your face any which way, the result looks soft and natural, not puffy or stiff.
Though new to the United States, both Restylane Refyne and Defyne have been used in Europe under the name Emervel since 2010.
Defyne your expression.
Invest in yourself with real-life results that help maintain natural movement to help keep you looking like you
Crafted with XpresHAn Technology™, Restylane® Defyne helps smooth out deep laugh lines (nasolabial folds and marionette lines). Using innovative cross-linking technology, Restylane Defyne is a hyaluronic acid dermal filler that is able to help restore a more youthful, natural-looking appearance, while helping you maintain your natural expressions.
Refyne
As skin loses elasticity with age, the lines that run from the sides of your nose toward the corners of your mouth (nasolabial folds) and the lines that run from the corner of your mouth toward the chin (marionette lines) appear more noticeable. Restylane Refyne is a specifically formulated hyaluronic acid dermal filler made with XpresHAn Technology™ that helps correct these lines for a more natural look to your face.3† The unique cross-linking of the gel in Restylane Refyne is also designed to help support your natural expression—for real-life results that help maintain natural movement when you’re smiling, frowning and even puckering up.
Restylane® Silk
Finally, a filler that can help you achieve your ideal lips.
Restylane® Silk is the first FDA-approved product specifically designed for lip augmentation and the smoothing of wrinkles around the mouth in patients 21 years of age and older.
Radiesse®
Radiesse is a wrinkle filler used to plump the skin. Radiesse is injected through a small needle and placed under the skin. Immediately, this filler works to add volume under the skin and over time, the benefits of Radiesse continue by stimulating your body’s own natural collagen. The natural results have been shown to last a year or more in many patients, making the treatment results both immediate and long lasting.
Sculptra®
Sculptra® Aesthetic works subtly and gradually over time for a more youthful-looking appearance. Unlike hyaluronic acid (HA) fillers, Sculptra Aesthetic helps stimulate your skin’s own natural collagen production to help restore its inner structure and increase facial volume that has been lost to aging.1-3 Sculptra Aesthetic is intended for use in people with healthy immune systems as a one-time treatment regimen of up to four injection sessions that are scheduled about three weeks apart.
Fat Transfer
Fat transfer involves harvesting a small amount of fat from one area of your body and injecting into the face. The fat is then placed in a centrifuge and then injected. The new fat that is injected develops it’s own blood supply with an 80-90% survival of the transplanted fat. The result is a very natural look that can last for a year or longer.
Kybella®
KYBELLA® is the only FDA-approved injectable treatment that destroys fat cells under the chin to improve your profile.
POD THREAD LIFTS
Natural results Non-invasive lunchtime treatment. The answer to loose and sagging skin. A beautiful and healthy face has a “V—Shape”. With the ageing of tissues and the action of gravity, this “V-shape “ diminishes or inverts.
The idea behind the Nu-mesh and Nu-Lift technique is to either create scaffolding in order to support the tissues and keep them in the “V-Shape” or where necessary to delicately lift the tissues and reposition the skin to recreate the “V-Shape” where it’s been lost.
Although POD Threads can be inserted almost anywhere, one area where they are especially effective is the neck and jawline. The lower third of the face Is challenging to treat effectively with Botox or fillers, which are most effective in the upper and middle third of the face, respectively.

