San Francisco Plastic Surgery - Dr. Karen Horton's Before & Afters

01/06/2026

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Before and after lower facelift/neck lift using the MACS lift technique in a 54-year-old woman. She felt her neck had aged significantly in the last ten years and having meetings on Zoom was a big distraction for her, as she focused on how bad her neck looked!⁠
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A MACS lift removed excess fat from under her chin, it lifted her jowls and provided a more defined jawline while maintaining a normal and natural look that was imperceptible to others. An upper lid blepharoplasty was performed at the same time to also rejuvenate the look of her eyes and remove tired-looking excess upper eyelid skin.⁠
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Follow up photos are shown 1 year after surgery. She is very pleased with her results!⁠
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⁠To see other facelift & neck lift cases, visit my website gallery: https://www.drkarenhorton.com/gallery/face-and-neck/neckmacs-lift/⁠
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facelift MACS MACSlift minimalaccesscranialsuspension shortscarfacelift jowls naturalresults womanplasticsurgeon mommymakeover cosmeticsurgery sanfranciscoplasticsurgery SMAS turkeywaddle turkeyneck

01/06/2026

Before and after liposuction of the arms in a 39-year-old woman. At the same time as a breast augmentation and liposuction of other areas of her body, she wanted to improve the appearance of her upper arms.⁠
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Liposuction permanently removed excess fat through several tiny incisions. After surgery, she wore compression sleeves for two months to help encourage skin contraction and to limit postoperative swellings.⁠
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Follow up photos are shown 4 months after surgery. Her incisions are still visible but are starting to fade. She is applying scar gel and feels motivated to work out her arms harder now that she can see her muscle definition!⁠
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⁠To see the complete set of before & afters for other liposuction cases, visit my website gallery: https://www.drkarenhorton.com/gallery/body/liposuction-of-the-arms/⁠
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sanfranciscoplasticsurgery

10/24/2025

Before and after bilateral in a 52-year-old woman. Her 18-year-old implants had developed contracture and were painful. She was tired of trying to conceal them in clothes and when she gave hugs since they were so hard.⁠
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Her breast implants were removed under local anesthesia as a straightforward outpatient procedure. The internal capsule did not require removal and gradually faded away once the implants were removed.⁠
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After surgery, she showered in two days and resumed exercise in two weeks. Follow up photos are shown 2 months after surgery.⁠
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⁠To see the complete set of before & afters for this case, visit my website gallery: https://www.drkarenhorton.com/gallery/breast/explantation/patient-45⁠
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10/24/2025

Before and after liposuction of the neck in a 39-year-old woman with lipodystrophy (excess unwanted fat) in the submental region of her neck, under her chin. At the same time as a breast augmentation, she wanted to improve the contour of her jawline.⁠
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Liposuction permanently removed fat through two tiny incisions under her jawline. After surgery, she wore a compressive chin strap for two weeks, and gradually resumed exercise at one month.⁠
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Early follow up photos are shown 3 months after surgery. Her scars are starting to fade, and she is actively applying scar gel and massaging her incisions. She knew going into surgery that her incisions would take a while to fade - she removed her makeup for these follow up photos but normally conceals the incisions with coverup.⁠
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⁠To see the complete set of before & afters for this case, visit my website gallery: https://www.drkarenhorton.com/gallery/face-and-neck/liposuction/patient-54⁠
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10/24/2025

Before and after bilateral breast reconstruction revision in a 48-year-old breast cancer survivor. Her previously placed submuscular implants during her breast cancer treatment felt painful, were constantly tight and caused her to feel self-conscious when not wearing a bra, even with her husband in intimate settings.⁠
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Her revision involved removal of the old implants, reconstruction of her chest wall musculature, returning the pectoralis major muscles to the chest wall and suturing them back into place on the ribs, and insertion of new smooth round silicone gel breast implants. Liposuction removed excess fat from her armpits and bra rolls.⁠
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The local flap technique was used to create two new ni**le prominences, and medical tattoo created new areolar circles. Follow up photos are shown 10 months after surgery. She went out of pocket for this breast revision, as she was in a strict managed-care organization health plan where she only had one option as a surgeon. “You get what you pay for” was her statement, “and this was worth it!”⁠
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⁠To see the complete set of before & afters for this case, visit my website gallery: https://www.drkarenhorton.com/gallery/breast/revision-breast-surgery/patient-308⁠
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10/21/2024

Before and after as part of a in a 44 year old woman. After having her children, she found that her abdominal muscles bulged apart and she felt less stability of her core. She was very physically active and no amount of ab work could bring her muscles back together. She had , permanent separation of the muscles after multiple pregnancies.⁠
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A was performed at the same time as a and . Excess skin and fat from her lower abdomen was excised, and her abdominal muscles were repaired to one another in the midline. Her belly button was brought out through a new skin opening. Liposuction removed stubborn fat from her upper and lower abdomen, flanks, upper inner thighs and axillary rolls.⁠
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Follow up photos are shown 6 months after surgery. Her scar is fading and her abdominal contour is flat. She feels like her has her pre-pregnancy abdomen back and no longer feels instability of her core when doing pushups and planks. She doesn’t mind the abdominal scar being longer than her old C-section scars – she feels it’s worth it!⁠
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⁠To see the complete set of before & afters for this case, visit my website gallery: https://www.drkarenhorton.com/gallery/body/abdominoplasty/patient-125⁠
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08/18/2024

Before and after in a 36-year-old Mom who lost a significant amount of weight in addition to giving birth to three children. She wished to improve the contour of her breasts without adding an implant and to regain her pre-pregnancy abdominal tone.⁠
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Her personalized Mommy Makeover included a ( ) without implants and a . This combined procedure rejuvenated the breasts and the tummy, repaired her abdominal muscles back toward one another in the midline, and helped to reestablish her body image.⁠
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After surgery, she felt more confident in her own skin and more like herself again. Follow up photos are shown 2 months after surgery. She has started scar therapy and understands that the dark pigmentation of her incisions is genetically normal for her. The incisions will gradually fade over several months to a year.⁠
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⁠To see the complete set of before & afters for this case, visit my website gallery: https://www.drkarenhorton.com/gallery/body/mommy-makeover/patient-6⁠
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06/29/2024

Take a tour of my office & operating room with me!

Dr. Karen Horton, Board-Certified Plastic Surgeon & founder of San Francisco Plastic Surgery, takes you on a tour of her beautiful office and in-suite operat...

04/25/2024

I have a favor to ask!

04/22/2024

Please remember to vote DAILY until noon on May 6th!!

Welcome to the voting round of SFGATE’s first-ever Best of Bay Area, a reader-driven popularity contest with 119 categories (including 18 exceptionally fun San Francisco-only “SFGATE Picks” dreamed up by our newsroom). Thanks to more than 100,000 nominations from you, we now have at least five...

04/18/2024

Voting is LIVE! I've been nominated officially in the SFGATE first-ever competition for local businesses! You can vote DAILY for me under the Beauty Section - Best Plastic Surgeon: https://www.instagram.com/p/C56OsAtxQJH/

03/21/2024

Every vote counts! We're excited to participate in the Best of Bay Area 2024 contest and would be honored to have your support!

Our practice is up for two nominations: 'Best BOTOX Center' with Karen M. Horton, MD & Emily Sespaniak, NP, and 'Best Cosmetic/Plastic Surgeon' with Dr. Karen Horton.

With your help, we can showcase our dedication to excellence in the community. Let's join forces and make our mark on the Bay Area together!

Tap the link below to nominate us now through April 2nd! https://www.sfgate.com/best/vote/?source=merchant #/gallery?group=477871