Friday, February 7, 2014

Plastic Surgery: What's new for your face in 2014?

While Hollywood stars seem to go to extremes when getting plastic surgery, most of my patients request more conservative procedures. Patients request a refreshed look, without the sigma of a "surgical" appearance.

Some patients request injections prior to trying surgery. Soft tissue replacement fillers are all the rage, Voluma by Allergan is the latest filler approved by the FDA to add volume to the cheeks and face. Most patients will need 4 to 6 cc's per cheek. This is the key to good results using adequate amounts of the filler. Patients that use a dollar limit to decide how to be treated will most of the time have inadequate results due to not fully correcting their soft tissue deficit.

Fillers temporarily fill wrinkles and add volume to deflated faces. They work best in patients who have experienced minimal changes in their appearance. There are permanent fillers available; however these agents cause a scar reaction. We all know scars are unpredictable and scars may leave patients with deformities that are very difficult to treat and may not be correctable.

Using your own fat is the most natural way to replace lost volume. However, fat grafting requires removing donor fat from another area of your body to be transferred to the face. This is usually done with the patient sedated but can be done under local anesthesia with oral sedation.

Wrinkles can also be treated with muscle blockers. Botox was the first muscle blocker and now we have two more; Dysport and Xeomin. These medications temporarily block the function of muscles to soften lines and delay wrinkle formation. Most patients that request treatment already have established lines on their faces; it can also be used to delay the formation or wrinkles in younger patients.

Fillers and muscle blockers are offered by physicians in many different fields of medicine. However, plastic surgeons can offer you all options to treat your face, injections and surgery.
Injections need to be properly done to avoid complications. Is the beauty salon, spa, or your friend's house the proper environment to minimize infection, and properly store medications? Would you normally make a decision on medical care after a cocktail of two during the next Botox party? Should your treating physician have residency training in cosmetic procedures or is an on line course enough training? After all it is your face.

Surgery has come full circle. The early procedures in plastic surgery were limited in scope with short lived results. In the 90's more extensive procedures were developed and dramatic results were obtained. However, patients experienced long recoveries and prolonged down time. In the last few years slick marketing companies have popularized smaller incisions for a facelift. These techniques are practiced by all plastic surgeons. Don't be fooled by Hollywood stars and infomercials. Pick your surgeon based on a solid reputation and documented results, not an 800 number with a catchy jingle. With the advent of new technologies we can again offer facial procedures with rapid recovery and excellent results. There is no such thing as lunch time facelift! A few patients can be back to work in a week or so but normally ten days to two weeks are required for recovery.

The American Society of Aesthetic Plastic Surgeons web site is an excellent reference for patients to get more information, You can also visit my web site, or call for more information, 772-562-5859, Ralph M. Rosato, MD, FACS.