I am pleased to announce the initiation of our new blog, which will allow our patients to stay informed on the latest advances and other news in Facial Plastic Surgery. I will be posting articles and other entries that help to ensure that you are exceedingly well-prepared for any procedure, and keep you updated on new developments and specials here at Cincinnati Facial Plastic Surgery. Importantly, I also encourage each of you to submit anything you might be interested in, including any articles, questions, or comments about recent developments. Having a running dialogue like this is a fantastic and stimulating way to learn more about how to get the best results and the best bang for your buck!
To kick things off, those of you who have been asking about alternatives to Botox will be happy to know that the long-awaited competitor, Reloxin (to be distributed by Medicis, the makers of Restylane and Perlane), is finally under review by the FDA. It's impossible to predict when exactly the review will be completed, but I will let you know as soon as I do. The Botox brand has had a monopoly on this market in the U.S. for years now, and we welcome the prospect of competition in this area to stabilize, or even improve, the affordability for all of our patients.
I also have a backlog of interesting articles I've accumulated over just the past few months. I'll start with this one from the front page of the Enquirer--it's a very well-written article. Please also see my reply to the author, pointing out the benefits of Fat Transfer for a more long-lasting effect of Volume Replacement in the face.
Dr. Donath
ForbesLife Executive Woman
Beauty: Face Time Feeling under the gun about going under the knife
For a growing number of executive women in their 40s, 50s, and older, the perception of cosmetic surgery as a pursuit of the vain and frivolous is giving way to a new reality. At the peak of their careers, with at least a decade or two of earning power in front of them, they see their futures in sharp focus. But the reflections in the mirror can be a little fuzzy. "I'm impressed by how many patients I meet who are this type of woman," says Manhattan facial plastic surgeon David Rosenberg, M.D. "They're executives, lawyers, bankers--people who want to work longer, not retire at 58. And they want to look like they're on their A-game, to appear as defined and rested as possible without a trace of surgery. That communicates confidence and wellness."
Many women (and men) are acquiring refreshed looks through so-called lunch-hour treatments, which get you out and on your way in the time it takes to have a three-course meal. These include the use of lasers, such as Fraxel and Laser Genesis, the ubiquitous Botox and Restylane injections, and light chemical peels. But there comes a point when the various noninvasive treatments are no longer enough.
The moment of truth, as Rosenberg notes, can be highly subjective: "There are some people who look fabulous at 65 who've never done anything. And there are those at 44 who just look worn out. I think of the lunchtime procedures as polishing agents. What we're talking about with surgery is taking away the sagging that comes with time."
"Do everything you can before the cutting," says Charla Krupp, author of How Not to Look Old (Springboard Press). "Once you have a face-lift, people know you're old enough to get a face-lift!" That's always been the risk with the standard-issue lift, which sometimes can result in an unnaturally taut look to the skin.
Over the past decade or so, some surgeons have been paying more attention to how the face fills out after surgery, modifying their techniques to make sure they preserve or restore fullness to the face. These face-lifts place more emphasis on so-called volumizing, although the procedures do not have a specific medical term. Volumizing lifts tighten the facial structure, restoring youthful contours instead of merely trimming sagging skin. This is accomplished surgically by repositioning the deeper tissue of the face, causing the fat attached to it to move as well.
Since the American Society of Plastic Surgeons does not have a separate designation for these procedures, it's unclear how many of 2007's nearly 120,000 face-lift patients--who paid from $6,000 to $25,000, depending on such factors as a surgeon's reputation and extras like eye-lifts--opted for the newer types of surgeries. (New York Magazine recently referred to the results of volumizing lifts as "the New New Face").
As if workplace pressures to have a face-lift weren't enough, consider escalating media demands on prominent businesspeople and the concerns about how one might look on high-definition television or projected onto a movie-size screen when speaking at a corporate conference. And it's not just the Michelle Pfeiffers of the world making things difficult: There has been widespread speculation in the press about Speaker of the House Nancy Pelosi's preternaturally youthful 60-something face. And gossipy New Yorkers have gone so far as to credit a specific surgeon (Dr. Sherrell Aston) with Vogue editor Anna Wintour's reported work.
Comment On This Story
"Look at the women on television--the real pioneers like Lesley Stahl and Diane Sawyer," says Charla Krupp. "Everyone wants to know who did their work. Look how gorgeous Lesley Stahl is. Then there's Morley Safer. He isn't getting a face-lift. . . . It's very unfair. We don't allow women to look like that on television in America. The bar is also much higher for women who have powerful corporate jobs."
While Safer may feel comfortable aging on camera, more and more men are seeing the benefits of going under the knife. George Clooney admitted to an eye-lift on an Oprah Oscar special. Michael Douglas and Rob Lowe (nyse: LOW - news - people ) are rumored to have had some plastic surgery. According to the American Society for Aesthetic Plastic Surgery, men had 1.1 million cosmetic procedures in 2007, up 17 percent from 2006--so it's not just Hollywood aiming to look better. More likely, it's the senior vice president of marketing down the hall. But even with this uptick, men account for only about 9 percent of total procedures.
"Every week I hear of another supersuccessful, accomplished woman in her 50s being let go," says Krupp. "My opinion is that they [cosmetic procedures] should be a tax write-off. You have to look good for work, or the next generation thinks they can get a bit of an edge."
While the idea of having plastic surgery to stay competitive in the business world is gradually gaining acceptance, it still bears a stigma in many corporate suites. Even women in so-called image businesses, like cosmetics and fashion, contend there's risk in owning up to a nip and tuck. "If you're a powerful woman executive, you don't want to look frivolous," says 48-year-old cosmetic company exec Francesca (declining to give her last name), who recently underwent a combination face- and eye-lift.
The irony of a cosmetics executive's reluctance to go public about going under the knife is not entirely lost on Francesca. Still, she insists her industry is hardly immune to the competitive forces that dominate corporate America, and that questions about someone's age are inevitably raised with news of her or his plastic surgery. But even though Francesca was cautious about announcing her intentions beforehand, she says that, with time, she has become a bit more relaxed in discussing her surgery. Indeed, if someone flat-out asks, she's now willing to tell them what she has had done. That degree of openness, Francesca maintains, might be much more difficult in other industries.
Add Comment |
Ask a Question |
Permalink
Tags:
ForbesLife Executive Woman
Interesting stats on facial plastic surgery procedures:
AAFPRS (ARA) - Our faces are our calling cards. They identify us, they show our emotions and they are connected with three of the five senses bringing outside information to our brains. But what happens when our identity starts to droop and turn us into someone else? Or eye and nose restoration is needed to help us look younger? It may be time to research facial plastic surgery and find a facial plastic surgeon you would trust working on your face.
A recent study conducted for the American Academy of Facial Plastic and Reconstructive Surgery reports that 85 percent of adult Americans would undergo a facial plastic surgery procedure if given the chance. Furthermore, 80 percent of those surveyed would rather trust their face to a facial plastic surgeon when having their procedure performed.
Last year Americans underwent 2.3 million facial plastic surgery procedures and more than 38,000 revision surgeries. Some were for a younger-looking face, while others were to correct breathing difficulties or drooping eyelids. Some were just because people feel better when they enhance their appearances. Eighty percent of men and women look for an experienced, certified facial plastic surgeon over generalists when it comes to facial plastic surgery.
Trust your face to a facial plastic surgeon. By doing your homework ahead of time, you can find a facial plastic surgeon you trust to maximize the benefits of your chosen treatments. A facial plastic surgeon should discuss options and make recommendations to correct the issues.
AAFPRS facial plastic surgeons have extra training for their specialties. All complete approved, post-graduate specialized residencies addressing facial plastic surgery. For most that includes four-year specialized residencies in otolaryngology - head and neck surgery - which includes facial plastic surgery. Many also undergo additional year-long AAFPRS fellowships in facial plastic surgery.
The AAFPRS is an excellent resource for researching the surgeons in your area and types of facial procedures. It is the world's largest association of facial plastic and reconstructive surgeons, with more than 3,000 members who concentrate on the face, head and neck.
Referrals from family and friends who have undergone a procedure are also good places to start your research. Or get a recommendation from a trusted physician or health-care professional. Once you find a surgeon, ask how many procedures of the type you are considering the surgeon has performed, and if the surgeon operates in an accredited facility. The surgeon needs to be one to whom you would trust your face.
The AAFPRS Web site, www.facemd.org , has information and brochures about different surgeries, and includes a listing of facial plastic surgeons in your area with board certification.
Courtesy of ARAcontent
Add Comment |
Ask a Question |
Permalink
Tags:
Interesting stats on facial plastic surgery procedures
ANNUAL MEETING OF THE AAFPRS
It was my great pleasure to participate in the annual meeting of our Academy in Chicago American Academy
An additional highlight of this Academy meeting was participating in the fundraiser for our Face To Face charity. This fantastic program provides medical and surgical care to individuals who suffer from deformities caused by circumstances beyond their control--including birth defects, domestic violence, and war. The fundraiser drew numerous members of our academy for a boat trip along the Lake Michigan coastline and helped to raise tens of thousands of dollars to help support the mission of Face to Face. This is one of the many wonderful ways in which our Academy lends its expertise for the good of society, and the one of which I am most proud. For a more detailed description of this program, please click on the link below:
http://www.aafprs.org/humanitarian/pa_humprog.html
Again, if you have any questions you would like to see answered on this blog, or if you would like to suggest an article to be posted and discussed, please feel free to email me at:
drdonath@cincyfacialplastics.com
I look forward to hearing from you!
Dr. Donath
Add Comment |
Ask a Question |
Permalink
Fillers aim to stop the clock
Debbie Williams of Amelia isn’t turning the big 4-0 or having a mid-life crisis. She doesn’t yearn for a shockingly taut chin line or baby-smooth forehead. But a few weeks before her 39th birthday, she was looking for a little pick-me-up.
Like many 30- and 40-somethings, Williams turned to a non-surgical injectable filler to smooth those irksome lines and restore youthful volume to her cheekbones.
“There’s something about turning 39. I just wanted a little something, to freshen up a little,” Williams said. “But I didn’t want to not be able to raise my eyebrows at my kids.”
Botox treatments are the No. 1 cosmetic procedure for 35- to 50-year-olds, the bulk of people who seek facial and other bodily enhancements. But “next-generation” injectable gels are now the second-most-popular option - driving a non-surgical beauty industry that’s grown eight times nationwide in the past 10 years.
Locally, at least seven “medical spas” have sprung up, offering Botox and other injections.
That’s in addition to the dozens of doctor’s offices from Fairfield to Florence
But as the popularity of cosmetic injections rises, new questions are being asked about who can - and cannot - safely administer them.
Licensed physicians are not required to have formal training or certification to administer an injectable gel. And in Ohio and Kentucky
“The big issue that’s up for discussion is what does ‘physician supervision’ mean? It’s sort of unregulated right now,” said Dr. Vito Quatela, past president of the American Academy
“I am deeply concerned when you have a day spa that’s evolved into a medical spa, and the doctor who’s supervisory isn’t even on-site; he’s a name on the wall,” Quatela said.
The Kentucky Nursing Board last month adopted guidelines specifying that the physician - or registered nurse with advanced training - must be in the room if a licensed nurse practitioner administers the injection, and must be “readily available” if a registered nurse performs the procedure. The Ohio Board of Nursing is considering similar guidelines.
Local practitioners say the guidelines - even though they’re not legal requirements - are welcome.
“There’s confusion in the medical community about who can do it, so imagine what it’s like for the public,” said Kathy Jones, a registered nurse and licensed plastic surgery nurse.
Although a botched Botox treatment or dermal filler injection rarely does permanent damage, even a tiny variation in the depth or technique of the injection affects the aesthetics of the end result.
Sandy Berling of Union believes the bruising and puffiness beneath her eyes that she experienced following a Restylane injection last year was due to the rushed technique of the plastic surgeon.
“His nurse got me ready, he came in with the needle, stuck it in (the skin beneath) my eye, and patted it real hard and left,” Berling says. “The way they made me feel was that I wasn’t very important to them, that maybe I wasn’t spending enough money or something,” says Berling, who since then has had several successful Botox and filler injections.
LOOKING TO STOP THE CLOCK
Fifty percent of all cosmetic procedures and 46 percent of dermal filler procedures are performed on 35- to 50-year-olds, according to a survey by the American Society for Aesthetic Plastic Surgery.
Today’s fillers are often synthetic or laboratory-created gels based on substances that occur naturally in the body but break down as we age. Some of the most popular brands are Restylane, Radiesse and Juvederm. Most clients receive 1 to 2 milliliters of the filler, which is injected into the skin via a syringe, usually after a numbing agent is injected into the area. The procedure takes less than 15 minutes.
Increasingly, patients are turning for their treatments to “medical spas,” which offer cosmetic dermal injections, laser vein and hair removal and light therapy skin treatments in addition to spa services such as massages and facials.
Eleven months ago, Williams had her smile lines and lines above her lips filled with Restylane by Dr. Navkaran Singh at the Avalon Salon and Aesthetic Day Spa in Oakley. She was so pleased with the subtle change that, for her second filler procedure in January, she added a few injections to the skin over her cheekbones to enhance her bone structure.
“People were saying, ‘Did you get new makeup?’ It was just very natural,” Williams said of her first treatment.
Like Williams, most 30- and 40-something filler clients are looking for a little pick-me-up, not the full lift of cosmetic surgery.
“A lot of women in their 30s are coming in to get these procedures,” said Kathy Jones, the owner of Kathy Jones Skin Care in Fort Wright
Singh, the medical director at Avalon, said his filler clients generally want to take off five years, but “don’t want to look like they’re 30 or 20 again.”
Unlike Botox injections, which block the transmission of nerve impulses to the muscles, dermal fillers fight the signs of aging on the face - such as sunken eyes, less-pronounced cheekbones and sagging eyelids and jowls - by filling in for the buoyancy that breaks down as skin ages.
“How we view aging has evolved a little. We used to look at it as sagging, so you had the lifting (to address it),” Quatela said.
Adding volume via a filler can, visually, fill in for a face lift or other surgical procedure.
“If somebody comes to you with baggy eyes and doesn’t want to have surgery, you can fill in the tear trough and it looks like you lifted their eyes,” said Jones.
“It’s an optical illusion. And that’s a lot of what plastic surgery is.”
LESS DOWNTIME A PLUS
According to a survey by the American Academy
“We’re seeing that minimally invasive-type treatments that offer patients less downtime are increasing in popularity,” said Dr. Peter A. Hilger, president of the American Academy
“The goal is to have a nice, natural-looking outcome - you don’t want to look like you’ve had surgery.The trend toward non-invasive cosmetic procedures has allowed more Americans to get the look they want without having to turn their busy lifestyles upside down.”
Because most filler treatments last 12 months or less, they’re more expensive to maintain long-term than a surgical procedure, but clients are willing to pay the price for the convenience.
“Over time (a filler) can cost more than a specific surgery,” said Dr. Allison MacGregor Holzapfel, a plastic and reconstructive surgeon with Mangat-Kuy Plastic Surgery Center in Edgewood . “It’s not always about money, but about the downtime.”
With the exception of swelling the day of the procedure and the chance of slight bruising, there is no downtime associated with filler treatments. The average time away from work for a face lift is about two weeks, and cheek implants usually require one to two weeks of recovery, according to figures from the American Society for Aesthetic Plastic Surgery.
OUT THE DOOR IN 15 MINUTES
For Williams, a stay-at-home mother of three, downtime wasn’t an option.
After a brief consultation and a half hour to allow a numbing agent to work, Singh injected 1.3 cubic centimeters (1 cc equals 1 milliliter) of Radiesse into each smile line and the skin over each cheekbone, stepping back several times to eyeball his work before massaging the gel into place using the pads of his thumbs.
Fifteen minutes after the first injection, Williams is out the door, with recommendations not to sleep on her face or do heavy exercise for 72 hours.
The Radiesse, which is thicker than Restylane and injected deeper into the skin, fills in more over the first month. Her plumped-up cheekbones will last a year or more, Singh said, and her smile lines will be undetectable for nine to 12 months, depending on how much she smiles and laughs.
Although the effects of injectable fillers are marketed as a “liquid face lift,” practitioners said the procedures aren’t interchangeable.
“This whole new genre of fillers, where we can use them deeper and actually use them as filling, has complemented what we can do,” Quatela said. “(But) it will never replace a face lift.”
Source: Cincinnati.com
Ms. Howell,
I wanted to compliment you on an outstanding summary of the available options for filling materials in the face. The review of the current state of affairs for the politics of injector safety was excellent and presents the public with very important points to consider prior to receiving an injection or other procedure; injections alone can lead to blindness and death of overlying skin in extreme circumstances and therefore must be done with all available precautions. Something that occurred to me as I read the article was that there is a less-publicized procedure available for restoring volume to the face which is more durable (in excess of 10 years typically, and it appears to be essentially permanent ): fat transfer per side of the face (even after swelling resolves), for the price of about only 2 to 3 syringes (2 to 3mL) of synthetic filler, and the patient typically gets 10 years or more of benefit. The end result is a cost of fat transfer of about $10 to $15 per mL per year vs. $600 to $900 per mL per year for synthetics. Couple that with no risk of allergic reaction for one’s own filling material and it is an excellent value for patients. I fell in love with this procedure during my fellowship with the authors of the textbook describing it, “Complementary Fat Grafting,” and find that, while the synthetic fillers absolutely have a role in my practice and are here to stay, fat transfer is a tremendous advancement in facial plastic surgery.
If you would like to know anything else about fat transfer I’d be happy to forward an article I recently published on the restoration of volume in the face, focusing on fat transfer. I am also nearing submission of a first-of-its-kind study on the durability of fillers for treatment of dark circles beneath the eyes; I could certainly forward you a copy once published, if you are interested.
Thank you once again for providing the public with an outstanding review of facial filling materials; they are obviously in huge demand, as you pointed out in your graphic. If you should ever need information on other facial procedures (my practice is limited to facial plastic surgery, as with Dr. Quatela and Dr. Hilger) I would be more than happy to help.
Best regards,
Add Comment |
Ask a Question |
Permalink
Tags:
Fillers aim to stop the clock
