I just attended my Aesthetic Plastic Surgical Meeting 2020 online. (Thank you coronavirus!). The meeting was GREAT. I know it was great, because when the meeting ended all I wanted to do was blog about all of my thoughts. One of the points brought up repeatedly was about how some treatments used to give improvements (and these tend to be the noninvasive or minimally invasive procedures) can cause issues down the road. Many of these things are controversial. You will find in plastic surgery if you meet 5 different surgeons, you are likely to get at least 4 different opinions. And as many of the presenters today stated, every doctor tends to do their way well.
So, knowing this is my personal viewpoint after having done plastic surgery for 20+ years now, please think about these procedures before doing them.
- Sculptra. I like this product to add large volumes to the face. It lasts for about 2 years, and looks very natural. The issue is if you do Sculptra, in the future fat grafting won’t work well. And I LOVE facial fat grafting. So for nonsurgical dermal fillers, I like the HA fillers like Juvederm, Voluma, Restylane, Defyne better. Adding volume back to the face as you age is key.
- Ulthera. It is supposed to tighten the skin. I almost bought the machine a few years back, as we are all trying to find something to improve the aging neck. Issues: It doesn’t give much change for many, the change it does do tends to be temporary, and it is likely damaging or removing the subcutaneous fat. READ MY BLOGS ON FAT GRAFTING. I spend so much of my time trying to get fat, the volume, and the lovely stem cells it brings back into the face. Don’t do anything which would remove fat, and that subcutaneous fat is key to make the quality of your skin look good as you age. A wrinkly sheet on the bed makes the bed look bad.
- Kybella. It is great at removing the fat in the central neck in young patients with good skin tone. Con- It is not no downtime- you have swelling. And for those with more diffuse fat or in need of tightening of the skin, it may not work well. Many don’t see much difference (cost, downtime, etc) over simple liposuction.
- Coolsculpt. It again is likely okay for those young patients with thicker skin and good skin tone. Coolsculpt can be applied more broadly than Kybella. The issue I have with coolsculpt is it works from the skin down, so again, I worry about long term effects of getting rid of the subcutaneous fat (getting thinner, more wrinkled etc skin).
- Removing the buccal fat pad. This was a controversial one particularly today. Many young patients want a thinner lower face and the more sculpted look. And those of us who are older, remember the heroin chic with the hollowed cheekbones of the 80s. But we know your face loses fat volume as you age, leaving older patients too hollow (hence we spend so much time trying to get fat back into the face).