In the world of face surgery and rejuvenation, the techniques and approaches vary from doctor to doctor. There’s the facial surgeons who love the deep plane facelift and there are others who prefer a different approach. Some facial experts incorporate the use of threads, others don’t. What we’ve found over the years is that the best aesthetic doctors, in addition to having their own preferences or positions, are committed to continuing education, learning from their peers, sharing their techniques, and staying abreast of advancements in the industry. This is why we make it a point to be where they are to learn about what’s happening now in aesthetics.
At the latest spring conferences—the Miami Cosmetic Surgery Conference and The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) Advances in Rhinoplasty—NewBeauty was there to catch up with our experts and find out about what’s new, what’s trending and what’s next.
A Scar-Free Rhinoplasty Option
At the Miami Cosmetic Surgery conference Arcadia, CA, plastic surgeon Art Yu, MD presented on a panel called “Things I Do that I Haven’t Published But You Should Know About,” where he talked about his completely closed rhinoplasty technique where he performs the surgery intra-orally. Dr. Yu shared with us photos of this procedure where he is able to reshape the nose internally without making any inside or outside cuts to the nose, but by using an incision made from inside the mouth. “There’s no cutting from the outside and all the reshaping is done from the inside upper lip,” he explains. From that incision he is able to reshape the nose using grafts to straighten the bridge and enhance the tip. “To create a better nose tip, I use the ear cartilage to make a tip graft and insert it through a tunnel made in front of the columella, through that intra-oral incision. This is followed by insertion of a columella graft just under the tip graft.” In addition to a natural-looking result, Dr. Yu says his patient love that there is absolutely no scar anywhere in the nose.
GenX and Millennial Middle-of-the-Road Anti-Aging Procedures
According to Los Angeles facial plastic surgeon Denise Wong, MD one trend she’s seeing a lot of is the use of minimally invasive procedures as an in-between anti-aging step for patients in their 30s and 40s who want a subtle lift. The doctor says that when patients aren’t ready for a facelift or eye surgery, but they want something more than injectables can provide, the thread lift serves as a good go-between. “It’s more like a bridge between the nonsurgical and more aggressive surgeries because either you don’t really need that much of an aggressive approach or patients aren’t willing to undergo surgery.” Another example she cites is using a combination approach, like a fat transfer and Botox Cosmetic injections to address problem areas rather than undergo some form of facelift. “You can really address some of those issues like volume loss and wrinkling. A combination approach is best when using nonsurgical treatments.”
A Better Way to PRP
From Southlake, TX and Monroe, LA dermatologist Janine Hopkins, MD, came the CuraCater, a medical device created to stop needle pricks, spillage, unnecessary waste and a hands-free experience when applying platelet-rich plasma, exosomes or other serums to newly wounded skin from lasers and microneedling. “This practical, simple sterile device attaches to any universal luer lock syringe to allow the user to slowly carefully and gently apply product to skin or any tissue.”
Considering “Mirror Image” With Surgical Results
According to New York facial plastic surgeon Steven Pearlman, MD the amount of people who think they have crooked noses because of cell phone lenses has skyrocketed, altering people’s perceptions of their features. We look in the mirror a dozen times a day, but our photos are reversed. So, when you see a photograph of yourself your asymmetries are exaggerated. During two months of consecutive consults, we asked patients to look at their mirror image versus their photographic image and asked them, ‘Which photo do you like better?’ More than 90 percent chose their mirror image. Dr. Pearlman says social media, selfies and cell phone wide-angle lenses have distorted our perception of ourselves so much, our noses have taken the hit. “This is why we are seeing an uptick in people who think their nose is crooked. Even a minor asymmetry will be grossly exaggerated.”
Younger Patients Open to Limited-Incision Lifts
When asked if facelift patients were trending younger, Atlanta facial plastic surgeon Mark Beaty, MD says his patients are more inclined to consider a lift and to what degree comes down to how he evaluates the face during surgery. “There are things that I don’t think you can evaluate in a preoperative phase until you can actually lay your hands on this SMAS and get a sense of its integrity, compliance, thickness, all of those things,” he says. Noting that skin and tissue quality are more of a factor than chronological age, he shares that repositioning that supportive tissue of the face may be done through a limited incision approach with relatively limited dissection. “That’s how I describe the technique to patients and it has opened a window for younger patients to be more inclined to consider surgery.”
Avoiding Hyperpigmentation from Filler Injections in Melanin-Rich Skin
As one of the first dermatologists to present at the AAFPRS Advances in Rhinoplasty event, New York dermatologist Michelle Henry, MD took the opportunity to share her techniques to avoid causing hyperpigmentation in skin of color when performing treatments like lasers and fillers. For lasers she recommends starting slow and with injections, she prefers the cannula to a needle. “It reduces the number of injection sites which reduces the potential for bruising which reduces the potential for hemosiderin deposition,” she explains. “Adverse effects like irritation, inflammation and post-inflammatory hyperpigmentation can be really long standing in skin of color and difficult to treat, so we try to employ best practices to avoid these things if we can.”
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