Face Forward: Choosing Surgery or Injectables

Face Forward: Choosing Surgery or Injectables featured image
Dmytro Buianskyi/Getty Images. Image Used for Illustrative Purposes Only.

To cut or not to cut?  

This decision isn’t merely a matter of preference but a delicate balance between aesthetic desires and individual facial characteristics. Seasoned plastic surgeons, such as those at the Plastic Surgery Center of Hampton Roads in Newport News, VA, plastic surgeons Drs. Michael Lofgren, MD, Peter Vonu, MD, Michael Zwicklbauer, MD and Randall Blanchard, MD, possess a keen eye for detecting signs of facial aging and an understanding of all treatment options to determine the most suitable approach for each patient.

Dr. Vonu suggests that you’ll recognize the need for change when you begin noticing things in the mirror that you dislike. He explains, “I feel the ideal timing is when one looks in the mirror and starts to feel they don’t look as good as they physically feel. It’s nice to look in the mirror and see yourself looking as good as you feel!”

When Should I Choose Injectables?

Knowing that you want rejuvenation is one thing, but knowing what to go for is something else entirely. And since we’re not experts, it can be difficult to know if an injectable solution will meet your goals without surgery, or just leave you unimpressed.

For plastic surgeons determining your best move, the focus is less on what age you are, and more on what age your skin seems to be. That can be influenced by things like sun exposure, weight loss, environmental pollution, lifestyle and genetics.

“Age isn’t as important as overall physical well-being and quality of the skin,” says Dr. Blanchard. “Facial aging is the most important factor in my mind,” adds Dr. Zwicklbauer. “The quality of the tissue is the most important variable when it comes to facial rejuvenation treatments.”

That means if you’re coming from a place of highly damaged skin that’s lost most of its collagen and elastin, you might not be getting the best result from a nonsurgical procedure.

“As an example, in younger patients with typically thicker skin containing more collagen, skin-tightening procedures using radio-frequency-assisted liposuction are a viable option, where in the older patient, you may lean towards more traditional skin tightening like a facelift or necklift,” explains Dr. Lofgren. “Careful assessment of the patient’s skin will help to reveal these subtleties and allow you to choose the best possible treatment.”

Do I Need Plastic Surgery?

As expert plastic surgeons, the team at the Plastic Surgery Center of Hampton Roads helps patients understand what kind of results a treatment can provide given their level of skin laxity, facial aging, weight loss, etc.

“When evaluating a patient, I find that clearly defining their goals is crucial to presenting them with options on how it can be achieved,” Dr. Lofgren says. “Just as important is carefully examining the patient and identifying characteristics that influence the options I may present.  Significant skin laxity and moderate to large amounts of unwanted fat in key areas will certainly play a role in the decision-making process.”

In nearly every case, skin laxity is a major determining factor on whether or not surgery is needed.

“To me, the amount of skin laxity dramatically affects my decision-making for surgery,” Dr. Zwicklbauer explains. “I have a heart-to-heart conversation with my patients about their true concerns.  If a patient has a lot of laxity, nonsurgical procedures will not give the result the patient desires.”

Collaborative Combinations

But that doesn’t mean that surgical patients can’t benefit from the addition of noninvasive treatments.

“I feel that a more holistic combination approach would benefit everyone,” says Dr. Vonu. “For example, almost everyone at a young age would benefit from skin care and in some cases if they want to prevent permanent wrinkles, they would consider a paralytic like Botox. Over time, those treatments can be paired with more aggressive approaches as the need suggests.”

And thanks to the sheer number of new and emerging cosmetic technologies, plastic surgeons are spoiled for choice.

“A wonderful thing about modern plastic surgery is the variety of options now available to us as surgeons,” Dr. Lofgren explains. “I have the enviable position of being able to pick and choose from both invasive and noninvasive treatment options to tailor a treatment plan for patients. Be cautious of anyone that only does one type of treatment. You may be missing other, more appropriate options that can result in better results.”

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