By Jana Soeldner Danger
City & Shore PRIME
If looking better can make you feel better – by boosting your self-confidence – today’s surgical and nonsurgical techniques can make it easier than ever to restore a more youthful appearance.
Surgery produces immediate results that are long-lasting, but it usually requires significant recovery time. It also causes scars, although a skilled physician may be able to minimize or conceal them effectively.
The results of non-surgical techniques may be less dramatic and require more than one treatment. They are not as long-lasting as surgery, but there is often very little recovery time and virtually no scarring.
We asked three experts – Dr. Martin Newman, a plastic surgeon with Cleveland Clinic Florida,
Dr. Jordana Herschthal, a dermatologist in Boca Raton and Dr. Jacob Steiger, a facial plastic surgeon in Boca Raton – to talk about some possibilities.
While there are procedures for improving just about every part of the body, many people are most concerned with their faces. “A youthful face has the shape of an inverted triangle,” says Dr. Herschthal. “But as a person ages, the face becomes more rectangular. Later, the triangle reverses, and the heaviest part of the face is at the jawline.”
When a person turns about 50, he or she loses facial fat, causing the midface to fall, Dr. Newman says. Nasolabial folds deepen, producing “marionette” lines; and jowls develop at the bottom of the face. Ligaments in the face start to sag, and cheeks start to fall, Dr. Steiger says.
But help is on the way.
Fillers are a minimally invasive solution to restore sagging facial features, filling grooves and reshaping the face. Results usually last from six months to a year. “When we use fillers, we’re simply replacing what’s been lost,” Dr. Herschthal says. “We use them for both deep and superficial lines.”
Fillers have improved in recent years. “The number of fillers we have available today is double what we had a few years ago, so we can customize and combine them with each other,” Dr. Steiger says. “It’s like an artist with a paint brush. Give him two or three colors and he can make a painting, but with a lot of colors, he can make a masterpiece. The new fillers are like more colors in the artist’s palette.”
Many recently introduced fillers are made with hyaluronic acid, a substance that occurs naturally in the body. “We find them to be the most predictable and safest,” Dr. Newman says.
Hyaluronic products are more flexible than older fillers, so the face doesn’t appear stiff. “They’re much more natural looking,” Dr. Herschthal says.
A different kind of filler that also lifts the face is made with an absorbable suturing material that has been used for years during surgery. “But its use as a filler is relatively new,” Dr. Herschthal says.
The physician inserts needles that are pre-loaded with the suturing material into the patient’s subdermal tissue. When the needles are pulled out, the threads remain to support the skin. “Some of them lift, some fill, and some do both,” Dr. Herschthal says.
Fat transfers are another method of filling wrinkles. Fat is harvested from the patient’s own body and reinserted to fill grooves. “They’ve proven effective as a stand alone or as an adjunct to other treatments,” Dr. Newman says.
Because the fat is tissue from the patient’s own body, the transfers can be more long-lasting than other fillers. The downside is that if there should be an unsatisfactory result, the fat can be difficult or impossible to remove. “Hyaluronics can be done more quickly and easily,” Dr. Newman says.
Fillers are best to address static wrinkles, or those that are there even when your face is still. For dynamic wrinkles, like smile lines that move when your face moves, neurotoxins like Botox can help, Dr. Newman says.
Botox relaxes the muscles that cause wrinkles by blocking the transmission of nerve impulses. It can take about two weeks for results to be complete, and they last about four months.
For those seeking a longer-lasting result, a surgical facelift may be the answer. “The facelift is the gold standard,” Dr. Newman says.
Facelifts have also improved significantly. “In the old days, we just pulled the skin tight,” Dr. Steiger says. “Today, we lift the skin and muscle layers together and restore the ligaments to their natural position to treat directly at the cause.”
For best results, a physician may combine a facelift with fillers, Dr. Steiger says. “Fillers don’t do everything a facelift does, and fillers don’t do what a facelift does.”
For those looking for a less invasive procedure than a full facelift, there is a mini-lift. The incision is shorter than with a full facelift, and there is less recovery time, but the procedure is more superficial and results are not as dramatic.
The eyes have it
If the eyes are the windows to the soul, who wants lids that sag over them, or bags that bulge underneath? An eye lift can be the solution, Dr. Newman says. “With an upper eye lift, an incision is made in the crease of the upper eyelid, and redundant skin is removed,” he says. For a lower lift, the incision is made under the eyelash. Under-eye bags are caused by fat, which is removed during the procedure.
Skin tightening and resurfacing
Today, there are a number of non-surgical tools available for skin tightening and resurfacing. Examples include:
With micro-needling, the physician uses a very thin needle to make microscopic perforations in the skin. “As the skin heals, it produces more collagen,” Dr. Herschthal says. The result: a smoother, tighter, more youthful look.
Ultherapy and ThermiTight
Ultherapy uses ultrasound to tighten skin on the face, neck and décolletage. It treats the deep dermis layer of skin and stimulates collagen growth. More than one treatment may be needed, and results require patience. “It can take three to six months to see the full effect,” Dr. Herschthal says.
Another method, ThermiTight, uses radio frequency energy to tighten skin, Dr. Steiger says. It heats the subdermal tissue, resulting in the production of collagen. It usually requires several treatments and improvement is gradual.
Lasers tighten and resurface skin by heating the subdermal tissue, causing the skin to contract and encouraging the growth of new collagen. Lasers can be non-ablative, ablative or a combination of both. A non-ablative laser will probably require more treatments than an ablative one. Recovery times will be shorter, but results won’t be as dramatic.
A fractional laser is a combination. “It gives the benefits of both,” Dr. Newman says. “It’s a shorter procedure [than ablative], with a quicker recovery and less downtime, and almost as good a result.”
CHOOSING A PRACTITIONER
Before choosing a physician, check his or her credentials and ask how much experience he or she has doing the specific corrections you are considering. Ask for references and look at reviews on social media.
Discuss all the possible options available, and don’t be afraid to ask questions about benefits, side effects, drawbacks and recovery times. Then decide which physician — and which procedures — are right for you.