“Do I need peels, surgery, laser, Botox, skin care, or filler?” That has to be one of the most common questions posed in my offices. The truth of the matter is, the correct answer is probably most of the above! The beautiful thing about practicing in the fields of aesthetic surgery and aesthetic medicine these days is I can pick and choose which type of rejuvenative treatments in combination will provide the specific patient at hand the best, most natural, and enduring improvements in their appearance.

Each type of treatment has a different role in facial rejuvenation. When the correct tools are used in the appropriate proportion to address the concerns the patient has, the most wonderful results occur. We have all seen (and cringed) when we encounter individuals who have had too much of a good thing and look odd or even worse, scary! Taking the time to counsel patients on which types of treatments are best for them is vitally important to helping patients make good decisions for themselves. In my opinion, a board certified plastic surgeon like myself is uniquely trained to offer excellent advice about all of the potential treatments listed above and design a treatment plan that matches your desired results, pocketbook, and available recovery time.

Doctor overseen skin care should be the back bone of any rejuvenative effort. Some patients will say they don’t want to stick to a regimen, but honestly, if you are going to invest time, finance, and effort in surgery, you are going to want to maintain the result to the best of your abilities. You wouldn’t go to the extent of gastric bypass surgery for weight loss and never exercise. Having a well-designed skin care program individually designed for you by a surgeon, that only includes products that have scientifically proven efficacy is vitally important to maintaining your surgical result. Healthy skin not only looks better, it heals better.

One very common myth believed by many potential patients is that surgery fixes wrinkles. Botox fixes wrinkles. Surgery moves saggy and loose tissue into more favorable positions, but it does not change the texture or quality of the skin. Botox prevents facial muscles from aggressively contracting and deepening wrinkles in the skin. The effects last ninety days, so four trips to the office a year can keep your face looking much less wrinkled. When Botox is expertly injected in appropriate doses, you can still move your face, but your muscles aren’t pulling so hard that they are robbing your skin of collagen which leads to wrinkling.

Filler is used for deep folds and furrows. I use hyaluronic acid (natural to your body) in almost all of my facial surgery patients. The folds between the nose and the mouth, and corners of the mouth and chin should not be treated by pulling on the skin during a facelift. If the thinned out collagen that leads to the furrow is filled, the fold becomes less deep and looks more natural than when tension is used. This type of filler lasts about one year.

Facial peels can be performed with different types of acid in different strengths to match the desired outcomes and down times. Some peels are light and recoveries are quick, while others are deep, and shedding can take up to ten days. Fine lines, pigmentation, and dull luster can all be improved with peeling. I find peeling to be more predictable, less expensive and more effective than laser. I do not use lasers in my practice for this reason.

Finally surgery should be used to re-position tissues that have sagged or become lax. Putting tissues back where they started and not into positions they have never lived in is the key to a natural result. NO tension should ever be applied to the skin. Our faces weren’t tight when we were twenty-five and looked great, so there is no reason to believe a tight face would look good on someone later in life. Skin is not designed to LIFT. Skin is for coverage and protection. Deeper tissues must be re-positioned to create a natural and long-lasting result in face lifting procedures. It is true that these procedures take longer than an antiquated “skin only” facelift, but the results are so much better!

Looking as good as you feel is a very realistic goal, and when the treatments above are combined appropriately, the results are wonderful. While a little maintenance is required for the best long term results, what if anything worthwhile in life doesn’t require a little maintenance? If you would like to improve your appearance, I would like to see you in consultation. Please contact my staff at 480-945-3300 to arrange an appointment. There is no time like the New Year to start creating the appearance you desire.


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