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To Cut or Not to Cut...

Some physicians, and especially rejuvenation technology companies, are now saying that rejuvenation surgery is not needed any more due to new, non-invasive technologies now available. To this I say: Not so fast. It really depends on a person’s goals and what his or her specific concerns are. A few crow’s feet wrinkles, or heavy, loose jowls and deep cheek lines and wrinkles? This is not a one-size-fits-all business. The first example can get away with Botox and maybe fillers like Expression, the latter may need a mini-face lift to reach his/her goals to appear more refreshed and even more youthful, if that is the desire.

There is no question that the public is more informed about the new technologies for rejuvenation than ever before – and that there are more options available than ever before to improve the appearance of the skin. Still, the old “standards” like mini-face tucks and lifts and body lipo-contouring have a big role when required to help people reach their goals for face and body rejuvenation. They will always be needed options.

Along with new non-invasive technologies, there is more hype out there than ever before, too. Some spas and even “rejuvenation” practices promote these devices to give the impression that surgery is no longer needed. Not so.

In my 18 years of experience as a cosmetic surgeon in Newport Beach and also a past lecturer for numerous technology companies, which promote non-invasive technologies for skin and alleged deeper soft tissue tightening and contouring, it is my experience that over the last several years, there has been a clear-cut movement back to patient interest in minimally-invasive surgical procedures like mini-face tucks, lipo of the neck and smaller lipo contouring and eyelid lifts over the non-invasive options whether new or old, including Thermage, Ulthera, Zeltiq, Zerona – or the fillers – as options to avoid any rejuvenation surgery. Why? Because the non-invasive options, based on RF (Radio Frequency), lasers or cold treatments (Zeltiq) to contour the body just don’t fulfill many patients' rejuvenation expectations.

Patients will try non-invasive options in hopes to avoid a surgical procedure, but we see many of the same patients in my office who have tried numerous non-invasive options and then come here to find out how they can really attain their facial or body improvement goals with a minimally-invasive or other surgical procedure. Because the non-invasive results are often non-results or results short of their expectations, whether for wrinkle reduction of soft tissue, tightening or contouring. Using fillers (Restylane, Juvederm, Expression, Radiesse) can help, but they are not a substitute for a well-planned surgery when needed to help meet a patient’s goals. When a “non-invasive rejuvenation practice” performs RF (Radio Frequency devices that deliver electrical energy to heat the skin) or other non-invasive procedures
(Zeltiq for body contouring), there is the risk for patients being oversold on the merits of the particular non-invasive technology – especially if the spa or practice does not offer surgical rejuvenation options as well. It is our experience that if a patient needs a face tuck or lift or neck lift or more invasive body contouring to fulfill some personal rejuvenation goals, then many non-invasive technology options will more often than not fall short of patient expectations. And clearly, there is a movement back to surgical options, especially the minimally-invasive options like mini-lifts and TickleLipo and SmartLipo, because so many potential patients have tried the non-invasive options and found them lacking.

You know what they say: if it’s too good to be true...

While there is a role for the non-surgical options to help improve the appearance of skin and even tone the face or body skin in many cases, I have yet to see any non-invasive technology that can equal a mini-face lift or liposculpture when someone desires significant results on this level.

As the Bard should have said: “to cut or not to cut, that is the question.” It’s still good medicine to consider all the options and go with those that are most likely to help attain personal rejuvenation goals.

We want your comments and feedback. Post questions or ideas below or contact me through my website.


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