The increase in non-invasive procedures administered by facial plastic surgeons was seen across the spectrum of treatments with the greatest increase being Sculptra, poly-l-lactic acid, (up 71 percent). Other increases include chemical peels (up 52 percent), hyaluronic acid (up 48%) and BOTOX® (up 45 percent).

The survey also showed that 77 percent of physicians agree that patients are more educated about plastic surgery options. With more people wanting to look younger, feel better and take an active role in their health, patients are researching different physicians and treatments to find the best one suited to meet their personal needs. Awareness of various procedures, appropriate physicians, best results and recovery times play an important role in the decision-making process.

“We are excited to see patients making educated choices. They are now open to newer, novel treatments and are making smart decisions that are tailored to their needs,” said Daniel Rousso, MD, President of the AAFPRS. “The overall rise in these procedures also shows that more patients are trusting their face to facial plastic surgeons who are trained and focus solely on the face and neck. Because of this, patients are seeing better outcomes.”

In 2009, women continued to be the most likely candidates for facial plastic surgery making up 84 percent of all surgical and non-surgical procedures. However, men and women are equally split when it comes to reconstructive procedures.

Surgical Procedures

In 2000, facial plastic surgeons reported the facelift as the most common cosmetic surgical procedure, followed by blepharoplasty (eyelid surgery), rhinoplasty (nose surgeries) and ablative skin resurfacing. These procedures are most commonly performed on patients between the ages of 35 and 60 years of age. For female patients under age 35, the most common procedure performed was rhinoplasty.

The surgical procedures with the largest increases over the past year were ablative skin resurfacing (up 57 percent), revision surgery (up 18 percent) and facelifts (up 14 percent). Decreases were seen in lip augmentation (down 52 percent) and rhinoplasty (down 13 percent).

Medispa Findings

Physicians continue to express concern over procedures performed at medical spas (medispas). 76 percent of facial plastic surgeons surveyed say they are aware that medical directors of medispas are not actually on site for medical treatments. Most cosmetic procedures are performed in a private office (54 percent) setting. Procedures performed in a hospital came in at 23 percent and the number of procedures performed at medical spas or medispas remained unchanged (2 percent). Half of the physicians surveyed are aware of misleading advertising involving injectables, lasers and other cosmetic therapies. 35 percent of physicians believe medispas will become a more popular location for patients undergoing treatments.

Other Facial Plastic Surgery Trends

The facelift is the most common procedure performed on Caucasian patients, African Americans and Hispanics are most likely to have rhinoplasty while Asian Americans get blepharoplasty most often. Overall, 80 percent of AAFPRS members who participated in the survey feel that the future holds more cosmetic surgery for ethnic populations.

In addition, more facial plastic surgeons will offer wellness and lifestyle techniques to enhance the patient experience and to provide a more comprehensive approach.

FUZION takes the guess-work out of finding a qualified expert who understands your needs. Consultations are always complimentary and include a full overview of your concerns and a variety of treatment options. Please let us help you find your beauty.

Marit tells Kati about her concerns

Kati makes recommendations & Marit reacts to consult

The smell of sweat might be an aphrodisiac to some, but “sweaty Betty” does not do it for most. Controlling odor and excessive sweating is now a multi-million dollar industry. Over the counter lubricants, hygiene products bring in revenues of $105 million annually. BOTOX has been effectively used to control hyperhidrosis (excessive sweating) for years. It has now reached new “lows” currently being used to treat perineal sweat glands. Sweet Spot™ Labs has created a line of personal care items to keep you clean, refreshed and smelling your best. Their “on the go wipettes” are a must have for any woman who enjoys spontaneous fun! I will bet everyone who works at FUZION has them in their handbag AT ALL TIMES! Sweet Spot has a full line of pH balanced products made specifically for your most intimate areas. These products are designed not to irritate, dry or abrade your skin. As they say “cleanliness is next to fabulousness!”

This is not the sexual revolution where “au naturale” rules the roost, we live in an era when grooming is queen. The days of the “thigh coat” are long gone (thank goodness), now women, and men, are trimming up and lasering down. Laser hair removal is an effective way to permanently reduce hair growth all over the body. Laser technology is more cost effective in the long run than electrolysis or waxing and significantly reduces the risk of unsightly ingrown hairs. There are some things that you should know prior to embarking on a laser hair removal journey. It does not treat white or gray hair. It requires a series of six, or more, treatments. Hormones play a part in hair growth cycles. Pregnancy, menopause and changes in estrogen will affect your results. Laser hair removal, with FUZION’s technology, can treat all skin types safely – you can even be tan! The most common nether-region treatment is the “brazillian,” my only word of caution is that you will not have any hair; not now or when you are older so make sure it is a look that you want to live with.

The feminine wrinkles and folds that make up our external genitalia are formed early in fetal development. They are about as unique as a fingerprint. The old line “you’ve seen one, you’ve seen them all” does not hold true here! Typically, the labia majora, or the most outer set, is larger and bears hair. The labia minora are the smaller, internal lips. In some women the inner most set is larger and often asymmetrical. Aging affects your vagina too! The drop off in estrogen, progesterone and testosterone can wreak havoc on your vaginal health. I am not writing to depress you, but declines in hormone levels can cause dryness, laxity, incontinence, vaginitis, loss of libido… and the list goes on! At FUZION we offer full service vaginal rejuvenation programs these include: Mons pubis liposuction, surgical labiaplasty, laser labia tightening and non-surgical clitoral or labial enhancement. Some of these issues require surgical intervention, but when it comes to intimate pleasures we do what we have to do!

Labiaplasty:
Labia minora reduction: Reduction of the inner lips or labia minora is the most commonly requested procedure in female aesthetic genital surgery. There are two commonly used procedures which consist of trimming the excess labial tissue along the edge of the labia minora which is often actually a “Y” shaped incision line as frequently the excess labia minora extend toward the clitoral hood. This procedure is best for more complicated or extensive surgeries or in patients who have longer labia minora. For patients with shorter labia minora, there is another procedure which involves taking a V-shaped section out of the most prominent portion of the labia then suturing the incision closed. Both procedures are usually performed with absorbable sutures. Either general anesthesia, local anesthesia with sedation, or local anesthesia with topical anesthesia prior to injection can be used.

Labia majora reduction:
Reduction of the outer lips or labia majora is less commonly requested but patients with this request often complain of an abnormal bulge in swimming suits or tight jeans due to overly large labia majora. Reduction of the labia majora can be performed using a wedge excision of the excess tissue with the incision along the length of the labia minora.

Clitoral hood reduction:
Reduction of the clitoral hood is usually performed for functional reasons with the goal to allow increased clitoral stimulation for sexual pleasure, or to improve the appearance of the genital area. It is a good idea to only reduce the outer hood and to do so in a fashion whereby scar contracture would not lead to problems near the clitoris. It is important for sexual functioning that the clitoris not be encumbered by thick or scarred tissue. It is also advisable to avoid scars close to the clitoris if possible.

Mons pubis reduction or SmartLipo MPX:
Reduction of the mons pubis is generally requested by patients who have massive weight reduction often after gastric bypass surgery. They have ptosis (drooping) and excess tissue in this area which requires direct wedge excision usually in a transverse direction. For those without skin excess, liposuction of the mons pubis is effective. SmartLipo MPX is an effective way to reduce the prominence of the mons while tightening the overlying skin. If the patient is undergoing an abdominoplasty, wedge resection of the fat pad through the lower abdominal incision is effective.

We understand that women are complicated, but treating your sweet spot right doesn’t have to be! FUZION’s medical professionals are capable of answering your most intimate questions. Beauty should come from within so start at the bottom!

1. What age is the “right age” to begin aesthetic procedures?
We at FUZION opt to reserve the right to refuse treatment to any person who is not physically or emotionally mature. It is not necessarily about a specific age, but it is preferred to operate on legally consenting patients who are physically mature. If a professional chooses to operate/perform an aesthetic procedure on a minor they must consider how that procedure will impact growth or future physical outcome. We have already established in previous blogs that there are plenty of teenagers who have moderate facial wrinkles. This is caused by excessive photodamage (tanning) or pure genetics. The most popular adolescent cosmetic surgery is rhinoplasty (“nosejob”), now I ask you, would you make your child suffer the taunting of other kids until they are 18?

2. Is the patient in front of you psychologically sound to undergo the proposed procedure(s)?
Each Board Certified Plastic Surgeon/ medical professional (like me, I’m a Certified Physician Assistant) is fully trained in psychologic evaluation. It is important to seek out medical professionals for your aesthetic procedure. During a consultation each patient is physically and psychologically evaluated. We screen for conditions including body dysmorphic disorder, anorexia, psychotic illness, histrionic or other personality disorders. If a prospective patient displays signs of these, or a number of other diseases, they will be referred to a mental health professional. Dr. Goodkind and I have many professional relationships with excellent mental health providers. It is never to be taken as a sign of disrespect if you are referred, it just means that we are concerned enough to take care of you. Remember, “DO NO HARM!”

3. Is the patient aware of the risks?
The risks of ALL procedures are thoroughly discussed as part of the informed consent process. If the patient doesn’t verbally express understanding the plan is thwarted. It is a huge responsibility, and a goal of ours at FUZION, to make sure that you, as the patient, are fully educated and understand all aspects of each procedure.

4. Do the desired effects outweigh the risk?
Example: if a patient asks for extraordinarily large breast implants, but we know that they will be too large for her small frame then she will be risking infection, delayed healing, increased risk of rupture, chronic pain and muscle imbalance of her chest wall. These risks outweigh the benefits and therefore would not be appropriate. We don’t like to trade one problem for another.

5. What are the longterm implications of these procedures?
We need to evaluate what these procedures mean for a patient’s future – example: when silicone  is injected into someone’s face it is permanent. As that person ages, the silicone may not appear natural – it does not age as they do and therefore makes them look unnatural. We see plenty of examples of this in Hollywood, New York and Miami. It may be a desirable look to start, but it may not end up that way.

6. What is the patient’s motivation?
During the consultation a patient’s motivation must be clearly established. Why are they seeking surgical or aesthetic procedures? Are they doing it for someone else?  To save a relationship? To “cure” depression?  These are all examples of poor motivation and would be deemed inappropriate candidates for surgery.

7. What are the patient’s expectations and are they realistic?
To achieve a natural look and excellent results, one must have realistic expectations. Aesthetics is ALL ABOUT setting realistic expectations. I encounter this everyday. Dermal fillers, in the right hands, can provide amazing non-surgical results, but the results are subtle and certainly NOT surgical results. It is about technique, skill of the injector, choosing the appropriate product and of course the right patient. I often times have to disappoint people by telling them that they are more apporpriate surgical candidates than filler candidates. This is a perfect example of why people look unnatural: the wrong amount of the wrong product in the wrong patient… (Mickey Rourke, Meg Ryan, “Cat Lady“)

8. When is enough enough?
If your Aesthetic Professional tells you that you need to lay off procedures, or that the procedure will give you an unnatural appearance you need to stop! Or seek mental health assistance if you have become obsessive. No professional should risk their reputation, and future in the field for one bad outcome that could have been avoided. This is the sole reason that I refuse to give people “DUCK LIPS!” Subtle is always more attractive and believeable. You want to be yourself, just more detailed.

Who is to say that Heidi went too far?  Her surgeon was a Professional Board Certified Plastic Surgeon, who has a stellar reputation (Dr. Frank Ryan). She thought about the procedures for three years prior to going ahead with them. Dr. Ryan performed multiple consultations about her procedures and states that she thoroughly and repeatedly expressed understanding her risks. Just because we may not agree with her decision to seek a significantly more mature, and augmented appearance does not mean that it was unethical on the part of the practitioner. All in all, on a professional level his work was impressively done – much more natural than some other examples. We must consider that if Ms. Montag had chosen to have one procedure at a time we would think nothing of this, but since she had multiple minor procedures (fat transfers and BOTOX) at the same time she had multiple surgeries it has been  sensationalized in the media. Don’t forget who we are talking about, “reality star”, Playboy model (to come), aspiring singer and 1/2 of the ”Speidi” duo… It all has to be taken with a grain of salt – a very big grain of salt.

Tell me what you think! I would love to hear what you have to say about all of this.

-Kati

Let me know if you have any questions on dermal fillers, BOTOX, etc!

KT