Rejuvenating the Face — Do We Need a Knife?

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June 24, 2009. In recent years, many new facial contouring treatments have been developed that can reduce or erase wrinkles, tighten the skin, and improve the overall look and shape of the face—all without the need to go “under the knife.” These non-surgical facial rejuvenation techniques were discussed by an expert panel at the annual meeting of the American Society for Aesthetic Plastic Surgeons (ASAPS) in Las Vegas last May. The ASAPS panel discussion focused on the nuances of the different agents and the importance of selecting the proper agent based on the patient, the area of the face, and other factors.

The achievement of cosmetic improvement without surgery is undoubtedly an attractive prospect to many. Factors that influence a patient to decide to pursue non-surgical procedures over surgery include shorter downtime, decreased risk of serious complications, the patient’s medical history, and his or her aesthetic goals. According the ASAPS statistics, Botox® injection was the most popular aesthetic procedure performed in the United States in 2008, with almost 2.5 million procedures. The other popular non-surgical procedures included hyaluronic acid (Restylane) injections, chemical peels, laser skin resurfacing, and microdermabrasion. Despite the growing popularity of non-surgical cosmetic treatments, facelifts are still the main component of many surgical practices, with over 132,000 procedures performed in 2008 according to ASAPS data.

The current fillers in the market have varying characteristics. It is essential that the person injecting understands how they work. Knowledge of facial anatomy, for example, is crucial in minimizing possible complications. The face is full of intricate muscles and fine nerves, and understanding not only the exact location of the parts that make up the patient’s facial structure, but also the way the particular filler interacts with its surroundings, is critical for a successful outcome.

Dr. Mark Mitchell Jones believes the fillers and other non-surgical facial procedures have an important role in facial rejuvenation; however, they cannot always replace what a facelift can accomplish a d thus may not be the recommended solution for everyone. “There is a limit to how much one can fill a sagging skin, or how much one can alter certain dimensions with just fillers,” he says. “On the other hand,” Dr. Jones continues, “a patients may think she needs a facelift when she really does not. Rather, a combination of non-surgical techniques accomplishes what she wants, but without the surgery.” Dr. Jones also reminds us that facial rejuvenation need not be a “one or the other” proposition. In fact, cosmetic surgery results can be enhanced by both pre and post-operative non-surgical procedures. These may or may not include strategically positioned fillers and a hydroquinone/tretinoin based skin care regimen.

Based on his years of experience and seeing product lines come and go, Dr. Jones and his aesthetician, Bella Molokandova, have chosen to carry what they believe are the most effective products in the market. They include Revision Skincare, Jan Marini, and IS Clinical. Depending on the patient’s skin, these lines offer safe and effective skin care systems to optimize any surgery or a non-surgical procedure results, and to make sure the delicate facial skin is cared for gently. Dr. Jones also offers Obagi, a leading hydroquinone/tretinoin skin care regimen, which has worked miracles with his patients. The main purpose of Obagi is to clear blemishes, minor sunspots, and acne scars, but the attractive side effect is that it also appears to even out wrinkles.

In the end, sometimes getting under the surgeon’s knife is the best and the most effective way to accomplish the desired aesthetic outcome. Fortunately, the fillers available today and the non-surgical procedures such as peels, laser, and dermabrasion allow for other options to accomplish the certain result. The optimal procedure choice depends on the patient’s health and skin condition and color, age, genetics, and some other factors. It is most advisable to discuss these options with an experienced board certified plastic surgeon.