Welcome to the no spin zone: no, you have not found your way to the O’Reilly blog, however when we read a recent article in the Daily Mail-UK we couldn’t help but wonder why these things would be reported in a newspaper. Do they actually research or do they decide a story they want and then find a number of people who will agree with them?

The story begins by telling us that the popularity of facelifts and anti-aging/ facial rejuvenation surgery is growing year after year, but then takes an abrupt turn by quoting a number of “cosmetic doctors,” who happen to have non surgical cosmetic practices (comprised of fillers- juvederm, restylane, perlane- and botox) who believe that surgery is bad.  What a surprise.

If you have been reading our blogs, especially those regarding the Hybrid Lift, you know by now that our Beverly Hills facial plastic surgery practice is dedicated to bringing natural looking results, and this means that we are strong advocates of a balanced approach utilizing volume enhancement, i.e. fillers, and lifting procedures in concert.

We recognize that potential patients are constantly bombarded by spin and hype from competing physicians and corporations [Allergan- Botox, Juvederm; McKesson- Restylane, Perlane, Myobloc; Artes- Artefill; Bioform- Radiesse, to name a few] and it is important for doctors to be advocates for their patients (not the corporation), so they can honestly explain all the risks and benefits of every available procedure. This is perhaps most important in plastic surgery and cosmetic surgery where we are talking about elective procedures.

The truth is that surgery works brilliantly when done correctly and for the right reasons. Let’s face it, if you have sagging skin and jowling, fillers are not the answer, though they may play a part. On the other hand, if you have hollowing in the cheeks or under the eyes, volume enhancement with a skin pinch may very well be better than traditional blepharoplasty (eyelid surgery). The key is understanding the difference between what a mini lift (lunch time lift) can do and how long it lasts as opposed to a lift that involves the deeper tissues.

Does anyone really believe you can correct these wrinkles by just filling under the skin without making this face look completely different?

We believe that for facial rejuvenation to work that lifting and volume must be coupled. Volume enhancement, for us, has come to mean fat, because some of it will last permanently and, perhaps more importantly, it is natural and safe. We remind you that none of the fillers to date have FDA approval outside the scope of the nasolabial folds (and perhaps lips but we have to check on that). As far as surgery, mini lifts occasionally are indicated, but we have found that patient satisfaction and long term results really depend on addressing the underlying, descending tissue (the SMAS).

The point of all this is that the story begins by telling us how the number of women and men having anti-aging surgery is growing rapidly. There is a reason for that: when it’s done correctly, it works.

Reading the New York Magazine we came across an interesting article that goes over a “new” phenomenon among New York’s higher echelons that involves volume enhancement using fillers and occasionally fat to restore the lost volume that many patients experience as they grow older. The article goes on to highlight a number of dermatologists and facial plastic surgeons in New York that are on the forefront of the phenomenon there.

Composite picture of Demi Moore, Angelina Jolie, Madonna, and Michelle Pfeiffer courtesy of the New York Magazine showing the natural aesthetics which are ideal when volume enhancement and facelifts are combined such as in the HYBRID LIFT

As we read the very well-written article trace the history of facial aesthetics and volume enhancement, we could not help but notice that many of the doctors and quotes noted that as patients age there is a descent of tissue, sagging of skin, wrinkles and jowling, but then they glossed over the fact that volume enhancement alone fails to correct all of these issues. The idea that adding fillers or fat can correct jowling and redundant skin is simply not true.

We don’t normally like to brag here on the post, but in this one instance we hope you permit us a minute to gloat over our HYBRID LIFT.  What we do for our own patients is a minimal incision deep facelift—this is tailored individually depending on how much skin descent and jowling there is—and then add the patient’s own fat back (as in the “new new face”) to recreate the volume so many patients lose as they age. The aesthetic results have been fantastic and our patients love that they can be up and around after only a few days.

While we respect the claims in the article and are proponents of volume enhancement, we find it disingenuous to claim that by replacing volume you can somehow correct the tissue and skin which descends with time. The  problem is that too many people with hammers begin to see everything as nails.

The key points of our HYBRID LIFT are:

1. By doing a deep lift we are able to first replace the patients’ own fallen deep tissue (the SMAS) back into its proper position

2. By using a minimal incision, we never get into the hairlines, move hair tufts, or get a windswept appearance

3. Unlike mini lifts, because we do the work in the deep layers; the results last

4. By then adding fat and restoring volume, we fill out the concavities that lead to an aged appearance and we restore the youthful heart-shaped face that people are drawn to

5. By using your own fat, we are confident that the results last and are natural. Temporary fillers unfortunately are just that: temporary. Permanent fillers are all too often not tested for safety in these other areas, are not approved for these uses by the FDA, and are used in “off- label” procedures whose safety is unclear.

For us, the HYBRID LIFT represents the culminant evolution of facial rejuvenation.  Stay tuned for the HYBRID LOWER EYELID LIFT…