Every face tells a story.
But after kids and a career, love and loss, success and failure, a woman’s reflection in the mirror might not reveal how she wants the world to see her.
“She feels like she lost her fit body,” says Dr. Gregory Fedele of the Art of Plastic Surgery in Beachwood. “We can give her a little lift, and she feels rejuvenated and recharged.”
Whether you’ve noticed aging around your eyes or extra skin around your waist, there’s a cosmetic procedure that can help you feel more confident.
While the reasons for choosing a cosmetic procedure is highly personal, it’s becoming more common. The number of cosmetic procedures increased last year by 2 percent, with 17.5 million people electing to do some sort of enhancement, surgical or nonsurgical procedure, according to the American Society of Plastic Surgeons. Breast augmentations topped the list, followed by liposuction, nose reshaping, eyelid surgery and tummy tucks.
The slight increase could be due to selfie culture and how it has made us more self-conscious about the images we share.
“We are taking more pictures than before,” says Fedele. “And we are showing those pictures to more people.”
Whatever look one is hoping to achieve, there are more choices than ever before. “We’re giving patients more options and involving them in the decision,” says Dr. Steven Goldman of Beachwood Plastic Surgery in Beachwood.
Here’s what’s new and evolving in cosmetic procedures and treatments today.
An About Face
While there has been an influx of injectables from Botox to Restylane, those haven’t been able to replace the gold standard procedure: the face-lift.
“We are seeing an increase in the number of people who are selecting a face-lift,” says Dr. Michael Wojtanowski of the Ohio Clinic for Aesthetic & Plastic Surgery in Westlake.
Surgical advances have made the procedure nearly undetectable, which has in turn helped patients feel confident. By targeting specific areas, doctors can deliver natural, younger looking results as opposed to the over-pulled effects of the past.
“If you’re in a restaurant and a stranger walks in and you can tell from across the room they’ve had a face-lift, it’s an overzealous procedure,” says Wojtanowski. “Even if someone knows you, they shouldn’t run up and say, ‘Who did your face?’ They should say, ‘Boy, you look good. Did you lose weight? Did you cut your hair?’ ”
To decide whether you’re ready for a face-lift, start out by having a conversation with your doctor, says Dr. Mark Foglietti of the Cosmetic Surgery Institute in Beachwood.
“If they take their hands and pull their neck and face back a little bit, that’s surgery,” he says. “Injectables don’t tighten the skin — they improve wrinkles, crevices and depressions.”
Your doctor may opt to combine a face-lift with injectables to amplify results. For example, a face-lift doesn’t affect the area around the mouth where people might complain of smoker’s lines.
“Face-lifts do improve lines and wrinkles, but they do not make them disappear,” Foglietti says. “That requires treatment on the skin.”
Indeed, a top-notch skin care regimen is essential before and after a lift. “If you have a suit and you lose weight and tailor that suit to fit your body, it’s still the same gray flannel,” says Wojtanowki. “When you do facial surgery and you are manipulating tissue, that tissue is still your skin. You can enhance the quality of that skin with good skin care such as microdermabrasion.”
Filling the Lines
If a face-lift seems too daunting, injectables such as Botox and Restylane can buy you more time. With 10.9 million vials of Botox sold in the United States since 2002, injectables have become almost mainstream.
“You can look fresher with minimum or almost no downtime,” says Fedele. “Some people do Botox on their lunch hour and they’re back to work.”
Last year, the American Society of Plastic Surgeons showed a 2 percent increase in Botox procedures, which paralyze muscles in the affected area to relax and soften the look of deeper wrinkles.
Meanwhile, soft tissue fillers such as Juvederm and Restylane, were up 3 percent with 2.7 million procedures.
All that popularity has increased the demand. An influx of providers, including medi spas, dermatologists and even some family doctors, offers injectables.
Fedele cautions patients to do their research and make sure they are selecting a practitioner who is experienced and knows what works best in different situations.
“A lot of patients are very concerned they’ll have ‘duck’ lips,” says Foglietti. “It’s really the expertise of the injector that ensures that won’t happen.”
A typical lip enhancement, for example, takes about five to 10 minutes and lasts up to a year. Superficial wrinkles and laugh lines can be smoothed out with Restylane Refyne or Juvederm’s Volbella.
Injectables such as Juvederm Voluma can even add volume, lift and contour to flattened or saggy cheeks.
Also notable in the filler department is the use of natural fat, a routine part of facial rejuvenation procedures these days, Wojtanowki says.
“By injecting natural fat into the facial tissue while we are doing face-lift surgery, it allows us to model and create natural looking results,” he says. “There is no possibility of rejection and it ages with you while fillers go away. Plus, your own fat doesn’t cost anything.”
A Back Story
You’ve heard of a Brazilian wax and a Brazilian blowout. Now there’s a Brazilian butt-lift.
A hot procedure in cities such as Miami, it’s getting bigger in Northeast Ohio.
“People will come in and say they don’t like the squareness of their hips, or they’ll say they don’t have a waist or butt,” Fedele says. “This procedure improves both areas.”
The procedure involves liposuction of the hip and/or abdomen. The fat removed from those areas is then used to enhance the buttocks.
“The procedure provides a better shape to the bottom so you can get the fullness while also losing some hip fat — that love handle or muffin top,” Fedele says.
This specific type of butt-lift appeals to women ages 25 to 45, though Fedele has clients well into their 50s who are also entertaining the procedure.
“If you feel like you don’t look good in your jeans and T-shirt because of a rounder waist and no butt,” he says, “this procedure takes the fat out of the bad area and puts it into the buttock area.”
Tummy Troubles
For many women, extra bulge around the belly is a daily struggle. Opting for a tummy tuck is one way to win the fight.
In fact, recent surgical advances have even cut recovery time and improved the overall experience.
Traditionally, a wound drain was inserted to prevent fluid from accumulating during healing. But sometimes the drain fluid would still accumulate and patients would have to come back in to get a new one.
Progressive tension suturing alleviates the need for wound drain by sewing the muscle and fat together.
“You eliminate that space, so the process is more comfortable and patients heal more quickly and better,” says Wojtanowski.
Meanwhile, an alternative to traditional liposuction called Vaserlipo uses minimally invasive ultrasonic technology to selectively break up and remove fat. The patient usually requires only about 12 hours of downtime.
Dr. Paul Vanek of Vanek Plastic Surgery in Mentor uses TruSculpt 3D, which employs radio frequency energy to target and disolve fat cells. The nonsurgical procedure can be performed on the abdomen, underarms, thighs, buttocks, chin and back and can be used several times on a body area.
“The energy waves go into the skin and fat, shrink the fat and tighten the skin,” Vanek says.
Another nonsurgical procedure that’s gaining popularity is CoolSculpting, which freezes unwanted fat while leaving the skin unaffected. Wojtanowski says patients can expect a 20 to 25 percent reduction in fat. So, if you can pinch 4 inches on your tummy, the procedure can potentially freeze out 1 inch.
“You can come in three to six weeks later and get a further reduction,” he says. “It fits into your life, you don’t have to heal from it and it’s ideal for the group of patients who either don’t need lipo or who have had lipo and have some fat areas left over.”
Center Stage
Breast augmentation remains the No. 1 cosmetic surgical procedure. Traditional saline implants remain a great choice, especially for younger patients who do not yet have children and are endowed with a fair amount of breast tissue.
But silicone breast implants are gaining popularity because of its appealing soft feel and ability to prevent leakage. It’s even gained the nickname “gummy bear” implants for its rubbery — not Jell-O — feel.
Studies in progress have shown that the gel inside silicone implants stay in place, even when a tiny pinhole pierces the shell.
The key with “gummy bear” implants is making sure your doctor is using high-quality material. “There are people out there who are using that term for implants that I would not consider to be true ‘gummy bear’ implants,” Goldman says.
Beyond choosing between saline and silicone, your doctor can help with other less talked about issues such as inverted nipples or nipple prominence. Nipple morphology can be done in conjunction with a breast augmentation or reduction.
“It changes how you see yourself in clothing, and once a woman realizes a plastic surgeon can take care of a nipple problem,” says Vanek, “they realize they are not alone in this world.”
