November 11th, 2019
If you read Time Magazine in June, one of the cover stories informed us that cosmetic surgery is the new norm - a closely akin to getting your hair done. The "taboo" that once surrounded aesthetic surgery is quickly disappearing. Conversations about "who had what done" and recommendations about which plastic surgeon is the "best" at which procedures - conversations that used to happen quietly and privately - are now discussed out in the open or online. In my mind, one of the major drivers of this trend has been the development of injectable cosmetic procedures such as BOTOX and fillers.
According to statistics from the American Society of Plastic Surgeons (ASPS), over 9 million people had some kind of "minimally invasive" injectable procedure in 2014. Because these were only procedures done by plastic surgeons, the real number is probably MUCH higher.
There is a misconception among the public that plastic surgeons don't have an interest in injectables because it's "not surgery". However, injectable treatments are incredibly powerful with respect to reversing the aging process or changing the whole appearance of the face in ways that surgery can't. Let's look at an example:
This young woman came to see me because she was unhappy with the appearance of her mouth, particularly the horizontal line above her lips and her "gummy" smile, which you can see in the upper photo. Surgically, this would be a tough problem to fix, and would mean she would have to take time off of work and endure the months-long healing process that accompanies any surgical procedure. Instead of surgery, the solution was a very small amount of Botox in just the right places to paralyze the small muscles that were causing the problem. Now, look at the second photo. The line across her upper lip is gone, and her smile looks much more natural. She is thrilled with the outcome, which is one that is very difficult to replicate with surgery. All it took was a trip to my office on her way home from work one day to have the procedure, and she was able to go out to dinner later that night as if nothing had happened.
I am a craniofacial surgeon, which means that after my plastic surgery training, I did an entire additional year of training focused only on the face; how it grows, how it ages, and how and why things go wrong. That year at Stanford completely changed the way I look at faces. Before, I looked at the face and had one question: "Which operation can I do to make it better?" Now, after that year of intensive study, I see the face very differently. What I have found is that with an intimate knowledge of anatomy and a few well-placed injections, many of the cosmetic issues that bring people to my office (thinking they need surgery) can be dealt with quickly and with what is an almost totally painless procedure.
The author of the Time Magazine article in June was onto something - "plastic surgery" is becoming a more openly discussed topic, as evidenced by the fact that I'm writing this and you've taken the time to read it. Driving this is our ability to make small, incremental improvements in your appearance here and there with injectables (Botox and fillers). What this "routine maintenance" can do is help you prevent or eliminate the need for surgery down the road.