Significant changes in plastic surgery expected in 2008

Disappointed with results from the last few years’ much ballyhooed “lunch hour” and “weekend” cosmetic surgery procedures, people interested in facial rejuvenation are expected to pursue more reliably effective approaches in 2008.

According to Jeffrey Spiegel, MD, chief of facial plastic and reconstructive surgery at Boston University School of Medicine and Boston Medical Center, people are frustrated and disappointed with the expensive, minimally effective procedures touted as rapid solutions. Several significant changes in plastic surgery are expected in the coming year.

“People are going to expect better and more predictable results. With the economy slowing somewhat, the desire to look your best will remain, but people will expect to get what they paid for and be less tolerant of only minor improvement with a big cost,” stated Spiegel.

Spiegel predicts the following specific trends in 2008:

-- A return to more traditional procedures with a decline in shortcuts. The time invested pays off in the long run and the safety of established procedures is so high that people don’t have the same concerns they may have had in the past. “We’ve really gotten people to heal nearly as quickly from the traditional procedures as they do from the much less effective interventions that are so widely publicized.”

-- New fillers last longer without the need for skin testing. Many new types of filler have been recently released to treat the fine facial lines and wrinkles for which Botox™ is not appropriate. Some of these may last a year or longer. “This is one area where you truly can expect good results with just a very short (few hours) recovery,” states Spiegel.

-- Laser technologies continue to progress but the greatest innovation is a new way to deliver energy beneath the skin. Smartlipo™ is an example of a technology where laser can be used to rapidly and safely melt fat beneath the skin with only a very tiny incision. Expect further refinements in how lasers are delivered (without the need to send energy through the outer layers of the skin).

A 47 year-old woman recently came to Spiegel to have threadlift™ barbed sutures removed from her face. “I’m so glad to have those things out of my face!” she said. The implants, which had been placed by a physician outside of Boston, were just one of several technologies that were supposed to provide all the benefits of a face lift with only a day or two of recovery.

“Unfortunately, the results weren’t there, the speed of recovery wasn’t there, and the plastic threads were often visible poking at the skin,” notes Spiegel. “Less recovery doesn’t do any good if there isn’t any benefit from the procedure.”

Spiegel also notes that many laser procedures can be particularly disappointing. “Patient reports of satisfaction with skin conditioning procedures such as Fraxel™, IPL, Thermage™ and others are not encouraging. While these approaches are as expensive as proven surgical techniques, only approximately 50 percent of people who have these done feel that it was worthwhile. The other percent can’t tell that anything was done,” he said.

Finally, Spiegel notes that his research efforts are beginning to change the way faces are evaluated. “We’re starting to make progress in understanding how our brains define and recognize attractiveness. This work should have important implications in determining what procedures are recommended for people to look their best. Parts of the face that previously have not been considered important for facial appearance will change greatly in significance and likely become more important than some more traditional procedures.”

Spiegel’s practice attracts patients from around the world who fly to Boston for facial plastic surgery for correction/modification of procedures done elsewhere. Nearly 80 percent of his cosmetic practice consists of patients from outside of Massachusetts.

Source: Boston University

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