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The profile of the typical facelift patient is changing. More and more younger women—those in their mid- to late-thirties and early-forties—are opting for the plastic surgery instead of injectable fillers and other noninvasive techniques.

The average age of the facelift patient has dropped from the early fifties to the mid-forties, and the pool of patients in their thirties has grown by about 50% over the last two decades.

The natural question is: Why? Industry insiders believe a lot of it has to do with the growing acceptance of plastic surgery. When Botox was introduced in 2002, it was widely thought to be the beginning of the end for the facelift. But, just the opposite happened. Facelifts increased over the ensuing years.

Botox and other facial fillers became a more accessible entry point for women (and men) who were curious about cosmetic surgery but concerned about the stigma or the cost. The more comfortable they (and the rest of society) became, the less intimidating a facelift was.

Millennials seem to be responsible for the latest evolution of the trend. They’re forgoing noninvasive treatments in favor of long-lasting or permanent procedures because they’re thought to be a more efficient use of their time.

There are also a growing number of plastic surgeons who are recommending facelifts when aging issues are still relatively minor, particularly for patients who are still concerned with being discreet about their cosmetic enhancements. The reason being that a facelift in your thirties and forties will be less extensive than it would be in your fifties and sixties.

And, while the aging process never stops, future treatments are likely to be less invasive with earlier intervention.

These aren’t not your mother’s facelifts

Regardless of the impetus, the reality is that today’s facelift is not your mother’s facelift. Not so long ago, surgeons used to simply lift the skin and stretch it taught. The effect didn’t last very long, so many doctors would overtighten the skin in an effort to overcompensate. The result was that expressionless look that became synonymous with the facelift and, really, all of plastic surgery for a while.

Doctors now have a better understanding of the underlying bone structure and musculature, which enables them restore volume deficiencies and tighten muscles that have relaxed, along with the skin, all with much smaller incisions. The result is subtler and far more natural-looking, as well as longer-lasting.

Exciting days for facial rejuvenation

The reality is, your age may have little to do with the appearance of your face. By luck of the genetic draw, some have a droopy jowls and sagging cheeks in their twenties. So, react to the person you see in the mirror, not your perception of what someone your age should look like.

If you decide a change is something you want, talk with a board-certified plastic surgeon. In most cases, slight-tightening treatments like Thermage or Ultherapy may be enough to achieve the desired effect. It’ll just require a little patience. If you prefer a faster-acting approach, look into facial fillers and lasers before leaping to a facelift.

These are exciting times for noninvasive cosmetic surgery, with so many options available. And, while none are a substitute for a facelift, each is capable of a significant rejuvenation.

If you feel like you’ve been hearing a lot about butt enhancement surgery, it’s not your imagination. Over the last few years, it’s become one of the fastest-growing types of cosmetic surgery in America.

Butt enhancement surgery is sort of an umbrella term that covers three separate procedures: buttock augmentation with fat grafting, buttock implants, and buttock lifts. When butt enhancement burst onto the scene, butt implants grabbed most of the headlines. They’ve since tailed off over the last couple of years (more on that in a moment), but the growing interest in butt lifts and augmentations has remained constant.

Last year, there were over 4,800 butt lifts done in the United States, according to the American Society of Plastic Surgeons (ASPS), and nearly 24,100 butt augmentations (also referred to as the “Brazilian butt lift”). In the case of the latter, that’s a 59% increase over just five years earlier.

What is butt augmentation, exactly?

Because butt implants have garnered so much attention, they’re often what patients request when they want butt enhancement surgery. But more and more plastic surgeons are steering them toward butt augmentations instead because it’s a safer procedure. The implants can cause pain and infection, and, not insignificantly, patients can have trouble sitting on their butts for a long time.

The augmentation is basically a two-step process. First, fat is liposuctioned out of the patient’s abdomen, hips, or thighs. It’s then cleaned and separated and injected into the patient’s butt. The whole thing can typically be done in about an hour, and patients often return to work within a day or two. Though, they’ll need to avoid sitting directly on their butt for about a week.

It’s important to enter into the procedure with realistic expectations. For one, about three-quarters of the grafted fat will survive. It can also shrink just like anywhere else on your body. So it’s common for patients to need a touch-up at some point in the future.

Butt augmentation is also more of a subtle enhancement of your natural figure. You’ll certainly notice a difference, but you won’t emerge as Kim Kardashian’s long lost sister.

Less-invasive alternatives

Butt augmentation isn’t the only option for a perkier booty. One alternative to consider is Sculptra Aesthetic, an off-the-label injectable that helps boost your body’s natural collagen. It’s FDA-approved for increasing volume in the face, but it can be used on other parts of the body, too.

The procedure, however, can be cost-prohibitive because, to gain a noticeable result in the butt, it would require a lot of Sculptra. A more affordable and completely noninvasive alternative is CoolSculpting, which freezes and kills the fat cells under your butt, which can improve your butt’s contour and help it to appear perkier.

Once you’ve gotten comfortable with the idea of having plastic surgery, Googling a plastic surgeon in your area is the easy part. But then comes another challenge after you’ve pieced together a list of promising prospects: how to find one you can trust.

The initial consultation is a critical part of the process, and one that shouldn’t be ignored. You’ll want to have done some homework on the plastic surgeon before the meeting, which will inform the questions you’ll be asking. (Yes, it’s OK to treat it like an interview.)

Just as important as knowing what to ask, though, is understanding the responses and being able to filter them for the information that’s most important to you. Here are a few tips to help with that.

The internet isn’t your only resource.

Sure, it puts a wealth of information at your fingertips, but it can be as overwhelming as it is helpful. So, before you start searching, talk to friends and family, even casual acquaintances, who’ve had work done recently. They’ll not only be able to help with a recommendation but they can also give you an honest rundown of the entire process, from the consultation and the surgery itself to the recovery.

If no one in your circle has had any work done recently, seek out someone you trust who works in health care, a nurse, for example, or a physician assistant. They’ll know who the best plastic surgeon is, and they’ll happily offer up recommendations.

Read everything you can online—but don’t buy into all of it.

Reviews can be incredibly helpful for developing a sense of previous patients’ experiences and a surgeon’s bedside manner. But they can also be misleading. This shouldn’t come as much of a surprise, but anonymous reviews, particularly negative ones, can be a means of seeking revenge or advancing an agenda.

It’s impossible, of course, to decipher the sincere from the purely-malicious in most cases. The best you can do is to try to look for a middle ground. Don’t be too buoyed by the gushing accounts. Nor should you necessarily buy into any overly-critical reviews. The exception in both instances is if they’re recurring themes in a very large sampling. (Think hundreds or thousands, not 10 or 20.)

Check their credentials before your consultation.

Specifically, find out if the plastic surgeon’s board-certified by the American Board of Plastic Surgery (ABPS). It’s the only specialty board for plastic surgery and cosmetic procedures that’s recognized by the American Board of Medical Specialties, the gold standard certifying body for specialty boards.

You’ll learn pretty quickly that there’s a lot of ambiguity when it comes to plastic surgery credentials. State medical boards, for example, don’t require a surgeon to be specifically trained in the procedures they offer. It’s a real problem in plastic surgery, where there are lots of other specialists performing cosmetic procedures. This is often the case when hearing about a plastic surgery procedure “gone wrong”. In fact, Dr. Davis was interviewed this Summer by the Daily Mail regarding Youtube personality, Alexa Dashian’s, recent experience with a botched lip plumbing injection.

To earn certification from the ABPS, a doctor needs to complete a minimum of six years of surgical training after medical school, with at least three of those years dedicated to a plastic surgery residency. After that, the surgeon has to pass comprehensive written and oral exams. They also need to supply the board with documentation of the cases they’ve completed since they finished their training. Basically, it’s a long, rigorous process, and there’s no room to hide.

More and more women are posting about their recent lip augmentation. So much so that fall’s most popular fashion trend appears to be the perfect pout.

Lip augmentation is one of the fastest-growing segments of cosmetic surgery at the moment, and that’s more than a casual observation. Last year, nearly 31,000 procedures were done in the United States, not including injectables. That’s a 4% increase over 2017 and a 19% increase over just five years ago.

The massive celebrity of Jennifer Lawrence and Scarlett Johansson is a big reason for the new interest, especially among very young women. But there’s more to it than envy. Lip augmentation itself has undergone a pretty dramatic makeover in recent years.

Fillers

For one, it’s not just a single procedure. It can be anything that enhances your lips, but the use of fillers and the injection of one’s own fat into their lips are the most popular forms. The likes of Restylane Silk and Juvéderm Ultra, both thinner, more versatile fillers, have been game-changers for lip augmentation.

Lip implant or fat-grafting surgery was once a fairly extensive process. Both have become much more efficient (more on that in a moment), but with injectables, the procedure lasts 15 to 20 minutes, and the recovery time is minimal, if there even is any.

Not to mention, plastic surgeons—make sure you find a board-certified with extensive experience in the procedure—have become so adept with the injections that they can produce very subtle, natural-looking enhancements. The days of the overdone lip augmentation are long gone.

Fat grafting

Fat grafting, also referred to as fat injections, is a longer-lasting treatment. Fat is removed from one part of the body, usually through liposuction, and used as a lip filler. The entire process can be done without a single incision.

Beyond the duration of the results, fat grafting is also popular because it creates a very natural-looking lip contour, and, without fear of an allergic reaction, it’s a very safe procedure.

Lip implants

If you can’t seem to shake the troubling image, from several years back, of a celebrity who very obviously had her lips done, know that today’s implants are very different. They’re made from a soft, pliable silicone rubber or biodegradable substance. And the procedure takes only about a half-hour.

That said, if lip augmentation is something you’re considering, start with a filler. It’s less of a commitment. The results typically last from six months to a year. It’ll also give you the chance to experiment with some different looks. (Injection technique and placement matter as much as the filler.) Then, if you like what you see, graduate to fat injections or implants.

Liposuction was the second-most popular cosmetic surgery procedure performed in America in 2018, behind only breast augmentation. And it appears to be gaining in popularity. Five percent more Americans had liposuction last year than in 2017.

But this isn’t the liposuction that you grew up hearing about. The more interest there is in a procedure, the more incentive there is to perfect it. That’s become the case with almost every kind of cosmetic surgery. As the stigma surrounding plastic surgery has fallen away, the new interest has given rise to widespread innovation.

Rapid evolution

In the case of liposuction, it’s felt most acutely because it’s a procedure that, for decades, didn’t really change much. We removed fat by sticking in a cannula and sucking—which made tunnels that could result in strange contours.

But there’s been so much evolution recently in the ways we remove fat that a technology that’s just a few years old can quickly begin to feel outdated. The cannulas got smaller and better. And in some forms of liposuction, instead of sucking out solid blocks of fat, surgeons are now melting it, which enables them to remove it more evenly.

The melting usually involves radio frequency or thermal energy emitted from a cannula. A new technique called BodyTite uses radio frequency in conjunction with liposuction to tighten skin. Before its arrival, surgeons could remove fat with liposuction, but if a patient had poor skin elasticity—which was just about everyone—they’d need a lift to remove the excess skin, which was a separate procedure.

BodyTite firms skin from 10% to 40%, which is enough to help skin bounce back if you’ve had 10 to 20 pounds removed with liposuction.

Rather than melting the fat, SafeLipo uses rapidly vibrating cannulas to emulsify it to the consistency of a smoothie, which allows it to be removed evenly and gently, without bleeding. Some of the remaining fat is then used as fat grafts, allowing the skin to be re-draped smoothly.

Smart surgery

Aside from better results, these new procedures are also enabling a much greater degree of precision. If, for example, your eyes go straight to a bulge of fat just outside your bra near your armpit every time you get dressed, a ping pong ball-size amount of tissue can be removed from that area under local anesthesia. Removing just that little bit can make a big difference.

The recovery is also garnering lots of new attention, driven largely by a concerted effort to discover and implement nonnarcotic (read: non-addictive) medications. One new slow-release pain medicine called liposomal bupivacaine can be injected during surgery and provide 48 to 72 of relief afterward.

So, think of liposuction as an umbrella term rather than a single surgery. And somewhere under that umbrella is a procedure that can help you achieve your unique goals.

The famous procedure of rhinoplasty sure hasn’t shown any signs of losing popularity. In fact, plastic surgery options for nose modifications have continued to be one of the most talked-about treatments in our Cherry Hill, New Jersey office.

Today on The Plastic Surgery Revolution, board-certified plastic surgeon Dr. Steven Davis explores the history of rhinoplasty. Dr. D also covers the evolution of this procedure, and the most common places patients tend to be treated.

We are proud to offer rhinoplasty as a specialty of ours here at Davis Cosmetic Plastic surgery. Would you like to see before and after photos from our patients? Take a look and see if this is the right procedure for you!

If you are interested in scheduling an appointment with Dr. Steven Davis, please feel free to give us a call or contact us here.

We look forward to speaking with you soon!

Thank you for tuning in to The Plastic Surgery Revolution on the evolution of rhinoplasty. If you would like more content, please check out our Youtube channel.

More Podcasts From Dr. Davis

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A breast lift always goes hand-in-hand with breast implants, right? Not anymore.

There are legions of women out there whose breasts sag, or maybe one breast droops a little more than the other, and they have zero interest in larger breasts. They just want them restored to what they used to be.

Until recently, their options would have been limited to a traditional breast lift, which helps, but only for a relatively short period. Now, plastic surgeons are turning to bioresorbable mesh scaffolds instead. It’s an absorbable mesh shaped like a demi cup that gives internal support to make breast lifts last longer. In clinical trials, patients are maintaining their results after almost six years. (For all the recent advances, none is capable of outlasting nature—not yet, at least.)

Internal support leads to longer-lasting results

Breast sagging is caused by a number of factors, including pregnancy and breastfeeding, changes in weight, high-impact exercise, aging, menopause, and genetics. In other words, life. These same factors can also cause the surrounding skin to weaken along with the breast tissue.

A traditional breast lift entails removing excess skin to tighten the surrounding tissue, which raises and firms the breast. The procedure’s popularity has risen an incredible 99% since 2000. But the result can be a bit disappointing, ultimately. Some of it is lost to gravity within weeks of the procedure. And after a year or two, even if the nipple stays high, the bottom part of the breast will begin to fall.

The idea of adding some internal support to help the traditional lifts last longer is not new. But earlier versions were prone to complications. The latest generation, however, of which there are several brands, is made of a polymer that breaks down naturally, a lot like absorbable stitches, but at a slower rate.

While the mesh dissolves over 12 to 18 months, collagen and elastin enter the scaffold and create a support system that’s three to four times stronger than the existing tissue. The procedure doesn’t change cup size, but it does result in higher, fuller breasts. Even more, unlike earlier versions, it’s completely undetectable to the touch.

Shape and proportion, now just size, matter now

A unique phenomenon has been unfolding over the last few years. As we’ve become more conscious of our appearance (thank you, social media), the stigma of plastic surgery has decreased sharply, all while the procedures themselves have gotten better. The breast lift is one instance. Breast augmentation, which is still commonly paired with the breast lift, is another.

Now, shape and proportion, not size alone, are what matter, which represents a significant paradigm shift in the way we’re approaching breast augmentation.

Today’s more anatomical implants are slightly fuller at the bottom than at the top. The most popular sizes are still relatively large, but they look more like real breasts. Beyond these new teardrop shapes, implants now also come in more sizes and widths, which allows the plastic surgeon to choose ones that uniquely fit each body.

While there’s a certain amount of artistry in every cosmetic procedure, it’s especially prominent in the breast lift and breast augmentation. The latest advances grant the plastic surgeon more freedom in that regard. And patient reaps the benefits, with results that are more in line with a subtle enhancement of their natural features.

The term laser has become a catchall for a very deep (and deepening) pool of plug-in dermatologic devices. But the truth is, they can function very differently. Many of these machines rely on different kinds of energy, such as ultrasound or radiofrequency, to achieve distinct effects.

A true laser—which stands for light amplification by stimulated emission of radiation—is characterized by a few key features, including its wavelength, which is absorbed by select targets in the skin, and its pulse width, or the rate at which that beam of light is delivered. Generally, the longer a wavelength, the deeper it penetrates (up to a point). And the faster a pulse width, the better it is for small targets.

Resurfacing lasers target water molecules within the collagen layer of the dermis. Heating the water creates a grid of what’s referred to as microthermal zones, which basically trick the skin into healing itself, triggering extensive repair and collagen production.

Lasers are being used to do pretty much everything these days, from erasing sun damage and wrinkles to rejuvenating tired-looking skin, and often with little to no downtime. Here’s a closer look at two of the most popular kinds.

Nonablative resurfacing lasers

Nonablative resurfacing lasers are the go-to treatment for moderate sun damage, melasma, and small scars.

The term encompasses fractional lasers and picosecond lasers outfitted with a special lens that essentially breaks up the beam. Rather than targeting lone spots, they cover widespread areas. Their main function is to refresh and rejuvenate by building new collagen, helping to smooth the skin, and getting rid of some of the pigmentation that comes with sun damage.

Nonablative resurfacing is appropriate for most skin types. As to which laser is right for you, it depends on what’s being treated. A mild fractional laser, like the Fraxel Clear + Brilliant, will provide a dramatic radiance boost, but only subtle textural improvements. On the stronger end of the spectrum, there’s the Fraxel Dual, whose wavelengths can correct significant, but not deep, UV damage on the face, neck, chest, arms, and hands.

The Dual’s 1927 wavelength is great for pigment, pores, fine lines, and even precancerous lesions, while its 1550 wavelength effectively treats deep wrinkles and scars.

With a mild resurfacer, the treated skin may be flush for an hour or so and a little dry for a day. With the stronger kinds, it’ll look red right after, then a little dirty for up to a week as the damaged cells are shed.

Ablative lasers

Ablative resurfacing lasers treat deep wrinkles, severe sun aging, and prominent scars.

These lasers act on water, too, but their higher energies, and the way in which they’re absorbed, generate greater heat, which creates a more purposeful wound on the skin’s surface than nonablative resurfacing, when the topmost layer remains intact. Ultimately, ablative resurfacing leads to even more collagen renewal.

It is a more intense process than nonablative resurfacing—in turn, it’s not recommended for dark complexions—but the latest generation of fractional ablative lasers are safer and more predictable than the old non-fractionated ablative lasers, with which depigmentation and scarring was a real risk.

That said, the downtime is still more significant than it is after a nonablative procedure. Plan on laying low for at least a week. There will likely be some significant swelling and scabbing, but the recovery