Buyer Beware: Cosmetic Facial Surgery
In this day and age of media hype, it is not uncommon to see, hear or read about “miracle” skin and surgery procedures that “can be done awake without anesthesia”, have “little or no down time” and promise to “take years of aging” off of the skin. BE CAREFUL! Some general rules to consider are:
• If it sounds too good to be true, it is.
We see so many patients that fell for these “miracle” procedures, spent a lot of money and saw no results. Do your homework. Research the procedure you are considering. You may be surprised how many unhappy patients and doctors there are out there with that specific procedure. Many of the procedures and devices you see on TV and Doctor shows turn out to be duds. When you see infomercials on “miracle or revolutionary” facelifts or procedures, stop and think. If something was truly revolutionary, would everyone be doing it? Wouldn’t you be more likely to read about this tremendous advance in the mainstream media? Believe me, if someone invents a facelift that is truly revolutionary and can be done awake with no downtime, they will receive a Nobel price, be on cover of Newsweek, etc. And no one would do “old style” lifts. This is called a paradigm shift. You don’t see horses on the expressway because the combustion engine was such an advancement that everyone drives cars. If and when we see paradigm shifts in cosmetic surgery you won’t learn about it from infomercials! Some examples of true cosmetic paradigm shifts include Botox, lasers and liposuction.
• Any skin resurfacing or tightening procedure that can be done without anesthesia is probably not going to do much, especially in a single treatment.
To truly address skin aging, deeper dermal treatment is important and this is simply too painful to be done without sedation. I see many patients that were treated awake and it was a terribly painful experience. Remember, in this day and age of safe and easy sedation, there is no reason to suffer for a procedure. I feel the same way about facelift surgery. Small facelifts can be done with local anesthesia, but larger lifts, in my opinion, can be done faster and better with sedation. I recently heard a surgeon discuss how he does facelifts with local anesthesia and his patients take bathroom breaks and have snacks. Not the way I want to do it, I can do a comprehensive facelift with platysmaplasty and SMASectomy in under 3 hours, but it requires sedation. Please don’t misinterpret me, some surgeons are very versed at local procedures, and do safe and effective surgery but the average facial surgeon uses sedation. Patients should have a good idea about the “standard” means of performing surgery and anesthesia and look closely at those surgeons that deviate from this definition. Does not mean they are bad, maybe just different. It is the safety and outcome that matters, so do your due diligence, look around.
• How many procedures are required to see a difference?
This is important as I see patients that were treated elsewhere and thought that their “light laser” was a single treatment. When they saw little or no difference, their doctor told them they need 3-5 more treatments to be effective. Personally, I think it would be advantageous to have a single Classic laser treatment and take 10 days off of work than to have 3-5 “fractional laser” treatments that take 3-5 days to heal. Remember, there are no miracle treatments and your result is equal to your recovery. Procedures with short recoveries have small results. Procedures with longer recoveries have much more impressive results.
• Don’t be afraid to ask!
Too many times, patients are hesitant to ask their surgeon to see actual before and after pictures of a procedure. It is important to make sure that the before and after pictures are from your doctor and not from a laser company. If you are considering a procedure from a doctor and they cannot show you ten before and after pictures, there may well be a reason! Ask the surgeon how many of these procedures he or she has done and ask for some patient references.
• Every Picture Tells a Story
As digital photography has progressed there should be no reason for any doctor to use poor quality or unstandardized before and after pictures. Although it is rare that surgeons “photoshop” their pictures to improve the outcome (yes, it happens) it is very common for some doctors to have very poor pictures. In my experience, surgeons that take pride in their images and pay attention to detail, do the same with their surgery. Beware for before pictures take without a flash (shadowy) and after pictures taken with a flash. This always makes the outcome look better because the shadows are gone in the after picture. Also look for before and after pictures that are not the same size, not the same background, not in focus. This is just astute observation I have made over the years. Doctors that have sloppy or misleading before and after pictures may not pay attention to detail. I always tell young doctors that “your images represent you and your ability”.
What kind of Surgeon Should I have do my Surgery?
This is important and the true answer is that in reality there are many specialties that are qualified to perform cosmetic surgery. Some specialties are deeply involved in turf battles and would like the consumer to think that only their specialty is qualified to perform cosmetic surgery. Nothing could be farther from the truth and these arguments are self serving to attempt to capture patients and dollars. If you are considering facial surgery, you could choose a cosmetic trained dermatologist, oculoplastic surgeon, oral and maxillofacial surgeon, ENT surgeon, or plastic surgeon. No one specialty is better than the other and it all boils down to the competency of the individual surgeon. Their training, ability, patient safety, and clinical outcomes are the most important thing. Numerous specialties are qualified. When seeking a surgeon, look for:
• A doctor that you feel good about and that has time for you.
• A doctor that has training in the area that you are considering.
• A doctor that has experience and can show you many examples of his or her work including patient testimonials.
• A doctor that has an accredited facility.
• A doctor that you can easily get in touch with if you need them.
• A doctor with a caring staff.
• A doctor that will back up their work and be able to handle complications.
For more information on cosmetic facial surgery by Dr. Joe Niamtu in Richmond, Virginia visit www.lovethatface.com
Niamtu, III DMD