Cosmetic Procedures Amid the Pandemic By Omar E. Beidas, MD The ripple effects of the pandemic over the past year-plus have indeed been far reaching. One unexpected effect, though perhaps more obvious in hindsight, has been a notable surge in the number of people seeking cosmetic procedures. While masks became the norm in many settings outside the home, inside, many people have been spending a lot of time on various video platforms, whether visiting with family and friends or attending work meetings. All that time seeing your own image looking back at you on screen can lead to increased self-scrutiny, particularly of facial features. Combined with remote working allowing for at-home recovery time, and entertainment and travel shutdowns providing a little extra disposable income for some, plastic surgeons across the country have been reporting significant increases in patient volumes. Once services opened back up to allow elective procedures, the Orlando Health Aesthetic and Reconstructive Surgery Institute plastics group has seen a definite uptick in the number of patients, particularly women, coming in looking for a more youthful, more refreshed appearance.
For patients in their 50s and 60s looking for facial rejuvenation, cosmetic surgery may be the best course of action. A facelift usually is a sameday procedure performed under general anesthesia. Because, as mentioned earlier, we lose fat as we age, these patients also may need volume. So, along with the facelift to stretch the face and smooth the wrinkles, a surgeon can perform a fat transfer, taking fat from an unwanted place on the body and transferring it to the face where it’s deficient. A very small amount of fat makes a big difference in the face. Once transferred, the fat cells will permanently stay in their new location. In the first six weeks after surgery, it is common to lose 30-40 percent of the fat initially transferred, so the surgeon will place extra fat during to account for the initial loss. Facial surgery definitely requires more downtime than Botox or fillers. For our patients, we recommend a gradual increase in activity over six weeks.
For patients in their 30s and 40s, minimally invasive injectables are a very popular and effective treatment. In cosmetics, injectables is a broad term that refers to a class of medications administered via needle that includes Botox® and similar type products and a number of dermal fillers, such as Juvéderm® and Restylane®.
Several other procedures are available for patients looking for more than facial rejuvenation.
Botox, a purified form of botulinum, is injected in very small amounts to relax facial muscles and in turn reduce wrinkles. Most commonly used for forehead lines, crow’s feet and frown lines, Botox lasts three to six months, but may also serve a longer-term preventive role. When started early and used consistently, Botox not only diminishes the dynamic, or active, wrinkles seen when someone frowns or raises their brows, but also can help lessen the deeper static wrinkles seen when the face is at rest, because the muscles causing them are not constantly activating. As the name suggests, fillers are used to add volume. We all lose fat in the face as we age, so fillers are the treatment of choice for hollowing under the eyes, nasal labial folds and sunken cheekbones, returning volume to smooth lines and enhance shape. Fillers can last one to two years, depending on the type of filler used and area treated. Another product on the market is Kybella®, the first FDA-approved injectable treatment to reduce fat under the chin. A type of nonsurgical fat reduction, Kybella contains a man-made form of deoxycholic acid, a naturally occurring material that helps the body absorb fat. Unlike Botox and fillers, the results from Kybella are permanent. Currently approved only for use on the neck, indications may expand in the future. All of these injectables are performed in-office, with minimal downtime. After an initial consultation to review medical history and discuss goals and options, the treatment time can be as little as 15 to 30 minutes. Recovery involves some bruising or redness at the treatment site, and it can take up to two weeks for the results to be noticeable. 16 FLORIDA MD - JUNE 2021
One option offered at Orlando Health Aesthetic and Reconstructive Surgery Institute is a “mommy makeover,” a restorative procedure that includes both breast and abdominal surgeries completed at the same time. Advanced options include breast augmentation with fat transfer, in which fat from liposuction is used to enhance the breasts in place of implants, and a drainless tummy tuck, which involves sealing off any openings left during surgery with more sutures rather than using drains that stay in place for weeks. Body contouring is a surgical process to remove excess skin and fat for people who have lost more than 50 pounds. Not just cosmetic, it also treats functional problems related to excess skin and improves the shape and tone of underlying tissue that supports the skin. Body contouring usually involves a number of surgical procedures and target areas, including the arms, abdomen, buttocks, thighs and back. It’s important for patients to choose a cosmetic surgeon who understands their goals. It can be helpful to provide a photo to give the surgeon a good idea of what the patient is looking for and to allow for discussion on whether those results are achievable. While it seems that many offer these services, the procedures are complex and should be performed by a surgeon who has extensive training and experience. By choosing a member of the American Society of Plastic Surgeons, listed on PlasticSurgery.org, patients can be assured a qualified, board-certified plastic surgeon. At at the end of the day, the goal of plastic surgery is to make the patient happy. So, for me, it’s all about setting expectations and then finding ways to make sure the patient makes the right decision that is going to give them the result they want.
