Dr Rod Rohrich interview

Dr. Rod J. Rohrich

push the boundaries of plastic surgery.

Is there an overriding, more classical and less transient

The preferred open approach to

aesthetic and what is it?

rhinoplasty to reveal the nasal

Please, describe the timeless ideal, if in fact there is one.

nasal anatomy clearly.

Do you as a plastic surgeon see a dichotomy between a timeless aesthetic and the prevailing aesthetic of the day? If so, do you

Dr. Rod J. Rohrich is based in Dallas, Texas, but is, by all accounts, a plastic surgeon of

instinctively go for one or the other, the patient’s preferences being equal?

outstanding international stature. After growing up on a ranch in North Dakota, Rohrich

A The overriding aesthetic of today is still that of natural beauty, the so-called ‘Golden Triangle’ (The 2500 -year-old formula for defining perfect beauty, established by intellectuals as a ratio of

graduated with high honours from North Dakota State University and the Baylor University

1:1.618. Known as ‘phi’, the ratio applies to a ‘triangle’ of aspects for facial beauty - the width of the mouth to the width of the cheek, the width of the nose to the width of the cheek and the width of the

College of Medicine.

nose to the width of the mouth.)

It’s one of a youthful, non-operated natural appearance He trained in plastic surgery at the University of Michigan from

– not looking ‘wind-swept’ or ‘the Hollywood’ appearance. As Plastic

1979-1985 and then undertook a fellowship in hand surgery at

Surgeons we are supposed to be in the FACE PROTECTION, NOT

Massachusetts General Hospital. In 1986, Dr. Rohrich accepted a

WITNESS PROTECTION PROGRAM. Most patients do not want to

position in the Department of Plastic Surgery at the University of

look like someone else or to look significantly different. People want

Texas Southwestern Medical Center at Dallas College of Medicine

to look as good as they feel. The wind-swept look of past decades

(UTSW) and became chairman of the department in 1991.

is out.

Since then, Dr. Rohrich has become well known as one of the pre-eminent plastic surgeons in the world. He has chaired over one hundred national and international symposia and delivered

to keep in mind the concepts of ‘Timeless Beauty’ by performing

Rohrich is author or co-author of over five hundred peer review

age-appropriate plastic surgery so that the patient and their plastic

articles and fifty chapters in plastic surgery, ranging across the

surgery will age well and proportionally with them. For example,

delivers the desired result. The nose is the most looked out facial

Q Most people’s faces are not identical on each side and as

board from cosmetic surgery to craniofacial surgery. Many of these

when performing a rhinoplasty on a 50 year old, one should make

feature so it must not shout out rhinoplasty.

they age, the difference between left side and right side is often

publications are considered to be landmark papers on their topics.

minimal changes in proportion to the patient’s facial features.

rhinoplasty. I prefer the open technique in most cases. This

use different procedures in combination or the same procedure,

breast implants that are out of proportion to the rest of her

means you make a very small 6 mm incision in the middle of the

but in different measure?

craniomaxillofacial trauma, secondary rhinoplasty and ultrasound-

body. We need to avoid the infamous “Cat Woman” and overdone

columella (the structure in the middle of the bottom of the nose).

A Of course, everybody’s face is asymmetrical. One eye is always

assisted liposuction. In 2005, he was also appointed editor-in-

distortions seen in the ‘Michael Jackson nose’. This simply is not

The procedure allows the surgeon to look directly at the nasal

bigger than the other; one side of the face always appears shorter

chief of Plastic & Reconstructive Surgery, the leading and most

good plastic surgery!!!

deformity, while with the closed approach he has to do everything

than the other. The beauty is in each face’s individuality. I ask my

in a blind way, so to speak, which means he doesn’t have the same

patients to look at the mirror and compare each side of their face

level of control.

and then to tell me which side they prefer. The goal of the plastic

shaped eyebrows. Innate or unique asymmetries are also beautiful.

teaching curriculum of plastic surgery training programs in the

When we turn the clock back through surgery we must try to

United States and thirty-eight foreign countries.

preserve these unique asymmetries rather than try to make the

Website: www.drrohrich.com

In the open approach, the surgeon can see the deformity

by improving it. The most important thing at this point is to analyse the patient’s face. We all age differently. The ageing face is not just

and correct it with the patients’ own tissue – and reshape the

about sagging skin but about losing facial fat and volume. There are

cartilages using sutures and/or invisible grafts.

21 facial fat compartments in the face.

Q When a patient goes to a particular surgeon, they would

is a Founding Member of the Board of Governors of the National

necessarily end up with a result reflecting the aesthetic

Endowment for Plastic Surgery and currently serves as President of

sensibilities of that surgeon. Should patients discuss this, as

as it is impossible to see the deformity – so, instead of correcting

patient, I would carry out different procedures or a combination of

the Association of Academic Chairmen of Plastic Surgery.

well as the procedure?

it, the surgeon has to camouflage it. Not the best thing to do long

procedures on each side of the face to provide for correction of that

term as visible grafts can become distorted after a while…

patient’s aesthetic concern, as well as restoration of the patient’s

A This is a very important point for the patient and their surgeon

In the closed approach the surgeon has to use more grafts

Plastic Surgery societies in America and worldwide, Dr. Rohrich

to discuss at the outset of the consultation. I fell this is an essential

actively engages in many philanthropic enterprises. He has served

element – I need to feel very comfortable, as does my patient, that

and ages well with the patient, without the need for revision in most

on the boards of charities such as the March of Dimes, Save the

I fully understand what they want and also what I can realistically

cases.

Children - Dallas, Dallas Chapter of the American Cancer Society,

deliver in the operating room. If I am not comfortable with the

the Evergreen Gala Advisory Board which directly benefits the

patient’s expectations, I would not operate.

Dallas community breast cancer efforts of the ACS and he is

I cannot go outside of my own aesthetic norm; else I would

With the open approach, the nose looks more natural longer

In any facial cosmetic surgery, based on my analysis of the

optimal facial contour I perform what is known as a LIFT AND FILL FACELIFT based entirely on the patient’s pre-op analysis, so that each

Rhinoplasty is a surgical procedure of millimetres. It is the most precise technique in cosmetic plastic surgery, therefore if you

patient’s operative plan is entirely customised .

I build up the centre-face by refilling the medial or central

are off by a mm one way or the other you can have either great

facial deep fat compartments, together with lateral or outer face

a Founding Member of the Dallas for Children Foundation. He

never know the end point that I would be seeking in the operating

or phenomenal result vs. a poor outcome. Rhinoplasty, in fact,

lifting. — These are the essence and fundamental cornerstones of

personally established The Rod J. Rohrich, M.D. Foundation to

room. One would be in Michael Jackson and Joan Rivers territory. I

epitomises plastic surgery as a whole because it is a surgery of

modern facial cosmetic surgery.

annually support a medical student who will practice primary care

need to be at one with my patients and their aesthetic sense has to

such great finesse and three dimensional thinking and execution,

in North Dakota. He has also performed and taught plastic surgery

match mine, otherwise I would not be able to operate on them.

as well as precise pre-op planning –all of which requires constant

Q In the introduction of this book we give a summary of the

learning and takes years to master if you truly want to be a real

different face lifts offered by surgeons today. In practice, how

expert. Experts are not born but are made through tireless learning,

important is the technique v. the skill and judgement of the

critical self-analysis and always seeking a higher level of excellence.

surgeon?

in Third World countries, focusing specifically on reconstructing severely burned and congenitally deformed children.

Q Today’s aesthetics are shaped by the media, whether print, film, Internet or advertising, which in turn fuel demand for and

84

procedure…

face look like someone else’s.

surgeon is to accentuate the better side; to enhance the asymmetry

Q Are there different techniques for achieving an excellent result in rhinoplasty? Please, describe them briefly.

A Yes, there are different techniques. However, it is not so much about the technique used as long as that particular technique

It takes an average of about 10 years or 10,000 hours to become a

A In the hands of a greatly skilled plastic surgeon, any technique

true expert in anything in life!!!

will provide good results, however, if you want to go to the next

Revolutionary concepts on how we age with loss of fat in special fat compartments of the face which will guide how to do a natural facelift without distortion.

Dr. ROD J. ROHRICH

Phone: +1 (214) 821-9114

And rhinoplasty is all about controlling every aspect of the

of Plastic Surgeons and the Texas Society of Plastic Surgeons. He

In addition to serving on the boards of numerous other

Dallas, Texas 75231, USA

The timeless ideal is an oval face with full eyes and well

for Selected Readings in Plastic Surgery, a supplement to the

of Plastic Surgery (ABPS) and as President of the Dallas Society

Suite 600

accentuated. How does a plastic surgeon address this? Would he

Likewise, it would not be wise to give a 50-year-old woman large

Dr. Rohrich has served as a Director of the American Board

9101 North Central Expressway

The main different techniques are open vs. closed

five textbooks in plastic surgery ranging from rhinoplasty,

prestigious journal in the world for plastic surgeons, and an editor

Contact

As Plastic Surgeons we must be always aware that we need

over 1500 scientific presentations on all aspects of plastic surgery.

As well as papers, Dr. Rohrich has also published

Dr. Rod J. Rohrich

There should be no surgery tell-tale signs, whether the surgery is rhinoplasty or facelift.

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level of excellence, the skill and judgement of the surgeon by

Q What are the limitations of plastic surgery in terms of

Q Fat replenishing seems to be the procedure of the moment.

far outweigh the technique. The technique eventually becomes

shedding years? Ten? Fifteen? More than that? Please, define an

If faces age outward rather than downward, would it not be

secondary.

unrealistic expectation.

possible to have a fat transplant facelift?

the surgeon’s sense of aesthetics as we have discussed. Everyone

turn the clock back somewhere between seven and ten years. The

understanding facial ageing, not every face can be rejuvenated

starts as a Da Vinci type of plastic surgeon - one who measures

results of browlift surgery will last that long as well and eyelid

through fat injections alone. We being to age after 30 and skin

things precisely - yet only few transcend this level to become a

surgery may last up to 15 years

starts sagging. The important thing to do is what I refer to as a fat

The other most important element of plastic surgery is

Michelangelo type of plastic surgeon - one who can combine the

A There is no perfect operation. In terms of facelifts you can

A properly done rhinoplasty lasts a lifetime while breast

especially in the deep central fat compartments. These are fixed

in achieving what is right for that particular patient.

all man-made implants need to be replaced every 10-15 years. Body

by injecting fat deep into each compartment. This alone will work

contouring could last a lifetime provided it is combined with proper

in the late thirties to forties using either fat or an FDA approved

innate and learned artistic sense which is integrated into making

diet and exercise. There is no point in liposuction unless people

filler like a hyaluronic acid filler or Radiesse. The key is to fill the

the most of each patient’s underlying best features – whether I am

change their lifestyle, i.e. change their diet and exercise routine for

fat compartments centrally and then do the face lift laterally, as

performing a facelift, rhinoplasty, breast lift or a body contouring

the better.

and when needed. This is a very exciting new arena for not only

Q Your thoughts on the deep plane facelift?

A The deep plane facelift is essentially dead as it never made good

Q If a woman of fifty has a facelift which makes her look around forty years old, if the same woman at sixty had another

understanding how we age but also how we can rejuvenate or restore facial youthfulness.

perpetually forty?

based and did not integrate with what a patient looked like or what

A No, at fifty after your facelift, you would look ten years younger

Q Is the mid-facelift a misnomer or a valid procedure?

A I don’t espouse the mid-facelift. It looks out of synch with

they would look like after. The end result produced, in many cases,

but will continue to age as time goes on. One can not stop the

procedure - it is in my opinion a procedure out of step with facial

facial distortion and the over-operated appearance which is out of

ageing process but merely turn it back in time. Therefore, when

ageing. It does not have a major role in surgical restoration of the

synch with modern facial aesthetics.

you turn sixty- ten years later - and have another facelift you would

ageing face

sense either anatomically or surgically. It was more anatomically

It was a great anatomic innovation however, which provoked

facelift would it ‘take off’ another ten years and would she look

still achieve a great improvement, but you will not remain forty! At

the rest of the face. I don’t see a role for an isolated mid facelift

us to look at the deeper layers of the face. Modern facelifts are

this stage, you can turn the clock back by five to seven years. Why?

Q Who in your opinion most closely embodies the ageless beauty

about the operative manipulation of multiple layers, based on

Because other features would have changed as well in those past

we asked you to describe in question 1?

individual facial analysis, not on a particular technique. The

ten years, such as you will have more facial fat loss especially in the

component facelift which uses multiple layers to reshape the face

orbital and temporal area, all of which will contribute to making you

Allie McGraw... Each of these women have the same facial beauty

without distortion is ideal for a natural facial rejuvenation.

look older.

traits: great oval faces with wonderful natural asymmetries that

The objective of repeat or secondary facelift surgery is to

A Sophia Loren, Elizabeth Taylor, Julia Roberts, Jackie Onassis, emphasise their individual beauty. I don’t like the Angelina Jolie

Q Minimally-invasive seems to mean many different things,

avoid looking tired and to keep the patient looking their best at

types that tend to over-amplify the central face or excessive lip

yet is often misunderstood by the average consumer. It often

each stage and phase of their life People who have unrealistic

fullness.

describes a complex procedure that is done endoscopically,

expectations are headed for disappointment. Another major factor

however, most scars are subject to the skin’s capacity to retract

of how each of us ages is genetic pre-determination. It is also

There are also many plastic surgery myths that tend to be

and the patient’s age, among other factors. In this context,

predicated on the shape of the face – whether the face is thin or fat.

perceived as truths as marketing hype has overtaken facts.

does it really matter how long or short the scar is?

For example, fat faces don’t age as fast as thin faces. The greatest

On the next page are some of my favourite myths debunked.

A Minimally invasive can indeed mean a number of different things

myth of plastic surgery was that taking fat out of the face and eyes

A deep layer facelift to reshape the face

in the field of plastic surgery but for the patients it means only one

was a good thing – that was the hardest lesson we had to learn. In

along with replenishing the facial fat

thing – fewer incisions and less recovery time. The true definition

most patients it is not a good thing at all; in fact it accelerates the

compartments.

and the ideal of a minimally invasive lift is the three incisions

ageing process.

endoscopic brow lift. In this procedure the patient can expect much shorter recovery, less discomfort and an improved overall result.

Q A youthful face on an old body is an unsightly thing. Do

Our job as plastic surgeons is to hide the scars or to make them

patients tend to focus too much on face and breasts and not

almost imperceptible – that is the ultimate result. The length of

enough on limbs/rest of body?

the scar is irrelevant. Indeed, how you attain the ultimate result

A People focus on what they can see or want to have others see.

is irrelevant, so long as you do. Most of the things written about

Young women tend to want to have breast augmentation surgery.

minimally invasive or short-scar procedures in relation to facelifts

As they get older they focus more on their nose, face and hands.

are primarily MARKETNG HYPE ONLY AND NOT BASED ON TRUE

The body and face also have to be in synchrony. Hands can tell

PATIENT OUTCOMES OR SCIENTIFIC DATA TO SUPPORT THE

the biological age and are highly visible. Often, in conjunction with

MARKETING EFFORTS.

a facelift, we will also perform fat compartment autologous fat

Q All educated consumers know that the skin lift is a thing of

The most important thing a consumer should remember is to do their homework.

Wherever you live, find a board-certified plastic surgeon in order to get good advice. The most important determinent of

Pre and post op 2 years — natural appearing facelift using LIFT AND FILL FACELIFT with fat replenishing of the fat compartments cnetrall and lifting of the deep layers in the outer face

your safety and outcome in plastic surgery is who you choose to do your plastic surgery.

injections in the hands, combined with later skin resurfacing. This will greatly enhance and replenish the top of the hand and last

the past. Are there new developments in face lift techniques

several years.

that will define the near future?

In the ageing cycle, cosmetic surgery is performed in the following sequence: young women will have a rhinoplasty and/or breast

different stages of ageing in different parts of the face. Modern

enhancement surgery first. As they get older and have children,

natural facelift techniques like the new Lift and Fill technique that

they are likely to have a tummy tuck and liposuction along with

I have described are based primarily upon each patient’s individual

facial fillers and Botox

facial analysis, which in turn determines which facelift technique

Then, at about age 50, they will have a facelift, eye surgery, a brow

should be used to obtain the desired result.

lift and at sixty-sixty plus they will probably re-do the face and rejuvenate the ageing and drooping nose.

Dr. ROD J. ROHRICH

A Plastic surgeons have reached an epiphany in understanding

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loss GPS mapping of the face and to target the areas of fat loss,

implants done for breast enhancement last ten to fifteen years as

surgery.

finess open rhinoplasty.

A Even though fat compartments are the key component to

precision of the measurement and combine it with the artistic sense My sense of the best aesthetic is a combination of the

Pre and post op 2 years —

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UT SouthWestern Department of plastic surgery Dr. Rohrich’s plastic surgery myth-busters

eyes.

Breast augmentation myths Myth: Breast implants are not safe.

Reality: Rigorous and long-term studies done all over the world from Harvard to UCLA to UT

General myths about plastic surgery Myth: All cosmetic surgeons are real plastic surgeons.

Reality: Unfortunately, anyone with a valid medical license can call themselves a plastic

there is preliminary data to show that it does diminish acne and may stall hair loss as well, but more studies are needed. They are being done now.

surgeon, hang up a shingle and begin treating patients! so plastic surgery has become a

Myth: Fillers and Botox are the new non-surgical facelift.

“buyer beware” specialty.

Reality: After a certain age, nothing can produce the results of an actual surgical facelift.

Myth: All plastic surgery board certifications are the same.

Reality: Only the American Board of Plastic Surgery certifies that someone is fully trained in plastic surgery of the face and body. It takes from 6-9 years to achieve this training, and then you must pass a rigorous written and 2-day oral exam.

Myth: Only real plastic surgeons can perform any type of plastic surgery or cosmetic procedures.

Reality: It may be hard to believe, but anyone with a valid medical license can call themselves a plastic surgeon. The consumer must investigate carefully before he or she goes to see a physician.

Myth: All plastic surgery procedures are done in an accredited operating facility.

Reality: Unless you’re a board-certified plastic surgeon by the American Board of Plastic

However, the proper and skilled combination of Botox and fillers can certainly postpone the appearance of ageing in younger patients. Botox can smooth the forehead while lifting and

SouthWestern have consistently shown and proven that both saline and silicone implants are safe and don’t cause cancer or rheumatoid diseases.

implants, following extensive consultation with our patients regarding their health, lifestyle and personal preferences, as well as the outcome of a physical examination.

layer of the skin. Touted as a minimally invasive procedure that treats everything from cellulite

Reality: All man-made implants – both saline and silicone – last about 10-15 years maximum.

to sagging skin to excess weight, most of mesotherapy’s claims are completely unfounded.

Myth: The “new” Botox – Dysport – is better and lasts longer.

Reality: The efficacy of Botox and Dysport is about the same. Both injectables are essentially purified forms of botulinum toxin a. Dysport may act somewhat faster and is expected to

And the new jelly bean implants have not been proven to be better since we have no 10-year data to evaluate. That is important for all implants placed into humans.

be about 15 percent cheaper. Dysport is currently being used in Europe and is anticipated to

Myth: Fat taken from the buttocks is now the preferred choice for breast augmentation.

launch soon in the USA with FDA approval.

Reality: It is still very experimental and not cost-effective – taking three times longer with

Myth: There are over a dozen FDA-approved fillers on the market. A person should be able to pick the newest one or the one that best fits their budget since they are all government-

inconsistent results. Furthermore, it may mask breast cancer if it develops, so this is a major drawback. This needs to be further investigated before we can reach a conclusion.

expertise, or to ask them to show you some results.

different properties is the preferred way for achieving facial rejuvenation. Some fillers are

injections may be useful in making small modifications to breast size, such as correcting breast

Reality: Board-certified plastic surgeons prefer informed patients. Knowledge is power and it

more viscous and don’t migrate as easily; others are more fluid and can plump larger areas.

asymmetry.

is very important to make the right decisions. It will determine not only your outcome, but your

Some cost more because they last longer (like Radiesse, which can last well over a year in

safety as well. In general, an educated patient recovers better because there are no surprises

comparison to some other hyaluronic acid fillers which act for 6-9 months). Your plastic

Body contouring and laser myths

surgeon should be your guide.

Myth: Permanent fillers are better and everyone should use them.

Reality: Permanent fillers in general have more permanent problems that cannot be

are adverse effects on our skin from the sun, wind and tobacco, among other things.

stimulate stem cells. But we’ll get there in the next five years!

Myth: Facelifts marketed as in-office procedures – usually taking just one hour with local

Myth: You won’t age naturally if you have cosmetic surgery.

anesthesia and minimal recovery time – are safe and effective.

Reality: When plastic surgery was in its infancy, surgeons focused on tightening the loose skin

Reality: Many patients have been disfigured or experienced complications from procedures like

of the ageing face. With further research done by UT Southwestern plastic surgeons, we now

these. If you want long-lasting changes that you’re going to be happy with, it is better to get a

know that an aged appearance is not only caused by loosening skin but by the loss of facial fat.

real facelift from a board-certified plastic surgeon performed in a real operating room under

We can naturally rejuvenate the face by techniques that both lift and fill the face. Using these

Reality: That’s incorrect. While exercising on a regular basis helps tone your body, it is your daily diet that will determine how effectively you lose weight and then maintain it. A balanced diet will allow for a slow and steady weight loss. Fad diets often yield only temporary weight loss results.

Myth: Herbal diet medications are safe and effective for weight loss.

Reality: Herbal medications and supplements are completely unregulated by the FDA, so you

The best and most advanced liposuction remains “UAL,” which gives the best contour and results with the least downtime. We are working on this technology at UT Southwestern, trying to develop standardised techniques that may yield more consistent and reliable results.

Myth: Fat can come back after liposuction and “reverse” the procedure.

Reality: Fat doesn’t come back in the same areas unless you gain over 30 percent of your body weight after liposuction. Then you can actually grow new fat! Long-term results in body contouring demand that you change your lifestyle. With regular exercise and proper diet, you shouldn’t see fat reappear in the liposuctioned areas.

Ageing myths Myth: Your genes are responsible for how you age.

Reality: This is partly true, but it is also true that ageing is directly related to how we live. In a few words, ageing is impacted by our environment, diet and habits (like smoking). Excessive sun exposure is a major cause of premature ageing, as is excessive eating. Unfortunately, the latter is becoming a major problem in our society: almost 60 percent of adults in the USA today are estimated to be overweight and 30 percent of our children are obese.

Myth: Supplements can help slow down the ageing process.

Reality: There is scientific evidence that we should consider one baby aspirin daily (82 mg) for heart attack prevention; omega-3 supplements or having 2-3 fish meals per week; and a good once-a-day vitamin. There is softer data for coenzyme q-10 (an enzyme activator), as well as Chondroitin for prevention or treatment of joint aches. The newest fad is Resveratrol, the

moved to the next generation of facelift technology.

active metabolite of red wine thought to be capable of increasing lifespan, but scientific data

be some benefit to both external ultrasound treatments as well as low-level laser treatments.

is still inconclusive. All supplementation should be considered under the advisement of your

This is an area of intense research at UT Southwestern and we anticipate more advances in

physician.

may help make injectable Botox last longer. However, it is difficult to say it will ever replace

the best ones to use are based on hyaluronic acid – but this solution doesn’t work for significant

injectable Botox as it doesn’t have the same ability to deliver the toxin to specific muscle areas

changes, nor do the results last more than 6-12 months.

the future. It has good science behind it as well. In research done at UT Southwestern we have shown that by using focused ultrasound beams you can remove a modest amount of unwanted fat in certain areas. This is a very exciting new field. Remember that diet and exercise are

Myth: You can remove dark under-eye circles with a cream.

required in order to achieve optimal results using these non-invasive treatments just as they

Myth: Botox is Botox. You can get it for $100 at a hair salon or spa, or pay a lot more to get

Reality: Unlikely. Under-eye circles can have many causes, including skin pigmentation,

are with surgery.

it from a doctor.

shadowing, thin skin and visibility of underlying blood vessels. Different procedures to treat

Reality: in Botox, as in life – you get what you pay for! The price of Botox is set by the company

these problems may include the use of Retin-a or bleaching creams, chemical peels or lasers,

(Allergan) that produces it. If you purchase Botox at a severely discounted rate, it is possible

and potentially surgery to blend the eyelid-cheek junction.

Myth: You can grow thicker, longer eyelashes by applying a liquid gel daily.

Reality: True. The gel is called “Latisse” and its active ingredient was originally developed as a drug to treat glaucoma. When used as directed, you can grow thick, long eyelashes in about 4-6 weeks. There are some side effects to consider, such as it can potentially darken light-colored

Myth: Extreme makeovers as seen on TV are commonly done and are very safe.

Reality: It is a total misconception that you can perform total body contouring and breast augmentation and teeth whitening in one setting. In general this is not safe or recommended for most patients.

Myth: As we age, it is the sagging skin of the face and neck that makes us look old.

Reality: It is the sagging skin, but more than that, it is the loss of facial fat, especially around the eyes and cheeks that makes us look older beginning at age 30. We have discovered these fat compartments in anatomic studies at UT Southwestern and have determined how to add fat to make you look young and more natural longer.

Myth: There is an anti-ageing cream that will keep you looking younger longer.

Reality: it is true! This product does exist and it’s called “Retin-a.” This cream or lotion works by forcing skin cells to turn over faster. With long-term use, it can improve acne and fine wrinkles, smooth the skin and remove age spots. The other great ageing prophylactic is a

Myth: Skin tightening lasers work well and will replace facelifts in the future.

sunscreen with both UVB and UVA protection. The combined usage of these two lotions, Retin-

Reality: There isn’t a predictable and reliable way to tighten the skin non-invasively. However,

a and sunscreen, will make a big difference in how fast your skin shows visible signs of ageing.

PLASTIC SURGERY MYTH-BUSTERS

Reality: Not really. Fillers can help make some bumps and depressions go away temporarily –

Myth: Botox cures migraine headaches, acne and hair loss.

Myth: Exercising is the most important component to a weight-loss program.

Reality: Yes, it does. While it is not a replacement for liposuction, in some patients there may

Early indications are that it may work in small areas around the eyes (crows feet) and that it

training, which can result in problems like asymmetry and droopy eyelids or brows.

body contouring. This must begin before surgery.

new concepts of fat compartments and fat replacements within the deeper layers, we have

Myth: Non-surgical rhinoplasty can provide the same results as surgery.

Botox at all. What’s more, in salons the product is often injected by people with insufficient

Reality: Eating right, exercising and lifestyle changes are imperative to optimising success in

Myth: Non-surgical fat removal doesn’t really work.

Reality: Not true… yet, topical application of botulinum toxin a is still in the clinical trial phase.

that you are receiving a very diluted form of Botox or perhaps something that is not even real

Myth: Liposuction or a tummy tuck can jumpstart me to eat better and exercise.

react adversely with other medications or your body.

It is due to estrogen. There are exciting things on the horizon, but they’re not here yet.

Reality: Not true. It has not even been proven to work as effectively as traditional liposuction.

Reality: Perhaps in the future, but not now, as we still have to refine how we harvest, grow and

labiaplasty is different and is effective for reshaping or reducing the external genitalia.

never really know what you’re going to get. They can often contain “stimulants” which may

Temporary fillers that last longer – up to 1-2 years – are optimal at this time.

facelifts for the future. Additionally, the environment clearly plays a role in how we age. There

Reality: This is primarily marketing hype and does not work. Period. Cosmetic surgical

Reality: There is no permanent cure for cellulite, which is present in all females from age 11–99.

Myth: Laser liposuction is the best form of liposuction today.

Myth: Stem cells from fat work so well they will replace all facial fillers used today.

Myth: Cosmetic laser vaginal rejuvenation can tighten / tone / shrink the vaginal walls.

Myth: There is now a permanent cure for cellulite.

removed without disfigurement. And they don’t age well with the patient – so don’t use them.

shown that we all age differently. This has led to new and more natural ways to customise

with pinpoint accuracy.

yields little or no results. Also known as “the French method,” mesotherapy uses multiple needle injections to deliver small amounts of herbal and vitamin compounds to the middle

successfully grafts to a new location (the rest scars or is absorbed by the body). However, fat

Myth: Topical Botox is replacing injectable Botox.

Reality: Mesotherapy is not approved by the FDA. It can be dangerous and very painful and

available.

give you the best results in a cost-efficient manner. A combination of different fillers with

sterile conditions.

Myth: Mesotherapy is an easy and safe way to spot-reduce fat and lose weight.

shaping the brows. Fillers can plump up the lips and cheeks and soften the nasolabial folds. The

Myth: It is disrespectful to ask a plastic surgeon tough questions about their experience or

Reality: Recent groundbreaking work at UT Southwestern on facial fat compartments has

this is not a predictable benefit. While fractional lasers offer minimal downtime, other types of

results are not permanent, but they require very little downtime.

or silicone implants any time soon. With current technology, only 50 percent of transplanted fat

everyone.

and even acne scars. A small percentage of patients may achieve some skin tightening, but

Myth: The new jelly bean silicone implants last forever and are better than what is now

knowledgeable person to determine which fillers to use on the different parts of the face to

Myth: Everyone ages the same in the face, so the same facelift procedure will work for

devices. However, they can be a good choice to correct sun damage, discoloration, fine lines

less improvement you can expect.

with each type. At UT SouthWestern we perform surgeries using both saline and silicone

Reality: Fat injections are truly experimental and are not going to replace conventional saline

Facelift and skin-care myths

Reality: Despite lots of advertising to the contrary, fractional lasers are not skin-tightening

lasers can offer more visible results. The rule of thumb is: the shorter the recovery time, the

Reality: A practicing board-certified plastic surgeon or dermatologist is the most

and less anxiety about the procedure.

Myth: Fractional laser skin resurfacing tightens the skin non-surgically.

Reality: Both types of implants are approved by the FDA and there are benefits and drawbacks

Myth: Fat injections to the breast will replace breast implants.

you in harm’s way if there is a problem.

face with less discomfort and recovery.

Myth: Saline implants are just as good as silicone implants.

approved.

Surgeons, you aren’t required to perform plastic surgery in an accredited facility. That may put

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Reality: It is very effective for both stress and migraine headaches if placed correctly. And

we do have advances in laser resurfacing that allow us to treat fine and moderate lines of the

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