In today’s information age, people have more information than ever before about cosmetic medical procedures. But in the face of many competing claims, how can they know which procedures are worthwhile and which are an ineffectual waste of money? In the rapidly evolving world of cosmetic medicine, which technologies that made news headlines a year ago are now outdated?
The Plastic Surgery Department addressed these issues at UT Southwestern’s first ever Cosmetic Medicine Symposium in Dallas, an event held to educate the general public about the latest and most effective uses of cosmetic medicine and specifically discussed myths about fillers and botox.
1. 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 be about 15 percent cheaper. Dysport is currently being used in Europe and is anticipated to launch soon in the U.S. with FDA approval.
2. MYTH: Fillers and Botox are the new non-surgical facelift.
REALITY: After a certain age, nothing can replicate the results of an actual surgical facelift. However, the proper and skilled combination of Botox and fillers can certainly postpone the appearance of aging in younger patients. Botox can smooth the forehead while lifting and shaping the brows. Fillers can plump up the lips and cheeks and soften the nasolabial folds. The results are not permanent, but require very little down-time.
3. MYTH: Permanent fillers are better as they last forever.
REALITY: Permanent fillers cause permanent problems. Longer lasting fillers are good, but permanent substances such as silicone do not age well. Your face changes over time, and permanent fillers can begin to look strange, migrate to the skin surface or cause other long-term problems. Consult with a knowledgeable plastic surgeon to find a filler substance that will age along with you instead of in spite of you.
4. MYTH: Topical Botox is replacing injectable Botox.
REALITY: This is not true… yet. Topical application of botulinum toxin A is still in the clinical trial phase. Early indications are that it may work in small areas around the eyes (crows feet) and that it may help make injectable Botox last longer. However it is difficult to say it will ever replace Botox, as it does not have the same ability to deliver the toxin to specific muscles areas with pinpoint accuracy.
5. MYTH: Facelifts marketed as in-office procedures – usually taking just one hour with local anesthesia and minimal recovery time – are safe and effective.
REALITY: Countless patients have been disfigured or experienced complications from procedures like these. If you want long-lasting changes that you are going to be happy with, it is better to get a real facelift from a legitimate cosmetic surgeon performed in a sterile operating room under general anesthesia. These “lunchtime lifts” may occasionally work for some, but the results are temporary as they don’t do anything to the deeper layers of skin and muscle tissue.
6. MYTH: Botox is Botox. You can get it for $100 at a hair salon or spa, or pay a lot more to get it from a doctor.
REALITY: In Botox as in life – you get what you pay for! The price of Botox is set by the company (Allergan) that produces it. If you purchase Botox at a severely discounted rate, it’s possible that you are receiving a very diluted form of Botox or perhaps something that is not even real Botox at all. What’s more, in salons the product is often injected by people with insufficient training, which can result in problems like asymmetry and droopy eyelids or brows.
7. MYTH: There are over a dozen FDA-approved fillers on the market. Consumers should be able to pick the newest one or the one that best fits their budget since they are all government-approved.
REALITY: A practiced cosmetic surgeon is the most knowledgeable person to determine which fillers to use on the different parts of the face to deliver natural, long-lasting results in a cost-efficient manner. A combination of different fillers with different properties is now the preferred method for achieving facial rejuvenation. Some fillers are more viscous and don’t migrate as easily; others are more fluid and can plump larger areas. Some cost more because they last longer (like Radiesse, which can last well over a year in comparison to some other hyaluronic acid fillers which act for 6-9 months). Your cosmetic surgeon should be your guide.
8. MYTH: There is a true anti-aging cream that will keep you looking younger longer.
REALITY: It’s true! This product does exist and it is 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 aging prophylactic is a sunscreen with both UVB and UVA protection. The combined usage of these two lotions, Retin-A and sunscreen, will make a big difference in how fast your skin shows visible signs of aging.
9. MYTH: Fractional laser skin resurfacing tightens the skin non-surgically.
REALITY: Despite a lot of advertising to the contrary, fractional lasers are not skin-tightening devices. However, they can be a good choice to correct sun damage, discoloration, fine lines and even acne scars. A small percentage of patients may achieve some skin tightening, but this is not a predictable benefit. While fractional lasers offer minimal down-time, other types of lasers can offer more visible results. The rule of thumb is: the shorter the recovery time, the less improvement you can expect.
10. MYTH: Laser liposuction is superior to traditional liposuction as it shrinks skin and selectively removes fat.
REALITY: Laser liposuction (an invasive procedure employing a laser-equipped cannula) may be useful for small areas but is not better or safer than traditional liposuction. It does not shrink skin selectively and can cause skin burns if not used properly. It is imperative to choose a board certified surgeon with specialized training when opting for any type of liposuction as there are many unqualified practitioners on the market offering this surgical procedure.
11. MYTH: Mesotherapy is an easy and safe way to spot-reduce fat and lose weight.
REALITY: Mesotherapy is not approved by the FDA. It can be dangerous and very painful and 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 layer of the skin. Touted as a minimally invasive procedure that treats everything from cellulite to sagging skin to excess weight, most of mesotherapy’s claims are completely unfounded.
12. MYTH: Non-surgical fat removal will replace traditional liposuction.
REALITY: Yes, there is a new, non-invasive device that uses high frequency ultrasound to break up fat deposits, which the body then absorbs and eliminates through urination. Patients get immediate, permanent spot reduction of fat with no pain, bruising, bleeding or risk of infection. UT Southwestern is leading the clinical trials of this device for FDA approval, and will probably have the first unit in the U.S. available to consumers. It will not replace liposuction: the device is better for small areas and a series of treatments is required for visible results.
13. MYTH: There is a proven way to permanently remove cellulite that really works.
REALITY: To date, all known methods to eliminate cellulite (such as Endermologie and others) are temporary. Cellulite is a byproduct of hormones which govern the distribution of fat storage, and most women have some cellulite regardless of their weight. There is no known long-lasting, proven treatment for cellulite.