14 Myths: Facelifts, Fillers, and Skin-Care

Dr. Rohrich addresses these 14 myths about facial cosmetic procedures including facelifts, non surgical rhinoplasty, botox, dysport, fillers, skin care, and aging along with the use of cosmetic surgery.

1. MYTH: Everyone ages the same in the face, so the same facelift procedure will work for everyone.

Dr. Rohrich: Not true. Recent groundbreaking work at UT Southwestern on facial fat compartments has shown that we all age differently. This has led to new and more natural ways to customize facelifts for the future. Additionally, the environment clearly plays a role in how we age. There are adverse effects on our skin from the sun, wind and tobacco, among other things.

2. MYTH: Facelifts marketed as in-office procedures – usually taking just one hour with local anesthesia and minimal recovery time – are safe and effective.

Dr. Rohrich: Many patients have been disfigured or experienced complications from procedures like these. If you want long-lasting changes that you’re going to be happy with, it’s better to get a real facelift from a Board-Certified Plastic Surgeon performed in a real operating room under sterile conditions.

3. MYTH: Topical Botox is replacing injectable Botox.

Dr. Rohrich: Not true… yet. Topical application of botulinum toxin A are 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’s difficult to say it will ever replace injectable Botox, as it doesn’t have the same ability to deliver the toxin to specific muscle areas with pinpoint accuracy.

4. 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.

Dr. Rohrich: 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’re receiving a very diluted form of Botox or perhaps something that’s 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.

5. MYTH: Botox cures migraine headaches, acne and hair loss.

Dr. Rohrich: It’s very effective for both stress and migraine headaches if placed correctly. And there’s preliminary data to show that it does diminish acne and may stall hair loss as well, but more studies are needed. They’re being done now..

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

Dr. Rohrich: After a certain age, nothing can produce 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 aren’t permanent, but they require very little downtime..

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

Dr. Rohrich: 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..

8. 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’re all government-approved.

Dr. Rohrich: A practicing Board-Certified plastic surgeon or dermatologist is the most knowledgeable person to determine which fillers to use on the different parts of the face to give you the best results in a cost-efficient manner. A combination of different fillers with different properties is the preferred way 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 plastic surgeon should be your guide..

9. MYTH: Permanent fillers are better and everyone should use them.

Dr. Rohrich: Permanent fillers in general have more permanent problems that can’t be removed without disfigurement. And they don’t age well with the patient – so don’t use them. Temporary fillers that last longer – up to 1-2 years – are optimal at this time..

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

Dr. Rohrich: Perhaps in the future, but not now, as we still have to refine how we harvest, grow and stimulate stem cells. But we’ll get there in the next five years!

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

Dr. Rohrich: When plastic surgery was in its infancy, surgeons focused on tightening the loose skin of the aging face. With further research done by UT Southwestern plastic surgeons, we now know that an aged appearance is not only caused by loosening skin but by the loss of facial fat. We can naturally rejuvenate the face by techniques that both lift and fill the face. Using these new concepts of fat compartments and fat replacements within the deeper layers, we’ve moved to the next generation of facelift technology.

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

Dr. Rohrich: Not really. Fillers can help make some bumps and depressions go away temporarily – the best ones to use are based on hyaluronic acid – but this solution doesn’t work for significant changes, nor do the results last more than 6-12 months.

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

Dr. Rohrich: Unlikely. Under-eye circles can have many causes, including skin pigmentation, shadowing, thin skin and visibility of underlying blood vessels. Different procedures to treat these problems may include the use of Retin-A or bleaching creams, chemical peels or lasers, and potentially surgery to blend the eyelid-cheek junction.

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

Dr. Rohrich: 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 eyes.