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.

REALITY: Unfortunately, anyone with a valid medical license can call themselves a plastic surgeon, hang up a shingle and begin treating patients! So plastic surgery has become a “buyer beware” specialty.

2. 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.

3. 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.

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

REALITY: Unless you are a Board-Certified plastic surgeon by the American Board of Plastic Surgery, you are not required to perform plastic surgery in an accredited facility. That may put you in harm’s way if there’s a problem.

5. MYTH: It’s disrespectful to ask a plastic surgeon tough questions about their experience or expertise, or to ask them to show you some results.

REALITY: Board-Certified Plastic Surgeons prefer informed patients. Knowledge is power, and it’s very important to make the right decisions. It will determine not only your outcome, but your safety as well. In general, an educated patient recovers better because there are no surprises and less anxiety about the procedure.

1. MYTH: There’s now a permanent cure for cellulite.

REALITY: There’s no permanent cure for cellulite, which is present in all females from age 11–99. It’s due to estrogen. There are exciting things on the horizon, but they’re not here yet.

2. MYTH: Laser liposuction is the best form of liposuction today.

REALITY: Not true. It hasn’t even been proven to work as effectively as traditional liposuction. The best and most advanced liposuction remains “UAL,” which gives the best contour and results with the least downtime. We’re working on this technology at UT Southwestern, trying to develop standardized techniques that may yield more consistent and reliable results.

3. 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.

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

REALITY: Yes, it does. While it’s not a replacement for liposuction, in some patients there may be some benefit to both external ultrasound treatments as well as low-level laser treatments. This is an area of intense research at UT Southwestern, and we anticipate more advances in the future. It has good science behind it as well. In research done at UT Southwestern we’ve 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 required in order to achieve optimal results using these non-invasive treatments just as they are with surgery.

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

REALITY: It’s a total misconception that you can perform total body contouring and breast augmentation and teeth whitening in one setting. In general, this isn’t safe or recommended for most patients.

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

REALITY: There isn’t a predictable and reliable way to tighten the skin non-invasively. However, we do have advances in laser resurfacing that allow us to treat fine and moderate lines of the face with less discomfort and recovery.

7. MYTH: Fractional laser skin resurfacing tightens the skin non-surgically.

REALITY: Despite lots of advertising to the contrary, fractional lasers aren’t 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 isn’t a predictable benefit. While fractional lasers offer minimal downtime, 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.

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

REALITY: Mesotherapy isn’t 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.

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

REALITY: This is primarily marketing hype and doesn’t work. Period. Cosmetic surgical labiaplasty is different and is effective for reshaping or reducing the external genitalia.

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

REALITY: Eating right, exercising and lifestyle changes are imperative to optimizing success in body contouring. This must begin before surgery.

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

REALITY: That’s incorrect. While exercising on a regular basis helps tone your body, it’s 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.

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

REALITY: Herbal medications and supplements are completely unregulated by the FDA, so you never really know what you’re going to get. They can often contain “stimulants” which may react adversely with other medications or your body.

1. MYTH: Breast implants are not safe.

REALITY: Rigorous and long-term studies done all over the world from Harvard to UCLA to UT Southwestern have consistently shown and proven that both saline and silicone implants are safe and do not cause cancer or rheumatoid diseases.

2. MYTH: Saline implants are just as good as silicone implants.

REALITY: Both types of implants are approved by the FDA, and there are benefits and drawbacks with each type. At UT Southwestern we perform surgeries using both saline and silicone implants, following extensive consultation with our patients regarding their health, lifestyle and personal preferences, as well as the outcome of a physical examination.

3. MYTH: The new jelly bean silicone implants last forever and are better than what’s now available.

REALITY: All man-made implants – both saline and silicone – last about 10-15 years maximum. And the new jelly bean implants have not been proven to be better since we have no 10-year data to evaluate. That’s important for all implants placed into humans.

4. MYTH: Fat take from the buttocks is now the preferred choice for breast augmentation.

REALITY: It’s still very experimental and not cost effective – taking three times longer with 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.

5. MYTH: Fat injections to the breast will replace breast implants.

REALITY: Fat injections are truly experimental and aren’t going to replace conventional saline or silicone implants any time soon. With current technology, only 50 percent of transplanted fat successfully grafts to a new location (the rest scars or is absorbed by the body). However, fat injections may be useful in making small modifications to breast size, such as correcting breast asymmetry.

1. MYTH: Your genes are responsible for how you age.

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

2. MYTH: Supplements can help slow down the aging process.

REALITY: There’s 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’s softer data for Coenzyme Q-10 (an enyzme activator) as well as Chondroitin for prevention or treatment of joint aches. The newest fad is Resveratrol, the active metabolite of red wine thought to be capable of increasing lifespan, but scientific data is still inconclusive. All supplementation should be considered under the advisement of your physician.

3. MYTH: As we age, it’s the sagging skin of the face and neck that makes us look old.

REALITY: It’s the sagging skin, but more than that, it’s the loss of facial fat, especially around the eyes and cheeks that make us look older beginning at age 30. We’ve 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.

4. MYTH: There’s an anti-aging cream that will keep you looking younger longer.

REALITY: It’s 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 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.

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.