Cosmetic Plastic Surgery & Injectables in the 20 to 30 Age Group

Recently, at a large conference of the top Cosmetic and Plastic Surgeons and Dermatologists across Canada, the subject of cosmetic procedures among the 20 to 30 year old set was addressed. This group was identified as one of the fastest growing subsets of people seeking these procedures. Big news in the United States when this trend was detected there a couple of years back, this upswing among the younger generation is only just starting to make waves here in Canada. Those that study generational attitudes and characteristics, like Lisa Mattam who spoke recently at the FACE meeting, describe so called generation "X" and "Y" individuals as multi-taskers, willing to explore all options, wanting to obtain and digest information quickly, and not afraid to use multiple means to obtain goals. These young people act proactively, and if they can prevent looking progressively older , they will. In a survey conducted by Beauty For Life, an organization sponsored by the Canadian Society for Aesthetic Plastic Surgery and by the Canadian Society of Plastic Surgeons, the top reasons among those in their 20s for having cosmetic medical procedures was " To boost self confidence", followed by " To attract potential partners". For those in their 30s, " To increase professional opportunities" was also important.

In an ABC show in the US a couple of years ago, women in there 20s, one young lady being 22, were asked about their attitude to Botox injections. Their enthusiasm was obvious. They wanted to act preventatively, and were not interested in developing the lines and wrinkles women in their 40s were complaining about. However, an American Plastic Surgeon interviewed on the same show had a very different attitude. He was very discouraging of cosmetic treatments among the 20 year old set, stating that " if it isn't broken, we shouldn't be fixing it".

We asked Dr. Michael Weinberg, Toronto Plastic Surgeon, to comment on this issue. Should women in their 20s and 30s consider cosmetic injections? " This issue is not black and white" says Dr. Weinberg. " I disagree with my American colleague who is adamant that these treatments are always wrong in this age group. You need to evaluate each individual carefully. Even in one's 20s, it is possible to see the early signs that suggest someone is at risk for premature aging". Dr. Weinberg went on to elaborate: " If someone is genetically predisposed, for example, with very fine , thin , fair and dry skin, they may go on to look older earlier in life. Certain structural features , for example a sunken mid-face, bony injury to a cheek, a small jaw or tooth loss can all result in the early development of volume loss and lines and wrinkles. Starting with small amounts of cosmetic injections, infrequently, can be preventative, and can mean that a given individual may require less extensive treatments later on, and enjoy an overall better result for many years to come."

" It's also important to remember", says Dr. Weinberg, " the modern approach to cosmetic injections isn't just about treating lines and wrinkles. It's about enhancing one's overall appearance, and of course ultimately it's about enhancing self esteem. So, for example, many of my young patients see me for treatment of a subtle but bothersome facial asymmetry that can be corrected by injections, as, for example, when one brow sits higher than another. Lip augmentation is another commonly performed procedure in the younger patient, and can look really lovely when it is subtle, and improves the overall proportion of the face. Filler injections to alter nose shape, and improve nose symmetry is yet another example of something that is easily done in the young, and I would say that I think it is much better for a young person, who is at that stage of life when appearance can be so important, to deal with this sort of thing early rather than spend years being self conscious."

However, Dr. Weinberg does go on to say that there are occasions when he resists a patient's desire for early cosmetic treatments. Young people with good complexions and solid facial architecture, no early sun damage, and no early visible signs of lines or wrinkles are probably wasting their time and money getting injections early, when it may be years before they will really benefit from them.

That's not to say there aren't things they should definitely be doing if they want to stave off signs of aging. "I think it is interesting that some surveys reveal only a small percentages of young women are interested in aesthetic skin treatments like microdermabrasions and peels, and even fewer are opting for good skin care and sunscreen", points out Dr. Weinberg. Most cosmetic physicians believe that good skin care, including high quality 'medical grade' at-home creams coupled with periodic exfoliation will help maintain a youthful looking skin as we age. " Unfortunately, many young women are still quite keen on looking tanned", Dr. Weinberg says, "and it's often an uphill battle to persuade them of the significant health risks, not to mention aging risks, that are associated with overexposure to UV radiation.". Dr. Weinberg and his staff frequently point out that a spray tan is a good substitute for the real thing, and other treatments like Peels or Photofacials, have many of the perceived benefits of a tan, in that skin looks more even toned, brighter, and smoother, but these options are healthy for the skin instead of damaging.

Leaving aside skin issues for a moment, and looking more broadly at what procedures are popular among those in their 20s and 30s, body contouring, tummy tuck and breast surgeries all rank highly. When Beauty For Life respondents were asked " Which part of your body are you most concerned about" 37% in the 30s age range chose abdomen & hips, and 18% chose breasts as their top concern. " Liposuction, breast reduction, tummy tuck and breast augmentation are all quite popular among many of the young women I see, and these are among my happiest patients after surgery" reports Dr. Weinberg. When asked how this group differs from patients in older age groups, he responded " People in their 20s and 30s don't attach any stigma to cosmetic procedures. They proceed from the premise that physical attributes are important to how we feel about ourselves, and they have no hesitation taking charge and instituting change when they can."

Does he have any concerns about cosmetic procedures in the young? " While this younger generation have more access to information than ever before, it is still always a concern that they receive the right information. Because these procedures are increasingly prevalent, it can give the impression that they have no potential downside. Any young person considering a cosmetic procedure needs to understand all the pros and cons, and they need to have realistic expectations. Proper education can only come from seeing a reputable person who is going to spend the time to explain things in detail and answer lots of questions. If a young patient understands their procedure, is a good candidate, and is doing it for sensible reasons, then I have no hesitation trying to help them reach their goals."

What Is Body Contouring?

Body contouring or sculpting refers to methods of removing fat from specific problem areas, typically over the love handles, abdomen, and hip rolls. There's lots of buzz in the press about non surgical ways to achieve this. You only have to google to find that it can be very confusing . Ultrashape, Velashape, Zeltique, and Zerona are just some of the technologies you may read about. What are they and what do they do and should you consider one of these treatments, or another option?

Essentially the aim of all these machines is to destroy fat cells without any incision, and without affecting surrounding tissues, like skin, or deeper organs. It's important to know that none of these treatments is intended for weight loss. Even liposuction and tummy tuck are not intended for very overweight individuals. If someone is well beyond their ideal body weight, fat not only accumulates beneath the skin , but deep within the body, beneath the muscular abdominal wall around the organs. Niether liposuction, nor tummy tuck, nor any non invasive method of fat burning on the market can address this kind of fat. The only way to lose this is with diet and exercise or with the help of lap band or gastric bypass surgery.

What about people who are close to ideal weight, but have particular problem areas where stubborn fat has accumulated? If the amount of fat is not too large, and the skin tone is reasonable, either liposuction or a non surgical fat reduction method can be considered.

How do these non invasive methods destroy fat cells? These machines attempt to disrupt these cells by sending different forms of energy into the tissues, which, at the cellular level is transformed into heat energy. This in turn essentially burns the fat. The forms of energy emitted by these machines differ and can include laser, radio frequency, and ultrasound. Criticisms leveled at these machines is that in order not to burn surrounding tissues, amounts of energy emitted are very low, poorly controlled and not focused directly at the fat layer . As a result, benefits may be very slight, or none at all, or there can be potentially uneven effects. Looking at patient reviews of these different machines online, on Realself for example, one can see that patient satisfaction with most of these methods was low, only in the 26-32% range! Many physicians who have treated patients with these machines have become disenchanted with the limited results as well.

Zeltique is somewhat different in that it capitalizes on the fact that fat freezes at a different temperature than surrounding water based tissues, and therefore one can damage the fat through freezing, without harming other structures. It seems to have a higher patient satisfaction rating, but does require sufficient fat to be able to suction the area to be treated into the treatment head.

Because of these limitations Dr. Weinberg of Mississauag Cosmetic Surgery and Laser Clinic and the Toronto Plastic Surgery Clinic has waited for a non invasive treatment that in his opinion holds more promise of success . He believes, based on the results from European physicians who have been using the technology for some time, that the Liposonix machine from Medicis shows much more promise as a successful non invasive method to sculpt fat. Liposonix differs substantially from the other ultrasound methods of fat reduction out there in that it uses high frequency ultrasound energy that can be focused quite precisely at the fat layer. Because the amounts of energy are quite high, there is some discomfort associated with the treatment, but the degree of discomfort has been decreased since it was shown that multiple passes at a slightly lower energy level are as effective as fewer passes with the higher energy settings initially used in Europe. A recent study performed here in Canada, in which some of Dr. Weinberg’s patient’s took part, showed patient satisfaction to be 90%. Liposonix is presently approved for use for tummy fat and is also used for “love handles” as an “off label” use. More areas are likely to emerge in the near future. After the successful experiences of his patients with his Liposonix machine downtown at the Toronto Plastic Surgery Clinic, Dr. Weinberg has just introduced a second machine at his Mississauga location. If you are considering non invasive fat contouring , visit Dr. Weinberg in December for a free consultation to find out if Liposonix is right for you. Call 905-273-3045

The Latest Thing From Toronto Plastic Surgery Clinic - Latisse!

Latisse Is finally due to land in Canada! If you haven't heard of Latisse, here is the scoop. It is a topical medication that grows longer, thicker, darker eyelashes. It is thought to do this by prolonging the anagen ( growth) phase of the lashes. It is the first prescription medication officially approved for this purpose by the FDA and Health Canada, and is due to be available here in Canada in Nov 2010. The active ingredient is a compound used for the treatment of an eye condition called glaucoma. When researchers realized that patients treated with the medication intraocularly ( ie in the eyedrops) were developing longer thicker eyelashes they knew they were on to something. The medication has been reformulated to be applied on the skin at the base of the upper lashes, once a day. It acts gradually over many weeks and has been shown in clinical studies to successfully increase the length , thickness and darkness of lashes in the vast majority of patients studied.

Latisse has been shown to be safe. In a small percentage of patients side effects such as redness, itching, or eye or lid irritation were reported ( in about 4% of patients). There is also the possibility of increased pigmentation of the upper lid in a small percentage of patients, that resolves in most cases after discontinuation of the drug. While there have not been cases of pigment ( color) changes in the iris of the eye itself using Latisse, the same medication used in the eye for treatment of glaucoma has on occasion caused eye color darkening that may not be reversible.

Latiise can be used in most individuals and is perfect for those with thin, short or light eyelashes. However, it cannot be used in patients with certain eye conditions such as in those with glaucoma on treatment. It takes a number of weeks to see results. Some patients will report results within 4 weeks of starting treatment, with maximal results requiring 16 weeks of treatment.

Latisse is a prescription medication that will be available through pharmacies and also at selective cosmetic medical clinics . It is advisable to see a physician with expertise and knowledge in the use of this revolutionary treatment, to receive a proper evaluation as to whether you are a good candidate for the medication, and to receive appropriate instruction on it's use.

If you are interested in Latisse, call Mississauga Cosmetic Surgery and laser Clinic at 905-273-3045, or the Toronto Plastic Surgery Clinic at 416-207-9090

Plastic Surgery and Cosmetic Medical Procedures, and "How to Look Good Naked" In Toronto and Mississauga

The focus of many articles on plastic surgery and non surgical cosmetic procedures such as Botox, Restylane and Juvederm is most often on the physical benefits of these treatments. But the popularity of shows like "How to Look Good Naked" provide strong evidence that how women feel about themselves on the inside is what really drives behaviour.   Ask most patients why they chose to have their breast augmentation, tummy tuck or even why they chose a simple non invasive skincare treatment like microdermabrasion, and you'll find most will identify emotional and psychological motivations. Dr. Weinberg, plastic surgeon at Mississauga Cosmetic Surgery and Laser Clinic, and the Toronto Plastic Surgery Clinic, is delighted to see a show like "How to Look Good Naked" come to Canada, as it conveys a message of empowerment, and really promotes the whole notion that people should be comfortable with their body. The right way to view cosmetic medical treatment is as just one more tool to help people gain that confidence and comfort, says Dr. Weinberg. 

In an article in the April 2004 issue of Plastic and Reconstuctive Surgery ( Vol113). psychiatrists Katherine Phillips and David Castle, and  social worker Roberta Honigman analysed 37 studies that have looked at Psychological well being before and after plastic surgery, and concluded that most of the research suggests patients gain improvements in body image and quality of life from cosmetic surgery. In a recent research paper published in the Aesthetic Surgery Journal ( Vol 25), PhD psychologist and professor David Sarwer found that 1 year after undergoing plastic surgery , 87% of patients reported satisfaction, with improvement in  overall body image, and specifically in perception of the feature surgically altered. They suffered from less negative emotions with respect to body image in social situations. 

The beneficial byproducts of cosmetic medicine can include feelings of being more "normal", for many people who have always had a disfiguring or unattractive feature, or whose physical endowments have been at the extremes of the "norm". Many people report feeling more physically attractive to others. This translates into greater social ease, and improved interpersonal relationships. Others point to the demands within the job market for a youthful, well put together appearance, and a confidant demeanor. They credit their facelift or liposuction procedure as having given them a competitive edge in their career goals.

Finally, even non invasive treatments, like Photofacials and laser hair removal, or Botox treatment for hyperhydrosis can be beneficial psychologically. Registered nurse Cathy Mckay of MCSC reports many patients are thrilled when they can shake someone's hand without a sweaty palm, or wear any color T shirt they want without sweat marks under the arms. Botox is a great cure for the social embarrassment associated with excessive sweating. Furthermore the winter months are often a bit of a downer for many people, the cold grey weather , and lack of sunlight can lead to a low mood . Pampering oneself with a facial or skin treatment helps people cope, says Suzanne, medical aesthetician. "It breaks up the monotony of winter, and helps improve their appearance at the very time when the weather can be most punishing to their skin."

Dr. Weinberg and Dr. Schiffer Of Mississauga Cosmetic Surgery And Laser Clinic Attended Prestigious FACE Conference

Allergan, makers of Botox and Juvederm, presented data on Botox, Juvederm and Voluma at the FACE meeting Oct 15 to 18. Botox sales have continued to rise in 2009 compared to 2008, and it is the leading muscle relaxing wrinkle treatment on the market, with growing uses in the cosmetic field , including the so called "Nefertiti" technique for restoring more definition to the jawline. Among leading Plastic Surgeons and Dermatologists the botox "brow lift" is among the most populary performed botox procedure. Allergan has submitted data from a large study showing efficacy of Botox treatment in chronic headache sufferers to the FDA and is hopeful for official approval for use in this indication. Juvederm with Lidocaine has proved to be a hugely popular hyaluronic acid filler , and experience to date by leading injectors with Voluma, a very highly viscous filler has showed it to be extremely successful at volumizing cheeks and other areas with less volume required to achieve optimal cosmetic results. Dr. Weinberg attended the Breast Augmentation portion of the conference, and enjoyed the lively discussion on challenging cases. Detailed scientific measurements can now improve the method of choosing the ideal breast implant for each patient.

Liposonix In Toronto - An Exciting New Non Invasive Technology To Get Rid of Unwanted Fat

In today’s appearance concsious population, the growth in both surgical and non invasive cosmetic treatments is exponential. Now in addition to things like Botox, Restylane and Juvederm, Dr. Weinberg of Mississauga Cosmetic Surgery and Laser Clinic and Toronto Plastic Surgery Clinic, reports the hottest trend in non surgical treatments is definitely Fat Burning Machines.  The newly introduced Liposonix Machine is the latest and most promising thing Dr. Weinberg has seen on the cosmetic horizon in quite some time. Emitting a focused high frequency ultrasound beam, it is able to target ultrasound energy at specific areas of fat at precise depths beneath the skin. No damage is done to the overlying skin, thus Liposonix is truly non - invasive. And there is no sagging of the skin after the fat has disappeared, as Liposonix promotes skin tightening over the treated area. The results are permanent!

Treatment takes about 1 hour. There is no contraindication to usual activities like work or exercise after the procedure. Thus there is very little downtime. Peak results are seen in 8 to 12 weeks after treatment. No serious or unanticipated side effects have been observed in international multicentre studies.

The areas that can be treated with Liposonix include the abdomen, hip rolls ( love handles), as well as the outer and inner thigh area. ON AVERAGE, PATIENTS TREATED IN THE LIPOSONIX STUDIES HAD A REDUCTION OF 2.8 CM ( 1.1 INCH) IN THEIR WAISTLINE, WHICH TRANSLATES INTO ONE FULL PANT OR SKIRT SIZE!  For more information on Toronto Liposonix or other options for fat reduction call TPSC at 416-207-9090 or for Mississauga liposonix call  MCSC, 905-273-3045 .

Face Lifts Made Simple

Face Lift In Toronto and Mississauga

Anyone who has ever looked in the mirror and noticed signs of aging, and has looked into the available options for facial rejuvenation will have come across a myriad of articles on facelifts. But you may have wondered, how can one make sense of all the confusing and often conflicting information? You may have seen many different terms like “ Mini Face Lift” , “Weekend Face Lift”, “Short Scar”, Long Scar”. Well read on, and we will try to demystify all of these descriptions in a simple and digestible manner.

As you may be aware, the hallmark signs of aging are often summarized as “deflation , descent and degradation”, meaning that as we age our faces lose volume, gravity takes effect, and our skin quality changes such that we develop fine lines, discoloration and crepiness to the skin. Non surgical treatments like the hyaluronic acid fillers Juvederm and Restylane, and a new product , Voluma, can temporarily restore volume. For those not yet suffering from marked skin laxity these treatments can achieve dramatic improvements when administered as part of a  "Soft Lift" , or our signature "Allure Lift". These treatments are often referred to as non surgical facelifts. but eventually when we  develop significant laxity, or looseness , particularly in the mid and lower face and neck resulting in drooping skin in the cheek, jowls, and hanging skin in the neck, this laxity cannot be sufficiently improved with injectable products, and that is the time surgical face lift becomes the one definitive way to restore a more youthful appearance.

Facelift surgery , or rhytidectomy, is achieved by lifting away the skin and tightening the underlying tissues by means of suturing ( stitching). It is the underlying connective tissue, referred to as the SMAS, or superficial musculo-aponeurotic system, that gives structure to the face, not the skin itself. Often,some skin is removed, and sometimes liposuction is done to remove fat in the jowls and neck. the skin is then redraped. In traditional facelift surgery, the neck is therefore also treated. The main incision , and therefore the scar in this case extends from the temple down to the ear, traveling either in front of or concealed within the superficial aspect of the ear, and then circles up behind the ear and down to the back of the scalp. This is a so called “long scar” facelift. The scar itself is usually well concealed within the hair, just behind the hairline, and in the creases of skin around the ear.

In Short Scar Facelifts, also called Mini Lifts, ‘S’ Lifts, or Weekend Lifts by some ,the incision extends from the temple to the front aspect of the ear, and depending on the individual’s anatomy and needs, may extend a bit behind the ear as well. The main determining factor as to whether a given patient needs a long scar or could have a short scar is whether or not they need a concomitant neck lift with their facelift. Neck bands can only be addressed with long scar facelift.

Both traditional and short scar facelifts take 2 to 5 hours and are done under general anaesthetic. The amount of bruising and downtime varies, but with Dr. Weinberg’s expertise and gentle treatment of the tissues, some patients have very little bruising and return to normal activities within days. However, it is reasonable to prepare for a 2 to 3 week recovery.

You may see references to other kinds of procedures like endoscopic facelifts, or thread lifts ( sometimes called featherlifts, or string lifts. In endoscopic facelifts small incisions are made at the corner of the mouth and within the mouth and adjacent to the ear, and an endoscopic probe is inserted, and the surgeon attempts to tighten the underlying tissues through this “keyhole”. These surgeries are not offered by many surgeons, in general because most do not believe they give the same reliable and long lasting results. As much of the procedure is done “ blind”, without directly visualizing underlying structures, there is an increased risk of damaging nerves or blood vessels. Thread lifts were achieved using string-like surgical material to hike up the underlying tissues to tighten and counteract the effects of gravity. They have been associated with short lived, not very satisfactory results, and are generally no longer offered as the “ threads” are no longer being manufactured.  There are a variety of other less invasive procedures offered by some practitioners claiming to achieve wonderful results with smaller scars and little downtime, but it is important to note that in many cases these procedures do not address underlying connective tissue structure, and rather simply “pull” the skin.These will inevitably give short lived benefits, and can often result in distortion of the anatomy, such as an upward pulling on the earlobe, which is not aesthetic.

While facelift and neck lift surgery is the only definitive way to deal with significant looseness of facial skin, for those who are not ready or willing to undergo a surgical procedure , some skin tightening of a more modest degree can also be achieved with treatments like Thermage and Fractionated Laser, available at our downtown location.

It is adviseable to seek out a board certified Plastic surgeon with a great deal of facelift experieince, such as Dr. Weinberg, when considering facelift surgery. 

If you are interested in more information on surgical Facelift, Soft Lift, Allure Lift, Thermage or fractionated Laser, visit our Website at antiwrinkle clinic .com, or call to 905-273-3045 in Mississauga, or 414-207-9090 in Toronto, and book an appointment for a consultation.