Every year the American Society of Plastic Surgeons as well as numerous fashion and beauty magazines conduct surveys to see what the upcoming trends and most popular procedures are in the plastic surgery space. Covid added a whole new level of calculability to last year’s list, as elective surgeries were put on hold. Below is a list of the most popular procedures our busy clinic has provided this year and we predict will be sought-after in 2022.
The eye area is one of the areas of the face that shows the earliest signs of aging amongst all individuals. It first manifests as a heavy or tired appearance in the upper eyelids. Genetics play a role but so can age, gender and lifestyle. When you look tired, it can often affect how you feel, so that you feel more tired. Other times, people will tell you that you look tired, but you don’t feel tired. That gets old very quickly:) It is usually from the upper eyelid skin stretching over time. Virtually everyone has it to some degree in their 40’s but I have operated on women in their 30’s where it was present. When women are in their late 40’s and older, it is important to also examine the role of the eyebrow position since this can be a contributing factor.
Usually, but not always, the lower lids can either get puffy (usually due to fat herniation) or the skin becomes loose. I have operated on a few people in their early 20’s who had a family trait of very puffy lower eyelids, even at this young age.
The most common upper eyelid surgery is blepharoplasty. The great news is that I do these in my office under local anesthesia with oral sedation. It takes about one hour. There is a single suture that weaves through the skin and is removed in 5-6 days. You can shower the next day. You need to take 2 days off of work so that you can ice it as much as possible. You need to sleep with 3-5 pillows to keep your head elevated. You do not need to sleep exactly on your back. Many people will have very little bruising but I cannot predict this. Everyone will get some degree of swelling. You should have very little discomfort. If there is sagginess to the eyebrow, especially laterally, this can be addressed through a lateral brow lift, where the incision is hidden behind the hairline. No antibiotics are required.
Not surprisingly, everyone’s facial skin becomes more lax with time. Aging is not just facial skin getting saggier, there is a loss of volume due to loss of fat with aging. In addition, the skin also changes. This means that there is no one treatment that restores youth. In fact, there is zero possibility of restoring a totally youthful face. However, good treatments can take years off your appearance and also make you look better at your current age. This requires a multifaceted approach. Botox will do a great job on the dynamic lines. Fillers (I use the Juvaderm family which includes Volbella, Vollure, and Voluma) are used to replace fat loss and to even up the facial contour, as well as fill in deeper lines and folds. Each one of these has a different thickness and longevity, allowing maximum individuation of a treatment plan. Our Picosure laser can improve irregular pigmentation of the skin and is safe for ethnic skin. This is often combined with micro needling and PRP which will also help with fine lines, scarring and makes the skin really radiant. If there is only a small degree of skin laxity, laser treatments can give a nice subtle degree of skin tightening. However, usually by the time, late 40’s and older roll in, then often surgery is still the best solution.
Lately, I have been doing far more “mini-facelifts” in the office under local oral sedation. This requires an incision at the front of the ear and then around the earlobe and then along the back of the ear. The scar with time becomes very hard to see. It is important to realize that the skin will stretch after surgery so the results will not be perfect, but often, gives a very nice improvement. I also tighten the underlying muscles in the face. Usually, the most improvement is in the upper neck and jowl area. There is only a minor change in the nasolabial folds. Doing these in the office with local anesthetic and oral sedation, allows a much more rapid return to work and play. You can shower the very next day.
Not surprisingly, liposuction consistently makes the list of top procedures, year after year. As a society, we are not getting thinner and many people faced with Covid lockdowns, refraining from going to the gym, with the refrigerator more accessible than ever nearby an ( not to mention the additional stress), are putting on the Covid 15 or Covid 20 or 30 lbs. No type of liposuction is a weight loss technique. It is imperative that you get back to healthier eating to drop those extra pounds. However, liposuction can reduce fat in targeted areas (you cannot just liposuction the entire body) making you look and feel much better. It also provides an important incentive, when you are starting your diet since you can see positive changes much more quickly, than if you just dieted alone.
I am a huge fan of Smartlipo or laser lipo. This is always done in my office under local anesthetic with oral sedation. I stopped counting my Smartlipo cases after 1,300! I can treat any area with excess fat but as you would expect the commonest areas are: abdomen, flanks, bra fat, upper arms, neck, fat pads anteriorly and lateral to the breasts, inner and outer thighs, medial knees, and the banana roll. Patients return to work the next day after Smartlipo. The incisions are very tiny being only about 3mm. You can return to exercising in just 5 days. You can shower the next day. You will continue to improve for 6 months after surgery. Follow-up is at 2 weeks and then at 3 and 6 months. However, if you live far away (like many of my patients), you can just email photos and your weight at the designated follow-up times.
I do breast augmentation under general anesthesia, allowing women to return to work within 3-4 days. More and more women are selecting silicone implants which I think is the better choice for most. About 90% of my patients select the periareolar incision since it is very hard to see in a short period of time. All sutures are dissolving. There are no drains. You need to wear a sports bra for about 10 days. You can shower the next day. You can resume exercising in about 7 days, though I will guide you about which exercises you can do and when you can do them. If the nipple-areolar complexes are low, then a lift will be needed at the time of the BA. There are several types of lifts and the different options will be discussed at the time of your consultation. You can usually breastfeed after a breast augmentation. Although patients sometimes worry about breaking the implants, it is extremely hard to rupture the implants and you should be able to do any sport that you desire. For follow-up, I usually see you at one week, 3 weeks, 6 weeks, 3 months, 6 months, and one year. You can definitely get mammograms and this will not damage the implants in any way. I personally do not believe the implants need to be replaced within 10 years. I very recently saw one of my patients (she brought her daughter in) that I placed saline implants back in 1993, a full 28 years ago.