Home > Articles > Surgery or No Surgery?

SURGERY OR NO SURGERY?

The trend over the past few years has been to minimally or non-invasive treatments to minimize the signs of aging. There is no doubt that the new injectable fillers, especially the hyaluronic acids such as Juvederm and Restylane, have provided an effective and safe way to treat wrinkles, plump up furrows, and improve facial contour where there has been tissue volume loss. And Botox continues to find new uses, with most patients finding its calming effect on the hyperdynamic lines and ability to elevate the brows most satisfying. Some of the newer lasers such as Fraxel, and the tried and true IPL (intense pulsed light) offer obvious improvements to skin quality.

However, as recently noted in Vogue and New Beauty magazines, patients and their doctors must recognize the limitations of these procedures. For many of the problems of facial aging, surgical intervention has been and still remains the gold standard. This includes rhinoplasty to correct a droopy nasal tip and dorsal hump associated with aging. Or eyelid lifting (blepharoplasty) to re-contour upper or lower eyelid fat and remove redundant, hooded skin. There is also no non-surgical option that even closely provides the rejuvenation that a face and neck lift does for sagging jowls, a submental wattle or neck bands. The forehead lift, of which there are several types, still sets the standard for saggy brow elevation and improving forehead balance.

Each person has their own goals for facial rejuvenation. Minimally invasive procedures are obviously best if the results they deliver can truly meet your expectations. But, like many things in life, you get out of something what you put into it. In restoring signs of vitality and youth to the aging face surgical intervention is often the most rewarding choice and best long-term investment.

American and International Patients Now Treated by Adamson Associates

For several years, due to insurance issues, we have been unable to treat American and other international patients. These issues have now been resolved, and we are able to provide all of our facial surgical procedures and non-invasive rejuvenation treatments to patients, no matter their nationality or where they live.

In our experience, many patients from afar prefer to have their surgery or treatments here. This may be due to their desire to be anonymous, the opportunity to be with family or friends, or with the services provided by Adamson Associates.

Our staff is pleased to assist patients in making their arrangements for their stay with us comfortable and easy.

The Botox Twin Study

A very interesting study on the long-term effects of Botox™ injections has been published by Dr. William Binder in Archives of Facial Plastic Surgery, Volume 8, Nov, December 2006. One young woman had regular Botox injections into the hyperdynamic lines of her glabella (area between the eyes), forehead and crows feet for 13 years. Her identical twin sister only had Botox twice in the last 2 years.

Subsequent photographic analysis showed much less prominent lines in the treated twin in all the areas treated with Botox™. This suggests that not only does Botox have an immediate acute effect to decrease hyperdynamic lines and wrinkles, but may over the long-term prevent the formation of permanent lines. These so-called imprinted lines are the result of breakdown of the skin structure. This ability of Botox to prevent the development of imprinted lines could be due to different factors. It inhibits the patient's ability to contract the muscle, but also may cause the person to alter their habit of contracting that muscle. This, in turn, may allow the dermis of the skin to rejuvenate in that area since it is not under the constant mechanical pressure of muscle contraction. These same factors may help explain why some people who receive Botox over longer periods of time come to have a longer duration of action after each treatment.

Botox™ continues to be one of the most satisfying non-invasive treatments to combat the effects of aging.

Peter A. Adamson, M.D., F.R.C.S.C., F.A.C.S.