In their 2015 annual statistics, the American Society of Aesthetic Plastic Surgeons (ASAPS) reported that over the last 15 years, cosmetic procedures have grown by an astonishing 274%. Even more compelling — while surgical intervention grew by 82%, non-surgical treatments increased by 508%. Skin rejuvenation and fat removal are two popular categories that offer promising results with no scalpels or downtime.
What are the latest, best options? Dr. Kevin Smith of Charlotte moderates a discussion between Drs. Ned Snyder and Mark Epstein on the techniques and innovations they feel live up to the hype.
by Isabel Bolt
and The Plastic Surgery Channel
Skin Tight without a Scalpel
Dr. Mark Epstein whose practice is based in Stony Brook, New York is enthusiastic about the latest in skin tightening and rejuvenation that delivers energy to tissue rather than scalpel-to-skin. “Laser, ultrasound or radio frequency energy all can have a positive effect on tissue but we have to be sure we apply the correct frequency, amount and intensity.” Of the 3 options, Epstein prefers radio frequency, such as with the Thermi™ system.
ThermiTight™ is a non-surgical, minimally invasive skin tightening treatment that uses a tiny probe to deliver radio frequency energy just beneath the surface of the skin through pinholes. It’s primarily used to tighten sagging skin on the face, but it can also be used on the neck, tummy, and thighs. “You can apply it completely noninvasively with a topical method, but by using the micro-invasive technique there are definite advantages because it treats the skin below the dermis,” says Epstein. His patients have been extremely satisfied.
The Coolest Way to Remove Fat
In Austin, Dr. Ned Snyder IV is a fan of CoolSculpting®, an FDA approved non-invasive fat reduction procedure featuring a “no needles-no downtime-no kidding” approach. “Cold technology is so exciting. Essentially we bring fat cells down to a temperature where they die without injuring any other surrounding tissue.” Once certain areas are selected, a specially designed device is positioned on the patient’s body and controlled cooling is applied for about an hour. Several sessions may be needed and fat is gradually, and naturally eliminated from the body. Results are seen in about 12 weeks. “Common areas we have treated are thighs, abs, saddle bags, and love handles. It’s a great way to permanently reduce fat in spots resistant to diet and exercise. It really works.”
The Right Patient, the Right Way
According to Dr. Snyder, many of the non-surgical modalities available today do have proven efficacy. The issue is more about application than the device itself. “All of these technologies are proven but it has to be the right procedure for the right patient. What does that mean? There’s lots of practitioners advertising… but a board certified plastic surgeon has all the tools in their tool box.” He explains the advantage of going to a plastic surgeon is getting an honest consultation by someone who has the ability and knowledge to offer a wide spectrum of procedures from non-invasive to micro invasive to surgical depending upon each patient. “To be able to look at it in an unbiased way, so the patient gets the procedure they need,” says Dr. Snyder.
Examples he cites are liposuction versus CoolSculpting®, or a facelift versus non-surgical skin tightening. Sometimes a patient will not benefit from a lesser procedure. Dr. Epstein agrees. “The key thing is patient selection. You have to match the patient to the technology and their expectations. We can achieve more sculpting and fat reduction with liposuction, however the ideal candidate for CoolSculpting® is someone who is willing to accept a little less result in exchange for no downtime.”
Close to Surgical Results
Not all non-surgical procedures are “less than” surgery. Dr. Epstein believes Thermi™ on the neck exceeds some surgical necklifts. “The neck is an area of frustration. (With Thermi) you are changing quality of tissue which surgery doesn’t do. Lines in the skin are smoothed.”
Dr. Kevin Smith summarized the gathering this way; “The real take home for the patient is, look at non-invasive devices, they are efficacious. But talk to a board certified plastic surgeon who has the whole menu of options to do the best procedure for the patient’s indications.” Good advice, promising outcomes.