Original Article By Elise Minton.
In the world of aesthetic procedures, there are the noninvasive ones and the invasive ones. And for every beauty concern that you could possibly think of, there’s an option out there for it—some of which involves surgery and some doesn’t.
Not every noninvasive treatment out there is going to address every problem. And, while some nonsurgical techniques can lead to improvement, they may not garner the same result as what you may get with surgery.
We asked the experts for their opinions on when you should go the surgical route versus opting for a nonsurgical treatment, and here’s what they had to say.
Go nonsurgical when you want to test-drive what your surgery results could look like.
New York facial plastic surgeon Matthew White, MD, says that many patients who are nervous about getting surgery feel more comfortable with a noninvasive option, like Ultherapy. “They like the results, and about one year or so later, end up going in for a facelift. Interestingly enough, some of my patients also do Ultherapy following surgery to help maintain their results,” he says. “The purpose of a surgical facelift is to reposition the supporting fascia and ligaments of the face, which affects the architecture of the face. Ultherapy stimulates cell turnover and creates new collagen and elastin, affecting the biology of the skin.”
Do a pinch test to determine how much loose skin you have—a lot means you need surgery.
Purchase, NY, plastic surgeon Michael Suzman, MD, says you can follow this general rule when deciding between a noninvasive treatment and surgery. “When there is significant loose skin—enough that you can easily pinch it between two fingers—it likely has to be removed to be improved. This is true of the neck, jowls and eyelids.”
Nonsurgical can only help so much; there will come a time where you’ll have to make the leap to surgery.
Pittsburgh, PA, plastic surgeon Leo R. McCafferty, MD, says that in his practice he sees a lot of patients have either had fillers done by someone else or are seeking fillers to solve their aging issues. “The latter group are trying to avoid surgery. I think advertising and the pervasive coverage of fillers in various media outlets including social media tend to fuel this perception among patients,” he adds. “While fillers may help a portion of these patients, a very large percentage have too much facial deflation and skin laxity to allow fillers to do much good. I would rather see them do nothing than having them spend a lot of money on fillers that will give them a so-so result, or worse yet a case of buyers remorse.”
If you don’t want downtime and don’t mind a series of treatments, go the nonsurgical route.
Fresno, CA, dermatologist Kathleen Behr, MD, explains that there are nonsurgical procedures, like CoolSculpting or Kybella, which are great options for those who don’t want a surgical treatment, desire less downtime and aren’t bothered by the fact that a series of treatments are necessary. “Liposuction is done when there’s fullness along the entire neckline and the patients wants a ‘one and done’ type of treatment,” she says.
If just a little bit of immediate definition is what you want, try filler.
In a matter of minutes, injectable fillers can add contours to a facial feature. “It’s remarkable how filler can immediately define a chin or minimize a bump on the nose,” says New York dermatologist Julie Russak, MD. “I can instantly add volume and lift the face. If there is significant laxity and sagging, such as severe hooded lids or jowls, I can refer out, if that patient desires all that to be corrected significantly.”
Your health plays a role as to what you are suitable for.
Not everyone who wants plastic surgery is a candidate for it. And there are some cases where your current health status instantly rules you out for surgery. Miami dermatologist Dr. Janice Lima Maribona says that for patients who can’t have surgery due to health issues or just because they doesn't want to undergo surgery, multiple modalities like Ultherapy, modern thread lifts and "liquid facelifts" can be used, along with other treatments, to correct what’s bothering them.
If you don’t want to make a majorly dramatic change, you might opt for something less-invasive.
“Gone are the days when people wanted 'extreme' changes and dramatic results. Most seem to be happier 'flying under the radar' and showing more modest, natural-appearing results rather than pushing things to the limit,” says San Diego plastic surgeon Joseph L. Grzeskiewicz, MD. “Personally, I am a huge proponent of minimally invasive treatments and more natural results, whether they be surgical or nonsurgical.”