Adam Augenstein, MD, Plastic Surgeon in Charlotte, NC, Discusses Popular Male-Focused Procedures

The latest statistics for the past year from the American Society of Plastic Surgeons (ASPS) show that more and more men in the country are dipping their toes into cosmetic procedures, increasing by nearly 30 percent since 2000. Adam C. Augenstein, MD, dual board-certified plastic surgeon in Charlotte, NC, and founder of Aesthetic Surgery of Charlotte, explains how awareness is spreading among men about the benefits of both surgical and minimally invasive aesthetic procedures.

The latest techniques practised by plastic surgeons today tend to be quick and require little to no downtime. This has also led to plastic surgery becoming much more accessible and offering benefits to men from a variety of backgrounds. Men are also taking more interest in their physical appearance, as exhibited by the metrosexual and hipster grooming habits of today.

The competitive job market often propels men to opt for facial rejuvenation procedures such as BOTOX® Cosmetic (often dubbed “brotox”), dermal fillers, or facelift surgery, due to a fear of encountering ageism in the workplace and wanting to appear more fresh-faced and energetic. Additionally, cosmetic procedures can provide men with a shot of confidence as they increasingly become single later in life and re-enter the dating pool.

Non-surgical methods, such as Kybella® (to reduce chin fat) and the above-mentioned facial rejuvenation injectables, are very convenient options with minimal treatment and recovery time, and provide subtle but effective improvements without the average person being able to tell they had a procedure performed.

Surgical procedures tend to be performed quite differently for male and female patients. Popular cosmetic surgeries for men include:

  • Liposuction: The most often-treated areas in men include love handles and the “beer belly”. Liposuction for the neck and chin area is also becoming popular as a way to achieve a more chiseled jawline.
  • Chin augmentation: Along with reducing chin fat, an augmentation can strengthen the look of the jawline. In 2016, 55 percent of surgical chin augmentations were performed on men.
  • Rhinoplasty: In men, the overlying skin on the nose is typically thicker, which will affect the extent of change surgery can produce. Men’s noses also tend to have a higher bridge and greater width. Men often prefer a more prominent, angular nose with a less delicate tip. Many are also looking to correct injured noses or a deviated septum to improve both form and function.
  • Gynecomastia (enlarged male breast) reduction and pectoral implants: A sculpted and toned chest is the ideal for most men.
  • Eyelid surgery: Skin, muscle, and fat can be tightened, or skin and fat may be removed from the eyelids if they are in excess and cause drooping (which can also cause obstructions to a clear field of vision). Eyelid contours may also be improved. The result is a more wide-awake, youthful appearance.
  • Facelift: As the gold standard in facial rejuvenation, this procedure can tighten facial tissues, remove excess, sagging skin and fat, and boost volume in deflated areas. Brow lifts and eyelid surgeries are often performed in conjunction with a facelift.

Both surgical and non-surgical cosmetic procedures can carry an element of risk, which is why it is important to conduct your own research on both the procedures you may be interested in, as well as potential doctors you plan to visit (ensure they are board-certified in plastic surgery and experienced in the procedures of your interest).

The consultation is the first step to determining what treatment plan would be most beneficial for you. Be prepared with information about your personal and family medical history, which areas of the face or body you would like to improve, and any questions you may have for the surgeon.

Adam C. Augenstein is one of the few plastic surgeons in the Charlotte, NC, area to be certified by both the American Board of Plastic Surgery and the American Board of Otolaryngology – Head & Neck Surgery. He would be happy to advise anyone looking to learn more about cosmetic and reconstructive surgery or non-surgical cosmetic procedures. To request a consultation with him, contact Aesthetic Surgery of Charlotte online or by phone at (704) 837-1150.


Statistics on Facial Plastic Surgery: The Bay Area’s Dr. Stanley Jacobs Notes Increases

The face has been an object of attention for as long as humanity has been around: It graces ancient pottery, fills museums of antiquities, and now is presented virtually on countless smartphones and social media platforms each day. In addition to driving technology’s ability to capture and preserve someone’s looks for posterity, the world’s collective fascination with the face has also given rise to a growing desire to adjust individual features, an endeavor possible now like never before via facial plastic surgery. Bay Area facial cosmetic surgeon Dr. Stanley Jacobs has studied the long and fascinating history of facial aesthetics, which is why he noted with interest the recently released statistics from the American Society of Plastic Surgeons.

According to the published numbers, plastic surgeons in the United States performed about 17.1 million total cosmetic procedures in the United States in 2016, an increase of three percent over the year before.

While the most commonly performed surgery was breast augmentation, three other surgeries in the top five—rhinoplasty, blepharoplasty, and facelift—are focused solely on the face, and the other—liposuction—is frequently used to shape specific regions of the face. Given that the numbers for each procedure were higher in 2016 than 2015, it’s safe to say that facial plastic surgery is on the rise.

Liposuction—a surgical fat-removal technique that can be used on the neck, cheeks, and elsewhere—is in the second slot, with 235,237 procedures reported. That’s an increase of six percent in one year.

The next three most commonly performed procedures ranked as:

  • Nose reshaping, up two percent to 223,018
  • Eyelid surgery, up two percent to 209,020
  • Facelift surgery, up four percent to 131,106

Breast augmentation was the most commonly chosen cosmetic surgery procedure among women. Not surprisingly, this didn’t register at all on the list of male-chosen surgeries. For men, facial plastic surgery ruled the year, with nose reshaping and eyelid surgery taking the top two spots. Liposuction and facelift were at places four and five, respectively, with male breast reduction sitting at No. 3.

As facial plastic surgery is proving increasingly popular, so, too, are minimally invasive procedures that focus on temporarily rejuvenating and refreshing the skin. The uncontested top procedure overall—dominating over all other options, nonsurgical and surgical alike—is an injectable form of botulinum toxin type A. The 7,056,255 injection sessions in 2016 are up four percent from 2015’s 6,757,198.

There are several brand names available in this category (Dysport® and Xeomin® among them), but the most prominent is BOTOX®. Injections reduce muscle contractions. If properly applied with precision by a trained and experienced injector, BOTOX® can slow activity in the specific muscles that cause noticeable frown lines on the forehead, as well as crinkly crow’s feet.

Second to botulinum toxins, but still far surpassing surgical choices are soft-tissue fillers, tallying 2.6 million applications in 2016. This is followed by chemical peels with 1.3 million

Often, patients can combine the effects of facial plastic surgery and nonsurgical options to get a benefit unattainable from a single procedure or treatment. Dr. Jacobs, for instance, combines a surgical facelift with a the carefully controlled application of chemical peels to address both the skin and its underlying architecture in what he’s called a SynergyLift™.

The American Society of Plastic Surgeons compiles its statistics annually by sending out a survey to member surgeons, combing a dedicated database, and extrapolating the resulting aggregated information. The results are considered by many to be the most comprehensive statistics exploring cosmetic and reconstructive plastic surgery in the United States each year.

Dr. Stanley Jacobs is a triple board certified doctor specializing in facial plastic surgery. Bay Area residents may recognize him from his segments on KRON4, as well as his frequent appearances at events in the greater community. For more information, call his office in Healdsburg at (707) 473-0220 or in San Francisco at (415) 433-0303. He also has an online contact form.

Four Ways to Rejuvenate an Aging Neck, from Surgery to Kybella®

While a wrinkled and sagging face bears most of the blame for giving away a person’s age—or even making someone look older than their years—the reality is that the neck also significantly contributes to the problem. Considering the 2015 introduction of Kybella®, Boston-area board-certified plastic surgeon Christopher Davidson, MD, has appreciated the increasing availability and popularity of neck-focused procedures and treatments. Here are four to consider:

• Kybella®

A primary aesthetic complaint from both men and women is a double chin, caused by a pocket of fat that can stubbornly refuse to change no matter how consistently someone diets or exercises. This fat is a problem for anyone who wants facial definition, as it softens what would otherwise be angular lines and creates the impression of multiple chins—especially when looking down. Since fat-reducing lifestyle alterations are not always successful, the most effective treatment often involves the physical destruction of the unwanted fat cells. Kybella® accomplishes this by rupturing them with deoxycholic acid, a chemical the body uses to break down fat during digestion. The form used in Kybella® destroys fat cells it encounters in the submental area, and these cells are then eliminated from the body.

Kybella® is an injectable, and a single treatment session can involve up to 40 or 50 injections, all carefully placed in the targeted area. The FDA has cleared Kybella® for use in reducing double chins, and since its powerful active ingredient can damage any cells it encounters, application is limited to specially trained medical professionals who can minimize risk and maximize results, which appear over the course of weeks and months as fat is gradually removed.

• Liposuction

Another option for eliminating unwanted neck fat is liposuction, which involves removing fat cells by suctioning out the unwanted material with a thin tube known as a cannula. This takes the fat cells in question out of the equation and can give the chin-to-neck transition area more definition. With the fat gone, results are immediately noticeable—and will become increasingly apparent as post-procedure swelling subsides. Patients who choose this method are often those searching for a double chin treatment with fast-acting results.

• Neck lift/facelift

Not all aesthetic neck issues are due to excess fat. In fact, the loss of fat can, in some cases, leave loose skin behind. Young, healthy skin readily conforms to body contours, but after years of being stretched out by underlying fat, some skin—especially skin that has lost collagen, hyaluronic acid, and elastin due to aging and environmental factors—simply won’t shrink back down.

Sagging skin on the neck creates a turkey wattle effect, and drooping skin on the face, due to volume loss higher on the cheeks, can form jowls that appear at the jawline. A facelift is a surgical procedure that lifts away those jowls, while a neck lift focuses on tightening the skin below the chin. Together, these two options can significantly revitalize a patient’s profile, so they are frequently performed in combination.

These procedures may also involve some amount of fat removal via liposuction.

• Juvéderm Voluma®

As noted above, volume loss in the cheeks leads to problems farther down, as the natural structures holding tissues in a firm, youthful position give way to laxity. By reintroducing volume with the hyaluronic-acid-based injectable Juvéderm Voluma®, support can be temporarily rebuilt, rounding out what is known as the “apple” of the cheek and effectively pulling up the sagging tissue that forms jowls.

Any of these options can be performed as a standalone procedure, but they may also be combined to produce a desired youthful effect over time.

Learn more about any of the neck treatments and procedures mentioned here, including Kybella®, from Boston-area plastic surgeon Christopher Davidson, MD, who has more than a decade of experience in the field. Call his office at (781) 237-7700 or visit his contact page.

Focus on the Neck: Facelift and More in San Francisco

Patients who desire well-defined facial contours naturally examine their cheeks and nose, but also often express dissatisfaction with their neck. The area below the chin and above the chest is where bulges can disrupt an otherwise sleek profile by creating a double chin and hiding an obvious jawline. This problem may be due to excess fat, loose tissue, or a combination of the two.

Just as there are multiple causes for that double-chin look, there are multiple solutions.

Many patients choose to focus on rejuvenating the cheeks, jawline, and neck to create more youthful contours via a neck lift or facelift surgery. San Francisco plastic surgeons Dr. David Lieberman and Dr. Sachin Parikh have noted that the facelift remains one of the most popular cosmetic surgeries performed in the United States, according to figures recently released by the American Society of Plastic Surgeons. Survey-based statistics show that more than 125,000 people chose a facelift in 2015, with almost 97,000 opting for a full facelift and about 29,000 selecting a mini facelift. The mini facelift focuses on the lowermost portion of the face, including the neck.

A facelift and neck lift may be performed at the same time, and either one may involve some fat removal, deep tissue and muscle lifting, and skin tightening to eliminate jowls and bulges. The entire area can be literally resculpted to create clean lines.

The doctors at For the Face – Lieberman and Parikh Facial Plastic Surgery also apply advanced techniques that allow them to avoid skin bunching or laxity beneath the chin, which can be a problem for surgeons who take a cookie-cutter approach to the surgeries. A natural look will result from a lift carried out with a patient’s unique anatomy—from skeletal structure to skin characteristics—in mind. Incision placement and the angle at which skin is tightened can make the difference between a surgery that looks like a surgery, and one that makes the patient appear younger and refreshed without any obvious manipulation.

Neck liposuction alone may be enough to help a patient achieve a desired look, as sometimes removing a small amount of fat can make a big aesthetic difference. Choosing a board-certified plastic surgeon with dedicated facial experience can help when patients want to determine which surgery will best deliver what they are seeking.

Nothing can duplicate the effects of a surgical lift, but there are also nonsurgical options that yield natural-looking results without requiring the incisions or post-procedure down time associated with a facelift, neck lift, or liposuction.

One of the most popular minimally invasive choices is Kybella®, which was approved by the FDA in early 2015 to treat submental fullness and came to the San Francisco area at For the Face – Lieberman and Parikh Facial Plastic Surgery shortly after that.

Kybella® is an injectable form of deoxycholic acid, which destroys fat cells and leads to their physical removal from the body. The entire process is natural and safe, especially at the hands of an experienced medical professional handling the administration. A single treatment session can last a matter of minutes, with results gradually appearing over the following weeks and months. A most ideal outcome may require more than one treatment, each spaced a suitable time apart.

Patients with little fat, but dealing with loose skin that creates the appearance of a turkey neck, can have it tightened with Ultherapy™, which uses ultrasound technology to prompt the body into lifting its own sagging tissue. The treatment stimulates new collagen production, boosting the skin’s supply of the structure-providing protein.

Learn more about Ultherapy®, Kybella®, neck lift, and facelift from the San Francisco Bay Area’s facial plastic surgery and aesthetics experts: Dr. David Lieberman and Dr. Sachin Parikh at Lieberman & Parikh Facial Plastic Surgery. Call (650) 327-3232 to set up a consultation or discuss other options for neck rejuvenation.

Deep Skin Resurfacing vs. Plastic Surgery in Philadelphia

Many patients with aging skin know that they want to bring a youthful vitality back to their face, but they’re not sure which method would best suit their specific needs. Plastic surgery is a Philadelphia-area standard, with facelifts sitting among the top five most commonly performed cosmetic surgical procedures in the Middle Atlantic and New England regions. Deep skin resurfacing, however, is another option that can yield excellent aesthetic results.

Bala Cynwyd’s Dr. Timothy Greco is a facial plastic surgery expert who often hears from patients who want to know which procedure is best for them. He explains that not every patient is a candidate for a facelift, but may be a candidate for a minimally invasive cosmetic procedure. The ideal treatment varies from patient to patient depending on a range of factors, including medical history, the degree of correction desired, sun damage, facial structure, significant weight loss, and more. A person’s needs can change over time, too, so deep skin resurfacing may be suited for wrinkles, pigmentation changes, and laxity of the skin, while plastic surgery is more appropriate for sagging tissues, such as jowls and excessive skin.

Whether they’re considering plastic surgery or resurfacing, people are generally prompted to seek out an aesthetic treatment for one underlying condition: changes to the skin due to internal and external factors. Over time, we all experience a reduction in the collagen and hyaluronic acid. Collagen provides structural support for the skin, and hyaluronic acid retains moisture. Most commonly, environmental damage, such as burning from UV rays, coupled with the natural breakdown of these vital proteins and carbohydrates, causes skin to lose its supple, youthful character. This leads to wrinkling and sagging. Cheeks can flatten, hollows can form, and lines can deepen into creases.

As inevitable as these problems are, both plastic surgery and/or deep skin resurfacing can help to remedy them. Treatment is most often sought by patients in their 40s, 50s, 60s, and older. Patients seeking plastic surgery and related treatments have a desire to achieve an appearance that is years younger than their actual age. Basically, patients want to look as young as they feel.

Plastic surgery in the form of a facelift involves treating fat accumulation, sagging skin, and general laxity of the face, which occurs over time. The main goal of a facelift is to provide a fresher, rested appearance without looking distorted. Results from plastic surgery move a patient back on the conveyor belt of aging, but they do not stop it.

Since a facelift is plastic surgery, it offers significant, enduring, and dramatic results. The procedure involves incisions, sutures, and recovery time on the scale of two weeks. Many patients find the new contours to be worth the necessary recuperation period, but some prefer to choose the less-invasive resurfacing option with more subtle results and a shorter window of healing time required. The decision is a personal one, but a plastic surgery expert such as Dr. Timothy Greco can help anyone weight their options.

Laser resurfacing helps with wrinkles and pigmentation issues by removing the outermost and medium-level layers of skin to expose fresh, unmarked skin beneath. Heat energy from the lasers used for this treatment can resculpt existing collagen and trigger the formation of new collagen, tightening the skin to further smooth away wrinkles. This treatment is ideal for treating fine lines, wrinkles, acne scars, sun damage, spots, uneven tones, and more.

Finally, consider that the two procedures are not mutually exclusive. Deep skin resurfacing can enhance the effects of plastic surgery, providing an aesthetic boost and adding to the longevity of facelift results when performed at six months to a year after the surgical procedure. It can also improve the skin that remains unresponsive after a facelift. While plastic surgery and deep skin resurfacing should not be performed simultaneously, they can yield optimal cosmetic results when performed sequentially.

Learn more about deep skin resurfacing, lasers, and plastic surgery for Philadelphia-area patients. Contact Dr. Timothy M. Greco’s Eastern Cosmetic Surgery Institute to arrange a consultation by calling the office in Bala Cynwyd at (610) 664-8830.

Could a Facelift in San Francisco Make You More Likeable in Addition to Younger Looking?

Women seeking a facelift in San Francisco may be as interested as Dr. David Lieberman and Dr. Sachin Parikh were to hear the results of a recent study performed by researchers who set out to learn about the effects of a facelift or other facial rejuvenation surgery on perception. Specifically, the doctors behind the May/June 2015 study aimed to introduce and confirm the idea of “facial profiling,” which they defined as the process of one person determining the personality attributes of another person through visual observation.

The proposition is that we all practice this facial profiling every day, consciously or unconsciously, with every person we look at. Key facial features communicate certain attitudes and even personality traits to others, whether those traits are positive or negative or the perception is accurate or inaccurate.

One of the researchers noted that these traits, when negatively perceived, can inspire in others a desire for caution or distance because of our hard-wired genetics. Speaking to Science Daily, Michael J. Reilly, MD, explained that even what we may consider to be neutral expressions convey perceived personality traits. If a person’s traits are considered to be negative, other people’s animal instincts will push them to steer clear. Historically, we have a greater chance of survival when avoiding people who appear to bear us ill will.

Consider this: Would you be more likely to approach a stranger who has raised eyebrows, an overall alert expression, and a smile? Or one who’s got a deeply furrowed brow, half-lowered eyelids, and a downturned mouth?

The study’s authors focused specifically on 60 before-and-after photos of 30 women who had received a facelift or some other sort of facial plastic surgery within a five-year period. Aside from the facelift, the other procedures included eyelid lifts, neck lifts, eyebrow lifts, and chin implants.

Participants in the study were given a set of photos showing women before their facelift or other surgery, followed by photos of the same women after the surgery. The viewers were then asked to rate eight personality traits for each photo, judging each one for likeability, social skills, attractiveness, femininity, trustworthiness, aggressiveness, extroversion, and risk seeking.

The study authors’ conclusion: “Facial plastic surgery changes the perception of patients by those around them.”

The researchers found that the participants examining the pre- and post-facelift and other surgery photographs failed to note any statistically significant changes in four perceived traits: trustworthiness, aggressiveness, extroversion, and risk-seeking. There were, however, statistical improvements in perceptions of likeability, social skills, attractiveness, and femininity.

While this study certainly raises interesting points about which characteristics a facelift or other rejuvenating plastic surgery impacts, there’s little to no question that youthfulness has been and remains a significant goal of patients who seek out facelift experts Drs. Lieberman and Parikh and other plastic surgeons. The intent of most facial-region lifts, including a facelift, is to take areas that have sagged over time and restore them to more closely resemble how they looked in a patient’s youth, when skin was tighter and smoother, volume was distributed in aesthetically pleasing ways, and the overall effect was one of health, vigor, and vitality.

As a society, we’re learning more, now, about how a brow lift or an eyelid lift, particularly an upper-lid blepharoplasty, seems to contribute to positive perceptions of likeability, since a drooping or sagging brow can give someone a stern or disapproving appearance. Consider how skin pulled down in the forehead area can create the impression of a perpetual scowl. Facial plastic surgery intended to rejuvenate that upper-face area can simultaneously remove an unintentional expression that may have been sending the wrong attitudinal signals to everyone around.

Learn more about what goes into a facelift from San Francisco Bay Area Dr. David Lieberman and Dr. Sachin Parikh at Lieberman & Parikh Facial Plastic Surgery. Call (650) 327-3232 to set up a facelift consultation or discuss other options for facial rejuvenation.