Cosmetic Surgery

“I had a professor tell me once that if I get bored in plastic surgery then I am not reading enough because there is always something new in plastic surgery every month,” said Dr. Jeffrey Roth, M.D., board certified plastic surgeon who runs the Las Vegas Plastic Surgery clinic.

Roth, who started off as a general surgeon, said he was drawn by the creativity and challenges of finding the perfect and the best way to perform surgery.

“No two people are alike and cosmetic surgery has to tailor to that,” Roth said.

While Roth performs the basic cosmetic surgeries at his practice from breast augmentation and tummy tucks, he says sometimes he gets to work beyond the basics and “fix” unique areas from hands to even earlobes.

“If you look at someone’s hands, that’s how you can tell their real age. But in China they can tell by looking at the earlobes and now there is interest in earlobe plumping,” Roth explained.

Other unique surgeries that are being performed more frequently according to the American Society of Plastic Surgeons are lower body lifts, butt lifts, cheek implants and pectoral implants, which went up by 203 percent in 2008.

But even with the new procedures and alternatives sometimes the more traditional surgeries continue to be the best option.

“Some people will keep putting in their face when honestly you need a face lift so you have to have some judgment as to what is right,” Roth said.

How a procedure is performed is also one of the advances in cosmetic surgery at Dr. Himansu Shah’s Signature Institute of Aesthetic Sculpting practice they use a new liposuction procedure which is an ultrasound system of liposuction where fatty tissue are removed with the assistance of sound waves which offer a more complete removal of fat cells than traditional liposuction. While Shah performs all types of cosmetic procedures, his practice specializes in body sculpting from liposuction to body lifts.

“There is a lot of demand for body lifts. Some patients have bariatric surgery and lose 200 pounds but then what do they do with all that loose skin? As cosmetic surgeons we complete the process so they can wear shorts again and people don’t have to stare at them,” Shah said.

Shah also performs endoscopic browlifts, in which incisions are made in the scalp to lift the eyebrows. Locating the incisions in the scalp helps to hide them from view. He has also performed thigh lifts.

“As long as there is gravity there is always something to lift,” said Dr. Shah.

Even with all these new procedures and surgeries the basic surgeries still remain the top procedures as Dr. Roth points out at his practice.

“We do have the basics of plastic surgery from working on the nose, eyelids, trunk work with lipo and tummy tucks and of course the most popular work that we do is breast augmentation and breast lifts…a lot of that is the mommy makeover,” Dr. Roth said.

“We have a lot of women with kids and they say they want things where they used to be and that is fine,” he added.

In fact, according to Plasticsurgery.org the five most popular cosmetic surgeries are breast augmentation, nose reshaping, liposuction, eyelid surgery and surgery. In 2008 more than 300,000 women had a breast augmentation, a process that can take three to seven days for recovery depending on how it was performed. In Las Vegas, breast augmentations and other cosmetic procedures are so common; one would be hard pressed not to know someone with implants or a lift.

“Of course Vegas is an entity of its own and you are free to talk about those things and yes plastic surgery is much more acceptable,” said Dr. Roth.

Among a new demographic where plastic surgery is acceptable are the men, while Roth says the majority of his clients are women he has seen a growing number of men, several have Botox or fillers, surgical liposuctions and rhinoplasty surgery. Percentage of Hispanics, Asians and African Americans also rose in numbers of cosmetic surgery patients in 2008, according to Plasticsurgery.org.

In fact, plastic surgery is so much more acceptable and widespread that the economic crisis has just barely put a dent in number of cosmetic procedures.

The American Society of Plastic Surgeons reported that cosmetic procedures were up by three percent in 2008, even after the economic hardship started.

However, it doesn’t necessarily mean that cosmetic procedures continue in full force with the norm. Trends show procedures that people are getting are just adjusting to the economic conditions.

Costly cosmetic surgeries such as tummy tucks, breast augmentations, face lifts and liposuction took a down-turn in terms of the number performed in 2008, but “substitute” procedures such as Botox and skin resurfacing climbed up.

“You will always have a need for cosmetic surgery but even that is still subject to economic variations; what we do is elective and disposable income and having said that the demand can be different,” Roth said adding that more women are opting for procedures such as Botox to hold them over until they can afford to have a face lift done.

However, Dr. Shah, who said he has also seen this trend at his practice warns that putting off the face lift can become expensive.

“If you keep using fillers and the Botox, yes you certainly put off the facelift but it can become more expensive overtime than one big expense,” Shah said.

But another much more surprising impact of the economy is that in some cases it has increased the need for cosmetic procedures and brought in many first-time clients as Dr. Roth has seen at his office.

“We have people who have just been laid off and are competing in the work force for a job and while the motivation has always been to look good it’s now driven by economic reasons. People want to look good and young and refreshed when they are out competing against 20 year-olds for jobs,” Roth said.

However, saving a few bucks is never a reason to skimp out on a good doctor, even in this economy. Dr. Roth recommends doing detailed research before committing to one surgeon. The problem is that although this seems like common sense, the American Society of Plastic Surgeons reported that 40 percent of patients surveyed believed they should have been more proactive in learning about potential side effects and complications before surgery and doing thorough research; even though eight out of ten patients reported they were satisfied with their procedures. Furthermore almost a third of cosmetic surgery patients reported not having checked their doctor’s credentials before surgery.

Dr. Shah, who is board-certified, cautions strongly to find a doctor that is board-certified by the American Society of Plastic Surgeons.

“You don’t want someone who just took a weekend course to operate on you we do have people in Vegas who think they can just watch a video and do surgery on you,” Dr. Shah warned.

Roth, who is also board-certified, details why having an board-certified doctor is so important.

“We train for a long time and the reason is so you can recognize the problems that occur and know how to treat them and fix them, you are in a room with other experienced guys and you help each other with situations…you just can’t get that from a weekend course,” he said.

In order to check if a doctor is indeed board certified Roth suggests looking them up in plasticsurgery.org.

Aside from checking if a doctor is board certified, Roth recommends getting different opinions from several doctors to find one the patient is most comfortable with.

“You really have to do your homework and have reasonable expectations and really talk to your doctor. It’s also a good idea to bring a visual picture of what you want to help the doctor,” he said.

Dr. Shah suggests quitting smoking when looking into having any kind of surgery.

“I usually recommend quitting four to six weeks post operatively as it increases the risk for complications,” Shah said.

When someone smokes the nicotine levels can cause blood vessels to constrict during surgery and the blood doesn’t get to the area that it needs to for healing, lengthening recovery time.

In fact, in some cases Dr. Shah won’t even perform a surgery if the patient had been smoking.

“I will never do a face lift on a patient who was just smoking because you are talking about a face. If the skin died, then you have a big problem. To me it’s important to see someone be healthy and recover. Your reputation is also on the line,” Shah said.

And on top of everything Dr. Roth recommends “you have to keep your expectations reasonable, everyone is different and everyone will have different results.”