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'One Word, Benjamin: Plastics'

November 10, 2005 By:
Frank Rosci, JE Feature
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Dr. Bruce Genter at work at his Jenkintown center

Ongoing advances in plastic-surgery treatments and techniques, notably the latest trends in non- and less-invasive procedures, are being put to good use by area plastic surgeons.

"Non-invasive treatments offer quicker healing, less expense and less downtime," said Bruce Genter, M.D., FACS, a board-certified plastic surgeon with more than 20 years of experience in the field, and founder and medical director of the Aesthetic Plastic Surgery and Skin Center in Jenkintown.

"But these procedures aren't right for all patients," he continued. "To determine which ones are a good match, consultations that explore all of the possible options are done first to correctly match the person with the appropriate treatment."

Among the most in-demand non-invasive procedures being requested by patients today are so-called "injectibles," such as Sculptra TM, which "follows a different way of thinking," Genter said, ""in that it creates more structure to lift skin that is hanging down."

The process takes either three or four treatments, administered a month apart and lasts about two years.

Other non-invasive treatments, he continued, are injections of Botox, which reduce facial frown lines, and Restylane, an instant and long-lasting facial-wrinkle correction also administered through injection.

A newer treatment in the less invasive category, he said, is Contour Threadlift TM, a nonsurgical facelift procedure that uses barbed sutures threaded through the face to pull it upward. These are then anchored in the scalp behind the hair line. It achieves 30 percent to 40 percent of what surgery could do, he said, and lasts about three years. While there is minimal bleeding with this procedure, there can be swelling and bruising, he noted.

But "it can't be used if a person's face is too thin, because the threads will be visible, and it won't work if a person's face is too fat, either, because it won't hold up the tissue," he explained.

"With every procedure, every patient must have realistic expectations," he said.

To resolve bruising more quickly, he puts patients on anti-inflammatory herbs, he stated, and before any surgery is done, also takes patients off commercial vitamins that can cause blood-pressure problems.

Quicker and Cheaper

A nonsurgical technique, at a fraction of the cost of plastic surgery ($1,000 for neck or cheeks to $10,000 for a complete facelift of neck, jowls and cheeks), he said, is the Titan TM procedure, which can tone, lift and tighten skin on the face, neck, abdomen, thighs and underarms by heating the skin through an infrared light source, causing collagen contraction. "Additionally, the process stimulates long-term collagen rebuilding, leaving skin looking younger," said Genter, who foresees non-invasive skin tightening as the wave of the future in plastic surgery.

In connection with less invasive procedures, Louis Bucky, M.D., plastic surgeon, Pennsylvania Hospital, stressed that these procedures don't necessarily mean bloodless.

"There is some confusion about this because there is bleeding - not as much as in more traditional methods - but it's still there. The goal in plastic surgery is to diminish the amount of bleeding and bruising. But to avoid bleeding entirely in plastic surgery is a very different concept," he said.

Techniques that reduce bleeding and bruising include taking patients off aspirin and red wine before surgery, he said, because these act as blood thinners.

"Reducing the size of incisions, as is done in brow lifting, also limits bleeding. Breast reduction, for example, can be achieved through a small underarm incision of less than two inches, and the insertion of an endoscopic TV camera that allows the surgeon to see and work on the area to be reduced."

No matter what the nature of the procedure, said Bucky, it's important that a plastic surgeon never compromises either ethics or what the patient wants, using, as needed, a combination of more traditional and newer, less-invasive approaches to achieve the ultimate goal.

Steven Copit, M.D., clinical assistant professor of surgery at Jefferson Medical College of Thomas Jefferson University in Philadelphia, said the trend continues toward "injectibles" and facial fillers, such as collagen, all of which have been safety-approved by the Federal Drug Administration. In light of today's techniques, bleeding and bruising are "as low as they can be today."

"There is no golden or perfect pill to take, but there is some treatment that can help every patient," he explained. "Every potential procedure, even less invasive ones, for every patient must be taken on a case-by-case basis."

According to Copit, because of today's non- and less-invasive treatments, there's been a sharp rise in younger patients - people in their 30s and 40s, including more men - who know they can get quicker results, and want them since they don't have time to take off the 10 days or so usually needed to recover from a traditional facelift and other more invasive procedures.

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