Maintenance Is Key
Foad Nahai, MD, vice president of the ASAPS and a plastic surgeon in private practice at Paces Plastic Surgery in Atlanta, likes to start his younger patients on an aging maintenance program.
"We start by giving advice on skin care including exposure to sun and smoking, and then I ask if they are using anything on their skin," he says. Depending on the answer, he may prescribe retinoids and alpha-hydroxy acids that have some rejuvenating effects.
Both products help get rid of dead skin, revealing a fresher layer of skin.
"I have patients smile and frown for me and if they have deep lines, I may suggest that Botox could help their appearance, but it will also have a preventive effect over the years," he says. "Getting Botox now may prevent lines from becoming very deep and, in turn, stave off the need for more aggressive treatments such as facelifts down the road."
"In the long run," Nahai says, "the need for invasive major facelifts will be much less because the current generation of 20- and 30-year-olds will not allow their faces to get to the stage that today's 50- and 60-year-olds have," he says.
"It's too early to go under the knife, but we have needles, creams, and potions you can do and use that will not only delay the inevitable, but will also improve on what is now a youthful appearance," he says.
Hold the Botox
Not all cosmetic surgeons are sold on pumping up 20- and 30-year-olds with fillers and toxins. Steve Fallek, MD, a plastic and reconstructive surgeon in New York City, tells WebMD that "if you have wrinkles, I am happy to inject Botox, but if you are 20 to 25 and worried about wrinkles, I don't think that is a great idea right now."
George Lefkovits, MD, director of Park Plaza Plastic Surgery in New York City, agrees. "Today Botox is so commonplace, it's almost like having cappuccino," he says.
"If celebrities are having their lips plumped or having Botox, then people may think they should have it done also, but that's wrong, and this is where the plastic surgeon has to educate patients that they are not Jessica Simpson and that they have different lives," he says. "Just because the rest of world is having cappuccino doesn't mean you have to have it, too. You can have a regular cup of coffee."