Doctors that are not trained as surgeons tend to view therapy as a recurrent event. For example, they don’t “cure” high blood pressure with a single pill, rather they prescribe medication and lifestyle changes to control the blood pressure. They fully expect that if you stop taking the blood pressure pill, the high blood pressure will come back.
A surgeon, on the other hand is trained to do procedures that hopefully will take care of the problem “once and for all” For example, if your gallbladder is sick, you “take it out”. In the case of treatment of the ageing face, these distinctions tend to blur, as aging is a continuous process. What does one recommend to the patient who comes in wanting to get rid of, for example, wrinkles around the eyes and forehead?
The cosmetic dermatologist, having a medical background, will tend to recommend “therapy”, or Facial fillers such as Restylane, or Botox. All of these injectables have to be repeated over time, with the full knowledge that if therapy is stopped, the wrinkles will come back.
The plastic surgeon, on the other hand, will think of a more permanent solution,such as lifting the muscles that cause those wrinkles in the first place.
A Brow lift is a permanent solution to forehead wrinkles, but Botox is a good short term approach.
Thus he may recommend an Endoscopic Brow lift.
Recognizing this, many plastic surgeons are gaining expertise with more temporary forms of therapy in order to be able to offer the patient the full spectrum of choice. The patient may ask, well which is better? It depends. Restylane, Sculptra, and Botox, have two main advantages- No down time, and the price per intervention is lower. The obvious disadvantages of injectables are that the results are not as dramatic as a surgical intervention – and you have to keep on coming back for more.
But is this such a negative? A lot of women go frequently to the hair salon and they certainly don’t expect permanent results from a haircut or hair coloring. They accept that beauty in some cases is not “created”, but “maintained”.
This is something that took some time for me to fully recognize. This is because as a surgeon I take a lot of pride in “creating” a beautiful result that will stand the test of time. As I myself age and look at some of my own wrinkles, I begin to think more as a patient. Can I spare the time off from work to go through surgery? Do I want to spend that money now? Surprisingly, I find myself agreeing with a lot of patients who ask the same questions. Yes, if you have doubts, go ahead, do the Restylane or Sculptra or Botox, they’ll do the trick for now and you’ll get a lot of “bang for the buck” .
When you are ready for a more permanent solution, you and the surgeon will be a lot better informed on exactly what kind of result you are looking for. Perhaps more importantly, you will have built a deeper professional relationship with your surgeon. And that in itself is worth a lot.