A renowned plastic surgeon discusses what’s new in the beauty world.
Until as recently as a decade ago, the only available medical antidote for aging skin involved scalpels, anesthesia and long and painful recoveries. For some, that meant faces that were pulled and stretched so taut that the results were, well, scary. We’ve all seen them. These are the people who sit through The Notebook or Steel Magnolias smiling—because they are simply unable to cry.
But going under the knife isn’t always the answer. Fortunately, there are now many effective, non-invasive treatments and techniques, which, along with a holistic approach to taking good care of yourself, will leave you looking and feeling not a day over fabulous, no matter what your actual age.
To tell us all about the effect of optimal health on beauty from a medical angle, as well as the latest rejuvenation techniques out there, we sought advice from Dr. Haideh Hirmand. Dr. Hirmand, herself absolutely stunning, is a leading, Harvard-educated, New York City-based plastic surgeon, who feels that the goal should be to look flawless while still letting your unique beauty shine.
Below, Dr. Hirmand, who in conjunction with her thriving practice is now launching SkinLabRx, a highly personal SurgiSpa offering the latest in technology and skin care treatments to effectively revitalize the face and body, updates Spry readers on the best therapies for eternal youth.
Spry Living: You describe your philosophy as rethinking beauty – intelligently. What does that mean?
Dr. Hirmand: Being truly beautiful is about feeling and being your best through our varying stages. It is inside out and outside in! It is living a vital 360-degree life. It is happiness and health and it is confidence about who you are and what you look like.
It’s important to distinguish the ‘wanting to look young’ look, which implies age, from the ‘looking naturally youthful at any age’ appearance, which implies youth. Fortunately, today we can actually change the direction of aging. Studies have shown that fillers can create new collagen, and neuromodulators (like Botox) redirect the way we move our faces. So you can essentially slow down the genetic aging pattern that your skin will pursue.
In other words, if your mother’s skin didn’t age well, that doesn’t mean that yours has to, too! So much for the needle-point pillow that says: “Mirror, mirror on the wall…I am my mother after all!” Now, aside from that concern, what are the key complaints you hear the most from your patients – both men and women – and what do you suggest they do?
They think they appear fatigued, especially under the eyes, and want to look refreshed. But they are afraid of having surgery thinking they will look different or ‘done.’
But doesn’t puffiness and under-eye bags usually require surgery?
Not always. There is often a hollowness that happens along the tear trough and the bony eye rim (underneath the eye) area. Better understanding of the aging process dictates that we should fill the area of volume loss, instead of surgically removing tissue; although sometimes both are needed, depending on the individual.
Which begs the question: When is the right time to have cosmetic surgery – of any type?
I would say only when you are psychologically and practically ready for it. It’s a personal decision, and a big step; but sometimes it’s the only sure way to get a great result.
Until we come to the decision – or if, like many, we are of frightened of anything that even remotely relates to an operating room — what are the non-surgical rejuvenation options?
Fillers and energy devices, such as micro-focused ultrasound – Ulthera and the Radiofrequency device –can help postpone the need for surgery.
What is the newest filler on the market?
Voluma. It can soften the look and impart a youthful appearance in a simple and expeditious way by restoring volume where it is typically lost in an aging face. The jawline can be straightened, as well as the cheek, temple and eye areas. This kind of treatment can make the face appear ‘tighter’ simply by creating smoother planes and transitions. Know, though, that to stay natural- looking, if a little filler is good, a lot is not necessarily better!
What about all the laser treatments that are advertised? How do you know which lasers are right for you?
I recommend having an in-person evaluation with a board certified, “core” aesthetic physician — which means a plastic surgeon, dermatologist, oculoplastic surgeon, or a facial plastic surgeon—who specializes in lasers. I am a big fan of the factional C02 Active Fx/ Deep Fx platform for the real deal (ablative) laser surgeries; but also applaud non-ablatives, such as the Palomar Clear (fractional Erbium). I am also a fan of IPL. Lasers are all about customization and seeing what is right for the person depending on the problem, their skin, and what downtime or regimen they can undertake.
Should you ever have these –or fillers–done in a non-medical settings? They them offered pretty much everywhere. In fact, some nail salons even boast a Botox treatment — along with a pedicure!
A great deal of distortion can be done with fillers if used incorrectly, disproportionately, or to an extreme trying to correct a surgical issue. We are seeing more and more of these issues. And the ‘filled’ look is just as bad, if not worse, than the ‘pulled’ look of the past!
Doctor, every day we read about some other quick surgical fix. They promise, for example, a 15-minute face lift or nose job. Do we really want our surgeons to be going for speed records? What should our readers be wary of?
As in so many other contexts, if it seems too good to be true, it is probably not true! Be suspicious of catchy marketing names that are not real techniques. They should ask what the procedure actually entails and who is doing it. I also stress that it is important to make sure that any cosmetic procedure is done by a core aesthetic physician. Many doctors call themselves plastic surgeons or facial surgeons who are not properly trained in one of these specialties; so it is important to check if they are board certified by the appropriate accredited board and didn’t just take a few weekend courses.
As a plastic surgeon who sees all types of complexions and how they age, what are the most important ‘disciplines’ we should do on a daily basis to keep it looking youthful?
From a medical anti-aging perspective, I have a rule of three: 1) An antioxidant in the morning or twice a day (for example, SkinCeuticals CE Ferulic for the daytime and SkinCeuticals Resveratrol for nighttime). 2) A retinoid /vitamin A derivative at night. 3) Sunblock everyday (such as SkinCeuticals Physical Fusion Spf 50). There is science and data that these products do work. Beyond that, NO SMOKING, alcohol in moderation, and avoid processed sugars. Hydration and sleep are also essential. I am also a big nutrition fanatic. Your health is what you put in your mouth. That means high-impact low inflammatory, antioxidant foods. I am also a big believer in investing in one’s self. Remember: A happy person has a glow to the skin that is undeniable!