Synergy Plus Personalization Maximizes Results

The American Society of Plastic Surgeons (ASPS), which represents 92% of all board-certified plastic surgeons in the United States, recently released a deeper dive into the trends behind its procedural statistics report.¹ In addition to generational data regarding which groups are getting what types of procedures, the society reports that, despite high inflation in the “post-pandemic economy,” Americans continue to invest in wellness and beauty to the tune of almost $26 billion on both minimally invasive and surgical options.

The report notes that, although surgeons’ fees vary widely according to surgeon, procedure, and region, the cost of some popular procedures decreased or rose less than inflation (7% in 2022). The ASPS notes that more demand on the part of patients has led to more supply, which has decreased the cost of surgeries such as cheek implants, chin augmentation, and ear surgery. The ASPS further reports that patients are paying less for blepharoplasty but the costs of neck lifts, rhinoplasties, and browlifts have increased by double-digits.

Against this backdrop, it is important that practices remain nimble and adapt, differentiating themselves by offering a synergistic suite of aesthetic services tailored to each patient and delivered in a very personal and skillful manner. As a double board-certified facial plastic surgeon in Beverly Hills and Newport Beach, I focus on facial rejuvenation surgery, which includes upper and lower lid blepharoplasty, ptosis surgery, and browlifts. I perform everything from hair transplants to rhinoplasties to facelifts and neck lifts using both surgical and nonsurgical treatments.

SKIN CARE BEFORE AND AFTER PROCEDURES

Before a face and/or neck lift, it is important to prime the skin to ensure an even tone—particularly in an area where there will be an incision. Some patients are prone to skin conditions such as melasma or keloids, making a high-quality skincare regimen even more crucial. Typically, that includes a cleanser, a brightener and tightener, moisturizer, and, of course, sunscreen. We try to get all patients started on good habits right away that will help them look their best after the surgery, too. Lifting and tightening is only part of it; the products will give an outer glow.

Before mole removals or skin cancer work, preparing the skin allows us to get the best results. It isn’t just the techniques used to take the mole off; it’s implementing great products in addition to the procedure. Keep in mind, the same formulation should not be used for every single patient; they should get different amounts of an active ingredient, for example, depending on their specific needs. In a boutique-style practice, a cookie-cutter plan is not needed for everyone; what I do is customized for each individual.

Rather than laser methods, I prefer chemical peels. I like to couple that with the popular Morpheus8 (InMode) microneedling. Traditional microneedling goes to a depth of approximately 1 mm or 2 mm, whereas this goes down to 4 mm and then adds radiofrequency energy. It works deep underneath the skin to maintain tightness and prevent sagging. Alone, this won’t give the same result as facelift, but it will help with skin tone maintenance and prevention of sagging and allow patients to hold on to their tightness as long as possible.

The technique and experience of the providers matters. For example, the settings used make a difference in the result and the energy can be boosted. This is just one example of a device we can use along with more invasive options to optimize the outcome or to delay a facelift. Everything works together, and I tell patients there is no magic wand for everything. Surgery is not the only answer, but neither are devices nor a cream going to be the solution for all problem areas.

PHILOSOPHY AND EXPERIENCE

Experience is equally important when injecting fillers. A specialist should truly have an aesthetic eye and the ability to create a look that does not appear unnatural or surgical. In fact, many patients come to me from all over the country, having spent significant sums of money on fillers and laser procedures, and still feel as though their skin is droopy or they have bags under their eyes; they do not look the way they want to. If instead they had had a mini facelift—what I call the “Ardesh Refresh” which requires no general anesthesia—they would enjoy the lifting of the face and definition along the jaw line or neck that they were looking for. Ultimately, they would have spent less for a much better result.

Although I do a limited number of insurance-based procedures—mostly skin cancer treatments, rhinoplasty for breathing purposes, and occasionally blepharoplasty/eyelid surgery needed medically for vision loss—the low (and declining) reimbursement rates make these types of procedures hard to justify for most plastic surgeons. One newer alternative to upper eyelid surgery that I frequently recommend is oxymetazoline drops (Upneeq, RVL pharmaceuticals). This pharmaceutical solution provides aesthetic as well as sometimes functional benefits for ptosis patients who are seeking a more wide-open appearance of their eyes and a more refreshed look.

My philosophy is to deliver real results. The outcome must be significant enough to justify the time, energy, and money that patients invest. A provider being able to show a nice before-and-after of some nonsurgical procedure does not mean that another patient will obtain the result they are seeking. When it comes to the price tag, regardless of the procedure, patients are literally wearing it every single day. There is no covering up of anything; everyone can see each one of my incisions for my face lifts or rhinoplasty.

I do all my patient consultations myself—I ask the questions, collect the information, and perform the physical examination. I want to personally build a close rapport with patients. Some practices often focus more on sales, relying on consultants and not medical providers to explain the options, showing patients a book of choices to select A, B, or C. Creating connections with patients is important, however, and that is what keeps them (and me) happy and coming back for other procedures.

a thriving practice

By nurturing relationships with my patients, synergizing the right treatment approaches, and achieving real, personalized results, plastic surgeons can create a total boutique experience with bespoke patient outcomes and enjoy a thriving aesthetic practice—regardless of the economic environment.

1. American Society of Plastic Surgeons. American Society of Plastic Surgeons Breaks Down 2022 Plastic Surgery Trends Among Different Demographics. https://www.plasticsurgery.org/news/press-releases/american-society-of-plastic-surgeons-breaks-down-2022-plastic-surgery-trends-among-different-demographics. Published December 7, 2023. Accessed March 27, 2024.