Philadelphia Plastic Surgeon on Innovations at ASAPS 2013

June 20, 2013

The emphasis at this year’s Aesthetic Meeting was on long term results. I attended a number of Master panels that discussed procedures that work and create long-lasting results; and in turn, discussed those procedures that have fallen out of favor for one reason or another.

This meeting is one of the leading conferences in the plastic surgery community and is hosted by the American Society for Aesthetic Plastic Surgery (ASAPS). Each year, ASAPS remains dedicated to improving patient care and education, while pushing the envelope to create better techniques and technology to further support successful procedures and patient satisfaction.

In the plastic surgery community, at shows such as this especially, we talk about the latest and greatest procedures and technology, the latest advancements and techniques. The important thing for us to remember is that these procedures, while important at the time, often get replaced with a better approach, and for good reason. So as we focus on the newest procedures and why those have proven successful, we also returned to procedures of similar impact from the past, and discussed why we no longer perform them.

Fillers and Fat Transfers Replace Brow Lift

One procedure in particular that was discussed was the brow lift, as we simply aren’t performing this procedure in the same way as it was traditionally performed. This change in philosophy is analogous to the way we used to think about the facelift: tighten or stretch the skin to improve the youthful appearance of the patient. However, as with the facelift, simply lifting the brow to achieve a younger aesthetic is insufficient in addressing the appearance of aging because this does not take into account the actual cause of aging, which is a loss of fat and a loss of bone.

To not take this loss of volume into consideration would be the same as pulling on the skin in the old approach to a facelift. Without adding volume and improving the quality of the skin, the brow lift can result in an overdone appearance, or one that looks good in the short-term, but less so as patients continue to age.

Instead of a traditional brow lift, we now use fillers and fat to help rejuvenate the entire peri-orbital area, and create a natural and long-lasting result. This shift has been reflected in patient preference at my Philadelphia and Ardmore plastic surgery offices, as the number of browlifts performed is roughly 5% of what it used to be.

Improved Breast Augmentation with Cohesive Gel Implants

The FDA has approved more cohesive gel implants. The Allergan 410 implant is the latest implant of this type to be approved, which means 2 of the 3 manufacturers have approved cohesive gel implants available for patient use.

Traditionally, 4th generation implants, those available before the new cohesive gel implants, were not quite as firm. Because of the improved cohesiveness, we are able to provide a better, more natural shape to the patient’s breast. This is especially important for women that do not have a well-developed lower part of the breast, as we can address this concern and help them achieve their cosmetic goals and a more proportionate figure.

These new breast implants are highly textured, which helps with rotation of the shaped implants. The one caveat here is that the shaped implants need to be placed in a well developed pocket, akin to a the way our hands fit into a glove. This takes more technical expertise than the placement of a traditional silicone implant, and often is improved with fat transfer in breast augmentation procedures.

Overall, I commend Allergan and Sientra for putting out very thorough and insightful educational information, in addition to conducting courses to help surgeons achieve the best result. These two manufacturers are truly focused on helping plastic surgeons optimize how these cohesive gel implants are used.

Final Thoughts on ASAPS 2013

Being in New York City elevated the level of discourse and excitement for this year’s conference. This is a venue that always attracts some impressive and influential talent in the plastic surgery community, and with NYC as the stage, the audience and presenters did not disappoint. I thoroughly enjoy the chance to engage with some of the leading minds in our industry, and look forward to the coming year’s Aesthetic Meeting.