Jacob Gerzenshtein, MD FACS ©2012 PlasticG LLC
Quick fixes and fads come and go. Sound surgical principles deliver the most viable and lasting results.
There are many new gadgets, “non-invasive” procedures, 15-minute face-lifts, miracle creams, and painless skin tighteners. I believe the makers of such products, and some of the “physicians” who “endorse” or “highly recommend” such products or procedures prey shamelessly on the average consumer. THERE IS NO LEGITIMATE SCIENTIFIC STUDY THAT DEMONSTRATES ANY REVERSAL IN AGE-RELATED WRINKLES, CREASES, OR DIVOTS WITH THE — USE OF ANY CREAM, MAGIC SPELL OR POTION—NONE—PERIOD. This is not to say that most consumers are stupid or uninformed. Most are fed poor-quality, pre-intervention and post-intervention photographs with changes in lighting, background and focus (or complete absence of focus). People are trained to pick up on this. They see a change for the better and attribute it to a miracle treatment.
There has also been a media push to embellish medical advances. This misleads the average patient into believing that “new” techniques are somehow better, less invasive, and with the added benefit of less downtime. Patients are fed nonsense about “minimally invasive plastic surgery” and they believe it. To understand why the term is laughable, we need to go back to the origins of minimally invasive surgery. The entire purpose of laparoscopic surgery was, and is, two-fold. Using very small incisions to perform intra-abdominal, intra-pelvic, or intra-thoracic surgery allowed patients to return to activity quicker, because most pain caused by such surgery is related to the incisions across skin and muscle.
The second purpose is obviously to improve the cosmetic appearance of scars by making them tiny. Plastic surgery, however, for the most part, focuses on skin. There may be too much, too little, it may need to be reshaped, etc. Plastic surgeons operate on skin. To say that an operation designed to remove, add or reshape skin can be performed by not making incisions in the skin is downright silly.
For any plastic surgeon to endorse a technique that promises long-lasting results in a fraction of the time, with no downtime, implies one of two things. The surgeon is a fool, or the surgeon is more interested in making money than in his or her work and in the satisfaction and ultimate appearance of the patient.
There are cases—breast augmentation, closed rhinoplasty or endoscopy brow lift—where making a smaller incision may yield a more pleasing result. For the most part, however, operations that have been around for 30 years are still around for a reason. The same cannot be said of the gadgets sold to “doctors” two years ago for hundreds of thousands of dollars, that are now available for a few thousand bucks as refurbished resale items.
Results don’t lie, and once word gets around, people know what not to pay for. The trouble is that “new” and “improved” treatments are being churned out so quickly, those who have them done first don’t have the luxury of the truth.
Having said this, my practice philosophy is rooted in honesty, humility and quality. I would never promise the stars and the moon, no matter how good a job I thought I may be able to do. I have always given a fair assessment of the situation, presented working alternatives, discussed most of the unfavorable events that could possibly occur, and made sure that my treatment plans were in line with my patient’s goals and expectations.
I have never thought myself too good or proud to refer to someone else who may have more expertise in a given area, rather than operate on a patient for a quick buck without regard for potential problems.
Finally, I have stood by my work, and I am happy to display any case when allowed to do so by my patients. I will strive to preserve the honesty, humility and quality of my practice as long as I am caring for patients.