True or False: A good plastic surgeon = scar-less surgery

False! (Unfortunately...)

The reality is, anytime an incision is made into the skin a scar will result. A scar by definition is the seam where the skin heals back together. It's the seam itself that can vary-from a hairline scar that is barely perceptible to one that is red, raised and hypertrophic or, at the most extreme, a keloid.

What a good plastic surgeon can do is to make it inconspicuous by putting it in a discrete place and minimizing the scar itself. But, take note, even a good surgeon is at the mercy of the healing process. The fact is, some patients are more susceptible to scarring. (This is often determined by your personal history of scarring: If you've never had any problems, chances are you'll continue on that same path, and vice versa.)

The good news is that new and innovative treatments are in development to manage less-than-ideal scars. In fact, Dr. Few will be giving a presentation at the annual meeting of the American Society of Plastic Surgeons in Denver this September on an injectable substance to limit scarring. Stay tuned for more on this hot topic!

Dark or light skin tones: which do you think is more sensitive to aging?

Last week we asked you on Facebook to answer the question, Dark or light skin tones: which do you think is more sensitive to aging? Your answers varied. Here's what Dr. Few has to say:

Lighter and darker skin have their advantages and disadvantages. Lighter skin tends to be more susceptible to aging because of it's greater susceptibility to sun-related damage. Lighter skin also tends to be thinner and less oily than it's darker counterparts, making it more susceptible to environmental forces such as cold, dry weather and smoking.

Darker skin has inherent SPF in it, helping to minimize the damaging effects of the sun. The disadvantage with darker skin is related to an increased risk of hyperpigmentation (darkening) and bad scars with trauma.

Lip Service

When it comes to the perfect pout, what do your lips say?

While we used to frequently encounter that so-called "trout pout" of the last decade, today there’s definitely a backlash against any enhancement that looks obvious and “overdone.”

“It’s about enhancing your natural lip contours,” says Dr. Few. “If you try to change the shape, you could have a very unnatural-looking result.”

But how do you know? Dr. Few offers up 5 lip tips that will wipe the pout off your lips and leave you all smiles:

1. The upper lip shouldn’t be larger than the lower lip.
   “Although Julia Roberts has a larger upper lip [and pulls it off!], it’s generally an unnatural proportion and will result in an unnatural looking lip,” says Dr. Few.
2. Enhance your natural lip definition.
   “Don’t just make your lips bigger. This is a common mistake that creates those unnaturally protruding ‘duck lips’.”
3. Don’t expect to erase all your lip and mouth ridges and folds.
   “If you inject too much filler, the skin will stretch and create what we call ‘sausage lips’.”
4. Maintain your filler. (Restylane lasts approximately 6 months.)
   “Regular maintenance of your lips will create a more natural look, so don’t wait until it disappears to get a refill.”
5. Avoid permanent fillers in the lips.
   “While the idea of a permanent filler is appealing, if you don’t like your result, you’ll have to have it surgically removed. As we like to say in the industry, permanent fillers, permanent problems.”

Rethinking Anti-Aging

Media love to jump all over the still young and beautiful who feel compelled to stop aging in its tracks before it even begins. (Hello, Botox Babies!) If you think about it, it’s the quintessential attempt to “anti-age.” Imagine: no lines, no wrinkles and, yes, no sign of life’s experience… pros and cons to be sure.

But is that what we’re really after, anti-aging? I’d venture to say, most of us wear the odd line proudly. My very own are indications to the world that I’m not a baby and have indeed earned the respect that goes with my age and experience. Of course, I don’t want ALL of them left unchecked. (Yes, I do like my Botox, thank-you-very-much!)

So in a recent conversation with plastic surgeon and industry leader Julius Few, MD, of The Few Institute in Chicago, Dr. Few told me that he doesn’t use the term “anti-aging” in his practice. Wow. (Right?) I was intrigued by his perspective and it made me stop and ponder how the industry has changed and is continuing to change.

Let’s start with the Botox Babies phenomenon of the past decade. Pretty obvious. We don’t want to let time slip by and become the 50-something-year-old woman who faces the hard choice of (a) major surgery to get the results she wants or (b) settling for less-than-significant results with less invasive procedures (fillers can’t always replace a facelift!).

But that doesn’t mean we need to start erasing all signs of aging before they begin to avoid the “big” surgical procedure. According to Dr. Few, it’s all about timing and customizing your cosmetic treatment protocol based on the way your particular face and skin age (we all have different aging traits). The idea is to begin an individualized, step-up approach to facial rejuvenation that combines less invasive procedures with selective surgical procedures—at the right time, over time.

The take home message? It’s all about gradual, subtle change that changes with your aging face, rather than trying to change your face.

So it isn’t about anti-aging, it’s about managing the aging process selectively and strategically, embracing elements of aging while maintaining a youthful quality to your skin and facial contours. It’s that age-old (pun intended) expression: Age with grace.