Changing Beauty Ideas, New Trends in Minimally Invasive Surgery

Experts Define 21st Century Facial Rejuvenation at ASAPS Annual Meeting

NEW YORK, NY (April 16, 2004)--Eyebrows may not be a true “fashion accessory,” but preferences in
brow shape tend to change with the times. Plastic surgeons have adapted standard techniques and are developing
new ones to address contemporary aesthetic goals, including patient desire for minimally-invasive facial procedures
with reduced recovery time. Innovations in facial aesthetic surgery will be discussed by leading experts at the
Annual Meeting of the American Society for Aesthetic Plastic Surgery (ASAPS) in Vancouver, BC. The
ASAPS meeting, considered the major international forum for education and research in cosmetic plastic surgery,
takes place April 16-21 at the Vancouver Convention Centre.

“Joan Crawford epitomized beauty ideals of her time with her high, mid-arched brows, while the
contemporary ideal is more of the Cindy Crawford look – a brow that is generally lower but with the lateral portion
(the outer one-third) elevated,” says Vancouver plastic surgeon Richard Warren, MD. Dr. Warren will discuss
brow positioning with minimally-invasive endoscopic techniques which are, for some patients, an alternative to the
traditional, or “coronal,” brow lift requiring a long incision across the top of the scalp.

An endoscopic brow lift uses special instrumentation that allows the surgeon to see and work on the interior
structures of the brow through several very small incisions. According to plastic surgeon and ASAPS panel
moderator Foad Nahai, MD, “The endoscope allows plastic surgeons to modify muscles and position brows so that
wrinkles and furrows are diminished and the desired brow shape is achieved.” Dr. Nahai says the use of the
endoscope in facial surgery has been proven both safe and effective. “There has long been a debate among
surgeons regarding whether the results of endoscopic brow lifts last as long as those of traditional brow lifts,” he
says. “After more than ten years of looking at results, I believe that endoscopic forehead lifts are as effective as
coronal forehead lifts, and patients like the concept of shorter incisions.”

“Patients are interested in less invasive procedures with faster recoveries,” says plastic surgeon and ASAPS
Past President Robert Singer, MD, who will moderate a panel entitled Minimally and Noninvasive Facial
Rejuvenation – Why Less Can Be More. Jay Burns, MD, chair of the ASAPS Facial Surgery Committee agrees,
but adds that minimally-invasive or nonsurgical procedures often have limitations.

“If there is a great deal of excess skin to be removed, longer incisions sometimes are necessary,” he says.
As far as nonsurgical procedures, Dr. Burns says that comparisons with surgical procedures are difficult. “People
want nonsurgical solutions to aging, but for many patients noninvasive procedures simply can’t take the place of
surgery,” he says. “Surgery achieves the most dramatic, predictable and longest lasting results.”

Thermage, a device that uses radiofrequency to tighten facial skin, produces highly variable results, says
Dr. Burns. The Dallas plastic surgeon says that the upside to Thermage is that there are no incisions, no
appreciable downtime, and no great risks. However, he says, “Twenty percent of results are amazing, 60 percent
are just average, and in 20 percent of cases there are no results at all.” Dr. Burns says that patients considering
Thermage must be fully informed about the unpredictability of this nonsurgical treatment.

ASAPS President Robert Bernard, MD, agrees that patient expectations must be realistic. “We have
decades of experience and science behind plastic surgical techniques, but there is little science to back up the claims
of many noninvasive procedures,” says the White Plains, NY plastic surgeon. “The ASAPS Annual Meeting gives
leading plastic surgeons an opportunity to share their thoughts and experiences about the newest developments in
the field, so that patients can benefit.”

According to ASAPS panelist Richard Ellenbogen, MD, of Los Angeles, fat grafting is one of the most
effective nonsurgical procedures and can replace more invasive techniques for properly selected patients.
However, many surgeons today use fat grafting in conjunction with surgery, to enhance the results of procedures
such as facelifts and brow lifts. According to 2003 ASAPS Cosmetic Surgery Statistics, the number of fat grafting
procedures increased 21 percent last year compared to 2002. The patient's own fat, taken from a donor site, can be
used to add mass and enhance contour in many areas of the face including the cheeks, hollow areas under the eyes,
and arch areas of the brow.

According to ASAPS 2003 statistics, Americans had nearly 77,000 forehead lift procedures last year, up
39% since 1997. There were 2.3 million nonsurgical procedures, up 471 percent from 1997.

About ASAPS
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body.  ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

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