North Bay Woman

S P R I N G 2 0 1 5 | NORTH BAY WOMAN 33 patient's own fat or the more commonly utilized synthetic fillers like Restylane and Perlane. Dr. Dean Vistnes, MD, of SkinSpirit Skincare Clinic and Spa, agrees and says he has seen a paradigm shift in the way surgeons advise their patients. "We are no longer simply treating the aging face with tightening," he explains. "Non-surgical solutions are exploding!" Vistnes cautions that while injectable fillers can fill lines and wrinkles at a deep level to restore volume and give the illusion of a lift, doctors must be careful not to overfill or the patient runs the risk of looking unnatural. "The purpose of plastic surgery is to restore normal to normal," he says, "less is more, you don't want to look like someone you've never looked like." Dr. Tancredi D'Amore, MD, FACS, a plastic surgeon in Corte Madera, is also enthusiastic about the use of fillers because as we age, the volume in our faces is reduced. "It's really not gravity that makes us look older," D'Amore says, "it's loss of fat in our faces." D'Amore says there are promising techniques being developed and used, particularly in the area of fat grafting. Fat grafting, or fat transfer as it's also known, is a procedure in which a patient's own fat from another part of the body is injected into the face in very small amounts and in multiple layers. The theory is the transferred fat creates stem cells that will regenerate tissue and help improve the overall appearance of the skin. While using one's own fat as filler is exciting, as it's a readily available and natural option, Marcus warns that the science is still being developed and refined. "Injecting fat as a filler is a promising technique," he says, "but still somewhat unpredictable when it comes to both symmetry and how long the injection's results will last." The prospect of fat injections is encouraging and thrilling for those who seek the aesthetic benefits of fillers without as many artificial properties. As far as surgical procedures go, D'Amore points to neck lifts as the newest trend. These days, his patients almost always have a neck lift with a facelift, but some are forgoing the facelift. "We will often do a neck lift with a Browpexy instead of lifting the forehead, we haven't done a forehead lift in the last 8 years," he says, explaining that a Browpexy >> "Procedures are not going to look the same on everyone," he says. "You must consider and respect the person's anatomy." – Dr. David E. Marcus, MD

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