By Jimmy Magahern
Many anti-aging procedures can now be done without going under the knife – and often in a lunch hour. Here’s what older adults need to know about the latest trends in cosmetic techniques.
To hear Debbie Alvira describe the people who inject her face with cosmetic fillers, you’d think she was talking about the great Renaissance sculptors, rather than aestheticians.
“After the first syringe, they literally stand back and they look at you and then decide where they’re going to go next,” she says. “Then after they’ve done the next syringe, they step back again and take another hard look. They don’t just say, ‘Where do you want it?’ and shoot it in there. They’ll step back and say, ‘You know, I really think she needs a little more in this temple area.’ And they work together. They’re artists.”
Actually, any plastic surgeon who works with Bellafill, the dermal filler that the 63-year-old Alvira had injected into her face to smooth out the so-called “marionette lines” around the mouth and bags under the eyes, has good reason to work with the patience and perfectionism of Michelangelo. Unlike other popular dermal fillers such as Botox or Juvaderm, which produce short-term effects and typically have to be readministered every six to nine months, Bellafill is likely permanent, and non-reversible.
The filler is just one of the relatively new techniques older adults are turning to in an effort to turn back time, without going under the knife. From improved fillers to facelifts using biodegradable sutures to lift and tighten sagging skin without the need for surgery, many patients over 50 are trying cutting-edge procedures that shy away from actual cutting, but still carry their own unique risks.
Here’s a look at some of the newest anti-aging cosmetic procedures, and the associated risks and benefits for older adults.
Bellafill’s manufacturer, Suneva Medical, claims the filler lasts for five years, but the treatment may actually last longer. The figure refers to the length of a study the substance passed to gain FDA approval in 2015. Researchers reported 87 percent of the 1,008 patients studied retained the effects of the treatment at the conclusion of the five-year period. Anecdotally, many patients who’ve received Bellafill treatments claim the effects have already lasted longer than that.
That’s because Bellafill is made up of 80 percent bovine collagen gel and 20 percent polymethylmethacrylate – the same transparent thermoplastic used in Plexiglas. The non-absorbable acrylic beads form a structure that the patient’s own collagen grows around, to lift the depressions seen in wrinkles, smile lines and acne scars.
The long-lasting effect is the filler’s main selling point, but patients should be cautioned that while a good job can last indefinitely, so too can a botched job.
“We like to combine Bellafill facial filler with Ultherapy, which uses micro-focused ultrasound energy to stimulate the growth of new collagen and elastin, fibers in our skin that keep it firm and supple,” says Jean Rossolillo, aesthetician and certified laser technician at Full Circle Health in Mesa, where Alvira goes for her treatments. “We believe there isn’t one stand-alone treatment that will ‘do it all,’” Rossolillo adds. “For the best results in facial rejuvenation, combination therapies work best.”
The new facelift?
In 2015, Gwyneth Paltrow, the actress and owner of the fringe-y lifestyle brand Goop, touted a procedure called the thread lift as an “under the radar” alternative to facelifts that was “sending A-listers flocking to Europe and Asia” for the less-invasive treatment, which didn’t require the incisions or deep-tissue manipulation of the traditional surgical facelift.
At the time, the treatment, in which threads are sewn under the skin using a large needle and grab the skin to pull and tighten it, was not yet FDA-approved for use in the U.S. That changed after two new variations, the Silhouette Instalift, from Silhouette Lift Inc., and Novathreads, from Aesthetic Experts Laboratory, developed ways to replace the permanent suture materials previously used with dissolvable sutures made from biodegradable polymers, reducing the risk of bacterial infection.
In Arizona, the Nova ThreadLift is offered by Dr. Daniel Shapiro of Shapiro Aesthetic Plastic Surgery, who’s also trademarked his own variation of the procedure, called the GenXLift. A press release claims the treatment is “customized for each patient based upon where they fall on the aging spectrum,” although it adds that the procedure is designed for people aged 33 to 53, as it’s best used for correcting the beginning signs of wrinkles.
With faster, knife-free alternatives to surgical facelifts on the rise, fillers are also being used to contour the upper and lower eyelids, restoring volume that is typically lost as we age, creating dark under-eye circles. But the FDA warns that the area around the eyes can be danger zones for injections, as filler accidentally injected into blood vessels (more prevalent around the eyes) can actually result in strokes, vision changes or even blindness.
For that reason, traditional eyelid surgery, or blepharoplasty, where incisions are hidden in the natural crease of the lids and excess skin is removed, is still the technique most recommended by the American Society for Aesthetic Plastic Surgery (ASAPS). In this area, Dr. Marc Malek of Scottsdale is recognized as one of the nation’s best. Malek’s clinic says recovery for eyelid surgery is short – one to two days, with bruises fully disappearing after one week.
Another popular procedure that’s come under scrutiny is the “Brazilian butt lift,” which promises to give patients the “curvaceous derrieres often found on the beaches of Brazil,” according to one press release, by injecting excess fat removed from other body areas through liposuction back into the buttocks. A string of deaths have resulted from surgeons accidentally injecting the gluteal fat too deeply, sometimes striking a gluteal vein or sciatic nerve or blocking arteries with a fat clot, causing organ failure.
Accordingly, the ASAPS strongly recommends using only board-certified surgeons to perform the procedure. In Phoenix, plastic surgeons Dr. Rozbeh Torabi and Dr. Tim Matatov of Elite Plastic Surgery are considered to have the most experience with this particular technique. Even when performed safely, however, patients should still anticipate a one-day hospital stay followed by at least six weeks of “minimum sitting” – a caveat which in itself makes it prohibitive for some older patients.
Not for mature audiences
Coolsculpting, a procedure that completely destroys fat cells in the treated area, is another cosmetic procedure that’s been gaining popularity. But experts say it may not be appropriate for older patients.
“The decision of whether or not to perform this procedure would be based on the condition of the patient’s skin,” Rossolillo says. “If the patient has laxity to the skin, we would not advise Coolsculpting as it may result in the skin becoming even ‘looser’ post-treatment, as there would be less fat to support the tissue.”
Dee Siverhus, owner of Contour You MedSpa in Scottsdale, agrees – even though she says Coolsculpting has become the gold standard in the aesthetic industry for non-invasive fat reduction.
“I love Coolsculpting, but it is best used on the appropriate patient,” Siverhus says. “It works by freezing only the fat cells that exist just beneath the level of the skin. The patient’s metabolism then has to be sufficient enough to naturally shed the cells. Skin laxity is also an issue to be considered with the Coolsculpting assessment. Every individual is different; some seniors are candidates and some are not.”
Another popular procedure that should be avoided by those over 50 is microdermabrasion. “It’s a very popular skin exfoliation treatment,” Rossolillo says, “but it should never be performed on seniors as their skin is typically too thin and more fragile. Negative outcomes from this treatment can include damage to the already fragile tissue, creating more laxity and broken blood vessels.”
One technique Siverhus says is safe for her over-60 patients is the Sciton Halo laser treatment, which is used to minimize sun damage and tones and tighten skin. “This laser will remove the damaged brown skin cells and tighten the skin by stimulating the elastin and collagen proteins.”
As with any decision to have cosmetic procedures performed, however, Siverhus advises checking with your doctor first: “I recommend a good consultation by a certified provider with a medical background before making any decision.”