Latest techniques in plastic surgery

Dr. Sam RizkPlastic surgery isn’t for everyone, but it can be a fabulous option. If you have ever thought about it, you will be interested to know that it has come a long way in the past decade. No longer do women need to fear disfiguring scars or a scary wind tunnel look, if they choose their doctor wisely.Top Manhattan facial plastic surgeon Dr. Sam Rizk will explain his signature procedures as well as the latest trends and advances in plastic surgery.

Dr. Rizk treats patients from all over the world, including socialites, royalty and celebrities. He has been nominated by his peers in Castle Connelly’s yearly survey of Best Doctors for Facial Plastic Surgery and his techniques have been featured in peer-reviewed journals as well as on national TV and in international magazines. If you have ever considered plastic surgery or you just like to be in the know about beauty, don’t miss a word of this informative and exclusive interview.
DD: Can you please explain the advantage of  3D rhinoplasty and facelifts? Are they really accurate?
Dr. R:  In the fast-paced realm of aesthetic facial surgery, my preferred techniques are continually evolving, incorporating new technology and methodology that ultimately improve the patient’s results and recovery.  The main advantage in my hands of the 3D high definition approach to rhinoplasty and face and neck lifts in a nutshell is precision. Due to the increased visualization the technology affords me while I am operating, I can see internal structures with pinpoint accuracy and can operate more efficiently to achieve optimal outcomes for my patients. I believe that this is the future of facial rejuvenation surgery. However, technology is only a tool. It is never a substitute for skills and expertise and experience. Yet in the right hands and on the right patient, this technology can absolutely increase the precision and accuracy of results that can be delivered in surgery.
DD: Are there different types of facelifts? Is it possible to get achieve a natural look?
Dr. R: I believe in the concept of a custom-tailored approach because that is truly what I do and what makes the facial work I do different for each person. Consumers are confused by all the variations on face and neck lifts that are presented to them, both in the media as well as from each surgeon they consult.  
Surgeons often become robotic in their approach after many years in practice — but there is no one size fits all facelift. I never do exactly the same procedure on any two patients. Creativity and customizing a lift requires a deep knowledge of anatomy and a high level of comfort in all layers of face and neck. For example, I am using autologous fat grafts on many facelifts to provide additional volume in areas that are deflated. However, I do not use fat on all my facelift patients, especially for fat faces where volume loss is not their concern. Some patients may also benefit from a chin implant or endoscopic (working under the skin with a scope) temporal or brow lift that may be combined with a face or neck lift.
The true artistry of face lifting is customized the procedure to the patients’ anatomical structures, their needs, as well as his or her personal goals. My goal with face and neck lifts is to beautify the face, not just to make a face look younger through volume repositioning, stretching and tightening skin as was done with facelifts in the 80s and 90s. Today’s patients want natural-looking results without any telltale signs of intervention or anatomical distortion, as in pulled-back ears, overdone brow lifts, aggressive fat removal from the neck and under eyes, or the classic stretched wind-tunnel look.
DD: How long does it take the average person to heal from a facelift or a rhinoplasty (nose job)?
 Dr. R: My rapid recovery facelift and rhinoplasty approach allows the average patient to be back to work in 10 days, depending on the extent of the procedure. Especially in New York, most people do not have the luxury of prolonged time out of work or their busy schedules. With camouflage makeup, some of my high profile female patients will be back in their office or chairing a committee in a week because they have to.
DD: Some scars from facelifts, even good ones, are very obvious. Is there any way to avoid that?
Dr. R: It is absolutely avoidable to have visible scars from facelift surgery with proper planning and execution. I always ask my patients how they wear their hair to factor that into my incision placement. If you wear your hair up for events or in a ponytail to go to the gym, you are not going to want visible scars behind the ears that are obvious. I always take care to hide my incisions to avoid these problems. In most cases, the incisions will be placed at the hairline to avoid disrupting the sideburns or temples, and will be placed inside the ear when possible to avoid a telltale scar in front of the ear or the tragus (little nub of cartilage in the middle of the ear) being pulled back. Facelift surgery has come a long way since the 1980s, and patients today will not accept long, thick, or visible scars anymore.
DD: What is the average age for a first facelift, and how long does it last?
Dr. R: This has also changed considerably over the years now that women are looking after themselves at an early age. In my practice, the average age of a modified facelift is the mid 40s. Doing it early when your skin is healthy and in good shape has advantages, but doing it too early is not recommended if there is no skin laxity. Sometimes I turn away patients who aren’t ready. I tell them to come back and see me in a few years.
There are other techniques we can use to help maintain a youthful face as well, including Botox, dermal fillers, autologous (their own extra) fat and stem cells, and fractional laser resurfacing; that greatly improves skin quality and texture.
I have developed an isolated neck lift that is ideal for younger patients with minimal skin laxity who just want a subtle firming and tightening of the lower jowls. This procedure involves less recovery and shorter incisions to address the early slackening of the jowl area that so many women complain about. When they are ready for a full lift, we can use the same incisions and address the upper face as well. I also operate on healthy women in their 60s and 70s all the time, so there is really no age limit.  If you have a lift while your skin is in optimal condition, it tends to last longer, especially if you commit to having maintenance procedures along the way. If you wait until you have more skin excess, sagging and fat deposits and severe sun damage, lines and wrinkles, your results are not going to last as long or look as good. Plastic surgeons are not magicians; we have to work with what you have.
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