What are the main trends in aesthetic medicine this year?
The first trend – it is nose injection. I specifically created and I use daily my personal method the Eiffel Tower Nose-Lift®: first we make an injection on nasal spine, to lift and support the tip of the nose, and finally, we can work on the dorsum. The concept is to begin to work with the tip of the nose, because if you reverse by injecting the dorsum firstly you will drop the tip and make the nose too long and too wide. This procedure is a new trend because it is safe – there are no vessels medially where I recommend to inject. So there is no risk of vascular complications. In addition, it’s very effective method. So it is very interesting for the patients, who don’t want to do surgery.
The second trend is to use the technology of 3D photo and modeling. We take 6 photos simultaneous of the patient, and then make face reconstitution, like you can see in the movies – complete virtual 3d picture- or with a CT-scanner. You can play with it, showing your patient the future result, you can check what is wrong, for example, the eyes, or the chin, or the temple, which is difficult to see on the regular search, or on a 2D picture.
I use this 3D photo and morphing to all my patients because it is interactive, easy to understand the patient demand, to compare the face, before and after correction.
The third new trend is the return to the Endoscopic Facelift. We have a lot of demand for mini lifting. We perform a face-lift using very short scars, small cameras and small instruments. For example, to elevate an eyebrow (Endoscopic Brow Lift) we get just 2-4 cm scar instead of 10- 15 cm. This method is less aggressive , less painful and can be done in ambulatory. For the lower part of the face, we can also use this endoscopic method with a scar of 8-9 cm compare to 30 cm scar after a traditional facelift.
The fourth innovation is Earfold® for otoplasty. Instead of traumatic traditional Otoplasty with general anesthesia, skin resection, cartilage plication and sutures, bandage for 2 weeks…we can use now a simple tungsten/gold clip, adjusted under the skin, on local anesthesia, with no downtime, to plicate and create a smart new ear. Very successful for kids or adults with a minimal damage.
The last one new trend- it is my new website www.raspaldo.ch, with a new way of showing Facial plastic surgery and aesthetic medicine.
What are the most popular procedures among the patients inquires this year?
This year the most popular procedure is nose correction (Rhinoplasty). People want to have a beautiful nose without scars. There was a tendency the last years to do open approach – to make a cut under the tip of the nose on the columella to lift the nose and to work with the open roof- or to use traumatic machines (ultrasound, piezoelectric) to cut the bones with large dissection (undermining of the soft tissue around the nose). It was supposed that this type of nose correction will be better, but this method is very aggressive. People don’t want a visible scar, don’t want unnecessary swelling nor traumatism of the tissue around the nose. I personally use, for 30 years, the elegant and non agressive minimal rhinoplasty that gives a very natural result. After 40-45 minutes we achieve a very natural result without huge swelling, pain or visible scar.
Also, Blepharoplasty (or eyelift) is very popular now. After years of using fillers, peelings and other non-surgical methods, people finally realized that when they have the excess of skin, fat and bags, that need to be removed — The best solution for this problem is surgery. It is an ambulatory procedure with a very short scar on the fold of the eyelid. A lot of people think that when you use some of these non-surgical methods for periorbital area correction (like laser, deep chemical peel, Plexr) – it is less aggressive procedures. But the truth is that Laser, deep chemical peel, or Plexr are more aggressive and cause huge swelling and inflammation. Not with an elegant and quick surgical Blepharoplasty.
Third very popular method – my FaceSculpture® concept. This is the global approach of the face. I show to the patient the 3d picture of his face and explain which problems is noticiable. Then we treat completely the whole face only with injectable: botulinum toxin and hyaluronic acid. It is an art to pick the correct area to enhance and the exact amount of product to use.
The last popular method this year that is also very good is using skin boosters. I was surprised that here in Switzerland people like a lot of skin boosters, more than in French riviera.
What do you think about the skin-boosters?
I think it’s great , but not a one shoot treatment. It is the complementary treatment with botulinum toxin, fillers, and surgery. To work with good skin is better than work with rough, thin or very dry skin. Skin Boosters work, but all depends on the product. Some of them, you have to inject every week, some of them – every month or every 3 months. There are a lot of brands in the market so my choice of the booster depends on the patient skin. In the past, we thought that boosters are like the face cream but now we understand that is not. It is a really deep hydration of the skin.
Are non-surgical methods more popular now, than the plastic surgery?
According to the statistics, the popularity of the plastic surgery has grown on 3-6 % but compared to the fillers or botulinum toxin, which popularity has grown on 22-23%, it is not too much. What I see – I do now more injections for patients, especially with my FaceSculpture® method (global approach),. I do also more injection of the temple, nose and chin. These methods need less time and they cause less pain.
But after a couple of years, people understand that they have to inject botulinum toxin every six months and fillers every year. Also, they realize that when they have the sagging of the eyelid, the brows, or the neck, they have to do surgery. I show my patients all problems on their face on the 3D image, and what can we do with it — and it increases the quantities of plastic surgery. And it’s amazing because a few years ago we were afraid that the plastic surgery may disappear. But finally, we know that more injections mean more patients – and more plastic surgery.
I see every month , some of my regular patients, or long term patients that come to ask for surgery: Endoscopic Face-Lift, non-traumatic Rhinoplasty, minimal invasive Blepharoplasty.
How do you think, which trends should be expected in the near future?
In my opinion, the deoxycholic acid injection— product for reducing the fat, it is the future trend. In some countries, it is already available. In Australia, USA, Northern European countries, Spain and Italy, this product is available for people with a heavy neck. Three sessions of this procedure lead to dissolve fat, and retract the soft tissue.
Also, the new trend that might happened is longer duration botulinum toxin. Now we have botulinum toxin for 4-6 months duration. In the near future we can expect 8-9 months or even a year duration.
We finally have got products to augment, to relax the muscles, to hydrate and to reduce the fat. My recent hope and thought are about injectable products that can retract the soft tissues. Now we can use for the retraction laser or RF-therapy, but we need something more effective and simple.
Interview made by Estet Portal :