Trends in Aesthetic Plastic Surgery revealed
World-leading experts and thought leaders in the field of Aesthetic Plastic Surgery have unveiled the latest industry trends and techniques at the British Association of Aesthetic Surgeons’ Annual Scientific Meeting.
The theme of this year’s conference was ‘elevation in surgery’: elevation of technique, elevation of results and elevation of patient experience.
Aesthetic Plastic Surgery is booming in the UK. According to the BAAPS annual audit, 31,057 cosmetic procedures took place in 2022, up 102% from the previous year. Partly responsible for this boom are advancements in techniques that help to improve patient outcomes, satisfaction, and safety.
As vice president of BAAPS Nora Nugent explains: “BAAPS stands for education and training, but also innovation and advancement. Techniques must move on and be modern and contemporary while staying safe at the same time.”
An assembly of the best surgeons from around the world, some of the leading experts in facial and body contouring surgery shared insight into the pioneering techniques that are helping to shape the future of cosmetic surgery.
The ‘Ponytail Lift’
Chia Chi Kao, an esteemed facial surgeon located in Los Angeles, has gained widespread recognition for transforming facelift procedures. His innovative approach, dubbed the ‘Ponytail Lift’, involves discreet, minimal incisions strategically placed behind the ear and within the hairline. Unlike traditional methods that primarily focus on elevating the brow, Kao’s technique prioritises altering the brow’s shape, rather than its height. Through skilful rotation of the outer brow, the emphasis is shifted from lifting to reshaping, mitigating the risk of a “windblown” or “surprised” appearance.
“One of the many interesting things about Dr Kao’s pioneering work is that it can be used earlier on in the ageing process because it’s not so much about lifting sagging skin”, says BAAPS president Marc Pacifico.
In a recent survey of BAAPS members, 70% observed a trend for patients under 50 enquiring about facelifts. “It was observed that facelifts are often considered by patients in their early to mid-40s who usually have the mindset of maintenance rather than later rejuvenation,” adds Pacifico.
The ‘Gliding Lip Lift’
With many celebrities taking to social media to renounce lip fillers, alternative techniques for achieving plump, natural-looking lips are gaining popularity. Jerry O’Daniel brings over 30 years of experience to the full spectrum of cosmetic and non-surgical procedures and is renowned for his anatomical approach to face, neck, and lip lifting.
As O’Daniel points out, we judge age not by the eyes but by the lips, making them all the more crucial to get right.
The challenge with a traditional ‘Bullhorn Lip Lift’ is that if only the central third of the lip is lifted, in some patients it can over-elevate this section and might look unnatural and result in ‘bunny lips’.
O’Daniel’s ‘Gliding Lip Lift’ helps with elevation of the lip more laterally as well as in the middle, helping to maintain natural proportions. It is done under local anaesthetic and scarring is minimal.
Filler fatigue
Dermal fillers have gained in popularity, partly influenced by reality TV shows like Love Island and social media; howevermedical experts caution that the injected substance may face cause an immune reaction.
Dr Spero Theodorou, one of the conference speakers and director of the leading bodySCULPT plastic surgery practice in New York, spoke out about a study that will be published later this year in the international plastic surgery literature.
Hyaluronic acid, the key compound in most fillers, has been found to block lymphatic channels, which help the body drain fluid and are a key part of the immune system that helps to fight disease. Fillers have also been linked to cysts, lumps, swelling and facial pain.
“Under-eye filler is one of the biggest problems. You see women everywhere with swollen eyes. It’s taken us 20 years, but we’ve proved it I don’t gain anything from doing this. I will be a pariah. You have young women having fillers in their faces. It’s never going to go away. It’s very hard to remove and it blocks lymphatics in your face. This is a very important system. Not all patients will have swelling, but evidence suggests all will have some degree of lymphatic blockage,” says Dr Theodorou.
Pacifico adds “People don’t need to panic and have fillers dissolved as an emergency. This is preliminary research, but it gives us a scientific explanation for the side effects we are seeing with fillers. Whether it has more medical ramifications is unknown at this stage. However, this does highlight the importance of using a medically trained clinician for injectable fillers.”
Stem cell-enriched fat grafts for breast augmentation
According to the BAAPS Annual Audit, Breast Reduction procedures were up by 122% in 2022, with many women choosing a smaller cup size due to lifestyle choices. “Women are being influenced by wellness and improving the quality of their lives, rather than aesthetic concerns,” says Nugent.
Some are also having their implants removed due to implant-associated complications such as chronic pain, capsular contraction, breast deformities, or concerns over breast implant illness. Replacement with a new implant is therefore not desirable and alternatives are requested by patients to substitute the removed implant volume for a cosmetic satisfying result.
While fat transfer treatments are a natural and effective alternative to artificial implants, their success has been limited by an unpredictable fat survival rate, previously thought to be between 40-60%. Aiming to improve treatment outcomes, a new fat enrichment technique has been developed to replace the implant volume safely and efficaciously with fat grafts enriched with ex vivo expanded stem cells.
By boosting naturally occurring stem cells within the fat, that is harvested from the tummy or thighs, the new technique increases the fat survival rate to 80-100%, resulting in much more predictable treatment outcomes for patients.