The Science of Aesthetics

By James L. Fowler MD

Plastic Surgeon

The field of aesthetics has grown exponentially in the last 20 years.  When I began plastic surgery practice over 25 years ago, the aesthetics piece of our practice was a small, often overlooked, division of the office.  Today, it is a well-integrated part of a multidimensional practice drawing from surgery, dermatology, medicine, and medical aesthetics.  Let me walk you through the transition and what it means to you.

Skin care used to mean product bought at the store, usually recommended to you by friends and family, without medical or professional guidance.  Products were often evaluated by how they felt and applied to the skin.  Active ingredients were not addressed.  Visible results were rare.  Today the market is flooded with products with wild claims, convincing before and after pictures, flashy marketing, and unreasonable promises.  And of course, prices vary.  

Procedures available at spas and medical spas can also be marketed to a large population promising a projected look.  Sometimes the target “look” is not what that population is even after, but it is made to appear as a solution to all your aesthetic problems.  For example, lip filler techniques popular on the west coast may not be as popular in this region.  These procedures may include neurotoxins, such as Botox, filler, skin tightening procedures, laser resurfacing, muscle stimulation, among others.  Besides finding the appropriate procedure for you, there is the issue of who exactly is performing those procedures?  How experienced is your aesthetic professional?  Are they aggressive in their treatments, or are they more conservative?  Is your aesthetic professional taking the time to address your desired goals?

At the end of your aesthetic assessment, surgery may be considered.  What procedure is needed to achieve desired results?  Am I even a surgical candidate? Some people have medical conditions that can make surgery dangerous or contraindicated.  Is there another, less invasive way to achieve similar goals?  

Complete medical aesthetic consultation should include review of your medical record, evaluation of your skin, review of your skin care history including all products that you currently use, and a review of past products that have demonstrated desired and undesired results.  After history, a thorough examination of the skin is done to determine skin type and identify problems that may be addressed with skin care and procedural intervention.  Your specific goals are reviewed.  Once all pertinent information has been taken into account, a plan of intervention can be formulated.  Daily habits, cleansing, and products can be modified.  Specific procedures can be recommended based on goals and assessed need.  If desired, surgical consultation can be scheduled.  

Skin is the largest organ of the body.  It has multiple jobs including protection, preservation of a specific environment for other organs and structural components of the body, immunity, and healing.  We see medical conditions that negatively affect these functions, severely challenging those affected.  Medical doctors and dermatologists deal with many systemic problems associated with the skin.  Plastic surgeons are vital in the removal and treatment of many skin cancers, as well as reconstruction after removal.  Medical aesthetics play an important role in maintaining skin health and protecting the skin day to day.  

Aging of skin is a normal occurrence.  We often marvel at individuals blessed with good genetics and healthy, youthful skin.  Medical aesthetics can work to preserve the appearance of youthful skin as well as improve signs of aging.  Signs of aging can include fine lines of the skin (very often associated with lines around the mouth and lips), deeper lines of the face (including forehead, between the brows, and extending from the corners of the nose and mouth), and loss of midface volume (frequently described as the face “drooping” or falling to the jaw line).  Redness, small spreading vascular spots, undesired hair, and pigment are also on the agenda.  

Consultation and intervention are the cornerstone of Cedar Rock Plastic Surgery & Aesthetics.  We have several product lines, each with thoroughly scrutinized active ingredients, feel and usability, and monitored results/outcomes.  Everything from cleansing to moisturizing and conditioning is addressed.  Treatment interventions may include medical facials, hydro-facials, microneedling, dermaplaning, chemical peel, light (or deeper) laser resurfacing, among other indicated procedures.  Minimally invasive procedures may include neurotoxin (such as Botox), hyaluronic acid filler, or metabolic filler (depending on need).  Minimally invasive procedures, including deeper laser resurfacing, are performed by our Board-Certified Plastic Surgeons.  

Cedar Rock Plastic Surgery & Aesthetics is a plastic surgery group consisting of two board-certified plastic surgeons, each with greater than 20 years of experience with aesthetic andcosmetic surgical practice. We are joined by a talented group of medical and nurse aestheticians with a wealth of knowledge and personal experience.  Together we provide conscientious, informed assessment and treatment plans to maintain and improve skin health and appearance.  Every person is different.  Your skin is different from your friend’s skin who just had an aesthetic procedure.  We take pride in evaluating every individual’s skin and working to achieve goals.  Together we can guide you through aesthetic care hitting all the bases of skin care regimen, procedural treatments, minimally invasive interventions, and plastic surgery.