Walking The Fine Line

By Lexi Lampel

Dr. Paul Lorenc with a patient in Manhattan

“Getting my eyes done was completely worth it,” says 55 year-old Janet Lee as she indulges in a glass of red wine. Before receiving eyelid surgery, Lee, a magazine editor, avoided wine like the plague, stating it caused her eyes to become puffy. As a result of new advances made in nonsurgical cosmetic procedures, patients like Lee can receive a subtle, yet effective treatment for a fraction of what an invasive procedure would cost. The changes made to Lee’s eyes are virtually unnoticeable, allowing her to look her age without drawing attention to it. At $2,717, the national average spent on cosmetic eyelid surgery in 2009 according to the American Society for Aesthetic Plastic Surgery, we’re willing to spend generously for changes that appear minute if at all, but the upswing in nonsurgical procedures is ultimately costing us less.

“We have seen a transition from more surgically oriented procedures to less surgically oriented procedures, especially in 2009,” Dr. Paul Lorenc, MD, said, a cosmetic surgeron who has been practicing in Manhattan for 20 years. There were almost 10 million surgical and nonsurgical cosmetic procedures performed in the United States in 2009, as reported by the ASAPS, but surgical procedures only accounted for 15% of the total while nonsurgical procedures dominated 85% of the total.

Lorenc himself could be a factor in why patients are opting skip on the more dramatic and extensive procedures and consider the subtler, less expensive options. He is internationally recognized for the creation of endoscopic techniques used in many aesthetic procedures, most notably the endoscopic brow lift, for which he charges $3,200. With the use of endoscopic techniques, a plastic surgeon is able to make smaller, less invasive and more calculated cosmetic alterations that are also far less expensive than the procedures that require major surgery.

Lee, before undergoing cosmetic surgery

While it’s easiest to blame the recession for the drop in spending on cosmetic procedures performed in 2009, Lorenc feels that this information is incorrect.

“Patients aren’t interested in undergoing a procedure that their coworkers will notice,” Lorenc said, “They’re interested in the newer technologies that are being developed, that can be performed in an hour without an incisions, and those are the procedures that naturally cost less than something more invasive, such as a lower body lift or rhinoplasty.”

Dr. David J. Holcomb, a cosmetic laser surgeon based in Sarasota, FL, supports Lorenc’s findings that noninvasive procedures are the way of the future in plastic surgery. The co-developer of an innovative and new procedure called Acculift, Holcomb believes that previous methods of facial rejuvination, which leave the patient in need of touch-ups to maintain their youthful look, are slowing becoming a thing of the past.

“Instead of injecting the area with a filler, which becomes less effective over time, the Acculift procedure involves the actual removal of the sagging tissue so that the problem areas are no longer a problem,” Holcomb said. The removed tissue can even be reinjected into areas that the patient may want augmented, such as the lips or cheeks. According to Holcomb, a fiberlike device is placed through the skin and works similarly to how liposuction is performed. The fat is liquefied and then sucked out so incisions don’t have to be made. Not only is this procedure, at $1,500, far less expensive than previously used methods that start at $3,00, Acculift is permanent.

“Before Acculift,” Holcomb explains, “the only thing that could be done to add volume would be facial fillers. The issue has always been that you could only adjust the low points of the face, but with Acculift we can also adjust the high-points or jowls. Now we have so much more control over the three-dimensional outcome of the face.”

Lee, after surgery

Lee, a patient of Lorenc’s, still experiences some uncertainty regarding the slight changes made to her appearance. While the procedure Lee received leaves her feeling more confident, she worries about what will happen to our view of natural beauty if we can no longer distinguish between what is real or fake.

“So many of us have done it, but you never know anymore,” Lee said “It’s becoming cheaper and easier for us to avoid what’s natural, so how often will it be until we’re no longer sure what a ‘real’ 60-year-old woman should look like?”


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