THE HEALTHCARE HOLIDAY -EXCLUSIVE INTERVIEWS
INTERVIEWEE: DAVID ALESSI – ALESSI INSTITUTE
TOPIC: FACIAL REJUVENATION
As facial rejuvenation is increasingly becoming a sought-after cosmetic treatment, The Healthcare Holiday wanted to seek professional advice to share with you We contacted Dr Alessi, a renowned facial plastic surgeon, based in Beverly Hills, CA.
In this interview Dr Alessi offers his views on procedures and what to look out for when choosing treatments and practitioners.
QUESTION: Non-surgical facelifts and facial rejuvenation procedures are increasingly popular in today’s vanity–focused social world. What would your advice be to those considering these procedures but are concerned about undesirable results?
ANSWER: My advice to those considering any kind of facial rejuvenation procedure, whether surgical or non-surgical would be to go to an expert. These procedures are becoming very common but also, the number of doctors doing them is increasing, and many of them are not well-trained. Always look for Board Certification and primarily in the American Board of Facial Plastic Surgery or the American Board of Surgery. Non-surgical procedures should always be done first (if at all possible) because the chance for a bad outcome would be lower with a non-surgical procedure. There are many non-surgical procedures that are great such as: Profound that can tighten the skin, fillers such as Voluma to fill in the sunken look that occurs with the aging process. In terms of invasive procedures those that are the least invasive should always be done first. Everybody is an individual and no surgeon should use a cookie-cutter approach to every patient. It depends on what the patients concerns are, the surgeons to listen to the patient and come up with a surgical plan, or a non-surgical plan that the patient agrees with and fully understands.
QUESTION: You are renowned for your “natural looking” results. How do you achieve this? Does this stem mainly from your technique, experience and products you use?
ANSWER: In terms of obtaining ‘natural results’ it’s mainly by understanding anatomy and beauty, and not cutting corners. For example: when doing a neck lift or a face-lift, many surgeons will cut corners by only pulling back the skin. That will give a ‘too-tight’ appearance and an Old Hollywood Actress appearance to their look. For facial rejuvenation surgically, as somebody ages not only does their skin sag but also their fat and muscle will sag at the same time. These all need to be put back into place to achieve a very natural look. Also understanding the aging process and putting things back to where they were when the individual was younger is very important. It’s not just about tightening skin but also to reconstruct the underlying structures.
QUESTION: Botox v fillers: What are your views on these procedures? How long do the results last and is there any medical research to indicate that repeated treatments can be detrimental to health?
ANSWER: These are both very safe procedures and they do different things. Botox is for lines that are there part of the time, such as the lines in between the brows and the forehead that contract with muscular movement. The best uses for Botox would be forehead lines, the lines in between the eyes, and crow’s feet. We also use Botox to make the eyes a little bit bigger, and also to help keep somebody’s mouth look like its slightly smiling rather than looking like a fish mouth. There is no evidence to suggest that any repeated use of Botox or fillers can be detrimental to health. There is no incidents of cancers, or other medical problems occurring because of these fillers, assuming the individual does not have an allergy to the fillers or the Botox. Fillers are used for filling in lines that are there all the time such as the lines by the nose that go to the corner of the mouth, called the nasolabial folds, or for noses that have a defect in the bridge that needs to be filled out a little bit. It can also be used for the Tear Trough that is underneath the eyes (which gives a hollowness to the eyes), to fill out lips, or it can be used to make hands look younger, and there’s multiple other uses. Most of the fillers used nowadays are made out of a Hyaluronic acid. The neat thing about these fillers is that if the result isn’t exactly what the patient wants then it can be dissolved easily. There are different types of Hyaluronic acid depending on how cross-linked they are, and will change how long the substance will be in there. It also changes the consistency as to whether or not it’s thick or thin. Thicker fillers are used for deeper correction such as giving new cheekbones, and nasolabial folds. Thinner fillers are used for underneath the eyes and for the lips. These are done very frequently and an expert of hands can be a wonderful result for patients. In terms of fillers we actually do a lot of fat injections. Fat will function just as any other filler except the only issue with fat is that sometimes the fat can go away. However with better processing of the fat, the chance of the fat surviving for a long-term or forever, is much higher.
QUESTION: Being at the forefront of this area of the medical profession, can you provide any insight on new developments?
ANSWER: In terms of any new developments in medic procedures, there are better and longer lasting fillers. There is still the search for the perfect filler that is one that will last forever but can be dissolved very easily. Also, there is research in terms of neurotypes of Botox-like substances that will last for longer periods of time. There is research on topical Botox that will avoid the use of needles. Additionally, there is more research on better types of radio frequency that can tighten the skin non-invasively.
QUESTION: We all want to keep our skin looking as young as possible for as long as possible – what is essential for our daily skin regime.
ANSWER: In terms of keeping your skin looking as young as possible, for as long as possible, the four things you need to do are: 1) moisturize; 2) stay out of the sun; 3) avoid stress and; 4) don’t smoke. Also hormonal changes especially pre-menopause or menopause can have a detrimental effect on the skin. Hormonal replacement therapy is a wonderful treatment to keep your skin looking as young as possible for as long as possible. Basically, if somebody follows the four main points above, then the skin will look great for a long time. In terms of moisturizers there are many different types. Our studies show that our skincare line performs very well however the main factor is not the cream itself, but the fact that the skin is staying moist. Antioxidants can be very useful in helping to inhibit sun damage and free-radical damage, and that is what we have in our creams as well as in other creams.
QUESTION: I note that you have a residency at Niyama Private Islands Maldives, from 25 March – 5 April 2018, can you tell us why you have chosen this location?
ANSWER: We have chosen a residency at Niyama Private Islands because we have been to the Maldives several times and in fact this will be our 10th time there. The owner of the hotel discussed the opportunity of me performing more simple procedures such as Botox; fillers, Kybella at the resort. We are exploring the possibility of doing this on a bigger scale where we can even do surgeries and have this as a destination resort for recovery, not only from surgery and cosmetic procedures but also for overall health and wellness. The Maldives is one of the most spectacular creations in the world that we have been to, and given that we travel everywhere for a hobby, I think this means something.
QUESTION: Do you have a Practice in London or plan to in the future?
ANSWER: This has always been a consideration. My wife is British, being from the Highlands in Scotland, so ideally we would love to do this. Although practically to run an office in Beverly Hills, as well as in Dubai, with the periodic residency in the Maldives, this takes up a considerable amount of time. So we will have to see how we could possibly fit this into our schedule.
QUESTION: Would you provide a general quote on the key benefits of non-surgical facelifts for those seeking age-defying procedures?
ANSWER: Our preferences is the Profound RF. Procedures such as Ulthera and Thermage help somewhat with many patients noticing a subtle result, very few noticing the home run, and several patients, especially with Ulthera, not noticing any results at all. The Profound (in our opinion) is the best way to tighten the skin non-surgically. Everybody seems to have a result, and sometimes the results are spectacular. Combining this with Botox, resurfacing the face with a fractionated CO2 Laser, and fillers, can completely rejuvenate ones appearance without surgery. The results can be remarkable.
QUESTION: And finally, you are described as a “beauty whisperer to the stars”. We would like to hear more about this!
ANSWER: It’s basically because of where I’m located. I feel I do very good work and since I work in Beverly Hills where all of these stars seem to live, they come to trust me to give them advice in terms of beauty, and maintaining their beauty. It’s a special niche in terms of that they need to look natural and normal on television, without looking like they’ve had anything done. We will often adjust our Botox so that it will not affect the roles that they are doing. For example, comedians need to have more action in their eyebrows than perhaps for someone who is doing more dramatic work. In addition we will consult with their managers and casting directors to see if any of the changes we are considering will have any impact on the types of roles they may be getting.