In 2005, I wrote an article containing my predictions for the future of Plastic Surgery and what we might see happening within the next few years. I thought it would be fun to see, now some 7 years later, how accurate my predictions were.
Face– Seven years ago, I predicted that there would be less and less surgery and more innovations every year in the non-surgical, office-style methods to restore and rejuvenate the face. In 2005, I predicted that by 2010, non-surgical cosmetic procedures would actually outnumber surgical procedures. It occurred way before that. By 2007, non-surgical cosmetic procedures were responsible for 80% or more of all the cosmetic procedures performed annually in the U.S.and they have stayed in that dominating 80% range ever since! The number of injectable products, non-invasive treatments, and office options we have to offer is almost overwhelming! And each year, the bar gets raised just a little higher on the ease of the treatments, the quality and duration of the results, and the limited down-time. The “Facelift in a bottle” has really become the reality! There are currently literally dozens of very good options in “wrinkle fillers” – many lasting a year or even more. One filler – Artefill® – can smooth and fill out facial folds and wrinkles for several years with just one simple office treatment! We also have alternatives to Botox® such as Dysport® and Xeomin® – injectables which have subtle variations in benefits for individual patients. The word is out that we are very likely to see yet another “new and improved” form of Botox coming out this year from Johnson & Johnson called “Puretox”!
Body Fat– In 2005, I predicted that O.R. liposuction would fall by the wayside as minimally invasive and non-invasive techniques for body reshaping would take over. We’re still not quite there yet, but I guessed that the technology enabling office domination over the O.R.for body reshaping would take awhile – I gave this until about 2017. I guess the validity of this prediction still remains to be seen as Liposuction and Tummy Tucks still sit prominently among the top five cosmetic surgical procedures.But you may have noticed lately that there seems to be a lot more advertising and promoting about some interesting sounding techniques to reshape the body without surgery. For example: laser lipo, fat “freezing”, radiofrequency, body “tytening”, high intensity focused ultrasound, etc. We’ve all seen doctors “hawking” these unproven and often minimally effective new “machines” on TV, claiming that these can reshape and tighten the body just as well as liposuction or tummy tucks. But although they may be suggesting that these techniques are realistic alternatives to surgery, the results rarely even come close. There may be some value and truth to the science involved – but the bottom line is that we are still somewhat in the “developmental” phase of all this and no technology has yet emerged as a real winner. When non-invasive body contouring is truly perfected, ethical cosmetic surgeons will proudly offer it to their patients and we will then see an explosion in popularity rivaling that already seen for facial rejuvenation with the neurotoxins, like Botox® and the wrinkle fillers, like Restylane®!
Breasts– Nearly 10 years ago I predicted that an injectable-type product would ultimately be approved by the FDA which would allow women to enhance the shape and size of their breasts with a simple office treatment. I said that the treatment would take about an hour, with no implants, no surgery, no incisions, and no recovery. I called this fictitious injectable product “Breastylane” and commented on its softness, natural feel, lack of lumpiness and duration (about a year). Injections could be “supplemented” if desired at any time, and yearly visits could be used to simply maintain or modify as needed to account for aging, weight loss/gain or other factors. I did not think we would have this until 2020 or so. Sorry to say that we are not ahead of schedule on this one. But there are some indications that 2020 might not be all that unrealistic as a target date! Some “high volume”, biologically compatible, synthetic injectable products have already successfully been used for buttock augmentation (i.e. the “Brazilian butt lift”) instead of implants (not so good) or fat (not always enough). The results are being analyzed and the data is being put together. We might just have that “Breastylane” in a couple of years! Interestingly, however, currently fat injection/sculpting for the breasts seems to be picking up speed and acceptance in the Plastic Surgery community as an alternative to synthetic silicone implants. More and more surgeons are reporting some very nice and very natural looking results utilizing fat injection enhancement of the breasts.
Skin– One of the “Holy Grails” of Plastic Surgery for some time: a non-surgical, non-invasive technique for tightening loose skin. I predicted several years ago that a major revolution in bio-technology would hit the scene by 2025 which would allow for any hanging or loose skin of the face, jawline, and neck to be snugged up, smoothed and tightened – without any surgery. Well, we do have several types of lasers and similar technologies that have demonstrated some nice effects in this area, but we still don’t have a reliable technique for anything other than the most mild forms of skin laxity. And the application of lasers, radiofrequency, etc. to other areas of the body, such as loose arm skin, the abdominal skin, or loose skin of the thighs? No non-invasive technique seems to have been developed yet which we can really say works all that well. Lifts and tucks are still the mainstays for loose skin…at least for now. But when loose, inelastic skin anywhere on the body can be consistently tightened and smoothed, with a simple external treatment, the long scars and long surgeries of tummy tucks, thigh lifts and breast lifts might just become ancient medical history. Although I gave this all until 2025, there are some signs in the research I’m reading these days that perhaps we’ll see this a reality a little sooner. Imagine that although a grandmother of 5, Madonna might appear regularly in a very revealing “belly shirt”, advertising her “Hot Seniors” fashion line and honestly denying any suggestion that she’s had any cosmetic “surgery“!
Dr. Lyle Back is originally from New York City, receiving his medical and surgical training at Rutgers Medical School, Cooper Hospital – University Medical Center, and Ohio State. He is Board Certified in General Surgery (ABS) and Plastic Surgery (ABPS). He is a Fellow of the American College of Surgeons (ACS), the American Academy of Cosmetic Surgery (AACS), and a longstanding member of the premier American Society of Plastic Surgeons (ASPS). He served as a Professor of Plastic Surgery at Temple University and St. Christopher’s Hospital for Children and performed reconstructive surgery with “Operation Smile” in Vietnam. He specializes in the full range of the most modern and state of the art cosmetic surgery procedures for the body and non-surgical cosmetic enhancement techniques available today.