May 26, 2019

Plastic surgery gets lift

In Los Angeles, facelifts, breast augmentations, tummy tucks and nose jobs are about as common as juice bars and bad traffic on the 405. 

While Los Angeles and the United States in general are known as a hotbed of cosmetic surgery, things aren’t so different in Israel. In fact, the Holy Land was host to an international conference on the topic this past March.

The four-day symposium, called “Plastic Surgery at the Red Sea,” was held in Eilat and focused on aesthetic and reconstructive surgery. The topics discussed included “fat grafting for aesthetic and reconstructive cases, aesthetic and reconstructive breast surgery, problem cases in rhinoplasty [nose reshaping], post-bariatric surgery and body contouring,” according to Dr. Amos Leviav, chairman of the Israel Society of Plastic and Aesthetic Surgery and head of the department of plastic surgery at Kaplan Medical Center in Rehovot.

The keynote lecture, given by Dr. Rod J. Rohrich of Dallas, offered a look further into the future. 

“He pointed out that the future of the specialty is related to the development of the field of stem-cell therapy, a technique based in the collection of cells and tissues of the patient, their cultivation in-vitro and their reinsertion in the damaged area of the [patient’s] body,” Dr. Marcos Harel, plastic surgeon and national secretary of the International Society of Aesthetic Plastic Surgery for Israel, wrote the Journal in an e-mail. “This will replace all the artificial devices used today like silicone implants.”

While there is no data on the subject, Harel wrote that the most popular plastic surgery procedures in Israel are breast augmentations, rhinoplasties, liposuction, eyelid surgeries and facelifts. This exactly mirrors the favorite choices of Americans,  according to a 2012 report by the American Society of Plastic Surgeons (ASPS).

Leviav pointed out in an e-mail that there are most likely similarities between the two countries because Dr. Leo Bornstein, an American, founded the first plastic surgery department in Israel, and many Israeli plastic surgeons are trained in America.

Although Americans and Israelis desire the same surgeries, there are some differences.

“In the U.S., women seeking breast augmentations ask for bigger sizes than Israelis,” Harel wrote. “In Israel, the average patient asks for a normal and ‘not surgical’ looking nose, while in the U.S. there is a large amount of such patients that ask for a ‘cute and small nose.’ ”

Here in the United States, the popularity of cosmetic procedures continues despite recent rough economic times. Last year, the ASPS report reveals, more than 14.5 million people underwent a procedure of some kind, including Botox. And while surgical procedures were down 16 percent since 2000, overall (including minimally invasive procedures), business was booming — up 98 percent during the same period.

Botox was by far the most popular non-surgical procedure,  with 6.1 million patients choosing it. Since 2000, the two biggest increases were in upper-arm lifts (skyrocketing 4,473 percent, from 338 in 2000 to 15,457 last year) and lower-body lifts (up 3,360 percent from a mere 207 to 7,163). 

Dr. Michael Salzhauer, who practices in Miami, attributed the explosion in arm and lower-body lifts to the obesity problem in America. 

“As the population has gotten fatter and fatter, more people have turned to gastric bypass and plastic surgery,” he said. “When you lose more than 60 pounds, you have a lot of extra skin. Nobody likes extra skin, especially in the arms. Because there are so many more people that have lost weight, they need those operations more and more.”

Salzhauer said he believes that facelifts are popular because of the baby boomer population. But Dr. Jason Diamond said that where he practices, in Beverly Hills, many of the facelift patients are in their 40s. The average age of his patients, he said, is going down. 

“They say, ‘Why wait till I’m 55 if I don’t like my neck now at 45? Why don’t I enjoy the next 10 years?’ People think that way now, and they know with the right doctor they will get the exact results they want.”

The Botox industry is booming, said Diamond, because it costs a patient $300 to $2,500, as opposed to $8,000 to $10,000 for a facelift. It is also preventative and used to treat migraines. 

Dr. Al Aly, a member of the ASPS at the University of California, Irvine, said Botox is popular due to the lack of risk it presents. 

“There’s a huge psychological push these days to accomplish things through non-surgical means. It is very effective with very low risk.”

In terms of his female Jewish patients, Salzhauer said that they go for mommy makeovers, which include breast lifts and tummy tucks after they’ve had children. Diamond said he sees a lot of Jewish girls just graduating high school who come in for a nose job, which can run $20,000. 

Plastic surgery, no matter what the procedure, will remain a lucrative and thriving industry because, Diamond said, it can improve one’s life and status. 

“It’s very important for people for their jobs and social lives. It’s a competitive world and people understand how important it is to look good.”

But what procedures are en vogue depends on time and place — whether it’s Hollywood, Haifa or somewhere else — and reflects different societies’ standards of beauty, according to Leviav. 

“The way we and society sees us, whether we are handsome and beautiful, is a question of education and culture,” he wrote. “In the extreme, a short fat green woman with sharp yellow teeth and red eyes may look a monster to us, but is Miss Universe of her world on Vega. In some African tribes, a lady weighing less than 250 pounds will not find a husband. Culture definitely influences how we want to look.”