October 8, 2024 • 15 mins
If you want better results from your anti-aging efforts, planning ahead is key. Teaming up with a plastic surgeon can help you restore right when it's needed, not when it's screaming to be done.
While restorative treatments become more essential with age, prevention and maintenance are crucial at every stage. Dr. Bass explains the importance of creating a personalized anti-aging plan that works with your budget.
Find out how to know when it's time for surgical interventions like facelifts or neck lifts, how to reverse early signs of skin laxity, and the best body contouring procedures for the stubborn areas that don't respond to diet and exercise.
Links
Learn more about facelift, MyEllevate, and laser skin resurfacing
About Dr. Lawrence Bass
Innovator. Industry veteran. In-demand Park Avenue board certified plastic surgeon, Dr. Lawrence Bass is a true master of his craft, not only in the OR but as an industry pioneer in the development and evaluation of new aesthetic technologies. With locations in both Manhattan (on Park Avenue between 62nd and 63rd Streets) and in Great Neck, Long Island, Dr. Bass has earned his reputation as the plastic surgeon for the most discerning patients in NYC and beyond.
To learn more, visit the Bass Plastic Surgery website or follow the team on Instagram @drbassnyc
Subscribe to the Park Avenue Plastic Surgery Class newsletter to be notified of new episodes & receive exclusive invitations, offers, and information from Dr. Bass.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to Park AvenuePlastic Surgery Class,
a podcast where we explore controversiesand breaking issues in plastic surgery.
I'm your co-host, Doreen Wu,
a clinical assistant at BassPlastic Surgery in New York City.
I'm excited to be here with Dr. LawrenceBass, Park Avenue plastic surgeon,
educator, and technology innovator.
(00:21):
The title of today'sepisode is "Maintain vs.
Restore." I understand this title,it's more straightforward than usual,
but perhaps you can explain theintent behind this episode, Dr. Bass.
Basically this is an episodeabout planning and it's another
way of thinking about theneed to plan and how to
(00:43):
plan so you get the mostout of your plastic surgery,
you get the most out of whatever yourbudget might be and however much time you
can invest in the process.
I see. I think I knowwhere we're going here.
So let's get into the meat of the topic.What are the options that we have?
So in reconstructive plastic surgery,
(01:05):
we classically have thisreconstructive ladder.
We start with thesimplest, easiest things,
the smallest surgery with the least risk,
and based on the severity of the problem,
we progress.
If a simple reconstructionis not likely to work,
(01:27):
we pick something more complex,
but we don't start with themost complex reconstruction.
So in aesthetics, I meanwe're not reconstructing,
but let's use the word restore so we can
do things to fix somethingthat's already gone
awry. Some aging has taken place.
(01:49):
It's something that wedon't like looking at.
It's visible. We see it,
our friends and coworkers see it,
so we have to change something.
Ideally before we get to that point,
we're doing things tomaintain our appearance,
(02:10):
to keep us from aging or let us
age at the slowest rate possibleand things to prevent aging,
and so it's not one or the
other. We're obviously goingto do several things and
(02:30):
early in the game,
we're going to do things to prevent andthen we're going to do some prevention
and maintenance,
and eventually we're going to have todo some prevention and maintenance with
some restoration.
And that could be surgicalor it could be nonsurgical,
but some kind of treatment that'sactually going to fix a problem.
(02:50):
And so we're going toslowly progress to more
restoration as we age,
but we're still going to needprevention and maintenance.
So it's not one or the other.
There's a balance and that balance shifts.
And how does that change orshift depending on your age?
(03:12):
So as I mentioned,
we're going to start off withprevention and we're going to add on and
we'll start abandoning treatmentsand maintenance things that
are no longer helpful. There are afew things that kind of drop off,
but mostly we're adding newthings, either bigger treatments,
(03:33):
but we're keeping some of theprevention and maintenance.
And so an example might be like sunscreen,
that's prevention andyou're going to add to that,
but you're not going tostop using sunscreen.
So now let's put aside age.
Can you give me some overarching guidingprinciples for how planning should be
done regardless of age?
(03:54):
Well you start with what your needs are,
what you're starting to see or beautyissues that you're most concerned with.
And everyone's a little different.Some people come in and they say,
I don't mind my crow's feet. I earnedthem, but I hate that loose skin.
I'm starting to get undermy chin or the jowl.
I'm starting to see other patientssay, I hate the crow's feet,
(04:18):
but I don't mind my jawline.
And other people come inand say, fix everything.
So it starts with what you areseeing and what bothers you,
and you intersect that with your budget
and an assessment by your plastic
surgeon about what theplastic surgeon sees
(04:44):
and what's a prominent featurein your appearance at this time.
The other thing that the plasticsurgeon can help you with,
because you may not knowquite as well as someone who
spent 20, 30 years working on aging faces,
you may not know what's coming soon,
(05:04):
but your plastic surgeon probably does.And so that's
useful to help you with planning.
You don't want to do an energy-based skinlifting treatment if you think you're
doing a minimally invasivetreatment for your neck in the
next year,
you're going to save that money andbudget it towards the minimally invasive
(05:28):
procedure.
So you wouldn't do ulthera or softwave if you know you're going to
be doing something like myEllevateor submentoplasty something
surgical in the next year because you
know you're getting to that point whereyou're going to have to pull the trigger
on something surgical so yourplastic surgeon can advise you
(05:51):
what features are starting to show,
what features are likely toshow in the next few years,
and that helps you set priorities.
You've alluded to some proceduresrelated to the face so far,
but can you now tell us howdoes planning work in the face
area and the neck,
and can you give us some common examplesto help us understand more clearly?
(06:16):
So let's start with laxity.
Laxity is the ultimateconcern that we end up with
sooner or later loose skin in the
jawline, the gel hanging in the neck.
And so the big question isalways when is it time for the
facelift or the neck lift?
(06:37):
And some people are hoping they'renever going to have to do it.
For people that are intheir twenties, thirties,
I don't know what the options are goingto be when they get to the stage where
they might need it. Forpeople who are somewhat older,
somewhere between now andthe time you're a hundred,
if you want to look your best,
(06:58):
you're going to need thatsurgical facelift or neck lift.
Now you may choose never to do it,
but medically there isn't going to beany other way to meaningfully correct
that. However,
before we get to that point wherewe have a great deal of redundant
skin,
we have a lot of ways of reversing or
(07:20):
restoring some of the skin laxity and
maintaining that.So going forward you age more slowly.
And so that starts with externallyapplied energy, things like Ultherapy
and Sofwave,
internally applied energy designed tostimulate the skin to tighten up things
(07:43):
like FaceTite, AccuTite,
things like minimally invasiveprocedures that are done under local
anesthesia, through needle punctures,
thread lifts and MyEllevate,
which has very good durabilityand the greater degree of
(08:04):
correction.
And then eventually you're intothe formal surgical lifting.
Skin surface changes are another examplewhere there's this wide array and
sort of a progression.
So as you start to see roughtexture wrinkles in the skin,
you may be using home skinproducts and that makes sense,
(08:26):
retinoid or a growth factor product.
And of course we already said you're usingyour sunscreen since you were in your
twenties or hopefullysince your childhood.
But then when you startto see more things,
you need to get somethingmedical into the program.
It may be a series of in-office,
(08:48):
superficial chemical peels.
It may be energy-based treatmentslike radiofrequency microneedling
or fractional laser resurfacing.
And by ironing out small
changes,
we hope we can put offor possibly avoid the
(09:10):
need for deep chemical peel or a full
field deep laser resurfacing,
which has significantrecovery associated with it.
Now if you're 80 and youlived in Florida your whole
life and there was no sunscreenwhen you were a child,
you might need that fullfield laser resurfacing.
(09:35):
But if you're 40 or 50 andyou're doing some of these
light peels, energy based restorations,
and then you every once ina while do a little bit to
maintain that in termsof in-office treatment,
you may be able to avoid ever goingfor that big laser resurfacing.
(09:57):
So things like that illustratehow that maintenance is
both part of the plan beforeand after a big treatment,
but may modulate whether or notyou need the big treatment and
certainly modulates whenyou are going to need it.
So we've covered the progressionof treatments in the face.
(10:19):
How does this work on the body?
So body contouring is one of
several components that arepart of a lifestyle if you're
concerned about keeping yourbody shape in a range that you
find attractive. So it'spartly about sensible diet.
(10:40):
It's partly about acertain amount of exercise,
but there's certain stubborn areas thatare just notorious for not dieting or
exercising where that evenvery trim and fit people will
manifest, and that's what bodycontouring is ideally for.
There are surgical options likeliposuction, tummy tucks, thigh lifts,
(11:03):
there, non-surgical optionslike CoolSculpting, SculpSure
and several others,
but all of these aregoing to knock a shape
back where you want it. That'skind of come out of range.
So everyone walks around thinking, okay,
(11:24):
I'm just going to get my shape the wayI want it and then I'm good forever
and realistically, that'snot how life works.
Everybody has more thanone shape challenge
or contour challenge in their lifetime.Maybe you get pregnant,
maybe you sprain an ankle anddon't go to the gym for a month or
(11:48):
two.
Maybe you're busy at work or havesome life stress and eating more than
usual and exercising less.
So it's always a continuous
process of maintenancebecause the body is always
changing and in particularat different life stages,
(12:09):
you're going to have a differentbody shape even if your weight on the
scale is exactly stable,
your body shape is going to change,
particularly at pregnancy andmenopause, big shape changes.
I have ladies that come into my officelighter than they were before they had a
baby,
but their body shape is differentand it's different in ways they don't
(12:34):
always like that we haveto chase a little bit.
So that's a little bit of howmaintenance and restoration work
in body contouring.
Lastly, Dr. Bass, before we wrap up,
can you give our listeners someparting takeaways from this episode?
Yes. Again, it's aboutthis thought process,
(12:55):
how you're going to do things. Sofirst, recognize that planning is key.
You're going to be more efficient,
get much more out ofwhat you're trying to do,
be much more successful at achievingyour goals If you spend a little
bit of time and effort planningwith your plastic surgeon,
(13:15):
prevention is essential.
These are lifestyle choices thatwe hopefully adopt early in life
and maintain eating sensibly, not smoking,
wearing sunscreen.
Just certain basic practicalthings that contribute to our
health and wellbeing alsocontribute to a great extent to our
(13:38):
appearance.
Maintenance is a great idea anddedicating some time and budget to
maintenance activities is a good thing,
but you don't want to be soobsessed with maintenance that you
disrupt your life. I'm in NewYork, New Yorkers are busy.
(13:58):
Most of us don't want to play withour skin for three hours a day,
but if you put on a product after washingup in the morning and you put on a
product after washing up before bed,
you can probably do 90% ofwhat you could do with a much
more extensive regimen. Finally,
(14:19):
try to restore when it's needed,
not when it's screaming to be done.You get less return on the investment.
If a restoration is donevery late in the game,
it's not going to correct as completely,
it's not going to correct asdurably if you wait till it's
(14:40):
screaming to be done.
It's much more practical to say,
I know I'm going to do it sooner or later.
And when you are noticing the changes that
translate to a particular procedure,
then you resign yourself thatit's time to proceed. And again,
your plastic surgeon is your bestadvisor when these things are
(15:04):
appropriate and when it's too soonand you don't want to use your
big playing card yet.
Many important pointsthat were raised there.
Thank you Dr. Bass for sharingyour insight and expertise with us.
Thank you for listening to the ParkAvenue Plastic Surgery Class podcast.
Follow us on ApplePodcasts, write a review,
(15:25):
and share the show with your friends.
Be sure to join us next time to avoidmissing all the great content that's
coming your way. If you want tocontact us with comments or questions,
we'd love to hear from you.
Send us an email at podcast@drbass.netor DM us on Instagram @drbassnyc.
Welcome to Park AvenuePlastic Surgery Class,
a podcast where we explore controversiesand breaking issues in plastic surgery.
I'm your co-host, Doreen Wu,
a clinical assistant at BassPlastic Surgery in New York City.
I'm excited to be here with Dr. LawrenceBass, Park Avenue plastic surgeon,
educator, and technology innovator.
(00:21):
The title of today'sepisode is "Maintain vs.
Restore." I understand this title,it's more straightforward than usual,
but perhaps you can explain theintent behind this episode, Dr. Bass.
Basically this is an episodeabout planning and it's another
way of thinking about theneed to plan and how to
(00:43):
plan so you get the mostout of your plastic surgery,
you get the most out of whatever yourbudget might be and however much time you
can invest in the process.
I see. I think I knowwhere we're going here.
So let's get into the meat of the topic.What are the options that we have?
So in reconstructive plastic surgery,
(01:05):
we classically have thisreconstructive ladder.
We start with thesimplest, easiest things,
the smallest surgery with the least risk,
and based on the severity of the problem,
we progress.
If a simple reconstructionis not likely to work,
(01:27):
we pick something more complex,
but we don't start with themost complex reconstruction.
So in aesthetics, I meanwe're not reconstructing,
but let's use the word restore so we can
do things to fix somethingthat's already gone
awry. Some aging has taken place.
(01:49):
It's something that wedon't like looking at.
It's visible. We see it,
our friends and coworkers see it,
so we have to change something.
Ideally before we get to that point,
we're doing things tomaintain our appearance,
(02:10):
to keep us from aging or let us
age at the slowest rate possibleand things to prevent aging,
and so it's not one or the
other. We're obviously goingto do several things and
(02:30):
early in the game,
we're going to do things to prevent andthen we're going to do some prevention
and maintenance,
and eventually we're going to have todo some prevention and maintenance with
some restoration.
And that could be surgicalor it could be nonsurgical,
but some kind of treatment that'sactually going to fix a problem.
(02:50):
And so we're going toslowly progress to more
restoration as we age,
but we're still going to needprevention and maintenance.
So it's not one or the other.
There's a balance and that balance shifts.
And how does that change orshift depending on your age?
(03:12):
So as I mentioned,
we're going to start off withprevention and we're going to add on and
we'll start abandoning treatmentsand maintenance things that
are no longer helpful. There are afew things that kind of drop off,
but mostly we're adding newthings, either bigger treatments,
(03:33):
but we're keeping some of theprevention and maintenance.
And so an example might be like sunscreen,
that's prevention andyou're going to add to that,
but you're not going tostop using sunscreen.
So now let's put aside age.
Can you give me some overarching guidingprinciples for how planning should be
done regardless of age?
(03:54):
Well you start with what your needs are,
what you're starting to see or beautyissues that you're most concerned with.
And everyone's a little different.Some people come in and they say,
I don't mind my crow's feet. I earnedthem, but I hate that loose skin.
I'm starting to get undermy chin or the jowl.
I'm starting to see other patientssay, I hate the crow's feet,
(04:18):
but I don't mind my jawline.
And other people come inand say, fix everything.
So it starts with what you areseeing and what bothers you,
and you intersect that with your budget
and an assessment by your plastic
surgeon about what theplastic surgeon sees
(04:44):
and what's a prominent featurein your appearance at this time.
The other thing that the plasticsurgeon can help you with,
because you may not knowquite as well as someone who
spent 20, 30 years working on aging faces,
you may not know what's coming soon,
(05:04):
but your plastic surgeon probably does.And so that's
useful to help you with planning.
You don't want to do an energy-based skinlifting treatment if you think you're
doing a minimally invasivetreatment for your neck in the
next year,
you're going to save that money andbudget it towards the minimally invasive
(05:28):
procedure.
So you wouldn't do ulthera or softwave if you know you're going to
be doing something like myEllevateor submentoplasty something
surgical in the next year because you
know you're getting to that point whereyou're going to have to pull the trigger
on something surgical so yourplastic surgeon can advise you
(05:51):
what features are starting to show,
what features are likely toshow in the next few years,
and that helps you set priorities.
You've alluded to some proceduresrelated to the face so far,
but can you now tell us howdoes planning work in the face
area and the neck,
and can you give us some common examplesto help us understand more clearly?
(06:16):
So let's start with laxity.
Laxity is the ultimateconcern that we end up with
sooner or later loose skin in the
jawline, the gel hanging in the neck.
And so the big question isalways when is it time for the
facelift or the neck lift?
(06:37):
And some people are hoping they'renever going to have to do it.
For people that are intheir twenties, thirties,
I don't know what the options are goingto be when they get to the stage where
they might need it. Forpeople who are somewhat older,
somewhere between now andthe time you're a hundred,
if you want to look your best,
(06:58):
you're going to need thatsurgical facelift or neck lift.
Now you may choose never to do it,
but medically there isn't going to beany other way to meaningfully correct
that. However,
before we get to that point wherewe have a great deal of redundant
skin,
we have a lot of ways of reversing or
(07:20):
restoring some of the skin laxity and
maintaining that.So going forward you age more slowly.
And so that starts with externallyapplied energy, things like Ultherapy
and Sofwave,
internally applied energy designed tostimulate the skin to tighten up things
(07:43):
like FaceTite, AccuTite,
things like minimally invasiveprocedures that are done under local
anesthesia, through needle punctures,
thread lifts and MyEllevate,
which has very good durabilityand the greater degree of
(08:04):
correction.
And then eventually you're intothe formal surgical lifting.
Skin surface changes are another examplewhere there's this wide array and
sort of a progression.
So as you start to see roughtexture wrinkles in the skin,
you may be using home skinproducts and that makes sense,
(08:26):
retinoid or a growth factor product.
And of course we already said you're usingyour sunscreen since you were in your
twenties or hopefullysince your childhood.
But then when you startto see more things,
you need to get somethingmedical into the program.
It may be a series of in-office,
(08:48):
superficial chemical peels.
It may be energy-based treatmentslike radiofrequency microneedling
or fractional laser resurfacing.
And by ironing out small
changes,
we hope we can put offor possibly avoid the
(09:10):
need for deep chemical peel or a full
field deep laser resurfacing,
which has significantrecovery associated with it.
Now if you're 80 and youlived in Florida your whole
life and there was no sunscreenwhen you were a child,
you might need that fullfield laser resurfacing.
(09:35):
But if you're 40 or 50 andyou're doing some of these
light peels, energy based restorations,
and then you every once ina while do a little bit to
maintain that in termsof in-office treatment,
you may be able to avoid ever goingfor that big laser resurfacing.
(09:57):
So things like that illustratehow that maintenance is
both part of the plan beforeand after a big treatment,
but may modulate whether or notyou need the big treatment and
certainly modulates whenyou are going to need it.
So we've covered the progressionof treatments in the face.
(10:19):
How does this work on the body?
So body contouring is one of
several components that arepart of a lifestyle if you're
concerned about keeping yourbody shape in a range that you
find attractive. So it'spartly about sensible diet.
(10:40):
It's partly about acertain amount of exercise,
but there's certain stubborn areas thatare just notorious for not dieting or
exercising where that evenvery trim and fit people will
manifest, and that's what bodycontouring is ideally for.
There are surgical options likeliposuction, tummy tucks, thigh lifts,
(11:03):
there, non-surgical optionslike CoolSculpting, SculpSure
and several others,
but all of these aregoing to knock a shape
back where you want it. That'skind of come out of range.
So everyone walks around thinking, okay,
(11:24):
I'm just going to get my shape the wayI want it and then I'm good forever
and realistically, that'snot how life works.
Everybody has more thanone shape challenge
or contour challenge in their lifetime.Maybe you get pregnant,
maybe you sprain an ankle anddon't go to the gym for a month or
(11:48):
two.
Maybe you're busy at work or havesome life stress and eating more than
usual and exercising less.
So it's always a continuous
process of maintenancebecause the body is always
changing and in particularat different life stages,
(12:09):
you're going to have a differentbody shape even if your weight on the
scale is exactly stable,
your body shape is going to change,
particularly at pregnancy andmenopause, big shape changes.
I have ladies that come into my officelighter than they were before they had a
baby,
but their body shape is differentand it's different in ways they don't
(12:34):
always like that we haveto chase a little bit.
So that's a little bit of howmaintenance and restoration work
in body contouring.
Lastly, Dr. Bass, before we wrap up,
can you give our listeners someparting takeaways from this episode?
Yes. Again, it's aboutthis thought process,
(12:55):
how you're going to do things. Sofirst, recognize that planning is key.
You're going to be more efficient,
get much more out ofwhat you're trying to do,
be much more successful at achievingyour goals If you spend a little
bit of time and effort planningwith your plastic surgeon,
(13:15):
prevention is essential.
These are lifestyle choices thatwe hopefully adopt early in life
and maintain eating sensibly, not smoking,
wearing sunscreen.
Just certain basic practicalthings that contribute to our
health and wellbeing alsocontribute to a great extent to our
(13:38):
appearance.
Maintenance is a great idea anddedicating some time and budget to
maintenance activities is a good thing,
but you don't want to be soobsessed with maintenance that you
disrupt your life. I'm in NewYork, New Yorkers are busy.
(13:58):
Most of us don't want to play withour skin for three hours a day,
but if you put on a product after washingup in the morning and you put on a
product after washing up before bed,
you can probably do 90% ofwhat you could do with a much
more extensive regimen. Finally,
(14:19):
try to restore when it's needed,
not when it's screaming to be done.You get less return on the investment.
If a restoration is donevery late in the game,
it's not going to correct as completely,
it's not going to correct asdurably if you wait till it's
(14:40):
screaming to be done.
It's much more practical to say,
I know I'm going to do it sooner or later.
And when you are noticing the changes that
translate to a particular procedure,
then you resign yourself thatit's time to proceed. And again,
your plastic surgeon is your bestadvisor when these things are
(15:04):
appropriate and when it's too soonand you don't want to use your
big playing card yet.
Many important pointsthat were raised there.
Thank you Dr. Bass for sharingyour insight and expertise with us.
Thank you for listening to the ParkAvenue Plastic Surgery Class podcast.
Follow us on ApplePodcasts, write a review,
(15:25):
and share the show with your friends.
Be sure to join us next time to avoidmissing all the great content that's
coming your way. If you want tocontact us with comments or questions,
we'd love to hear from you.
Send us an email at podcast@drbass.netor DM us on Instagram @drbassnyc.
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