Cosmetic and Plastic Surgery Explained with Dr. Josh Waltzman

What Age Should You Start Preventative Botox®?

You don't have to wait until age has set in to get Botox®. People in their mid-twenties can use Botox as “prejuvenation," to prevent such features as the ingrained line in the forehead or lines around the eyes. Botox can soften the appearance of lines between the brows or around the eye area before they’ve become noticeable.

How Long Does Botox® Typically Last?

On average, Botox® lasts about three months, though some people may get more time and some may get less. Patients who are super active and athletic may metabolize Botox more quickly than others.

Are There Long Term Side Effects From Using Botox®?

The most common side effects occur in people who have used Botox® for years, even decades, including muscle atrophy or tolerance to the product. Sometimes this means patients will require less product, as muscles have essentially shrunk; other times, it means the product may not be as effective on the skin. It may be necessary to switch to another neurotoxin such as Juvederm®, Xeomin® or Dysport®.

What Is the Difference Between Hyaluronic Acid and Botox® Injections?

Botox® falls into a category called neurotoxins, which are essentially wrinkle reducers. When injected into the muscle, Botox® and other neurotoxins temporarily paralyze the muscle for about three months, reducing the effects of wrinkles.

Hyaluronic acid is a type of filler, or plumper, which volumizes the skin and the tissues. The most well known brands of hyaluronic fillers are Juvederm®, Restalyn, and HRA fillers. Because hyaluronic acid is a naturally occurring substance in the body, which means the body doesn't recognize it as foreign, making it easy for bodies to tolerate. You can also reverse the effects of this product with another medication in about 24 to 48 hours.

How Often Should You Get Fillers?

Filler frequency depends on the part of the face and the type of filler product that you're having injected. Less movable parts of the face, such as cheeks, need less filler. Parts such as lips require more, about every four to six months, depending on what type of look you are trying to maintain. Patients should be able to get nine to twelve months out of some of the longer lasting fillers in less moving parts.

Injecting your own fat is a permanent filler. A small amount will dissolve or break down after about four to six months, but what remains will be permanent.

How Invasive Is a Facelift?

A facelift is a very broad term for a lot of different procedures. A facelift could be a mini facelift or a “lunchtime lift," where the surgeon makes a little incision in front of the ear, undermines the cheek and then lifts the tissues and closes along the ear. Or a facelift could involve a complete lower facelift which means addressing laxity all the way down through the neck, a much more involved procedure.

You should talk to a surgeon to understand the differences, and to find out how much recovery is involved in your desired facelift.

How Long Do Facelifts Last?

In general, the more aggressive and involved the procedure is, the longer the results are going to last. Small incisions and less releasing of the facial ligaments will probably last about three to five years. A full lower facelift can last around 10 to 12 years.

Preparing for a Facelift

First, you have to be a good surgical candidate, which means you:

• Have a healthy BMI
• Don't smoke
• Don't have major medical problems
• Eat healthy, don't crash diet
• Eat a diet high in healthy proteins
• Some surgeons may start their patients on a professional grade skincare routine, months before the procedure. This can help to blend skin tone, remove dead skin layers and brighten skin tone before the facelift.

What Is A Mommy Makeover?

The term is a catchall phrase for helping restore a patient to their pre-baby body. This typically involves a procedure for the breasts, such as an augmentation or lift, and some procedure on the abdomen, such as abdominal liposuction or a full abdominoplasty. You can expect about three to four weeks of recovery time after a Mommy Makeover.

What is the Difference Between Liposuction and a Tummy Tuck?

Liposuction is a procedure to surgically remove fat from the body by sucking out fat cells with a metal cannula connected to a vacuum.

A tummy tuck, or abdominoplasty, is a more invasive surgical procedure that treats the entire front of the abdomen. Most of the skin and tissue between the belly button and the pubic area gets removed and then the rest of the abdominal skin is pulled down like a window shade, and reattached. In some cases, the rectus muscles of the stomach are also sewn together to prevent bulging.

What Is the Difference Between a Breast Lift and Breast Implants?

A breast implant augments, or increases the size of your breasts by insertion of either a silicone or saline implant. A breast lift is a procedure to elevate the nipple position, which can change over time due to gravity, breastfeeding, pregnancy and so on. Implants will not achieve the same effects as a breast lift.

What Are the Benefits of Breast Reduction Surgery?

Large breasts can cause symptoms such as neck strain, back pain, bra strap grooving, rashes and chafing beneath the breast folds. Large breasts can also make it difficult to find clothing that fits. Breast reduction surgery can reverse all of those effects.

How Should You Shop for a Cosmetic Surgeon?

In addition to talking to friends and colleagues for referrals, you want to find a qualified plastic surgeon who is a member of a professional society such as The American Society for Plastic Surgeons and/or The American Board of Plastic Surgery. If a surgeon does not have privileges to operate in an operating room or privileges at a local hospital to do those types of procedures, that should be a giant red flag.

Dr. Waltzman advises to do more than just research a plastic surgeon, make a consultation to talk with one or several to get a gut reaction on which doctor is right for you.

CareCredit Financing for Plastic Surgery Procedures

Ready to revitalize your appearance and boost your confidence? The CareCredit credit card makes it easy to pay for plastic surgery procedures and related expenses not covered by health insurance.** Apply today and use our Acceptance Locator to find a doctor or cosmetic surgeon near you that accepts CareCredit so you can stop dreaming and start living your best life. Continue your wellness journey by downloading the CareCredit Mobile App to manage your CareCredit account, find a provider on the go, and easily access the Well U hub for more great articles, podcasts, and videos.

Author Bio

Jordan Rosenfeld has been freelance writing for 21 years about finances, health, education and more, and is the author of 9 books. Her work has appeared in The Atlantic, The Billfold, GoBanking Rates, Daily Worth, Quartz, Medical Economics, The New York Times, Paypal, The Washington Post and more.

Meet The Expert

Dr. Josh Waltzman is a board-certified plastic surgeon practicing at The Waltzman Institute in Long Beach, California. After graduating magna cum laude from the University of Southern California, Dr. Waltzman attended the University of California Irvine School of Medicine and a dual degree MD/MBA program at the Paul Merage School of Business. He then completed his plastic surgery residency at the University of Rochester in New York. Dr. Waltzman specializes in cosmetic surgery of the face, breast, and body, with an emphasis on facial rejuvenation.

He has been practicing medicine for 14 years and opened his office in Long Beach in 2015. Over the years, he has written book chapters and has published his research in various prestigious medical journals.