Beauty

The 5 Most-Asked Questions at the Plastic Surgeon’s Office (Answers Included)

Written by: Jean Godfrey-June

|

Published on: October 29, 2024

post__featured-image

Celebrities are used to being mobbed, but at a recent dinner at The Chateau Marmont in West Hollywood, it was the celebrities doing the mobbing. Their target? Renowned plastic surgeon Dr. Julius Few, in town to open a new branch of the Chicago-based Few Institute. “Doctors joke about getting cornered at a party by people with questions,” he laughs. “It happens to all of us.” From the looks of it, specializing in plastic surgery (and being tall and handsome to boot) definitely exacerbates the problem.

Like other plastic surgeons, the questions Few gets asked most (at parties, yes, but also in consultations in his offices in Chicago and LA) touch on actual surgery of course, but also in-office dermatological procedures and at-home skin treatments. Unlike some of his colleagues, Few’s a big fan of non-surgical interventions, and often conducts clinical studies on the effects of both in-office procedures like lasers and fillers, as well as topical products like the bestselling Peptide Serum he and his team worked with goop on last year.

  1. goop Beauty
    Youth-Boost Peptide Serum
    goop, $150/$135 with subscriptionSHOP NOW
  2. Dr. Few Skincare
    Tinted Mineral Sunscreen SPF 30
    goop, $85SHOP NOW

“There’s a lot you can do to stave off—or sometimes totally avoid—a facelift, from really taking care of your skin with topical treatments and sunscreen to a real range of clinical therapies,” says Few. “In-office technologies like thread lifting, ultra-sound and radio-frequency, neuromodulators like Botox and fillers can make a world of difference.” Here, the 5 questions Few says people ask him most often—along with his answers.

 


 

1

When Is it Too Early for a Facelift?

In a world of “baby Botox” and lip fillers for people still in their teens, Few hears patients asking about facelifts earlier and earlier. “They wonder whether they’re better off to do a facelift when they barely need it, or whether they should wait,” he says. Here’s what he tells them: If you’re in your 20s or 30s, “The surgery can be loaded with risk,” he says. “Younger skin scars less predictably, the results do not last as long, and there will be scar tissue to potentially complicate future surgery needs. There are only very special circumstances—massive weight loss, reconstruction after injury, salvaging of overdone non-surgical cosmetic treatments—where it might make sense in your 30s,” he says. “If you’re in your 40’s and have premature lower facial aging, facelifting can be a powerful tool that lasts a long time—a decade or more.”

 


 

2

What’s the Best Way to Prevent or Delay the Need for Plastic Surgery?

The lowest hanging fruit to prevent/delay plastic surgery is good, medical-grade skin care. “The most powerful and studied topical agents are retinoids like Retin A and retinol,” says Few. “I designed our retinol to be medical grade, free of irritants that can cause redness and irritation, and deliver clinically tested and published results that prevent visible signs of aging on the skin surface. In addition, retinol combined with other minimally invasive and non surgical treatments on the face like Botox, threads, or Sofwave, can work synergistically towards reducing the visible signs of aging.”

  1. Dr. Few Skincare
    Clean Retinol
    goop, $195SHOP NOW

A good moisturizer keeps skin looking plump and supple, while mineral sunscreen helps prevent sun damage that shows up as aging on skin.

  1. goop Beauty
    All-in-One Nourishing Face Cream
    goop, $105/$86 with subscriptionSHOP NOW
  2. Iris & Romeo
    Weekend Skin SPF 50 + Vitamin C + Glow
    goop, $50SHOP NOW
  3. Dr. Few Skincare
    Moisture Complete
    goop, $95SHOP NOW

 


 

3

Can Non-Surgical Cosmetic Treatments Make Surgery More Difficult in the Future?

It depends, Few says. “When a patient is over-treated with filler/non surgical applications—like we see in mega volume filler sessions to ‘lift the cheeks’ to the point that it looks unnatural—this can prematurely age the tissue, creating a tissue reaction and possible scar tissue, distorting the tissue planes for future surgery,” he says. “But in moderation, there is no issue with these technologies whatsoever—in fact, they can benefit the patient for future surgery, especially someone who has very thin skin.”

 


 

4

How Do I Pick The Right Plastic Surgeon?

“More important than what type of facelift a surgeon does, the qualifications a surgeon has is critical,” says Few, noting that making sure the plastic surgeon is board certified by the American Board of plastic surgery or facial plastic surgery is an essential step. “I’d add extra credit if the surgeon has had fellowship training in the area you’re looking to treat,” he says. “For example, my expertise and fellowship work has been in cosmetic and reconstructive surgery around the eye and face. It is important to ask the surgeon about their experience, risk and benefits for surgery, and how they manage unexpected results. Even better, go to a surgeon who’s comfortable with and offers non-surgical options for rejuvenating the face and neck because then you know those options that will be presented if they’re what’s needed, rather than, say, a full facelift.”

 


 

5

Are Fillers Bad?

The short answer: “No,” says Few, allowing that the full answer is more complex. “To say that would be like saying that cars are bad, given so many deaths occur each year while people are driving them. The reality is that how they are used makes the difference. Fillers have been used for more than 20 years and only in the past 5 have concerns been raised.

“As a person who helped develop some of the fillers on the market, I believe there are real reasons why we are seeing issues recently. To begin, there have been physicians and injectors out there suggesting an excessive amount of filler—10, 12, 15 syringes be used on someone’s face at one time. This is outrageous and in my personal opinion has no place in a cosmetic practice for the typical person.

“But in addition, the idea of using filler to ‘lift’ someone’s face is flawed—filler cannot replace a facelift. And filler lasts a long time, longer than we originally thought, and can affect movement of facial muscles. So less filler is definitely more, and less frequent filler is better in many cases.”

Bottom line: filler should never be visible. “If you can see it when the face moves or you smile, it’s too much,” says Few. Hold off on more until the issue has really calmed down, and consider having the filler dissolved, he continues. “I often have a patient coming from another clinic or spa with far too much filler, convinced that they need even more to look better—when in fact I need to dissolve their filler to make it better.”