Timeless Beauty: Why Planning is Crucial to Maintaining the Aging Face

Doreen Wu (00:00):
Welcome to another episode of Park Avenue Plastic Surgery Class, the podcast where we explore controversies and breaking issues in plastic surgery. I'm your co-host Doreen Wu. And I'm excited to be here with Dr. Lawrence Bass Park Avenue plastic surgeon, educator and technology innovator. The title of today's episode is timeless beauty. Why planning is crucial to maintaining the aging face. I wanna look my best after all I'm out and about in Midtown Manhattan every day, everyone looks so well dressed and groomed and beautiful. I wanna keep up, but I'm a busy New Yorker. How do I get it done without investing hours into daily beauty care?

Dr. Lawrence Bass (00:44):
Well, this is the a perfect example of an ounce of prevention by taking some basic steps to prevent aging changes, to maintain skin quality you can really get an awful lot of mileage and really maintain your appearance. So you can get a long way towards achieving your beauty goals in a minimum amount of time, money and intervention. If you just take a few basic steps and get in the game early,

Doreen Wu (01:22):
That all sounds great. How do I get started making this plan?

Dr. Lawrence Bass (01:26):
So the way to start is always to look at what you're seeing, what bugs you, what stands out in your appearance is maybe different from the way you looked a little bit younger. You may also look at selfies or look at yourself on zoom or FaceTime and start to notice various things showing that you didn't realize when you look at yourself in the mirror, brushing your teeth. So when you start to see things that are standing out, then you need to pick a provider to advise you and start chasing down those features before they become big issues.

Doreen Wu (02:08):
And I think that's the million dollar question. How do I select the right provider for me? What should I be looking for?

Dr. Lawrence Bass (02:16):
We've talked about this a bunch of times on this podcast. And just to review, you always want someone with excellent training, with a good block of experience, so that they've really refined their approach and a provider that's capable of providing multiple options, ideally both the surgical and non-surgical options. And of course you want to find someone who's a good listener. Who's really hearing what you are complaining about or what you are noticing rather than just trying to shoehorn you into their standard care plan and, and somebody who you feel comfortable with, who you'd really like to partner with in your care. Hopefully you're gonna spend time with this person over years, not, you know, hours every week, but cumulatively a lot of time. And so they should be someone you get along with and someone who you feel understands your beauty concerns and is as worried about them as you are

Doreen Wu (03:27):
Exactly. It should be a partnership where you and the provider are both listening to what your needs are, what your goals are and together creating a plan. So what kind of components are typically included in the beauty plan?

Dr. Lawrence Bass (03:40):
It really depends on where you are. What stage of aging. Obviously, if you're in your twenties, you're going to need a very different set of, of items than someone who's in their forties or their sixties. And it's also gonna be a product of what you've been doing leading up to it. But skin products are usually the first stop. These are products that protect the skin when you're outdoors from the elements, drying, ultraviolet exposure from sun as well as products that add a medication that helps the skin stay young, typically retinoids alpha and beta hydroxy acids, like glycolic acid growth factor products. There are a whole bunch of different products out there. And depending on your skin type and how your skin is behaving, just, you know, applying one or maybe two products a day, something in the morning and something before bedtime is probably the first step for folks in their twenties, thirties who want to protect their skin, maintain their skin. And when those things aren't enough, then you start to look at in-office energy based skin treatments and Botox and filler, which are mainstays of facial maintenance, even for people in their thirties and occasionally for people in their twenties surgery later on is where you get to eventually. But that's obviously not the first stop in making a beauty plan.

Doreen Wu (05:30):
Where does it go from there?

Dr. Lawrence Bass (05:32):
Well, you know, you've started off with some collection of treatments that are addressing the features. You are noticing the features that concern you. Ideally, you found a provider who you like, who you're comfortable with, and you stick with them. If they're a good fit because you and that provider, you're a plastic surgeon. Whoever you picked can look at your face together and decide how it's changing over time and decide how you're responding to the treatments you've been trying. If you're making a good response, okay, you stick with them. If you're making a response, but you need something better then you decide whether you need to add something or switch to a different treatment, but you can only do that if you and your plastic surgeon are looking at your face. And if every time you're someplace else, you're getting wherever the Groupon is this week. You're not going to have the chance to really look with that experience plastic surgeon and see what impact these treatments are having on your appearance. So that continuity is something that's really hard to come by in medicine today in general. But, but beauty treatments in plastic surgery is one of the places where you're still able to find that if you understand the real value of that kind of relationship,

Doreen Wu (07:06):
Now let's dive into some anecdotes. Dr. Bass, can you give me a few examples of how this works?

Dr. Lawrence Bass (07:13):
Sure. so one example that we see all the time and we're recording this, this particular podcast in may. So it's wedding season is someone coming in with, with a daughter's wedding or a son's wedding. And it makes a big difference. What kind of plan you can make, depending on when you're coming in. If the wedding is six to 12 months away, you pretty much have any option. You have surgical options, you have non-surgical options. It's basically whatever you need to look your best or to feel comfortable with your appearance. A lot of folks, unfortunately, don't plan ahead like that. And they show up a month or two before the wedding. Now at this point, very tough to do anything surgical. And a lot of folks in that situation would benefit from something surgical, which, you know, each individual might or might not be considering.

Dr. Lawrence Bass (08:19):
But if you were thinking maybe it's time to do the eyelid plasty or do the facelift. You're not going to have really a chance. If you come in a month before the wedding, there's barely time to do Botox and filler risking a bad bruise. You can't do that the week before the wedding, it's gotta be spaced out a couple of weeks in case you get unlucky and get a bruise. But the planning for what's going to work for your appearance really turns around how far from the wedding you showed up in the office. And not only what you look like or what stage of aging you're at. So that's one example.

Dr. Lawrence Bass (09:04):
I mean, another example is a person in their forties and they might be in the office getting their Botox and filler treatments. And they're not thinking about a facelift, you know, maybe not ever. And certainly not right now. They don't really need one and it's not on their radar. They know it might be out there somewhere in the future. But if they're starting to notice that there's some loose skin, that's the time to point out that change to your plastic surgeon? Not because they're going to try to arm twist you into doing a facelift in your forties when you don't really need it. But because that's the time when a little bit of, of maintenance care with one of the nonsurgical energy based lifting treatments like Ultherapy might benefit you. When you're 70, 80 years old, it's only about surgical lifting and the energy based treatments are usually not worthwhile in most individuals.

Dr. Lawrence Bass (10:09):
So this is the time when a little utilization of something like an energy based treatment to restore mild skin laxity or to prevent skin laxity is going to benefit you. And we've talked about this on the podcast before that, when I first went in practice over 25 years ago, the average facelift age was somewhere around 50. And now it's somewhere in the early to mid sixties. Why did that age change? Because people came in early before they needed something like a facelift and did a variety of treatments that maintained and restored the mild aging changes they were experiencing. And that allowed us to put off the bigger surgical interventions until much later chronologically in aging.

Dr. Lawrence Bass (11:09):
So, you know, again, you don't chase features if they're not bothering you, but at least it's useful to, to have that information and get a feel about what's going on. I'll give you another example. That's very commonplace. A lot of folks are coming in for Botox. They want a little bit of brow lifting because they feel like they're, they're browse are looking a little heavier, not quite as arched as they used to be. And it's, it's really important to have a good look with your provider at that and start planning. Because if you have a little bit of brow droopiness, you may be able to manage that with Botox for a number of years. But if your upper lid is starting to be very heavy in and of itself and have some extra skin laxity there, you may be headed towards eyelid plasty in the next few years.

Dr. Lawrence Bass (12:16):
And, you know, eyelid plasty is a procedure that's often needed in people even as early as their thirties or occasionally even earlier. Um, so you'd really like to know, are you planning towards an eyelid plasty know that that might be the needed option coming up in the next couple of years, or are you just gonna be coasting with Botox for years to come kind of a big difference? So it's better to know, not to guess, uh, show the plastic surgeon and hear what the options are. Even if you don't plan to pursue them or utilize them any time soon, it will help you plan and know which treatment can address, which feature what's happening in your face. It's your body. It's a good idea to know what's going on. And you can also get the real world answer about what having a given treatment might involve, what the recovery is like rather than what you imagine it to be or what somebody else friend or lay person might have told you. So again, it's just better to have that information

Doreen Wu (13:25):
Earlier in the episode, you briefly touched upon zoom, FaceTime and other video conferencing technology. What new things are helping to make this easier?

Dr. Lawrence Bass (13:36):
So there are a lot of advances in imaging and in 3d imaging that are making it easier for people to assess their appearance. Things like zoom and, and FaceTime may not show you in a particularly favorable way or a way that's even necessarily realistic, but medical imaging, which is designed to be very objective is useful in understanding what your appearance is like from there. There are a lot of apps on people's phones that are available for lay people, to retouch their appearance and see how they might look. If they looked a little different in addition to simulation software that surgeons used to show people what they might look like if they underwent one surgery or another. And so this gives people a chance to tinker with their appearance and see what they might look like if they had a certain feature on their face one way or another, and how much change in that feature might be a good thing versus too much of a change that looks a little overdone or a little obvious.

Dr. Lawrence Bass (15:00):
So that ability to sit at home in your leisure time and tinker with appearance, lets you commune and connect with your appearance in ways that weren't possible before those technologies existed. The things that are happening on the medical care side include things like sequential imaging with the ability to then demonstrate the aging changes over time. So you and your plastic surgeon can get a clearer idea of how your appearance is changing. Is something now starting to progress more rapidly or are features more or less stable, one feature or another, and doesn't really need to be addressed at this point in time, separate from that there are survey and artificial intelligence tools to help analyze these findings, analyze the features that your providers are seeing and that you may be concerned about to help prioritize on a rational basis, what program of care you should pursue.

Dr. Lawrence Bass (16:13):
And, you know, there are just tons of new options every year. It's very hard to sort out where should you prioritize? Where should you spend your beauty budget? And what is medically appropriate for the features that you're seeing? So these kind of tools make it easier to, again, objectively on a rational basis and reliably decide which things to incorporate. And this is part of the sort of research that I do and some of my interests in plastic surgery to help sort out and assimilate these new technologies in a way that makes sense, not based on, on the marketing promotion of the companies that are trying to sell them.

Doreen Wu (17:01):
Thank you, Dr. Bass. Well, this was certainly a thought provoking episode before we close. What should our listeners take away from our discussion today?

Dr. Lawrence Bass (17:10):
I think most important time invested in prevention and maintenance is really time well spent and a little bit of planning for the future lets you have a measured program of care that will give you much more success with a minimum of intervention. And that's what everyone's always really working hard to do. They're trying to avoid big surgery, big recovery time. And by putting a little time and effort into planning, you can get big dividends in return. It's okay to just come in and hit one feature or do one treatment that you've decided is a particularly pleasing part of your, your maintenance plan, but a little broader plan of care produces a lot more results. So thinking a little bit about what's coming next, you know, usually the common sense approach is if it's not broken, don't fix it. But starting to think about what might be coming next gives you a chance to stay ahead of the game rather than playing catch up. And you really don't wanna wait until your appearance is fallen apart and try to pull everything back together. That's really not the modern approach to aesthetic care in the aging face. So by at least putting a little bit of planning into it, you can get an awful lot of benefit.

Doreen Wu (18:55):
Thank you to our listeners for joining us today, to hear about how creating a customized beauty plan and planning ahead can make all the difference in helping you reach your aesthetic goals. I hope you found this episode as interesting and informative as I did. If you think of other exciting developments and plastic surgery that you would like us to discuss in upcoming episodes, please reach out by email or Instagram. We'll see you next time. This is Doreen Wu, thanking you for joining Dr. Bass and I for this discussion of how to successfully create a beauty plan. Be sure to tune in next time. And don't forget to subscribe to our podcast, to stay up to date with all of the exciting content that is coming your way.

Speaker 3 (19:34):
Thank you for joining us in this episode of the Park Avenue Plastic Surgery Class Podcast with Dr. Lawrence Bass Park Avenue plastic surgeon, educator and technology innovator. The commentary in this podcast represents opinion. This podcast does not present medical advice, but rather general information about plastic surgery that does not necessarily relate to the specific conditions of any individual patient. No doctor-patient relationship is established by listening to or participating in this podcast, consult your physician to advise you about your individual healthcare. If you enjoyed this episode, please share it with your friends and be sure to subscribe to our podcast on Apple Podcasts, Google, Spotify, Stitcher, or wherever you listen to podcasts.