As society increasingly accepts cosmetic surgery as a means to enhance one’s appearance, procedures are constantly being perfected to meet the needs of an ever-evolving patient base. Botox’s growing popularity, the recent surge of interest in facial feminization, and the demand for body modification revisions offer examples of the industry’s adaptability. We asked leading plastic surgeons Dr. Richard Swift and Dr. Jeffrey Spiegel for their thoughts on some of the biggest trends that are currently shaping the cosmetic surgery landscape.
Zwivel: Caitlyn Jenner’s transition has introduced many Americans to cosmetic procedures’ transformative power. Do you expect feminization surgery to become more mainstream in 2016?
RS: I’m not sure if it will become more mainstream, but it’s definitely an option that more transgender patients will be exploring. Caitlyn Jenner made it more acceptable and gave hope to many people who were not initially ready to take any action and change their looks.
JS: Feminization surgery is indeed something that people are asking for! Of course, transgender women want to look the way they know they are, but other women are also interested in these procedures. I often hear women say that they’d like to be better-looking, and recognize that the problem is that their appearance is somewhat manly. We offer great solutions to them, with safe surgeries that are very powerfully beautifying.
Zwivel: There’s been a lot of buzz around microneedling, which is used to improve acne scarring, fine lines, stretch marks and pore-tightening. Are lasers a thing of the past?
RS: Laser technology improves every year, so I don’t believe it’s a thing of the past. However, with procedures like microneedling and chemical peels there are now more options available to improve skin quality, texture, and tone. Microneedling is less expensive and requires less downtime, depending on the level of the needle used. It can be beneficial for patients in their 20s and 30s, but for patients in their 40s or 50s laser treatments may have more impact.
JS: Lasers aren’t a thing of the past, but we’ve gotten better at understanding when to use them. They’re great for getting rid of pigmented (dark) spots, reducing hair growth, and eliminating some blood vessels or veins. They’re also still the best way to eliminate unwanted tattoos. I use lasers for all of those purposes.
However, some of the things for which lasers used to be the best option – such as reducing large pores, stretch marks, or acne scarring – may now be better treated with microneedling. This is a much less expensive procedure, with less downtime in most cases. And it’s safe on all skin colors, too! We’re getting great results with microneedling for problems that used to be very hard to treat.
Zwivel: What can be done for patients who want to reverse body modifications like gauged earlobes and facial piercings to take on a more professional and mature look?
RS: I often do revisions under local anesthesia on scars left by gauged ears and old facial piercings. Most scars from piercings, stretched skin, or depressions can be surgically revised.
JS: I’m definitely seeing more and more people who want to get rid of what I call the “signs of youth” such as gauged ears, prominent piercings, tattoos, and other body modifications. Sometimes people regret their decision, and other times they just get older and want to advance in their careers or have different options. One person recently told me, “I met a nice woman and want to look nice when I meet her parents”. Another said that she wanted to “get a job outside of a hair salon or coffee shop.”
Thankfully, we can get rid of these very well. Gauged ears, for example, can be closed in a way that leaves virtually no evidence that there ever was an earring. Other times we can change the appearance of the mark – for example, we might be able to conceal a piercing scar by making it look like a freckle.
Zwivel: We’ve seen many examples in the media of unnatural looks caused by overfilling. With a more sophisticated understanding of aging, can we expect the best facial plastic surgeons to use tiny amounts of filler in unexpected areas – like the eyelids, the corners of the mouth, the temples and the hands – to truly restore an overall youthful appearance?
RS: Yes, with the array of fillers now on the market we’re able to provide women and men with a non-surgical option to make them look years younger. From restoring volume to the cheeks, or getting rid of under eye bags, to plumping the lips and hands, fillers are become increasingly popular. A board-certified plastic surgeon who has in-depth knowledge of facial anatomy and experience administering the different fillers can provide very natural-looking results.
JS: Our brains are very, very sophisticated at getting evidence from another person’s face. We don’t just look at how full the lips are or whether or not there are wrinkles on the forehead: we process many, many data points to draw our impressions of a person. Sometimes a tiny amount of filler into the eyelid, temple, or earlobe can make all the difference and change a person from looking done to looking young.
This is exactly the type of facial analysis and use of fillers that I speak about and that we offer in my office. Our chief injector, Dr. Onir Spiegel, is a master at seeing small areas you may not have thought of – you’ll look fantastic and nobody will even think you had fillers done. The hands are another important area to consider: people shake your hands and look at your hands. With fillers and lasers, we can now rejuvenate them in no time, eliminating yet another sign of aging.
Zwivel: Social media is all-pervasive. With more and more people taking selfies, everyone wants to look their best. Have you noticed an impact on the types of procedures people are asking for?
RS: The selfie craze has definitely impacted the way people feel about themselves. In my practice, many patients are requesting injectable treatments like Botox and Dysport, fillers and Kybella to melt fat from a “double chin.” These are all in-office procedures that are quick, relatively painless and require little or no downtime. They help get rid of lines and wrinkles around the eyes and in between the brows, fill the wrinkles around the nose and mouth, restore volume to the cheeks, plump lips and hands, get rid of saggy jowls and double chins… These procedures are for younger patients who want to reduce the signs of aging, look more rested and refreshed, and delay a full face-lift until later years.
JS: It’s true that people see themselves in photographs more often now, and looking good is important. Did you know that people who have received Botox are interpreted as friendlier, more competent, and better boyfriends or girlfriends? Even when you don’t know the person has had something done, the face sends its message. That’s what I love about my job – I get to help people present their best selves to the world.
Many times people come in saying “I’m not sure why, but I don’t like the way I look”. That’s a great starting point for a conversation and what we are here for. It’s quick and easy to get an opinion, and most solutions are office-based with very little downtime. Dark spots, tired eyes, frowning, aging hands, gummy smile, looking tired… many of these problems are improved in less than 20 minutes! You know, we all have one life to live. Looking your best helps you feel your best and make the most of your opportunities.
This post originally appeared on Zwivel.com





Life is short why not make the most of it!
My mom had fillers done and they were so subtle that it was really done well – I was like “You look different, like younger, is it your hair? What did you do?”
Its amazing the technology that is available now – and how much it changed! It used to be so dangerous to get some of these procedures done – now so much is non-invasive!
This is so interesting. I want to look into microneedling.
I am so curious about fillers. I have this wrinkle between my eyes that drives me crazy! I’ve even named it.
I’m really looking into getting minor lip fillers as my top lip is really starting to thin out.
I was just talking to a girl this weekend about doing lip fillers.
I just can’t get over how much is out there.
I have never heard of microneeding!!!
All so interesting.
Wow, they have hand-plumping,too? I never heard of that! I see no issues with small procedures. As long as they are safe, what’s the big deal? The micro needling is a new one to me, too, Love this article.
I definitely think this age of selfies has everyone wanting to look perfect all the time. I don’t think I’d be totally opposed to something small and minor.
I’m so fascinated by the advancements in the industry. I wonder what it will be like when my children are adults!
It’s pretty fascinating to see how far medical technology has come to give men and women these options.
A friend of mine started exploring subtle skin treatments after noticing how selfies highlighted every line during family gatherings. She went for something low-key like microneedling to smooth things out and looked refreshed without anyone guessing. It got me thinking about how these options have evolved from what older generations had available. I’ve been more mindful of my own routine since then, focusing on small updates that boost confidence. When stocking up on favorite scents recently, the perfume com phone number helped fix a delayed delivery so everything arrived in time for a special occasion.