Z PAUL LORENC MD FACS – New York Plastic Surgeon
Meet the Pioneer Plastic Surgeon
Dr. Lorenc is considered a front runner in the development of the new generation of dermal fillers. As a leading authority in facial anatomy, he was principle investigator on the Evolence U.S. pivotal study, as well as the sole aesthetic plastic surgeon involved in clinical research for Restylane. In fact, he led the team of experts who presented to the FDA Advisory Panel in 2003 before Restylane was approved to go to market. He is also owner of a patent for a unique endoscopic browlift device. Dr. Lorenc is currently leading clinical trials for Nuvance, a mesh facelift technique. Given his cutting edge credentials, it is fitting that Dr. Lorenc is Course Chairman of Aesthetic Plastic Surgery: The Next Generation Symposium, which will be held for the second year in New York, November 19-21, 2010, at the Waldorf Astoria. Dr. Lorenc is an avid collector of moderm art (his favorite is Man Ray), much of which adorns his home and Park Avenue office.
In the last few decades, how has the field of aesthetic plastic surgery evolved?
There has been a tremendous shift toward less invasive, minimal down time type of rejuvenative procedures. Also, the trend is towards non-hospital based facilities (87%), and with the advent of anesthesia agents that are quickly metabolized, patients are routinely operated on in an ambulatory fashion.
Have you seen a change in the patients that come in to be treated?
Today we are gearing our practice and services toward helping to prevent aging in younger patients, as evidenced by the fact that 47% of surgeries are now in the 35-50 age group. This was not the case in the 1980’s and 1990’s when the patients were typically in their 60’s. Today it is all about prevention and maintenance and much less about correction.
You treat local patients and many also travel great distances to benefit from your surgical expertise. What procedures have been the most popular?
A significant portion of my practice is neuromodulator and filler based. Laser lipolysis has also become a large part of my practice. The fact that it can be done under local anesthesia is very attractive to patients.
You recently presented at the 2009 APSSNY Symposium about delaying the aging process in the décolleté area. What does this treatment consist of, who is a candidate, and how long do outcomes last?
The treatment consists of injecting a very dilute solution of Sculptra and Lidocaine into the décolleté area. Any patient that has fine lines of the décolleté is a candidate. The injection may have to be repeated in 4-6 weeks depending on the severity. Results last about 2 years, but are also patient dependent. Any woman who shows signs of sun damage or aging may be a candidate.
In advance of next year’s Symposium, what are some anti-aging and surgical trends that you’re seeing? What can we anticipate learning about next year?
Not only will I continue to focus on the latest minimally invasive rejuvenative therapies available, but the very important issues of anti-aging hormonal therapies will also be discussed.
Today, you’re able to help patients who want to slim down without putting them under general anesthesia. What are some techniques that enable you to do this?
Laser lipolysis using SmoothLipo is routinely performed using local anesthesia. In my office we use SmoothShapes for the thighs, abdomen and the buttocks. Anyone who has cellulite is a candidate. Patients are routinely very pleased with the outcomes, but it requires a commitment to a series of therapy sessions in my office.
Word is that you are able to create natural outcomes while delaying the aging process for patients who may not want to go under the knife by using fillers. Tell us which fillers and toxins make this possible?
It’s all about technique, about filler selection, experience and more experience. I use eight different fillers and two different neuromodulators in my practice. Very frequently, in one patient I will inject two or three different fillers and two different neuromodulators in one sitting to get a great result. Again, it’s all about the experience.
What do you like about Sculptra?
I don’t like Sculptra, I love Sculptra. It is a very unique volumizing agent. It work by a very different mechanism than all the other agents. It lasts about two years. Anyone who needs an area to be “volumized” or the skin to be “modulated” is a candidate for Sculptra injection.
I CAN SEE CLEARLY NOW – ACUVUE
Photo Credit: www.acuvue.com
1•Day Acuvue Moist Brand Contact Lenses – After dressing my eyes with Acuvue for a 30 day trial period, I now have a new crush. These petite and dainty lenses are anything but overbearing or obvious. They are easy to put on – not only because the case that they are housed in is user friendly – but because they are so silky smooth that once in, they instill strong confidence. ACUVUE provides users with an inside-out mark and slight visibility tint. However, the tint was strictly utilitarian – wearing the lenses never compromised the natural color of my blue eyes.
They stayed put on my retina without ever moving (don’t you hate it when your lenses get caught under your lid or travel to the corner of your eye? Never happened to me with ACUVUE MOIST). Unlike some flimsy disposables that collect dust and debris long before the mandatory 3 pm office coffee hour, these lenses were bold and brave. They were able to keep up with me – never causing irritation or redness – even during allergy season.
They were a dream to wear: strong enough so that I forgot they were for one-day use, and they felt as substantial as my soft non-disposable lenses. I was able to wear them throughout the course of my 12-hour workday and then enjoyed the same lenses at the gym. They stayed clear throughout the day, never became cloudy in front of my computer screen, and eliminated the need for cleaning, disinfecting solutions and storage.
Now that the 30-day trial is complete, I am off to see my eye doctor for another round. These are available by prescription only for vision correction. The average daily cost for a pair is $2.00 (less than a cup of coffee) before any rebates. Talk to an eye care professional, as many vision care plans help cover the cost of contact lenses.
Final Verdict – RDW (Run Don’t Walk) - ACUVUE takes the guesswork out of wearing their MOIST lenses.
*gifted
JEFFREY EPSTEIN MD FACS – Foundation for Hair Restoration
Meet the Hair Guru
And by hair guru, we don’t mean king of the latest hairstyles and colors. We mean the surgeon who gives men and women across the globe natural growth when all other efforts have failed. Dr. Epstein is the Founder and Director of the Foundation for Hair Restoration, with nearly two decades of experience as a hair restoration surgeon and a facial plastic and reconstructive surgeon. He is renowned for his ability to use the smallest possible recipient sites to help hair transplant patients of both genders achieve the greatest possible density and the quickest recovery time.
How many procedures does it take to help a patient who has lost the majority his/her hair to grow a new head of hair?
With the ability to transplant as many as 3,000 or more grafts (each graft containing between one and three hairs), as much as one-third of a balding scalp can be filled in nicely with hair in one single procedure. For those with advanced degrees of hair loss, complete coverage is not always available, due to limits in donor hair supply, but that still doesn’t mean that impressive improvements cannot be achieved.
How has the field evolved in the last decade?
Just about 10 years ago, the all-microscopic technique of follicular unit grafting became the standard of care, providing undetectable and rather impressive hair transplant results.
Are you using technology to achieve leading outcomes?
A newer development over the past three years has been the technique of follicular unit extraction (FUE), which avoids altogether any linear donor site incision. Instead, with the FUE technique, each graft is removed from the scalp one by one, in a tremendously time consuming and demanding procedure, but one that allows the patient to shave his or her head if desired. Much more recently we have begun to investigate the use of adjuvant healing technologies, including stem cells.
Aside from hair transplants to the head, where are able to help patients grow hair?
Hair restoration for the treatment of male and female pattern hair loss remains the mainstay of my practice. However, I have been at the forefront these past six years in the development of techniques to restore the eyebrows, beard, mustache and chest regions.
Are you able to help men and women of all ethnicities fight the battle against hair loss?
Few patients are not appropriate candidates for hair restoration. Practicing in two quite ethnically diverse cities - Miami and New York City - allows me to see first hand that hair loss is a problem for virtually all ethnic groups. Whether they are of Indian, African, Hispanic, Asian or Middle Eastern ethnicities, patients have options for hair transplant technologies that ensure excellent results.
When it comes to hair, how has the ideal beauty changed or evolved?
For women, beauty ideals have perhaps changed in terms of eyebrow shape, where the thicker, classically “Brooke Shields” eyebrows are now not as desirable as those that are finer. For men, the trend toward no body hair has reversed, and chest and facial hair are considered quite masculine and attractive. Thus the demand for these procedures s increased.
With offices throughout the US, you help people in all parts of the country. How do requests vary from East to West Coast?
Between the three main cities I serve – Miami, New York City, and Los Angeles – the variations are outweighed by the similarities. In fact, with so many international patients, it is clear that even variations among different areas of the world are outweighed by similarities.
How does hair restoration fit in with other plastic surgery procedures? It seems that they are two very different specialties.
Both are cosmetic surgery disciplines, and as such, total facial aesthetics should include an appreciation of the hairline and other important features of the hair. Being able to combine these treatments serves the aesthetically minded patient well.
What is the biggest risk to your continued practice of hair restoration? Is hair cloning going to be the final solution?
Actually, unless I get seriously injured playing ultimate frisbee, I don’t see my practice slowing down anytime in the next five to 10 years. A lot of research is being conducted on the use of hair cloning and cell multiplication, as well as other cellular and genetic interventions for treating hair loss. However, none of these technologies is less than five or more years away from having any clinical applicability. There are still enough poor transplants that will need revisions (my particular area of expertise) to keep me busy for a number of years.
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