Photo Credit: drmezrow.com
Board certified plastic surgeon Craig Mezrow’s career is impressive. He received a B.S. and M.S. from Emory University in Atlanta, and an M.D. from The Mount Sinai School of Medicine in New York City.Â He initially entered the field of cardiothoracic surgery, but after a decade, he found his true calling and trained for five years in plastic and reconstructive surgery at the Medical College of Wisconsin. Mezrow went on for additional training in Cosmetic Surgery at the prestigious Manhattan Eye, Ear & Throat Hospital in New York City. He is now in private practice in Bala Cynwyd, located on Philadelphia’s posh Main Line.
Along with breast enhancement, tummy tucks, and liposuction, Mezrow offers a comprehensive nonsurgical menu of BOTOX, fillers, skincare, Intense Pulsed Light (IPL), and lasers. He was one of the first plastic surgeons in the U.S. to offer the UltraShape focused ultrasound device for body shaping, and is also a big proponent of VelaShape to target cellulite and dimples.
He talked to Beauty in the Bag about his love for lasers and light-based devices, the body contouring revolution and where he thinks this field is headed. Here’s what he had to say:
As a board certified plastic surgeon, how and why have you embraced lasers in your practice?
I believe that lasers as well as radiofrequency and ultrasound devices are becoming essential tools in an aesthetic surgical practice. To illustrate this, consider the face and neck lift patient, whom not only has hanging jowls and loose neck skin but also has wrinkles and sun damaged skin. To only perform a face and neck lift without addressing the wrinkles and/or skin dyschromia (pigment discoloration) would be incomplete. Â Only with a comprehensive approach using light and/or energy-based devices can a complete rejuvenation be achieved. On the other hand, some patients do not wish to have any surgery but instead desire non-invasive treatments to improve their skin color, texture, firming and possibly even reduce regions of excess fat. We now have the ability to address their concerns without employing invasive treatments.
What is new and exciting in the world of body contouring?
Each year, hundreds of the thousands of patients undergo surgical body contouring procedures such as abdominoplasty and/or liposuction. Many desire additional refinements such as reduction of fat deposits without further surgery. For the aforementioned and for those patients who won’t consider surgical modalities, we now have non-invasive treatments. During the last decade, multiple non-invasive fat reduction therapies have been introduced into the United States. Some of these technologies include radiofrequency heating devices such as VelaShape, Venus Freeze, Venus Concept Legacy, and Vanquish. Other devices â€œfreezeâ€ the fat such as Coolsculpting by Zeltiq. Lastly, there are devices that employ ultrasound to destroy fat such as the Liposonix Â device and the most recently FDA-approved UltraShape device, which is the only non-thermal device in the U.S. market place.
I am very excited about the introduction of UltraShape to the U.S. because this technology uses pulsed, focused ultrasound that is not â€œcoldâ€ or â€œhotâ€ to selectively destroy fat cells without injuring nerves, blood vessels, muscle, and surrounding tissues. The area to be treated can be individualized, customized, designed to each patients needs. UltraShape is comfortable since it is non-thermal thus not requiring any type of anesthesia. It has no down time, as there is no swelling, bruising, induration, or soreness. With a series of three abdominal treatments performed every other week, a three to six centimeter circumferential reduction can be achieved with visible results as early as two weeks. I also expect to use UltraShape in the near future to treat fatty arms, necks, thighs, etc.
What do you use as your ‘go to’ techniques for turning the clock back?
The most important is the patientâ€™s concerns. Â After a complete history and examination, we have a discussion about whether the patient desires a combination approach of surgery and nonsurgical modalities or only desires non-invasive treatments.Â Significant non-invasive rejuvenation and patient satisfaction can be achieved when a combination of treatments are employed using multiple modalities.Â The treatments may incorporate a combination of lasers, IPL, radiofrequency, and ultrasound devices to achieve aesthetic goals.Â It would not be uncommon for non-invasive facial and body procedures to be performed on the same day in conjunction with injections of hyaluronic acid-based fillers, polylactic acid and/or botulinum toxins.
Does anything work well for acne scars, stretch marks, and cellulite?
When treating acne scarring, it is imperative to first evaluate the degree of scarring, the patientâ€™s skin type, and the patient’s desires of a single treatment with significant downtime or multiple treatment sessions with little or no downtime. If the patient has a lighter skin type (Fitzpatrick I-III), and accepts downtime, I will perform a single treatment of fractional CO2 laser resurfacing. I have obtained excellent results with Syneron Candelaâ€™s CORE CO2 laser. I am very fond of this system because I can perform full ablation and/or fractional ablation with varying settings without changing the hand piece. Full ablation is the complete removal of the skin’s top layers, while fractional ablation involves a controlled wound healing process. The laser places tinyÂ holes or micro channels in the skin whichÂ cover a fraction of the total treatment area. This activates the bodyâ€™s wound healing response, and stimulates the production of new collagen.
For the patients whom do not want significant downtime, I have been extremely pleased with fractional radiofrequency Sublative treatments using Syneronâ€™s Matrix RF. Whatâ€™s fabulous about this system is the rapid healing, minimal downtime, and the fact that it can be performed on all patient skin types including African American patients. The treatments to improve stretch marks are more complex. It is important to assess if the stretch marks are red, immature scars as compared to lighter, mature scars. While in my opinion, there are currently no reliable treatment options, I have had success using fractional radiofrequency Sublative treatments.
Cellulite continues to be concerning for millions of women. My view is that the technology is improving and hopefully one day, we will have a permanent treatment modality. Syneronâ€™s VelaShape technology has had the longest track record, totaling nearly a decade with four generation of machines to decrease cellulite. Their latest model is the 150 watt VelaShape III, that now has a three treatment regimen protocol. That is reduced from their earlier 20 watt machines requiring sixteen treatments. Another promising newcomer to the marketplace is the Venus Concept Legacy that combines multipolar radiofrequency with electromagnetic energy.
What are your East Coast patients looking for most often and how has that changed in the past decade?
What has changed the most in the aesthetic industry over the last decade is the patient demand, desiring non-invasive, nonsurgical options without downtime for facial rejuvenation and body contouring.
In your view, what is the future of aesthetic surgery?
My opinion of the future of the aesthetic industry is going to be the obvious future demand of non-invasive, nonsurgical, no downtime treatments.Â I also believe that more physicians are going to incorporate non-surgical modalities with their surgical aesthetic practices.