Facial plastic surgeon Edwin F. Williams III, MD, has witnessed an evolution in how facial aging and rejuvenation is approached during his 20-plus years in practice.
“We have a better understanding of the facial aging process today,” says Williams, the medical director of the Williams Center for Plastic Surgery in Albany, NY and New York City and the incoming vice president for public and regulatory affairs at the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). “Lifting is not the only answer, but overfilling isn’t either. We have become enlightened on how to use fillers today.”
What procedures do you perform most often?
Rhinoplasty makes up about 50 percent of my practice, and facial rejuvenation makes up the rest.
Do you do much revision rhinoplasty?
About 30 percent of my rhinoplasties are revision procedures. I have been in practice in Albany for 20 years, and when I first came here, there were a lot more revision rhinoplasties to be done.
Why is that?
I’m doing a lot of the primaries nowadays.
So is there an “Ed Williams, MD” nose?
No. We give someone a nose that fits with their ethnic background. I don’t have a signature nose.
What is a typical work week like for you?
Mondays and Tuesdays are my surgery days. I do consultations in the mornings during the rest of the week. I also work on the business side of the practice.
Are you seeing an increase in surgical procedures these days?
Yes. When the economy tanked, people were looking for less expensive non-surgical options but these don’t offer long-lasting solutions. The problems don’t go way. We are seeing a lot of people who were putting it off, and are now starting to spend again. Unlike people seeking breast procedures, those interested in facial rejuvenation are often older and they have the resources, but don’t like to spend when they are worried about the economy or the stock market is doing poorly. A couple of years ago, many surgical procedures were put off because of the above concerns and patients were opting for more non-surgical treatments in an attempt to not spend as much. I see that trend reversing now that this patient population is less worried and the stock market is in much better shape.
Has social media affected your practice?
Yes. People are seeing themselves on their friend’s Facebook pages and saying ‘I saw my nose, it’s time.’ You can’t just throw away a bad picture anymore.
How do you approach facial aging today?
At first, we just filled in lines and folds. Now we know that there are at least 10 different fat pockets on each side of the face and they deflate at different rates. As we start to pay attention to details, there is better understanding of how to use available fillers. We know that the answer is not overfilling the face with volume, especially the lower third of the face. When people see this, they think that it is bad plastic surgery when in reality it is just overfilling.
Are more men coming to you for plastic surgery?
Yes, it’s a growing population. It is more acceptable and women are not afraid to tell their husbands ‘you need some Botox.’ When I ask men ‘why now?,’ they usually say it is because they are staying in the workplace longer and the second answer I get is that ‘my wife tells me its time.’
What types of procedures are men seeking?
Eyelid surgery and functional/cosmetic rhinoplasty. They want to be able to breathe better, but also want some cosmetic change to their nose.
The AAFPRS has many charitable initiatives including the Face to Face National Domestic Violence Program. Are you involved?
Yes. Every April, we have a fun night out for women with gambling and boutique shopping to raise awareness and money for Face to Face. We give half of the money to our local women’s shelter and half to the AAFPRS. Our whole staff rallies behind this cause in an incredible way.
As a dad of teen girls, any thoughts on teen plastic surgery? Is it ever OK?
There has been a lot of publicity and press about teen plastic surgery during the past 10 years. I fix a lot of noses on 18-year-old women, but kids have enough to deal with before they start to tinker with their body image. If a Mom and a daughter come in and the mom wants a rhinoplasty, but the child has mixed feelings, I say ‘come back when the kid wants it.’
What about cosmetic surgery to prevent bullying?
If a kid is being bullied, I am OK with plastic surgery. It really depends on the procedure. I do otoplasty on kids who are four- or five-year-olds, which may prevent them from being teased about their ears.