In the lead up to the inaugural National Cosmetic Medicine Summit, I was honoured to be able to meet and interview Dr Ronald Feiner, who is an expert in minimally invasive cosmetic procedures, and is presenting and Chairing at the Summit. Here he speaks openly about his work, motivations and interests in the field, and some advice to those wishing to “age gracefully”.
Tell us a bit about your background:
After a wide-ranging career in general medicine and surgery, I entered the field of minimally invasive procedural aesthetics in 2000. Since that time I have attained 3 Australasian fellowships in cosmetic medicinal practice and I am currently the medicine dean of the Australasian College of Cosmetic Surgery. In addition to running a busy private cosmetic medical practice, I teach trainees in cosmetic medicine, tutor in various cosmetic medical workshops and lecture nationally and internationally.
What are some of the most common procedures that you perform? What minimally invasive procedures are trending in 2017 for men and women respectively?
I am recognised for my work in minimally invasive facial rejuvenation utilising a variety of injectable products, lipo-transfer grafting, liposculpture, suture suspension and eyelid blepharoplasty surgery. Among many other procedures I also perform body liposculpture, sclerotherapy for leg veins and radiofrequency urogynaecological rejuvenation.
Trending in 2017 for women will be a continued demand for more natural and harmonised facial outcomes. There will be more focus on enhancing noses, foreheads, jawlines, chins, necks and temples. Invasive facial surgery will continue to decline as women seek out innovative scarless innovations.
Trending for men is the realisation that natural facial rejuvenation can be achieved with injectables in a manner does not distort or feminise but can result in pleasingly masculine outcomes.
You are speaking on the topic of facial transfer grafting. What does this procedure involve, and what are the advantages or disadvantages over the use of dermal fillers?
Fat or lipo transfer grafting is achieved by harvesting fat by liposuction from one part of the body and injecting it into a facial deficiency such as the cheek region. Of course fat grafting can also be injected anywhere in the body to correct a defect as a result of soft tissue loss.
In my practice when I am performing a liposculpture on the body or neck it can be a great opportunity to transfer graft some of the harvested fat to re-volumise the face if necessary. The advantages of fat grafting is that it is a 100% homogenous and natural live biological filler, loaded with millions of stem cells and tissue growth factors (especially when platelet rich plasma (PRP) is added). The disadvantage is that it is a biological graft that can fail to “take” and be re-absorbed. The addition of PRP has improved graft “take” quite dramatically with up to 90% success rate. Other disadvantages include the time taken to perform the whole procedure and the reality that fat is difficult to use in more delicate facial regions without risking complications such as lumpiness.
On the other hand dermal fillers are pre-prepared and come in a convenient spectrum of rheological options that correlate beautifully with the target tissue region to be injected. Contemporary dermal fillers are manufactured utilising sophisticated technology that facilitates injectors to attain brilliant outcomes with minimal trauma.
What is your philosophy when it comes to beauty and the use of cosmetic procedures?
Well I am passionate about minimally invasive cosmetic procedures for facial beautification. The reality is that people desire a more beautiful and rejuvenated appearance. Actually it is often a very emotional experience for patients when they experience recaptured youthful beauty after a brief and relatively non- traumatic medical procedure.
So my philosophy is that with contemporary minimally-invasive surgical aesthetics, we can offer patients an opportunity to experience natural enhanced appearance without major risk and downtime. The objective is not to alter the appearance of a person to make them look unrecognisable, but to recapture the patient’s inherent youthful features.
What changes have you seen in the cosmetic industry over the past decade, as a doctor?
The changes in the cosmetic industry overwhelmingly relate to the transition from high risk invasive surgery to lower risk non-invasive and minimally invasive procedures. After all nobody likes a scar on their face and few people desire an appearance that overly changes their own unique character. Minimally invasive procedures enhance youthful appearance rather than creating an “operated on” appearance.
What advice would you give to people who were wanting to age gracefully?
The concept of “aging gracefully” is obsolete. It relates to a relatively despairing time when medically improving appearance meant a major and risky operation like a face-lift.
The reality is that virtually all women have a grooming regimen to enhance their appearance. After all most women wear make-up, wear flattering clothes and accessories. They regularly visit the hairdresser, beauty and nail salon.
Today, beautiful natural outcomes are achievable with minimally invasive procedures that can be considered as an extension of regular grooming. There is generally less trauma to the patient with contemporary methods than a visit to the dentist.