Millennials shouldn’t have much to complain about, cosmetically speaking. Those prime-of-their-lifers haven’t yet grappled with the cumulative effects of gravity and age. That’s why cosmetic medical procedures—excepting nose jobs and breast reductions—have chiefly been the domain of the 40-plus crowd.
Even so, plastic surgeons in our area say that millennials are their fastest growing patient demographic. For some, getting Botox, lip enhancements and filler injections are as normal as going to the dentist. “The audience for minimally invasive procedures has widened to include women in their mid to late-20s who see these things as preventative or want to change their look,” says Dr. Joshua Fosnot of Penn Plastic Surgery Bryn Mawr. “For some, it is logical, but I also talk patients out of doing things that won’t enhance their facial aesthetics.”
Minimally invasive procedures aren’t the only thing in high demand. Labiaplasty is one of the hottest procedures at Main Line Institute of Plastic Surgery in Wynnewood. “Millennials are absolutely driving the surge,” says Dr. Ryan Hoffman. “Women say they’re bothered by it and are now coming into the office to see how we can address it.”
Asymmetry and excess skin are the most common complaints for Dr. Brannon Claytor, who sees the same trend at Claytor/Noone Plastic Surgery Institute in Bryn Mawr. “Extra labial tissue can make clothes fit differently and interfere with exercise and sex,” he says. “Or women simply think it’s not attractive.”
In the past, labiaplasty was requested by women looking to undo the effects of vaginal childbirth. “But now, women who haven’t yet had children are getting this done,” Hoffman says. “They are cognizant that they don’t look like the norm. If they’re shaving or waxing a lot, more is visible.”
Blame social media. Body envy isn’t new, but graphic images are now readily available online. “I spend a lot of time talking to women about their social media wish pics,” says Dr. Christian Subbio, whose practice is in Newtown Square. “But what looks good on a screen doesn’t always look good in real life.”
SnapChat body dysmorphia is the trendy name for it—filters that shrink chins and noses, make brows higher, and more. And whereas tiny hinnies were once the standard, big booties are bountiful on social media. Forget squats and lunges; many women are opting for medical buttock enhancements. According to the American Society of Plastic Surgeons, approximately 20,300 buttock augmentations were performed in 2017, double the number from five years ago. “It’s not the oversized Kardashian look,” Hoffman says. “The look is fullness without outrageous augmentation.”
Subbio’s patients request different shapes and sizes. “Some people have a flatness and want to fill it out with roundness and projection,” Subbio says. “Others want an hour-glass shape.”
To achieve the look, surgeons use buttock implants, fat grafts from liposuction, or both. Hoffman combines surgical implants and patients’ fat. One implant goes in each cheek. Then, the top and sides are shaped with injections of harvested, cleaned fat. “People have gotten in trouble using only fat because a large volume of it may be needed,” Hoffman says. “That can lead to complications.”
But Claytor and Subbio use fat injections exclusively. “Implants in that area are prone to problems and have significant challenges,” Claytor cautions. Potential complications are linked to what Claytor calls a “hygienically challenged” part of the body that has “a high functional demand.”
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Subbio concurs. “As opposed to breast implants, buttock implants are constantly compressed when patients sit,” he says. “That wear and tear can cause implants to shift, becoming misshapen or infected. It can be catastrophic. In my opinion, the potential complications with implants are not worth taking.”
Last August, the American Society of Plastic Surgeons and a cohort of professional associations from around the world formed the Task Force for Safety in Gluteal Fat Grafting. They’ve found that patients are dying from improperly injected fat grafts. ASPS’s goal is to create and enforce universal safety standards for the procedures.
At Cirillo Cosmetic Dermatology Spa, Dr. Victoria Cirillo-Hyland boosts booties, builds abdominal muscles and burns fat with Emsculpt, a device that deploys high-intensity focused electromagnetic technology. “We see a 16 percent increase in muscle mass and 19 percent reduction in fat,” Cirillo-Hyland says.
Weakened pelvic muscles often lead to urinary incontinence, a common and embarrassing complaint, especially among mothers of multiple children and post-menopausal women. Cirillo-Hyland gives those muscles a workout with Emsella’s HiFem device, lovingly dubbed “the Kegel throne.” While women sit on the chair, Emsella creates 17,000 pelvic floor muscle contractions in 28 minutes. “You can’t do that many Kegels that fast,” Cirillo-Hyland says with a laugh. “It’s a game changer.”
Results are the best measure for other trends. The much-touted 10-step Korean skin care process doesn’t get much love from dermatologist Dr. Stacey Englander Turner. “While we all have different skin types, the majority of us don’t need 10 separate products,” she says. “The more complicated the process, the less likely people are to adhere to it.”
Turner is similarly skeptical about collagen and peptide shakes. While those substances are beneficial when applied to skin, she’s not sure they work when ingested. “There’s no real evidence-based medicine proving their efficacy,” she says. “And I worry about how much sugar and other unhealthy ingredients are in those shakes.”
Serum-soaked sheet masks get a similar “meh” from Turner. They may be good for the ‘gram, but they aren’t doing much for the skin. “Those sheets are not exfoliating or anti-aging and the moisturizing effect is very temporary,” she explains. “In some people, they can actually increase acne.”
Instead of wasting money on what’s hot, get what’s proven to work, she says. Like other MD-holding beauty experts, she offers a private label, medical grade skin care line at her newly renamed Turner Dermatology in Bryn Mawr. She also advocates microneedling, which boosts real facial collagen production, as well as hyaluronic acid fillers and Botox, all of which are FDA approved. “Botox is my love,” she states. “Over time, it will eliminate fine lines and prevent new ones.”
Meanwhile, men are flocking to Turner Dermatology and other cosmetic centers to get Botox and filler injections. Subbio and Hoffman say men comprise a sizeable chunk of their patient population, and Claytor also has them coming to him for liposuction on their necks, abdomens and love handles. “Seeing the women in their lives get liposuction or Botox or filler demystifies the procedures for men, and they see how happy their partners are with the results,” says Claytor. “More and more, when men come into the office with women, they’ll ask if we can do something for them, too.”