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Trends in Plastic Surgery

Dr. Wayne Carman
B.Sc., M.Sc., M.D., F.R.C.S.C.


There is no other field of medicine which demonstrates the degree of innovation and evolution that we see in plastic surgery. The concepts and techniques which we utilize are dynamic and constantly seek to improve efficiency, comfort and safety in the interests of our patients.

 One of the most significant trends today is the replacement and enhancement of facial volume. We have always known an increase in skin looseness as a feature of aging. More recently, it has been shown that a reduction in fullness of the cheek area greatly accentuates an aging look. This hollow look usually worsens with age but can be present in younger people if they are genetically predisposed. Hollow cheeks make people look older, sad and tired. Restoration of this lost volume makes a dramatic difference by creating a younger, fresher look.

The days of the common facelift stretching thin skin over a tight bony framework are numbered. The overstretched look which results may have fewer wrinkles, but does a patient really look younger? An alternative approach involves a procedure called Microfat Injection. In this technique we take some excess body fat from the abdomen or hip using fine liposuction instruments. The fat is then prepared and concentrated under sterile conditions and carefully injected into areas of volume deficiency. The result is a permanent enhancement of contour with no risk of allergic reactions or possible problems with implant materials.

Not only has Microfat Injection proven to be an excellent technique for recontouring the cheek area, but it has also been very successful in permanent lip enhancement giving a soft, plump, natural look. Contour problems of all types, such as scars, wrinkles, and expression lines around the mouth are all well treated by microfat injection It is a safe, conservative technique which, if properly planned and performed, gives a permanent result indistinguishable from natural facial contour. I have personally used this technique on hundreds of patients and they have been extremely pleased not only with the improvements in appearance but also with the long lasting nature of the result.

Another plastic surgical refinement involves breast reduction using a “no scar” technique. There are many ways to undertake breast reduction surgery to relieve the cumbersome weight of large, heavy breasts. All of the traditional methods leave surgical scars which can be significant and unsightly. A reduction method using liposuction can achieve excellent volume reduction while avoiding extensive scarring. The only incision is a one centimeter line in the crease under the breast on each side – virtually ”no scar”. This method is suitable for most, though not all patients and requires a preoperative examination and assessment as does any plastic surgery procedure. The procedure provides an excellent degree of reduction, insignificant scarring, and a much lower risk of complications when compared to older techniques.