Foreword

Drs. Stephen Bosniak and Marian Zilkha bring a 10-year history of collaboration to this book. They have shared a most interesting professional journey in which they have investigated many of the emerging therapies and techniques of minimally invasive oculo-facial rejuvenation. Both of them have demonstrated the curiosity and insight to think and rethink their approaches to achieve optimal results through minimal intervention. During their investigations, they have met many innovators from different disciplines. These associations have allowed Drs. Bosniak and Zilkha to gather this distinguished group of fellow travelers who have also looked beyond what is conventionally accepted. Each of the authors brings a perspective that has been forged and tempered during each author’s own journey of innovation.{AQ1} Together in this published text, they are defining the breadth of this area of emerging knowledge.

The organization of the text flows from noninvasive facial rejuvenation by photo, radiofrequency, and chemical modalities to the role of botulinum toxin in the first section. The second section is devoted to less invasive surgical procedures, with an excellent chapter on periobital surgery. The chapter on endoscopic techniques is a serviceable effort whereas the chapters on midface augmentation are well organized and cogently presented. Inclusion of the S-Lift technique by its modern developers makes this section especially strong.{AQ2} The third section includes perioral efforts, with a substantial emphasis on the rapidly expanding field of cosmetic dentistry. Finally, the fourth section moves to complementary treatments, including phototherapy of cancerous and precancerous facial lesions as well as a brief primer on traditional Chinese medicine. An appendix designed primarily for the lay reader is a valuable tool to help physicians frame treatment plans. Many of our patients have a surprisingly sophisticated understanding of their problems and want to participate in the choice of their therapy.

We all credit ourselves with having inquiring minds. Drs. Bosniak and Zilkha and their collaborators are colleagues who actually do think beyond the boundaries of conventional practice. For those who want an understanding of what are the most current techniques for minimally invasive oculo-facial rejuvenation and a glimpse of what might be, this text is a stimulating read.

Sterling S. Baker, M.D.

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Foreword

I am greatly honored to have been asked by Dr. Stephen Bosniak and Dr. Marian Zilkha to write a foreword to their new book. I have admired their combined energy and medical expertise for many years. They are dedicated to their research and teaching and have been highly innovative in their assessments of new techniques and their adjunctive application for the maximum benefit of each individual patient.

The timing of presentation of their book could hardly be better. Not only are the aging “baby boomer” clientele well informed and seeking successful strategies for low downtime rejuvenation, but the aesthetic physicians providing these services have unprecedented access to new and successful technologies as a means to this end. This book supplies the information which both patient and physician will need.

What do today’s cosmetically concerned adults actually want? Mainly they want to restore the natural appearance of their face from 10 to 15 years ago without looking “pulled”, “done”, or obvious. Today’s aesthetic consumer is well informed but still requires more information about treatment efficacy and safety than previous generations of clients who may not have been so aware of what questions to ask. They are also interested in how adverse events, should they occur, would be managed.

This book is a wonderful, up-to-date reference for physicians and surgeons in this rapidly expanding field. The topics that have been selected for the chapters carefully reflect the aims of treatment that are desired by the aesthetically concerned public.

There is in-depth discussion of combination treatments to achieve the optimum results for the cosmetic pa- tient—the all-important aim of cosmetic physicians and surgeons. This book is also written to be a valuable and important resource across all cosmetic specialties and disciplines.

Jean Carruthers, M.D., F.R.C.S.(C), F.R.C. OPHTH.{AQ1}

Fellow of the American Society of Ophthalmic Plastic and Reconstructive Surgery

Diplomat of the American Boards in Cosmetic Surgery

Cosmetic Surgeon

Clinical Professor

Department of Ophthalmology

University of British Columbia

Vancouver, Canada

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Preface

Patient expectations have risen, while their tolerance for downtime has diminished. Enhanced understanding about rejuvenation and the desire to please the patients have led to technological advances, which allow physicians and surgeons to deliver to patients what they want and need. In exchange for avoiding lengthy for healing processes, these techniques often require multiple treatment sessions in intervals that allow for the body to recover and respond appropriately while substantially contracting healing time. These noninvasive procedures have a cumulative effect, work in a complementary fashion, and are not, in many cases, stand-alone therapies. Clear instances of complementary therapy are Botox pretreatment for filling agents, ablative and nonablative laser therapies, intense pulsed light (IPL), microdermabrasion, and radiofrequency therapies. Skin therapies and home care products enhance the effects of Botox neuromodulation and filling agents. And low-emission diode (LED) treatments enhance the effects of IPL.{AQ1} Any physician treating the cosmetic patient must understand the need for multiple therapeutic options.

The effects of noninvasive therapies can be further enhanced by minimally invasive surgical techniques. Laserassisted blepharoplasty can be performed in a virtually bloodless field. Surgical outcomes can be improved and healing time can be minimized. Endoscopic browplasty and small-incision facelift techniques can add to the dimension of final correction. Once the rejuvenation goal is achieved with the aforementioned therapies, the result can be maximized and features can be enhanced, with micropigmentation (semipermanent makeup) of eyebrows, eyeline, and eyelashes.

Stephen Bosniak, M.D.

Marian Cantisano-Zilkha, M.D., Ph.D.

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