Because I can't personally see their effect.

Because I can't show their effect to my patients in standardized photographs.

Because I don't want to embarrass myself in front of my patients.

We have some basic principles that are well known to fellow plastic surgeons who are interested in and focus their practice on facial aesthetics.

For instance, a procedure must be active regardless of its price and ease of performance.

Procedure X costs 1 lira and is performed in 5 minutes, but if the patient does not benefit from that procedure and you cannot prove the visual benefit as a physician, you will find yourself in a situation as if you stole 1 lira from and fooled your patient.

Even if our patients do not expect a dramatic change in minimally invasive, non-surgical procedures, they expect a "visible" change. This has one single standard in the scientific community all over the world. You can only observe the change in standardized photographs before and after the procedure. The rest is a huge lie. Standardized photographs can be defined as photographs taken with the same camera against the same background, at the same place and under the same light, same camera settings, same body position, same camera position and without make-up.

If these criteria are met, we should see the difference in photos taken before and after the procedure.

Before the procedure: no make-up, and little light from the side. After the procedure: a beautiful make-up, and strong light from the opposite.

Not so, my dear friend.

If it is very effective, if it is very beautiful, if it has been applied to thousands of patients...

Couldn’t you get 10 standardized photos out of them?

When determining cosmetic benefits in plastic surgery, it doesn't matter what the doctor and the patient feel, because medical procedures cannot have subjective consequences. They should be objective, visible to all observers and measurable.

Another basic principle is that any procedure in plastic surgery is expected to create a result that is more effective than and cannot be achieved with make-up. If you could not even create a difference as much as that between patient photos with and without daily make-up, then it means you did more harm than good.

 

 

Here is the problem:

I can't show or see any difference in any of these procedures that I can prove in standardized photographs. Ultimately, the procedure-led change is not even close to the change a very simple daily make-up creates on the patient's face.

Once is never enough, sweetie! You need 5 to 10 sessions!

When PRP first became popular 10 years ago, they said so, and that was what we did. Again, I did not observe any benefits. Neither did my professor at Cleveland Clinic nor my colleagues in Turkey. Maybe our hands weren't magical enough. Maybe we failed to give percutaneous injections properly. Maybe we weren't trained to use our mouth to achieve what we couldn't achieve with our hands.

From a scientific perspective, it is impossible to find a scientific study in the plastic surgery/aesthetic surgery literature proving with standardized photographs that these applications do rejuvenate the face. On the contrary, there are many studies showing that they are not helpful. There are some studies showing that they work at the tissue level. But what use is it that researchers have seen under a microscope what you can't see with your eyes?

The only exception in mesotherapy is the bile acids used to reduce subcutaneous fat mass. Bile acids are applied into the subcutaneous fat tissue. They destroy fat cells and reduce the fat mass. However, this is for regional slimming and not for rejuvenation.

The reason why I wrote this article is that almost half of the patients who come to me for facial rejuvenation have already spent - in pursuit of rejuvenation - as much as they would for a surgical operation. The result, of course, is frustration. Many say, “If I knew, I wouldn't have it.” This article was written to give the next generation a chance to know.

After reading this article, I'm sure some of you will think:

“Well, doc, another doctor says it is very useful.

Another asks, ‘If it doesn't help, would we perform it?’

Another says, ‘Surgeons disparage nonsurgical procedures to make money from surgery.’

Well, you are all doctors, but now we don’t know who to trust.”

It is all up to you to decide who to believe and trust.

Try and see.

But just know that trying comes at a price.

Take good care... of yourself and your beauty.