This year marks the 20th Anniversary of Facial Plastic Surgery Clinics . I know this because on my bookshelf rests every edition since the flagship issue on Open Rhinoplasty published in August 1993. The first issue on Minimally Invasive Procedures was published in 2001 and discussed chemical peels, lasers, and endoscopic approaches to facial surgery. Botulinum toxin for facial aesthetics was FDA approved in 2002 and, only 1 year later, an entire issue of Facial Plastic Surgery Clinics was dedicated to the cosmetic use of Botox. Now, in 2013, we are asking if more invasive procedures are becoming or have become obsolete with the advent of newer, less invasive procedures.
We all agree that the practice of medicine evolves. Older physicians are likely not practicing the way they did 20 years ago. As our knowledge of facial aging improves in addition to the development of new materials, instruments, and techniques, we are able to improve our treatment outcomes with increased safety, less scarring, and faster recoveries. Medicine benefits from the advances in technology, which become both smaller and less expensive over time. We respond to the desires of our patients, who want less invasive procedures with minimal recovery. But are we still able to provide maximal results with minimal procedures?
For several years now, I have been thinking about how we are now able to perform many cosmetic procedures without resorting to more aggressive techniques of the past. I don’t perform coronal brow lifts, oral commissure-plasties, or vermillion advancements anymore. I learned how to augment the face with fat and fillers and how to sculpt the face with neurotoxins. I have abandoned ablative laser resurfacing of the face for gentler fractional resurfacing. I was excited to be given the task of posing directed questions to leaders in our field to ask them their thoughts about this less invasive trend in cosmetic procedures. I am grateful to the contributors to this issue and I appreciate the thought that each of the authors placed on their assigned topic. I applaud their insight into the difficult questions posed to them.
I am certain the reader will enjoy reading how far we have advanced in the last 20 years and how technological advancements have continued to shape our field. It will be interesting to watch how the titles of Facial Plastic Surgery Clinics will trend over the next 20 years. I suspect not only will the materials improve and techniques become noninvasive but also the “books” on my bookshelf will be replaced by the newest and most compact forms of electronic media!