Diversity and Medical Aesthetics

I am fortunate to have one of the most diverse plastic surgery practices in the world, from ethnic, racial, economic and gender perspectives.  This reality has given me a great opportunity within the space of cosmetic medicine to formulate approaches that will work with such a mix of consumers.  With the challenges of individuals with darker skin, being at a higher risk for scar formation and hyperpigmentation (darkening of the skin), to men who typically are not able to wear makeup to camouflage their recovery, there has never been a greater need to come up with an approach that is equally diverse yet highly effective.

Recently, I was making a continuing medical educational tutorial for an online program, and I reviewed my experience over the past five years with botulinum toxins (Botox and Dysport). I found some very interesting trends to consider. One, I found that patients I treated more than five years ago had skin that looked better now than it did five years ago.  In addition, the use of dermal fillers seemed to last much longer now as compared to when they first began using the products. I found that patients were getting treatments titrated to a very specific effect and the patient could be empowered to guide the treatment for its desired effect.  Ultimately, the use of injectables has become a tool of suspended animation for aging, setting the stage for small nips and tucks as needed.  This is particularly attractive to my patient who may not be the best candidate for facelifting or other more aggressive traditional plastic surgery procedures, the younger candidate or the patient who is prone to poor scarring – people with darker skin or ethnically prone (Asians and native Africans).  I think we are much better at the use of these non surgical techniques, and I tend to use them in a surgical way.  For example, I will have a patient who wants an upper eyelid lift and her brow is low.  I have found the use of Botox/Dysport with filler to the upper eyelid/brow can mimic my surgical release of the brow, through the upper eyelid, and using a person’s fat and soft tissue to fill the upper eyelid/brow unit.  While surgery is definitive, some people benefit from the real life simulation of effect and may wish to defer surgery to a later date. 

This approach has given birth to a term I have coined, Aesthetic/Cosmetic Enhancement –Lite, similar to the concept of popular iPhone applications.  The idea is simple… You may not want/need 100 percent right now, just something of an improvement to make a difference and to do an inexpensive (relatively) test drive before committing to the full deal.  Fractional laser technology has added an additional tool of importance, especially for my patients with darker skin.  I am able to treat skin irregularities in the full range of patients, again, minimizing the need to rely on any one given technology.  At the Few Institute, we have one of the largest experiences in treating darker skin with laser.  We treat unwanted hair, skin irregularities and scars.  Using sun block, skin lightening (hydroquinones, kojic acids, and azeliec acid) for prophylaxis, and test patch applications have made the use of laser technology safe and predictable. This makes sense to me and represents an approach I would personally take, depending where I was at in life.  It is taking advantage of the full spectrum of options and not getting stuck on one area, plastic surgery or dermatology, but a hybrid approach, one that fits a life in motion.  There is a secondary benefit, especially when a practice like ours makes healthy, graceful, aging a holistic approach.  I have found that my patients not only look better and are aging more gracefully, they are maintaining healthy lifestyles, through diet, exercise, prevention, and healthier relationships.   Aesthetic/Cosmetic Enhancement-Lite(ACE-Lite) is not a frivolous concept; it is a way to view life from a healthy place. 

Julius Few, MD, FACS
Chicago, IL

Julius Few, MD, FACS is in private practice at The Few Institute for Aesthetic Plastic Surgery in Chicago, IL.  Dr. Few also serves as a Clinical Associate Professor for the Division of Plastic Surgery at the University of Chicago.  In addition, Julius Few is the immediate past president of the Illinois Society of Plastic Surgeons.

Dr. Few received his medical degree from the University of Chicago Pritzker School of Medicine.  Dr. Few then completed his residency in general surgery at the University of Michigan Medical Center, followed by plastic surgery training at Northwestern University.  In addition, Dr. Few also received special facial and eye cosmetic training in Honolulu, New York, and Atlanta.

Dr. Few is a board-certified plastic surgeon.  He is a member of many professional organizations including the American Society for Aesthetic Plastic Surgery, the American Society of Plastic Surgeons, the American Medical Association and the American College of Surgeons. In addition, he is also a member of the American Society of Plastic and Reconstructive Surgery and the International Society for Aesthetic Plastic Surgery. 

Dr. Few has lectured extensively on the subject of cosmetic facial surgery and safety. He is also the author or co-author of numerous publications.  In addition, Dr. Few has appeared on numerous news programs, including NBC, ABC, CBS, and CNN. He currently holds advisory positions on the subject of plastic surgery at CNN and Good Morning America. Dr. Few was included in Crain's Chicago Business “Top Forty under 40,” for his work in Plastic Surgery Development in 2002.