Colorado’s own Heidi Montag Pratt of The Hills MTV reality series now in its sixth season underwent comprehensive plastic surgery earlier this year generating endless news feeds and paparazzi coverage. “This situation should not be perceived as reality,” says Jeffrey Raval, MD, FACS. “Reputable plastic surgeons do not engage in performing surgery to gain notoriety.”

While undergoing 10 plastic surgery procedures performed in one day – a mini brow lift, Botox injections, a nose job, fat injections in her cheeks and lips, a chin reduction, liposuction to her neck, her ears pinned back, buttocks augmentation, liposuction to her waist and thighs, and revision breast augmentation—Montag had the surgeries taped purportedly to use in a future reality show.

Post-surgical photos of Montag reveal a Barbie-shaped physique. “Truly, the responsibility of any cosmetic surgeon is to vet elective surgery options with a patient prior to surgery. Consults with the doctor would routinely identify what surgical procedures are indeed going to enhance an individual’s lifestyle and improve their health. A perceptive plastic surgeon will be able to assess whether an individual is seeking surgery for all the wrong reasons, i.e. to please a partner or to gain notoriety. From the outside, it would appear that this particular celeb pursued surgery to generate media attention rather than to correct physical flaws.”

Dr. Raval has gained a reputation among fellow surgeons in the Rocky Mountain West of being The Nose Doc, particularly proficient at revision rhinoplasty surgery, repeat nose jobs that are more complicated than first-time nose surgeries because of the scar tissue that develops in any surgical area.

Dr. Raval pioneered the use of Dermamatrix in nose surgeries resulting in a smoother, more natural shape to the nose. Introduced in 2006, this dermal matrix is preferred over others because of its uniformly soft and pliable consistency and its increased tensile strength.

To see a video on the benefits of Dermamatrix, go to www.ravalmd.com/rhinoplasty.html.

Botox injections were up 8.1%, as were Restylane filler injections. Laser treatments were up 1.6% in Q4 2009.

Is this a sign the economy is turned around? Or is it a signal that some people won’t forego ongoing cosmetic care that keeps them looking younger and consequently makes them feel younger?

“We see this as a positive,” says Jeffrey Raval, MD, FACS, facial plastic surgeon practicing in Cherry Creek North, the upscale boutique and restaurant epicenter of Denver, CO. “It underscores the value in less invasive procedures like injections done more frequently so as to forestall major cosmetic surgery.”

Dr. Raval operates his practice Raval Facial Aesthetics together with Rocky Mountain Laser Aesthetics, a laser hair and tattoo removal clinic, in the same location. He has gained the reputation of being The Nose Doc in the Rocky Mountain West by his peer surgeons who have recognized his capabilities especially in revision rhinoplasty, made more complex because of the scar tissue that results from an original nose job. Dr. Raval also has been referred to as The Face Doc for his achievements in treating head and neck needs of patients, particularly in the cosmetic market sector.

“BOTOX is the most commonly used injectable in the cosmetic field,” says Dr. Raval (www.ravalmd.com). “The filler injectables are increasingly preferred because they don’t require the downtime that a traditional face lift or forehead lift or neck lift can require. Patients are short on time, working longer hours, putting in more exhausting weeks. While they’re showing evidence of being more tired, they don’t want to appear tired because it takes away their competitive edge. Filler injectables are the ideal solution to treat this very active and busy patient.”

On Jan. 20, 1010, the International Association for Physicians in Aesthetic Medicine (IAPAM) released a report that Botox and filler injections will lead the cosmetic treatments performed in 2010 as the country works its way out of the most severe recession in decades.

The editors of Consumer Guide to Plastic Surgery concur, releasing a forecast for this year showing Botox at the top of services that patients will find the money to pay for.

Sculptra® makes you look years younger without surgery or down time

Q. There are so many dermal fillers on the market. What is Sculptra® and what makes it different from the others?

A. Sculptra is the only dermal filler in the United States approved for the restoration of facial fat loss or lipoatrophy most commonly seen in people with human immunodeficiency virus. Lipoatrophy is the loss of fat beneath the skin that results in sunken in cheeks, eyes and a hollow, gaunt look. Sculptra is a safe, biocompatible material that is injected into the skin where the fat loss occurs. The filler provides a gradual and natural increase in the thickness of the skin resulting in a full and healthy appearance. Sculptra® is also used in those who do not have HIV and have lost facial fat through aging.

Q. I want to receive Sculptra injections to reverse the hollow, sunken in parts of my face. Are the results immediate? How many treatments will I need and how long do they last?

A. Immediately after receiving Sculptra injections, you may appear swollen due to the injections. A few days later, the swelling subsides as your body absorbs the water. Sculptra takes time to fully develop and correct the hollows in your face. Dr. Raval will determine how many treatments you need; patients with severe facial fat loss will require between 3 and 6 treatments to have satisfactory results. Results last different lengths of time for each person, but in clinical studies they lasted up to 2 years. However, touch-up treatments may be needed to maintain the desired results.

Q. I am terrified of needles and worry about the Sculptra treatment. What can I expect during the procedure?

A. Prior to the treatment, all makeup and facial products should be removed to create a clean, smooth surface. The area of the injections will be thoroughly cleaned with an antiseptic and Dr. Raval will determine whether a topical or local anesthetic is required. Sculptra is then injected in small amounts into the skin through an extremely fine needle. Following the procedure, an ice pack should be applied to the area to reduce swelling and the area of the injection will then be massaged to distribute the product evenly.

Q. What can I expect to happen after treatment? Will I be able to return to my daily activities immediately?

A. Immediately following treatment, there may be some swelling, bruising, pain, redness or all of the above. These after-effects will usually subside in a few hours or, at most, a few days. Dr. Raval recommends that you massage the area for several days following treatment as well as apply an ice pack. It is also important to avoid direct sunlight until any redness has been resolved.
The after-effects differ from patient to patient but most patients feel well enough to return to their daily activities immediately afterwards.