Face Forward: Rewards And Potential Risks Of Altering Your Appearance

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This Patch article is sponsored by White Plains Hospital.

Dr. Anisha R. Kumar is the Director of Facial Plastic and Reconstructive Surgery at White Plains Hospital.

With an academic background in medical anthropology, Dr. Kumar’s interests include social perception of facial plastic surgery and quality of life measures associated with facial deformities. She offers the full complement of reconstructive and facial aesthetic procedures, including reconstruction of skin cancer defects, interventions for facial paralysis, gender affirmation surgery, rhinoplasty, face lift, neck lift, brow lift, eyelid surgery, ear reshaping, lip lift, cheek and chin implants, injectables treatments and skin resurfacing.

In addition, Dr. Kumar is a member of the American Academy of Facial Plastic & Reconstructive Surgery and the American Academy of Otolaryngology – Head and Neck Surgery.
Patch had the chance to speak with Dr. Kumar about the different types of aesthetic procedures available, how she approaches each patient’s wants and/or needs, and what should be kept in mind when considering facial alterations.


Patch: What attracted you to the medical/healthcare field, and how did you get started?
Dr. Kumar: My mom and several other family members were in healthcare, so I was encouraged to look at it as a possible career. I found that it lined up best with my interests.

I got my medical degree from the Stanford University School of Medicine after receiving a B.A. in anthropology at Harvard. Otolaryngology and ENT (ears, nose, throat) became sort of an obvious choice, since with anthropology, so much is about the face. We all look at our face in the mirror on a daily basis – it makes up so much of our identity and how we carry ourselves.


Patch: What led you to White Plains Hospital?
Dr. Kumar: I actually grew up in Westchester County, so it was close to home, and the opportunities at the Hospital are hard to beat. In addition to doing my own aesthetic and reconstructive procedures, I will be doing joint cases with the other surgeons in our Otolaryngology/ENT department. For example, I will be performing complex facial reconstruction after cancer resection/removal. The cancer resection will be done by my colleagues, and I will do the reconstruction.

For patients who are undergoing sinus surgery and who need specialized structural support inside their noses for their breathing, my colleagues will be doing the sinus surgery, and I will be doing the surgery for nasal structural support.


Patch: At the Hospital, you’re providing different aspects of what’s called “facial aesthetic medicine.” What does that consist of?
Dr. Kumar: It encompasses everything from skincare and injectables to laser treatments and surgical procedures. Since each patient is different, each of those elements can be personalized to that patient’s individual needs and wants. And it can be done at almost any age and gender – while historically things like Botox and injectable dermal fillers were seen as appealing primarily to women, a lot more men are now doing it.

There really is no age limit. What is needed, regardless of age, is a determination if the patient is medically fit to undergo a procedure. Are they allergic to what is in a given injectable? When it comes to certain laser skin treatments, you may need to stop certain medications six months prior to treatment.

If the patient is pregnant, then Botox and fillers are not recommended, as there has not been enough research done to tell if those procedures are safe or not. With surgery, if someone has a heart condition, is on blood-thinning medications, or otherwise is at an increased risk of bleeding, they may not be the best candidate. Again, you have to treat patients on a case-by-case basis – there is no cookie-cutter approach.


Patch: You mentioned laser treatments earlier. For what sort of procedures do you use a laser?
Dr. Kumar: Lasers are used to resurface specific layers of skin. Non-ablative, or less invasive, lasers heat the underlying layer of skin – the dermis – to stimulate collagen production. Ablative lasers destroy the outer layer of skin – the epidermis – to regenerate younger-looking skin. Lasers can also be used to target specific concerns like sunspots, rosacea, scars, and spider veins. There are other therapies like IPL (intense pulsed light) for skin maintenance that are good options for younger patients. But, again, laser procedures are used discriminately. Not all lasers can be used on every skin type.


Patch: Returning to the face: Are Botox and fillers different from each other?
Dr. Kumar: “Botox” is actually a brand name, like “Kleenex” or “Xerox.” People use those words as generics, but they actually refer to a specific product. Botulinum toxin is an injectable neurotoxin used to reduce fine lines and wrinkles by effectively paralyzing or freezing the muscle beneath the injection spot – the forehead, under the eyes, the cheeks, etc. Dermal fillers, as the name implies, are used to fill in wrinkles or to “plump up” features like lips and cheeks, or even to reshape certain parts of the face like the nose or cheeks.


Patch: How do you determine what the “right” amount of Botox is for a given patient?
Dr. Kumar: The dosage and placement are of course very important. For a first-time patient, I usually start with the standard dose recommended by the manufacturer and, if that doesn’t have the desired effect, we can titrate the dose. But it also depends upon what the patient wants. All of our faces age with time, so it’s really a matter of what the patient is looking for.

There is a wide range of options that focus on specific aspects of the face and neck, and a patient’s concerns. Some of these can be done in an office setting and others are better suited for the operating room, but in general, surgery is similar to injectables because it targets specific anatomic structures for rejuvenation. Examples include brow lift, upper and lower eyelid surgery (blepharoplasty), cheek implants, chin implants, facelift, neck lift, rhinoplasty, liposuction and much more.


Patch: What should a patient keep in mind when deciding if aesthetic medicine is the right path for them to take?
Dr. Kumar: Again, every face is unique and has different needs for rejuvenation, and even both sides of the same face may have minor structural differences. Therefore, it is important to consult with a provider who has the proper expertise to provide personalized care. It’s also important to consider the amount of time needed to complete a procedure, particularly when it comes to surgery – there can be several weeks’ worth of recovery time.

Medicine can “reverse” the effects of aging to a degree, but unfortunately it can’t stop the process of aging for any of us.

And lastly, there may be several people in a given community who offer injections and laser treatments, but there are risks involved with each procedure. I always emphasize that you should trust your face to a trained, certified professional.



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