Original photography by Mirelle Inglefield & Victor Red
After two years of cosmetic neglect and isolation, “getting some work done” is sounding more attractive than ever to many consumers. But the options for popular cosmetic procedures aren’t the same as they were 20 years ago.
Brazilian butt lifts, or the removal of fat from one part of the body and relocation to the buttocks, have grown astronomically, increasing by 77.6 percent between 2015 and 2020. However, the procedure is fraught with risk, according to some doctors.
“They are dangerous, as in one in 3,000 people that have one die,” says Dr. Patti Flint, a plastic surgeon who’s been practicing in the Valley since 1996. “It is the highest mortality rate of any aesthetic procedure… Unfortunately, the fat can find its way into veins and then the lungs. It is very popular and trendy, but it is straight-up dangerous.”
So, let’s assume a BBL is not an option worth pursuing right now. What other trending procedures are out there to consider?
“Brotox” is exactly what it sounds like: Botox for bros.
“We’re noticing… a lot more men that are interested in looking a little bit better, kind of smoothing out the lines on their face,” says aesthetic nurse Marissa Abdo, an Arizona State University nursing graduate who recently moved back to the Valley after practicing for nine years in Los Angeles. “Especially with this ‘Zoom effect,’ with the pandemic, with online dating,” she adds.
“But what actually is Botox?” some men might ask.
“Botox is botulinum toxin type A,” says Abdo, who co-owns Lumen + Bevel Aesthetics in North Phoenix. “Basically, what this product does is… interrupt that chemical message that tells your muscle to contract.” In short, it stops your face from wrinkling. It’s particularly useful for treating a man’s eyebrows, forehead or “crow’s feet,” those little skin crinkles at the corners of our eyes.
Abdo says that, in the past, her male clientele would come in for facial rejuvenation only at the behest of their wives or girlfriends. But now, they’re seeking Botox treatment of their own accord. In her estimation, men made up at most 5 percent of her injection patients a decade ago. Now, she says, it’s closer to 20 percent, with the upward arc indicating a further increase.
In addition to shifting toward men, the target market is getting younger, Abdo says, moving from 40s and 50s to as young as early 30s, as the emphasis shifts from eliminating wrinkles to preventing them before they form. She recounts one patient in that new age bracket, who said, “I finally told my guys’ group text message what I’ve been doing, and all of them were like, ‘Oh, I’ve been thinking about that!’”
And what does the procedure entail? Botox is injected in five to 10 sites, using “really, really tiny needles, like acupuncture-size needles,” Abdo says. “It lasts about three to four months… A lot of men like that. They can come in, try it out and see how they feel about it. And, of course, most of them are hooked at that time.”
For better or for worse, Instagram, TikTok and the like have placed an extreme cultural emphasis on the appearance of our faces. This has led people to seek out a wider array of options for alteration. One of these is “non-surgical rhinoplasty,” another filler-based treatment.
“By carefully injecting dermal filler above and below the ‘bump’ on the nose, we can very easily make the most ‘hooked’ of noses look completely straight,” the Milo Clinic’s Dr. Nick Milojevic told Harper’s Bazaar in 2020. “Additionally, by applying filler around the tip of the nose, we can make it look thinner and more refined, and can further lift the tip of the nose by injecting Botox into the depressor nasalis, the muscle which continuously pulls the nose down.”
Colloquially known as “liquid” rhinoplasty, the procedure is less expensive (typically between $600 and $1,500) than the surgical version ($9,000 to $12,000) with predictably less recovery time (sometimes a day or less) and fewer potential health complications. The downside? It’s impermanent, lasting only six months or so – which is why some doctors recommend it as a “test run” for patients not ready to commit to surgery.
QWO Cellulite Treatment
While Botox has been around long enough to have become the industry’s most common cosmetic procedure, Lumen + Bevel Aesthetics co-owner Morgan Renfro (see page 20) is equally interested in a new solution for cellulite called QWO.
“It’s the first non-surgical treatment for cellulite in the booty, so it’s very exciting,” Renfro, an R.N. and Arizona native, says. “Surprisingly, nine out of 10 women have cellulite, and it’s not due to anything through your lifestyle – it’s just genetic. Cellulite sometimes can make us feel just a little bit self-conscious, and we try to hide or cover things. With this treatment being available, we’re going to be able to smooth out our patient’s booty and actually treat the cause of the cellulite by breaking down the fibrous bands that cause them, so that our patients feel more confident.”
QWO involves injection of collagenase. “One injection per dimple,” Renfro says. “So somewhere between 12 and 24.”
“The actual injecting procedure takes about 10 minutes,” she says. “So essentially what happens is the patient comes in, we mark out the dimples, and then we go directly into the dimples with our QWO… They come back about 21 days later, because it’s a three-treatment period.”
Approved by the FDA in 2020, the procedure is still evolving – it remains to be seen how long it will be effective before repeat injections are needed to maintain results. Renfro is optimistic, saying one year’s worth of treatment could last up to three.
“It is so popular that we are hesitating to even tell all of our patients that we are up and running, because every patient that comes in and sees anything about QWO is instantly curious. Because they don’t know that there is a treatment that can tackle something as tricky as cellulite,” Renfro says. “We are very excited for the potential that this product has for our patients. And it seems like our patients are feeling the same way – they are just ready to go. Or QWO – ready to QWO!”
DIEP Breast Reconstruction
DIEP is shorthand for the Deep Inferior Epigastric Perforator flap.
“This is essentially taking the tissue that would normally be discarded during a tummy tuck and creating a new breast,” Dr. Jason Mussman, a plastic surgeon with Regency Specialties in Phoenix, says. “This is the most difficult and most sought-after breast reconstruction method. Many of our patients fly from neighboring states.”
The procedure is enormously helpful for patients who’ve had a mastectomy, as it enables them to have an entirely new breast mound, using fat, skin and blood vessels from the lower abdomen. Surgeons can also convey a sensory nerve from the abdomen with the flap to restore sensation in the breast.
“Chances are your new breast won’t look exactly like your natural one did,” according to the Mayo Clinic. “However, the contour of your new breast can usually be restored so that your silhouette looks similar to your silhouette before surgery.”
“Hands are one of the common things that are overlooked, shall we say, in plastic surgery,” says Dr. Pablo Prichard (“aka Dr. Scottsdale”), a plastic surgeon who’s been practicing reconstructive and cosmetic surgery in the Valley since 2005. According to Prichard, when patients get their face or nose done, often “their hands kind of don’t match their face. Their hands just look a lot older than the rest of them.”
Prichard says he’s seen “at least a 50 percent increase in hand-rejuvenation requests,” which are especially relevant in Arizona, where intense and relentless sunshine can cause damage to the hands, an area we don’t often protect with sunscreen and SPF makeup.
That’s where “hand lifts” come in. Rather than being a serious “cutting” procedure, hand lifts involve adding filler – made from hyaluronic acid (“a natural protein that is in our body already”) – to “make the area more plump, basically adding the volume that you lost over time.” It’s a 30-minute procedure with a fairly easy recovery, Prichard says, involving about four injections of filler into the back of each hand. The filler is then spread out, leaving them looking revitalized.
Another common tool for Prichard’s hand lifts is Morpheus8, which involves microneedling and radio frequencies to thicken the patient’s skin and eliminate sun spots. Prichard says that, beyond hand lifts, the Morpheus8 technique for skin rejuvenation is trending for use all over the body. He can use it “almost from head to toe.”
Of the cutting-edge procedures she offers, Scottsdale cosmetic surgeon Patti Flint is particularly bullish on the lip lift, which involves making the “white lip” smaller and the “red lip” (“the part where a woman would put lipstick”) bigger.
“I took a retrospective look at my facelift results, and I thought they were really pretty good,” Flint says. “I was critically assessing what could be better, and I realized that the lip proportions were off, and I started researching how the mouth specifically ages over time, and it turns out the ‘white lip’ gets longer and the ‘red lip’ gets shorter.”
With this procedure, she says, “Really, you give them more ‘dental show,’ meaning when they smile or speak, more of their teeth show. And that’s a much better aesthetic ideal.”
Flint believes that, across the board, the pandemic has changed the way we think about cosmetic surgery, which has led to a boom for the business.
“I think surgery in general has exploded through COVID,” Flint says. “Twenty-five years into practice, at this point you expect your surgical volumes to be pretty staid. For five years prior to COVID, very, very busy, stable for the most part. But in the last two years, my surgical volume has increased 40 percent.”