Christian Subbio, M.D., planned on attending art school as a young person, but fate took him in a different direction. Inspired by a documentary about reconstructive plastic surgery as a teen, Dr. Subbio found his passion in pursuing a career as a medical professional.
Now, as one of the area’s leading plastic surgeons, Dr. Subbio specializes in areas such as facial rejuvenation, which includes procedures ranging from Botox and fillers to noninvasive skin tightening to mini-facelifts in the office and full facelifts in the operating room. We sat down with Dr. Subbio, who is certified by the American Board of Plastic Surgery, to find the answers to some common questions regarding turning back the clock.
What kinds of results can facial rejuvenation provide?
The answer to that is dependent on what kind of treatment, or how invasive a treatment, a patient opts for. In general, less invasive treatments are fantastic because there is less cost, less downtime, less risk; those are the pros to doing less invasive procedures. However, patients have to realize when choosing these that the effects, by and large, are subtler than the more invasive procedures.
Whereas the more invasive procedures offer patients more dramatic results, they do come with more cost, more downtime, etcetera, so it really depends upon which treatment a patient chooses as far as how dramatic the resulting transformation can be.
What are some of the noninvasive options for facial rejuvenation?
Facial rejuvenation can start as early as a patient’s 20s or 30s, if it is in the form of chemical peels and laser treatments and skin regimens. In general, the less invasive procedures are better suited to patients who are younger. For instance, if a patient is in her 40s, most likely she may not need the more dramatic effects of a facelift. However, she may be a better candidate for less invasive treatments such as Botox or fillers or laser peels. As a patient ages, and the signs of aging become more pronounced, it is less likely that these less invasive fixes are going to do an adequate enough job.
When a patient is in her 50s, 60s or 70s, she more likely will need some kind of surgical intervention if she really wants to have a more dramatic transformation. One of the things I like about being a plastic surgeon is I can offer the whole gamut; I have the tools to offer someone a superficial or topical treatment if that’s what she needs. As well, I can offer the most invasive treatment in the form of face and neck lifting, if that’s what she needs. As such, I can be more honest with a patient and tailor my treatment according to what that patient’s needs actually are. If a patient visits with someone who is not a plastic surgeon, and who is incapable of offering the more invasive treatments, they may get sold on a less invasive treatment that is not going to give them the results they want simply for the fact that that provider can’t offer those more invasive options.
For some of the noninvasive procedures such as Botox and fillers, what types of issues can these treatments address?
Botox actually weakens the muscles that cause wrinkles in the upper face so patients have their “11” lines, which form between their brows; they have their forehead lines, which go across their forehead; they have their crows’ feet; in general, Botox is a perfect solution for these areas because these are caused by excessive muscle movement, which over the years is going to etch these lines in a patient’s skin so it can be used to prevent and treat and soften these lines.
Fillers are better suited toward the lower face and cheek area in that these areas have deeper valleys and crevices, [and] Botox and muscle weakening will not produce the desired effect. These areas can typically be softened by adding filler to blunt the folds of the lower face; however, they have their limits, and if these lower facial changes are more pronounced, [the patient] is probably better suited for more invasive procedures.
What is Clearlift, and who might be an ideal candidate for this procedure?
Clearlift is on the less invasive side. It’s a newer form of laser treatment that addresses the deeper layers of the skin. It’s normally sold as a package of multiple treatments. One treatment in itself is not going to give a patient a significant enough result, whereas the full package of four to five treatments can sequentially and progressively tighten the deeper layers of skin to give that patient a lifting effect over time. We’re very excited about it because it is a pain-free treatment which can quite literally be done over lunch with the only immediately noticeable side effect being a slight reddening of the skin, which should dissipate within a few hours. It’s pain free, it does not have any downtime, and with a series of treatments can provide a lifting effect to the lower face and neck areas for those patients for whom the surgical options are not yet the right answer.
What is involved in a facelift?
This, like most cosmetic treatments, has a variety of approaches and levels of invasiveness. In its most subtle and basic form, we have the mini-facelift, where we lift a certain degree of skin around the cheeks and around the ears and the sides of the neck and trim a very minimal amount of skin to give a very slight lifting effect. This can progress to a more involved facelift that lifts and trims and pulls more and thereby leads to a more dramatic effect but [with] more downtime involved.
A full facelift can involve the cheeks, the jowls, the marionette lines as well as the neck, whereas a mini-facelift may only address the jowls and the sides of the face. It really is an area where tailoring the specific operation to the specific patient comes into play.
What is fat grafting and what are the applications of that?
Fat grafting is one of the more recent focuses of facial rejuvenation. Twenty years ago, no one really talked about the role of replacing the lost volume of the aging face.
As someone’s face ages, one loses fat in the cheek area, in the temple area, all over the face, which allows the face to sag further. Twenty to 30 years ago, facelifting relied solely on pulling structures back up, which also led to the “overdone” look or the “operated” look, where a face seemed pulled too tightly. These days, plastic surgeons are placing more emphasis on complementing the lifting techniques with the filling techniques so that it’s not simply pulling structures back up and suturing them into place but rather also taking fat from elsewhere in the body, where it’s unwanted, and transferring it back to those areas in the face where it has lost that youthful fullness such as the cheeks, temples and nasal folds.
What is the first step for someone interested in turning back the clock?
The first step, I think, is to visit with a board-certified plastic surgeon. As I mentioned before, it’s important to see someone who can offer the full spectrum of interventions, everything from Botox to chemical peels to mini-facelifts to full facelifts. A patient has to do their homework to really research the doctor that they would like to consult with, and usually I would recommend they have more than one consultation with more than one doctor, so they really build a rapport with that doctor and get to trust him or her. … It’s very important that that person be certified by the American Board of Plastic Surgery as opposed to any other credentialing board because it’s the only plastic surgical board recognized by the American Board of Medical Specialties and signifies that that surgeon has had several years of surgical training as opposed to some weekend course that they can offer some mini-fix.
For more information on facial rejuvenation, contact Dr. Subbio at his practice, Subbio Plastic Surgery & Medical Spa, at 610-356-6100 or visit www.drsubbio.com.
Photograph by Jody Robinson
