For this reason, skin tightening alone with procedures such as a facelift, eyelid lift or brow lift may not be enough to restore a youthful appearance.

“The original thought was that skin goes through changes, such as a loss of elasticity and fat, so the primary approach to facial rejuvenation was skin tightening procedures,” study co-author Dr. Robert Shaw Jr. told HealthDay News.

“But a lot of faces never looked like they did when they were younger. Patients bring in pictures and say they want to go back to that look, but they can never really go back to that look just by tightening their skin alone. If there are changes to those underlying structures it’s going to change the appearance of how the skin looks.”

According to the study, which is published in the January issue of Plastic and Reconstructive Surgery, bone loss and recession is most pronounced in women over 40 and men over 65. Study authors performed CT scans on 120 Caucasian patients (60 men and 60 women) split into three age categories—20-40 years, 41-64 years and 65 years and older.

“We saw changes around the eye, and then in the cheek area and in the jaw,” study co-author Dr. Howard Langstein told NPR. “And if you think about it, it kind of makes sense. When people age, the eyes appear hollow, deep-set. And, in fact, that’s what we found. The cheek bones right beneath the eye socket descend somewhat and come back in. As a result, they don’t give as much support to the lower eyelid.”

Langstein also said that chin recession and thinning of the jawbone were also major contributors to facial aging, explaining the slack-jawed appearance of some of the study’s oldest participants.

To combat the effects of bone loss on facial aging, Dr. Shaw suggest combining skin tightening with other cosmetic procedures designed to restore the facial structure, such as fat grafting, injections with fillers like Radiesse or Sculptra and facial implants for the chin, cheeks and jaw.

“It’s not ever possible to bring someone back to how they looked when they were 20 years old, but adding volume back to the face can improve results for some patients,” says Dr. Shaw.

Since bones makeup the underlying structure of the skin and provide a sort of scaffold to support facial tissues, the study results are no surprise to cosmetic surgeons.

“It’s one of those things that, in retrospect, you sort of say, ‘Duh, I should have known that!’” says Dr. Langstein. “Nothing stays the same on the body. Everything ages.”

However, new data released by researchers at the University of Iowa suggests that among Americans, medical tourism is actually less popular than previously supposed.

Brandon Alleman and his team of researchers at the University of Iowa surveyed 45 companies that facilitate medical tourism for U.S. patients and found that these companies have referred only about 13,500 U.S. residents to healthcare and cosmetic surgery facilities outside the country.

These companies represent about 70 percent of the market serving U.S. medical tourists, so if, say 23,000 American patients traveled abroad for medical treatments, that makes up only a tiny fraction of the number of patients treated in the U.S. each year.

This is good news to Owensboro cosmetic surgeon Dr. Gerald Edds, as he and many of his colleagues discourage American patients from traveling abroad for cosmetic procedures like liposuction, breast augmentation and even injectables for a number of reasons.

For instance, countries outside the U.S. where cosmetic surgery is less expensive often do not have adequate standards of care and official oversight designed to prevent avoidable complications and poor outcomes.

There is also concern over whether medical tourists actually receive treatment with the products or devices they think they are getting, and that they paid for. Many patients think they’re getting Botox, but end up getting cheap knock-offs of the real thing, along with poor results.

In addition, most surgeons agree that it is important to receive follow-up care from the physician who performed the procedure, which is not usually possible weeks or months after surgery, when patients have returned to their homes in the U.S.

In fact, the study results showed that 93 percent of companies brokering medical tourism packages expect follow-up care to be performed by U.S. physicians.

Given the fact that many physicians are uncomfortable providing follow-up care to patients on whom they did not perform the initial surgical procedure, it can be not only difficult to find a physician who will provide post-surgical follow-up care after traveling abroad for cosmetic surgery, but costly to hire a new physician as well, especially if complications arise and revision surgery is needed.

To avoid the potential risks and difficulties with follow-up care that can arise from medical tourism, it’s best to first choose an accessible, board-certified cosmetic surgeon who performs procedures in an AAAHC accredited U.S. surgical facility.

Let cost be your final consideration in choosing a surgeon, as paying slightly more for a great outcome the first time can end up being much less expensive than paying separately for follow-up care and multiple revision procedures down the road.

There are also a number of financing options available to Americans who do not have the cash in-hand needed to pay for cosmetic surgery, so there is little reason to travel abroad when some of the world’s best surgeons are in your own backyard.

Whatever you call these criminals, they are changing the face of cosmetic medicine and forcing more and more doctors to require prepayment for facial rejuvenation, skin care treatments like microdermabrasion and other services.  Many are also no longer accept checks for services rendered and instead require cash or card payment for elective procedures that are not billed through insurance.

“From talking to our doctors, this is a problem that’s occurring from coast to coast,” said Jeff Karzen, spokesman for the American Academy of Cosmetic Surgery.

Physicians in a number of U.S. cities, including Arizona, Texas, California, Nevada and Florida, as well as internationally in the UK and Australia, have reported patients who received thousands in injectable filler and wrinkle relaxing treatments, such as Restylane and Botox, only to flee the doctor’s office without paying the bill.

After their cosmetic treatments are complete, those intending to pull the old dine-and-dash, or in this case, the prick-and-run routine typically give the doctor’s office staff some sort of excuse to leave, such as needing to withdraw cash from an ATM or go out to their car to get their purse or check on a waiting child.

Check fraud is another common practice for “Beauty Bandits,” as the doctor’s office won’t find out until the crook is long gone that they’ve knowingly written a bad check for cosmetic services they don’t have the means to pay for.

Highly publicized cases like those of Jaime Merk and Maria Chrysson, two “Beatuy Bandits” who got busted by Florida law enforcement after stiffing area doctors for thousands in beauty treatments, have forced physicians to become more aware of this increasingly common criminal practice.

So, when seeking cosmetic treatment, especially for the first time with a new clinic, don’t be alarmed if you are asked to pay with cash or credit upfront.  This is simply a precautionary measure that has become necessary for doctors to prevent fraud and revenue loss.

Novabel injectable filler

One of the most exciting innovations is a unique new injectable filler product by Merz that was launched in Europe earlier this year called Novabel.

Unlike any other injectable filler product on the market today, Novabel is made from brown marine algae, a substance that purportedly makes injections smooth, easy to administer and virtually pain-free.

Novabel is composed of spherical, flexible structures called Geleons, and it is this patented Geleon technology that is supposed to make Novabel ideal for filling areas of thin facial skin, such as the lower eyelids and tear troughs.

Novabel’s Geleon technology is also supposed to cause less swelling than other injectable dermal fillers.

Endoform Dermal Template

Mesynthes, an award-winning medical research and development company based in New Zealand, recently announced the release of Endoform Dermal Template, a tissue substitute recently FDA-approved for wound care and skin reconstruction.

This new skin substitute finally offers an alternative to skin grafts, which require skin tissue to be surgically removed from one body area to graft onto another.

Unlike skin grafts, Endoform Dermal Template is not composed of donor skin but rather of extracellular matrix material, which provides a unique mix of biological macromolecules that actively promote the skin regrowth via cell regeneration and blood vessel formation.

“Fly tape” for surgical incision closure

Caddisfly larvae offer a new twist on “fly tape,” as silk spun by these insects is currently being researched by scientists at the University of Utah to eventually develop a stronger surgical tape.

This fly-inspired surgical tape would be engineered to create a sort of “wet BandAid” that closes incisions similarly to surgical sutures but offers dramatically increased adhesive bond strength that would potentially lower incidence of suture failure in patients who have had a tummy tuck or other cosmetic surgery procedure.

Owensboro cosmetic surgeon Dr. Gerald Edds stays up-to-date on the latest surgical technology and research in cosmetic medicine so that he can offer his patients the most effective cutting-edge procedures  to achieve the best aesthetic results.

While Botox is commonly used – and FDA approved – to treat wrinkles on the face and forehead, a wide range of other treatment applications have been successfully used.  Doctors have used Botox to treat hyperhidrosis, migraine headaches, and muscle spasms.

Last year, the FDA announced that Botox complications had been linked to off-label use, particularly in children treated for limb spasticity.  According to current U.S. law, doctors are permitted to administer medicine for whatever application they deem appropriate.  Doctors aren’t however, allowed to market medicine for any application they please.

The marketing restrictions on Botox have apparently hindered the pharmaceutical company’s ability to distribute safety information related to off-label use.  The lawsuit is intended to increase the physician’s ability to access safety information such as possible risks, benefits, dosing, patient selection, etc. and is in no way intended to increase sales of Botox.