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<< Back to Health & Wellness, April 2014

Q&A with Lisa Ishii, MD

The Johns Hopkins surgeon and director of research, Center for Facial Plastic and Reconstructive Surgery, smoothes the wrinkles in our worried foreheads as she discusses aging with grace.

Health & Wellness: You have done some of the first research into the impact of facial anomalies on perception. Can you share the results?
DR. LISA ISHII Faces fascinate me: They are the portal for how we communicate with the world and how the world identifies us. If someone has a deformity, a crooked nose, or even a lesion or scar on the face, the casual observer may perceive that person as less attractive, less friendly, and less happy. This data reinforced my belief in helping people correct certain features and restore their sense of self.

H&W Are more men opting for plastic surgery?
LI Ten years ago, men comprised 10 percent of my plastic surgery patients. Now that number is 20 percent. The competitive job market has had an enormous impact; men seeking a new or better position often feel they need to look more youthful to compete.

H&W Can fillers both treat and prevent wrinkles?
LI Now, the most common fillers use hyaluronic acid, which is a natural component of skin and acts as a scaffold for cells that produce collagen. Hyaluronic acid fillers, such as Restylane and Juvederm, can boost collagen production and prevent wrinkles. Neuromodulators, such as Botox and Dysport, prevent grooves in the skin from getting so deep they cannot be smoothed. Both fillers and neuromodulator agents have long-term evidence of efficacy and safety.

H&W What is the latest science behind hair restoration?
LI No medications lead to regrowth yet; they only slow hair loss. However, there is some hope for bimatoprost, used in Latisse, the product that lengthens and thickens eyelashes and brows.

H&W Do anti-aging creams really work?
LI The right ones do, but consumers need to be skeptical. Products with retinoids like Retin-A can thicken skin, smooth fine lines, and boost collagen at the right strength. They need to be at least 0.02 percent. Retinol, found in over-the-counter products, is not the same thing; it may not effectively penetrate skin to make a difference.

H&W Regarding cosmetic surgery, what one procedure most restores a youthful appearance?
LI Blepharoplasty, or eyelid surgery. Eyes have a substantial impact on how people perceive us. Upper lid surgery requires little downtime and can be done in the doctor’s office with just local anesthesia, and eyelids typically need lifting only once, unlike a facelift. It is one of my favorite procedures.

H&W With sunscreen, are SPF designations higher than 30 useful?
LI Anything above 30 is a gimmick. The best sunscreens contain barrier protection—such as zinc oxide—to put a physical barrier between skin and the sun.

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