Cosmetic Surgery for Millennials

Millennials, also known as Generation Y, are ethnically diverse, tolerant of cultural and personal differences, confident in themselves, and proactive versus reactive.  By 2030 Millennial will account for 75% of the American workforce.  Similar to previous generations, this emerging largest generational group experience challenging and exciting years that signify the end or continuation of their educational process in preparation for their new occupation and passages in life ─ fitting in a new job, moving into a new place, meeting friends, and finding the special person.  Unlike previous generations, Millennial’s approach is to 1) address perceived flaws, 2) speak comfortably about them with others, 3) invest in their appearance, 4) research the qualification of providers, and 5) talk about preventive natural remedies in a holistic and organic manner.  Millennials are comfortable in getting ahead on anti-aging curve rather than waiting until later in life.   Social media, including the Internet, has provided them a platform to be familiar with products and services.  In the past, aesthetic procedures were look upon as frivolous, available only to those with means, and kept private.  In recent years, key influencers and celebrities on social media speak freely about their treatments, setting off a trickle-down effect where aesthetics procedures are no longer taboo.  Until the Millennials came along, plastic surgeons’ major demographic were over 40 years of age.  In recent years, plastic surgeons have recognized the social, economic, and personal needs of this special generation which are distinctly different from younger age groups (teenagers), middle-aged women in their 40s to 50s, and later-aged groups, 60s and beyond.

As Clinical Professor, Dr. Sasaki has helped hundreds of younger women and men in his internationally recognized Sasaki Advanced Aesthetic Medical Center that provide specialized service centers, devoted to Millennials, for skin care, injectables and devices, and surgery.  For over 35 years in his academic-private practice, his responsibility is to communicate safe and evidence-based treatments that bring out your inner and outer beauty for you to shine, be comfortable with your new age-appropriate appearance, and lead an exciting healthy life with full confidence and vigor.

 Aesthetic Procedures in Your 20s & 30s

Skin

Female Millennial patients, like their male counterparts, frequently wish to address skin problems from hormonal and sun damage.  They are concerned about superficial actinic pigmentations and deeper melasma pigmentations after pregnancy.  Acne outbreaks and scars diminish self-esteem and limit confidence in their social and professional life.  Moles (nevi), skin tags, and enlarged pores detract from a stunning, translucent and fresh appearance.  Pleasing expression lines turn into faint embedded wrinkle lines.  Wrinkle lines around thinning lips detract from welcoming smiles and projects a more mature appearance despite efforts to eat healthy, exercise and eliminate smoking.

The FDA recognizes the important benefits of sunscreen and retinoids for skin care in all ages.  Both these topicals have been extensively studied and form the basis for medical-based skin treatments.  The American Society for Aesthetic Plastic Surgery recommends at least a sun-protecting factor (SPF) of 30 that blocks about 96% of UV-B wavelengths to reduce skin cancers.  Blockage of UV-A (sun damage) and UV-B is provided optimally with the addition of a physical blockers, such as zinc and titanium oxide, in addition to the chemical SPF blocker.  Physical blockers do not require penetration of the epidermis to become active as they act as micro-reflectors on the skin surface and have a significantly longer life-span than chemical blockers (2 ½ hours).  Significant amount of UV-A exposure results in 1) slowing down the normal cycling time for sloughing epidermal cells, 2) stimulation of melanocytes for more melanosome pigmentations, 3) reduction and conformational changes to elastin and collagen fibers, and 4) reduction of the matrix glue in the dermis.  These damaging changes can be reduced by the application of appropriate sunscreen blockers.  The addition of retinoids in the acid form (retinoic-acid), alcohol form (retinol) and ester form (retinyl) can reverse the damaging effects of UV-A wavelengths, listed above.  Retinoids can also reduce the activity of sebaceous gland cells and aid in the treatment of acne formation.

True wrinkle lines develop in aging skin from repetitive activity of the underlying attached facial muscle(s) of animation.  The Sasaki InnoVessence SkinCare Center provides you evidence-based skin treatments tailored to your skin-concerns and your overall needs.  As transformation occurs, our  professionals adjust your skin care program by adding specific chemical peelings, acne treatments, pigmentation suppression, and topicals to reduce fine wrinkling.  For deeper etched lines, other treatments may be measured to enhance and sustain results with injections of neurotoxins, laser resurfacing, chemical peels, microneedling with/without radiofrequency, and fillers.  Dr. Sasaki, Skin Care Specialists (InnoVessence SkinCare Center), and Registered Nurses (Nurse Injectable and Device Center) are excellent team-resources that will coordinate efforts to achieve safe and effective treatments for a polished, glowing look.

Hair

Healthy thick hair is paramount to the well-being of young adults because of cultural influences, societal norms and a personal statement.  Given self-image’s important role in our social perception and psychosocial functioning, progressive hair loss is widely identified as one of the major causes of psych-emotional stress.   For Millennials in particular, premature hair loss or thinning in females may be even more devastating psychologically than it may be for males.  In 1993, one of the first studies dealing with the psychological impact reported 70% of women versus 25% of men expressed high levels of distress with their hair loss situation.  Women are skillful in camouflaging hair loss with creative styles as they retain the frontal hairline (85% of women).  When females lose more than 50% of their hair, alopecia (hair loss) becomes visible or noticeable by others.

Female Pattern Hair Loss (FPHL)

Currently, about 21 million women in the United States will experience some degree of female pattern hair loss (FPHL).  FPHL has no age predictor and may present as early as puberty or as late as age 40 years.  The peaks of onset are usually at the third decade (≈25%) and estimated to be 50% after age 40 years.  By the age of 60, 35-50% of women will develop hair loss.  Those who have earlier onset tend to develop more severe hair loss over time due to genetic influences (≈20%), hormones, stress, unusual dietary habits, medications, and medical disorders.  Some studies suggest that younger Millennial females may also be detrimentally affected through the androgen (testosterone) pathway that is believed to be the primary cause in male pattern hair loss (MPHL).

Typically, female pattern hair loss begins at the roots of follicles.  Miniaturization of the mature hairs occurs that leads to finer, smaller, thinner, slower growing, less pigmented hairs.  Although the hairline and temple are mostly maintained, the center part usually becomes first visible in a “Christmas tree” patterned hair loss.

As recently as 30 years ago, there were virtually no solutions for women with FPHL.  The factors that produced FPHL were not completely understood, and it was clear that more than dihydrotestosterone (DHT), the active androgen by-product of testosterone, was involved.  Today, there are thousands of nonmedical “cures” such as lotions, potions, herbs, home remedies, and vitamins.  If any of these were truly effective, reproducible medical studies would have validated their claims.

Currently, there is only one FDA-approved medication, Minoxidil (Rogaine®) solution or foam at 2.0% and 5%, for women’s hair loss.  Minoxidil is considered to be a nonspecific biological response modifier with an unknown mechanism of action.  Benefits of treatment include enlargement of miniaturized follicles, conversion of resting hair into growing hairs with minimal temporary side effects (irritant contact dermatitis).  When minoxidil is stopped, almost all of the stimulated hair will be loss.  Dr. Sasaki will inform you of options such as hair transplantation and other off-label anti-androgen drugs (finasteride (Propecia® for men only), cyproterone, spironolactone, dutasteride) and low-level laser therapy (LLLT) that have been used in the treatment of FPHL.  As these treatments are not without shortcomings, Dr. Sasaki will provide you a complete consultation, examination and tests, and microscopic phototrichogram as integral parts of your hair treatment program.  As a consultant-investigator in the field of platelet-rich plasma (PRP), regenerative cell therapy, growth factors, and the latest stimulating biologic (Exosomes) in FPHL, Dr. Sasaki is considered a leader in these novel off-label treatments conducted under the auspices of Investigational Review Boards.  Currently, Dr. Sasaki is the President-Elect of the Aesthetic Stem Cell Society, a multi-specialty group, that advances and supports the medical community’s understanding and use of regenerative cells for aesthetic medicine and is an advocate for patient safety and quality of medical care in its usage along Food and Drug Administration (FDA) guidelines.

Male Pattern Hair Loss (MPHL)

Male pattern hair loss or total baldness can be devastating in the younger patient.  In Millennial males, premature hair loss is often associated with loss of “manliness” that profoundly impacts their job status, dating opportunities, and well-being.  Studies report that in Caucasian males, 30% experienced androgenic alopecia by age 30 years and 50% by age 50 years with lower incidences in African-Americans and Asian populations.  In a population-based study of 30-35-year old, 51% was classified in the Grade I group, 43% in the Grade II group, and 19% in the Grade VI group, clearly highlighting early hair loss in younger populations.  In contrast, older populations with MPHL often perceived themselves as having a “distinguished” appearance.

Studies suggest that MPHL involves the upregulating activity of a 5-α enzyme that converts circulating testosterone into dihydrotestosterone which ultimately binds to the androgen receptors.  The molecular event leads to activation of genes responsible for the transformation of healthy terminal hairs into miniaturized vellus-like hairs.  Typically, the pattern of MPHL begins with thinning and recessive hair loss in the frontal hair line and temporal areas, then advancing forward from the vertex scalp (highest area of the scalp) and crown scalp (between the vertex and frontal scalp), ending in a U-shaped pattern loss of hair.

The FDA has approved the use of topical minoxidil and oral finasteride for MPHL.  These options typically require a great degree of compliance for long periods to achieve effectiveness.  Both of these medicines carry potential untoward side effects.  For finasteride, sexual dysfunction, particularly for the younger, male was observed in between 2.1% and 3.8%.  Like minoxidil, stopping finasteride will result in all gained hair.  Today, a surgical hair transplantation option remains the gold standard, but may require a number of surgeries to meet the patient’s, and may require a number of surgeries to fulfill the expectations of the patient.  Similar off-label treatments are available for MPHL as mentioned for FPHL.  Dr. Sasaki will assist you in planning your immediate and long-term treatment goals to match your stage of alopecia.

Face

Female and male Millennials usually do not need or request any major facial procedures but select  preventative treatments of early age-related problems such as aging around the eyes, mid-face, and mouth.  Congenital nasal deformities are in a special category as they can evolve into major anxieties by the early teens.  These distortions include asymmetries, irregularities, under- or over-projection of the dorsal profile and nasal tip, imbalance of the nasal openings, and overhanging or retracted contour of the columellar tissue between the nasal openings.  Occasionally, “the crooked nose” deformity, a consequence from accidents or sport injuries, can be addressed with fillers, but most commonly are managed by a surgical rhinoplasty. Dr. Sasaki is able to provide an in-depth consultation and management of your nasal deformation.

Within the Millennial population, most patients are females, starting in their early 20’s, while most of the males are in their late 20’s and early 30’s when they seek specific aesthetic procedures to their faces.

Skin Care Procedures
Concerns

Fillers: Hyaluronic Acids, Sculptra®, Radiesse®
Wrinkles, Folds, Hollow Cheeks, Thin Lips

Neurotoxins: Botox® Cosmetic
Fine Lines, Gummy Smile, Bunny Lines, Boxy Jawline

Lash Stimulator: Latisse®
Thin Upper Lash Line

Detoxifying Facials: Selected Branded Cosmeceuticals
Enlarged Pores, Dull Skin

Acne Treatments: Retinoids, Topical Antibiotics, Azaleic Acid, Benzoyl Peroxide,Glycolic Acid, Salicylic Acid, Lactic Acid, Cleanser, Toner, Branded Cosmeceuticals
Black Heads, Infections, Acne Scars

Microdermabrasion: MicroDerm® Diamond
Dull Skin, Age Spots, Wrinkles, Acne Scars

Microneedling: Bellus®
Dull Skin, Superficial Pigmenation, Wrinkles, Acne or Traumatic Scars

Pigmentation/Tattoo Treatments: Branded Sunscreens, Retinoids, Activated Ascorbic Acid, Lightening Creams, Chemical Peels
Sun Spots, Cosmetic Tattoos, Traumatic Pigmentations

Fat Reduction: Kybella® Injectable
Double-Chin (Submental Fat Pad)

 Non-invasive energy-based technologies are also easily adapted for facial rejuvenation to minimize downtime, greater safety, and immediate results.  LED light facial therapy (Lightstim®) reduces fine wrinkles, superficial pigmentations and skin dullness when combined with facials in our SkinCare Center.  Intense Pulse Light (Luminis® IPL) decreases rosacea and pigmentations.  Other energy-based devices tighten and lift loose skin (Ulthera®), remove unwanted facial hairs (Light Sheer® Laser), reduce superficial and deep pigmentations (PicoSure® Laser), smooth out skin wrinkles and scars (Fraxel® Dual Laser), tighten skin, efface wrinkles, and modify scars (INTRAcel® Microneedling-Radiofrequency), and fat reduction of the double-chin (CoolSculpting®).  Recently, Dr. Sasaki introduced a novel microneedling handheld device (AquaGold®) that delivers FDA-approved cosmeceuticals (neurotoxins, hyaluronic acid fillers, and Sculptra®) directly into the dermis for effective skin rejuvenation.  Dr. Sasaki is a consultant and on the Scientific Advisory Board for AquaGold® AquavitPharmaceutical, Inc. to advance this technology for the benefit of his patients. 

Dr. Sasaki and his staff will provide you personalized service to achieve your specific goals.  As consultant and investigator for all mentioned eleven devices in his office, Dr. Sasaki has lectured throughout the world and published on their safety and effectiveness by optimizing protocols and combined techniques. Your face reflects who you are.  Dr. Sasaki is committed to achieving your new look and well-being.

Breasts

Female breasts are specialized for breast-feeding (females).  In both sexes, breasts are organs of beauty but also sites for development of breast disorders (fibroadenomas, fibrocystic disease, malignancies).  No matter how healthy you are, any aesthetic procedure to the breast begins with a complete and detailed history and physical examination and culminates in a precise, tailored, procedure to enhance your profile.  Dr. Sasaki received special training in aesthetic and reconstructive breast procedures during his extensive residency training.  As Visiting Professor to over 30 countries, Dr. Sasaki has lectured about breast implants and tissue expanders that are currently used in aesthetic breast augmentation surgeries and in reconstructive procedures after mastectomies.

Almost 150,000 American female patients age 20-40 will select breast augmentation to enhance their upper body contour for a more flattering appearance.  Dr. Sasaki examination and consultation will require about one hour of your time in order to review your family history, evaluate available radiographic studies, measure your anatomical landmarks, describe the FDA’s concerns of silicone gel or saline implants, discuss your preferred available implant shape and volume outline, and the FDA’s and the American Society of Plastic Surgeon’s most recent decisions on the relationship on the use of textured-surfaced implants and Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).   Dr. Sasaki will spend additional time explaining how the procedure is done to ensure a stunning outcome.  At surgery, Dr. Sasaki first fills a temporary saline implant either in the under the breast tissue (pre-pectoral space) or under the pectoralis muscle (submuscular space) to assess the actual appearance of the trial disposable implant before insertion of the permanent implant.  This approach optimizes your preferred shape and volume for a beautiful customized silhouette.  Finally, Dr. Sasaki will discuss your post-operative care, side-effects, complications, and why replacement surgeries may be necessary in the future.

Gynecomastia (male breast enlargement) is the most common concern that detracts from a masculine appearance.  The surgical procedure focuses on a contoured-reduction of the primary breast tissue and surrounding fat, this is accomplished by both liposuction and direct excision of the fibrous breast tissue.  Surgery can be safely and effectively performed under local or general anesthesia.  Dr. Sasaki approach is to remove sufficient tissue for an aesthetic masculine look through minimal and hidden scars.  What is important is not how much tissue is removed but how much tissue remains for an appropriate shape that looks good with and without clothing.  Over the years, patients, who undergo this procedure, are most grateful and relieved of this concern.

Body Contouring

Millennials work and play hard, while practicing healthy eating habits, keeping in shape, and looking great.  However, no matter how much exercise or dieting is done, stubborn localized fat bulges persist that detract from a slimmer contoured healthy appearance.   Many young men and women observe the double-chin, flabby belly pouches, back rolls, widen hips, saddle bags thighs, and even touching knee bulges.  Sit-ups, crunches, treadmilling, swimming are helpful but not decisive.  In 2008, Dr. Sasaki was one of the first consultant-investigator in the nation to introduce CoolSculpting® in his practice.  This non-invasive technique is capable of reducing about 25% of the bulk in the cited areas after the first session.  However, much more contouring can be expected with the addition of Z- Wave® high-energy radial shock wave treatments to further reduce fluid and fatty tissue.  CoolSculpting® Cryolipolysis has minimal side-effects or downtime for the busy Millennial.   For larger and more resistant areas, liposuction is an effective alternative for body contouring.  Dr. Sasaki has been a consultant-investigator to all current devices, energized by mechanical pulse-assistance, radiofrequency, laser, hydro-water pulsations, and ultrasound for lipo-sculpturing in all areas of the body.  Liposuction may be performed under local tumescent anesthesia for smaller collections or under general anesthesia for larger multiple sites.  Dr. Sasaki’s philosophy is to remove sufficient fat to make a significant difference but, more importantly, leave enough fat for remodeling and sculpting.  Dr. Sasaki will give you a personal evaluation and help you select the optimal technique to exceed your expectations of a healthier outer and inner beauty.

Put your Best Self Forward

Dr. Sasaki has helped generations of his patients.  Aesthetics is a specialty within Plastic Surgery that restores the emotional and physical well-being of patients no matter age.  Dr. Sasaki’s goal is that you feel well with your new natural look and enjoy life to the fullest.  Please contact our office online or call our office at (626) 796-3373.   Better still, speak to one of our many patients of their experience.

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