Austrian television and many other media recently reported about an unusual Miss Hungary contest: in the Miss Hungary Plastic Surgery contest only candidates who had previously undergone plastic surgery were eligible to take part. The title was finally won by a 22 year-old hostess whom surgeons had not only assisted with injections – a Botox treatment alone would not have sufficed for eligibility in the Miss contest.

According to the reports, however, the winners were not just the girls who had been “prettied up” with implants but also the plastic surgeons who had helped nature with their scalpels and silicone. One candidate had even undergone an operation to her toes in order to get apparently closer to the ideal of a “perfect body”. However, in the light of current trends and developments in the area of cosmetic medicine, this contest seems positively out of date.

There is no doubt that for some time the trend in cosmetic medicine has been going in the direction of restoration of natural beauty and health. In other words, a healthy body always radiates beauty too, and natural beauty can lead to a better sense of well-being.

The goal of New Cosmetic Surgery is increased beauty and health through methods that are as gentle and natural as possible. Breast augmentation through silicone implants and operative face-lifting can in many cases be replaced by treatment using the body’s own fat enriched with stem cells – the consequences are natural results without scars and foreign body implants. Stubborn fat deposits can be removed gently by means of specially developed and patented microcannulas; in many cases it is sufficient to set hormonal imbalance right by means of bio-identical hormones (Hormonal Regeneration®) to achieve cosmetic improvement.

On the other hand, anyone wanting to look particularly artificial can in future fall back on implants and plastic surgery. Whether the results will earn a prize outside of a Miss Plastic Surgery contest is questionable.

Heinrich, MD

In Austrian television recently the theme of the Club 2 programme was “Silicone and slimness mania”. Amongst others, Dr. Mang, Dr. Holle, Cordula Reyer, as well as a philosopher, a music manager and a media sociologist took part in the discussion. I thought the discussion philosophically very inspiring in part, but even the cosmetic surgeons did not call the child by its name: people create demand, demand creates supply, the media reports on supply offers and this creates further demand. Doctors who enjoy cosmetic work offer their services. Patients choose between the services and suppliers offered and in this way create trends in cosmetic surgery.

It was inappropriate and incorrect that Dr. Holle, plastic and reconstructive surgeon, placed the blame for botched up cosmetic surgery on cosmetic surgeons who are not Board certified Plastic Surgeons. It was actually plastic surgeons who disfigured Michael Jackson.

Cosmetic surgeons who have specialised in plastic and reconstructive surgery have learnt surgically sophisticated and complex reconstructive operations during their training, and naturally tend towards a generous use of the scalpel, i.e. to perform complex and invasive operations. This, of course, is often unavoidable in reconstructive surgery following accidents or in the removal of tumours, but it is mostly “too much” in cosmetic medicine – also because the rate of unnatural results and complications increases greatly with invasive surgery.

Apart from this it is not true, as Dr. Holle maintains, that plastic surgeons learn cosmetic operations during their hospital training. Not one of the plastic surgeons working in Austria today learnt cosmetic surgery during their specialist training. This is also just as true of plastic surgeons in other countries, as we doctors know. Or would you allow a surgeon in training in a training hospital to perform cosmetic surgery on you?

All doctors who want to work in cosmetic medicine have to learn this initially in additional courses. Whether a plastic surgeon (like Dr. Holle), an ENT doctor (like Dr. Mang) or a general practitioner (like me). It is shown later who possesses the talent for this and whom the patients trust.

Heinrich, MD

The La Donna exhibition took place in the Vienna city hall from the middle to the end of the week. The topic of liposuction was raised during a panel discussion with other specialists on beauty and slimness, not least because apart from myself there were two other doctors present who like to offer liposuction for figure correction. In this discussion I spoke mainly about breast augmentation with stem cells, but naturally also made a contribution to the topic of liposuction.

There are still many misconceptions in this area of cosmetic surgery. Thus most cosmetic surgeons still do not know that the use of microcannulas (1.5–2 mm in diameter) make scar-free liposuction with a minimal after care of a few days  possible.

There are often controversial discussions on whether liposuction should be done before or after losing weight. My experience shows that it should be done beforehand, firstly because it makes further loss of weight easier and secondly because it creates space allowing the tissue to tighten up better during the subsequent weight loss. After a substantial weight loss the fat cells are so “sapped” that it is difficult to perform liposuction on them: they do not burst as easily as full fat cells when pierced by the liposuction cannula.

In many cases of weight loss, of course, liposuction is neither necessary nor effective. Only a consultation with the cosmetic surgeon can clarify things here. If you decide on this measure, however, then please have it done before your diet rather than afterwards.

Heinrich, MD

I have just read that my colleague Dr. Mang from Germany, a cosmetic surgeon well-known in the media who took part in a soap opera about beauty, has published a critical book on cosmetic surgery. General theme: no more superfluous breast augmentation, face lifts or liposuction – stop making zombies out of people! My respect!

Dr. Mang is remarkable for many reasons, not just because he speaks openly about the problems of the branch, but also because he openly admits to being an ENT doctor. It is no secret amongst us doctors that the specialist origins of a cosmetic surgeon say little about his ability, even though some specialists like to portray this differently to the public and the media.

I share Dr. Mang’s reservations – my misgivings about the stressful surgical methods of traditional plastic surgery are known. I am reminded here of the old saying: “Someone who has a hammer sees everything as a nail” – the more tools you have at your disposal the less likely you are to see everything as a nail that need to be hammered in! Surgery is often like the proverbial hammer…

For this reason I am of the opinion that (specialist) doctors for general practice with additional training in cosmetic surgery have a better basic training for the New Cosmetic Surgery than plastic surgeons! This is because they can choose the optimal tools for beauty and rejuvenation from all medical fields. In the area of beauty minimally invasive surgery, stem cells and bio-identical hormones are normally more effective methods than silicone and scalpels!

Stressful reconstructive surgery that of course belongs in the hands of an experienced plastic surgeon should normally not be necessary in cosmetic surgery.

Heinrich, MD

When I was in the USA recently, I read in the media that the wife of a well-known financial investor had been murdered. Her husband, incidentally, was being searched for as the main suspect after an adventurous escape to Canada with a speed boat, and apparently subsequently committed suicide. The murderer had made his victim’s body so unrecognisable that she could only be identified by means of the serial number of her breast implants. So implants good after all? This is admittedly macabre.

This reminds me of the novel “Do Androids dream of Electric Sheep?”, which was filmed as “Bladerunner”, directed by Ridley Scott, with Harrison Ford and Sean Young. Here on-the-run replicants, that is artificial humans who need to be destroyed, have to be distinguished from real humans. This can be done by examining skin cells bearing markers with serial numbers, which allow the clear identification of a cloned (replicant) human. Of course Harrison Ford, the Bladerunner, whose job it is to find and destroy the replicants, falls in love with replicant Sean Young of all people… You ought to see this film if you haven’t already done so.

oes this mean we will soon all have serial numbers implanted so that we can be clearly identified? As long as cosmetic surgery can do without implants by, for example, making breast augmentations from the body’s own fat, we should avoid using implants, even if this may one day make identification more difficult.

It really is time to put an end to patients undergoing the excesses of exaggerated aesthetic surgery that is no longer up to date! Unnatural-looking silicone breasts, tight, lifted, doll-like faces – from the point of view of doctors this could all soon be a thing of the past. An interdisciplinary beauty and rejuvenatory medical treatment is currently being developed from the scalpel and tightening cosmetic surgery, where silicone, tightening and scalpels will be unnecessary in most cases!

Instead of liberal cuts with the scalpel, the “New Cosmetic Surgery” uses minimally invasive, gentle cosmetic operations under local anaesthetic; instead of silicone, stem cells won through microcannulation from the body’s own fat tissue, whereby, for example, permanent, natural-looking, silicone-free breast augmentation has long been possible as well as bio-identical hormones and growth factors! This technology also puts an end to operations where a lot of tissue is cut away, such as the traditional face-lifting or lid correction. Stem cells from the patient’s own body have a local rejuvenating and regenerating effect and can be used in many aesthetic treatments instead of the tightening and shortening methods with the scalpel! The Mickey Rourke facelift look is thus a thing of the past!

The greatest potential of the New Cosmetic Surgery lies in its perfect and balanced combination of gentle treatment methods! Practically every cosmetic problem of face, body and skin can be treated optimally in this way. And above all, the results are completely natural. Cutting away with a scalpel or the implanting of silicone cushions or other artificial substances will in future happily be considered only in exceptional cases.

Heinrich, MD

In this blog I will be reporting in future about current developments from the domain of New Cosmetic Surgery.

A field of interdisciplinary beauty and rejuvenatory medicine is currently developing in cosmetic surgery, where in most cases silicon and scalpel are expendable. I call this the New Cosmetic Surgery.

Minimally-invasive, gentle cosmetic surgical intervention under local anaesthetic is an important pillar of New Cosmetic Surgery, which has already been carried out in a few leading centres in the USA and Japan.
A further important pillar are the body’s own stem cells, won from fat tissue, by means of which permanent breast augmentation has become possible without the use of silicone! Since we have been doing research on this topic for years and reported as early as 2004 on the work of Japanese and American researchers, I have decided – as the first European doctor – to offer our patients a new procedure using stem cells from the body’s own fat tissue. This technology means that operations such as traditional face-lifting or lid correction and also wrinkle treatment with so-called “fillers” can be dispensed with. Stem cells have a local rejuvenating and regenerating effect, and for this reason can be used in many aesthetic treatments instead of the tightening and shortening methods with the scalpel! In addition to this there is a wide range of uses of stem cell technology in regenerative and therapeutic medicine, and we will keep you up to date on this!

The third essential pillar of New Cosmetic Surgery is Hormonal Regeneration®! Many of the apparently “natural” cosmetic and functional problems of aging are in fact symptoms of a chronic deficiency of certain hormones, and this can be accordingly prevented and to a certain extent reversed! This means – overstated – that “aging” (or to be more precise, “premature aging”) is actually a treatable deficiency disease! By means of bio-identical hormones and further therapeutic measures the low hormone levels caused by aging can be raised to an individually optimal level again.

Heinrich, MD