Sculpting answers: 5 burning questions patients ask plastic surgeons
Cosmetic surgery is no longer a taboo topic. Whether you're scrolling through Instagram or chatting with friends over brunch, the conversation around aesthetic treatments is everywhere.
South Africans are increasingly exploring non-invasive and surgical enhancements, with Botox, fillers and facelifts topping the list.
Renowned plastic surgeon Dr. Julius Few, founder of the Chicago-based Few Institute, recently shared insights with Goop on the most common questions he gets from patients.
If you’ve ever wondered about the right time for a facelift, whether fillers are safe or how to choose the best plastic surgeon, here’s what the expert has to say.
When is it too early for a facelift?
With social media influencers promoting "baby Botox" and lip fillers in their early 20s, many young people wonder if getting a facelift sooner rather than later is a smart move.
Few cautions, “If you’re in your 20s or 30s, facelift surgery can be loaded with risks, he explains. Younger skin doesn’t scar as predictably, results don’t last as long, and scar tissue could complicate future procedures.”
However, there are exceptions like massive weight loss, injury reconstruction, or correcting botched aesthetic procedures where surgery might make sense for someone younger.
For most people, a facelift makes the most impact in their 40s or 50s when signs of ageing - like sagging skin and deep wrinkles become more prominent.
What’s the best way to prevent or delay plastic surgery?
If you’re looking to maintain a youthful glow without going under the knife, medical-grade skincare and non-surgical treatments can help.
According to Few, the gold standard in skincare includes:
Retinoids (like Retinol or Retin-A): These vitamin A derivatives are scientifically proven to reduce fine lines and improve skin texture.
Sunscreen: Sunny climate makes SPF a non-negotiable for preventing premature ageing.
Non-surgical treatments: Botox, thread lifts, and ultrasound-based therapies like Sofwave can slow down the ageing process.
By combining these with a healthy lifestyle, hydration, good sleep, and avoiding smoking, you can keep your skin looking fresh for longer.
Can non-surgical treatments make surgery more difficult later on?
It depends. Few warns that overuse of fillers, especially in the cheeks, can lead to tissue stretching and premature ageing, making future surgery more complex.
“If done in moderation, non-surgical treatments can actually benefit patients by maintaining skin quality. But excessive filler use can distort facial tissue and create scar tissue.”
The key takeaway? Less is more when it comes to fillers and other injectables.
How do I pick the right plastic surgeon?
With the rise of aesthetic clinics across Johannesburg, Cape Town, and Durban, choosing the right plastic surgeon is crucial.
Few notes that board certification should be your first checkpoint.
In South Africa, look for a surgeon registered with the Health Professions Council of South Africa (HPCSA).
Other important factors include:
- Specialisation: Some surgeons focus on facial procedures, while others are experts in body contouring. Find one with experience in your specific area of interest.
- Before-and-after photos: A reputable surgeon should have a portfolio of real patient results.
- Consultation process: A good surgeon will discuss risks, benefits and realistic expectations rather than pushing unnecessary procedures.
Few says, “Even better, choose a surgeon who offers both surgical and non-surgical options. So you know you’re getting the best treatment for your needs, not just what makes the clinic money.
Are fillers bad?
The short answer? No, but they need to be used wisely.
Fillers have been around for over 20 years but, recently, concerns have emerged due to overuse and unrealistic expectations.
Few explains, “Some practitioners suggest using 10 to 15 syringes of filler in one session, which is excessive. The filler should enhance, not distort, your natural features.”
Another common misconception is that fillers can replace a facelift, which is not true.
“Fillers are great for volume loss, but they can’t lift sagging skin. And because they last longer than we initially thought, overuse can lead to stiffness and unnatural movement.”
The bottom line? If you can see filler when you smile or move your face, you’ve likely had too much.
In cases of overfilled faces, it’s often advisable to dissolve excess filler to restore a more natural look.
If you're considering a cosmetic procedure, start by consulting a qualified plastic surgeon, exploring non-surgical options, and focusing on preventative skincare.
Most importantly, enhance; don’t erase because the best aesthetic treatments make you look like the best version of yourself, not someone else.