Ask The Expert: Dr. David Brothers, Plastic Surgeon

Renowned in his field, the extraordinarily gifted Dr. David Brothers has one of the premier plastic surgery practices in the country.  He was born in New York City but came to Atlanta and completed his undergraduate degree from Emory University where he graduated Phi Beta Kappa. He received his medical degree from the University of Miami School of Medicine where he was elected to the Alpha Omega Alpha national medical honor society.

    Dr. Brothers is certified by the American Board of Plastic Surgery, a member of the American Society of Plastic Surgeons and is a Fellow of the American College of Surgeons. He is the founder of the Plastic Surgery Centre of Atlanta, P.C. and has served as the chief of plastic surgery at Saint Joseph’s Hospital of Atlanta, Northside Hospital and Perimeter Surgery Center of Atlanta. The former secretary of the Georgia Society of Plastic Surgeons, Dr. Brothers has been published in the field of reconstructive and cosmetic surgery and is a frequent guest lecturer. 

    He’s an avid traveler and a family man; his three beloved children, Danielle, Amanda and Samantha, accompany him almost everywhere he goes.  Whether he’s relaxing in a villa in the Caribbean or trekking through Europe, his focus is always his family and his patients.  Blessed with hands of gold, this premier plastic surgeon has changed the faces and lives of both men and women throughout the U.S. and Canada.  People come from far and wide to seek his skill and advice.  Dr. Brothers says he enjoys growing older with his patients, but “unfortunately, they are looking younger while I am looking older.”

TG: Twenty years ago, a face lift seemed the best answer to look younger. Today, are there alternatives to a full facelift?

DB: Yes, people can turn back the clock and rejuvenate their faces with non-surgical techniques. We offer many. A good solution for some patients who want to soften fine lines and wrinkles can be to start with injectables such as Botox, which paralyzes the muscles that create wrinkles and lines between the eyebrows and in the forehead. There are also volumizing fillers that allow for a fuller more youthful appearance through the mid-face area. We also offer stimulators like Sculptra, that help replace lost collagen. In combination these fillers and injectables, sometimes known as a “Liquid Lift,” can be a great start into the cosmetic world of rewinding time without having surgery.

    We have laser treatments, such as Fractional C02 laser treatments that help rejuvenate the skin and give it a revitalized appearance. We also offer Venus Viva and Legacy treatments, which are radio frequency treatments that can help with acne scars, rosacea, stretch marks, fine lines, wrinkles and cellulite. All these treatments can be done in the office with little or no downtime in some cases.

TG: You mean someone can visit your office and leave looking younger?

DB: Absolutely. When I came out of my residency none of these products were available. We were trained as surgeons and therefore we were trained to focus on areas that we could only improve surgically. Now, when I examine people, I not only look at things that I can correct surgically, but I also observe  the person’s pattern of aging, where they are losing fat and how it is being redistributed throughout the face.

    The trend in plastic surgery today is no longer to just do a facelift and pull people as tight as you can but rather to turn back the clock and restore the lost volume of youth. A lot of aging is simply lost volume. Our job is no longer simply a matter of examining someone’s face and deciding what surgery you can do for them. Instead, it is evaluating a patient’s face in three dimensions, noting their pattern of aging and why they are aging. Today we have so many more tools to non-surgically rejuvenate the aging face.

TG:  There is a myriad of topical products available, some expensive, that promise a youthful appearance. Are they worth the cost?

DB: Unfortunately, I don’t believe that anything sold over-the-counter will really have any positive effect on your skin. The FDA is a strict regulating organization and anything that has a tremendous impact on the skin or potentially changes the skin significantly would need FDA approval. When people purchase these over-the-counter products very often they are paying for name, packaging and nice smells.  Unfortunately, most of these products are not going to do very much.

     In my office we offer Alchemy SkinCare, a private label made exclusively for us. We also offer Revision Skincare and Venus Skin products. It is best to make an appointment with one of our expert medical aestheticians with Alchemy Aesthetics who will carefully evaluate your skin, customize your regimen and teach you how to use the products.

TG: Let’s talk about Botox. Is it safe?

DB: Botox is very safe. The only complications I have ever had from Botox would be a little bruising; rarely it can drift and just touch a small muscle in the upper eyelid, causing it to droop slightly. If this happens, and again it is quite rare, it usually goes away within a week or two. Ideally, you would repeat Botox three to four times a year. It beautifully and naturally relaxes someone’s facial expressions, and done correctly, it does not give a surprised or frozen look. Botox relaxes the area between the eyebrows where people tend to look very severe. I can inject Botox to relax transverse lines in the forehead. We can also place it under the eyebrow to give a very natural lift to the lateral or outer eyebrow.

TG: What about Sculptra?

DB: Sculptra is a fascinating product and the only product in its class. I am a master trainer for Sanofi-Aventis-Dermik, the pharmaceutical company that manufactures Sculptra. It is a collagen stimulator, a naturally derived product that we inject over a few months that causes a gradual correction of lost volume. And, as the body degrades or breaks it down, eventually into carbon dioxide and water, Sculptra stimulates new collagen production. The actual correction that you get is from your body’s production of natural type 1 collagen. Once corrected, the results last no less than 25 months. I have patients whom we brought to full correction years ago and I have not yet had to re-treat. The product is amazing!

    There is no product out there that can do what Sculptra can do. Sculptra can replace lost volume in the temporal regions, the cheeks and close to the jowls. Even if you tighten the skin surgically you are still not restoring the lost volume. Sculptra, whether it is done without or after a facelift, will restore a youthful fullness to someone’s face.

TG: Can you talk about Restylane and collagen, which are also fillers. Is one product better than the other?

DB: There are many intradermal fillers on the market. I have narrowed the list down to the Juvederm and Restylane family of products. I use the products for the nasolabial folds (the lines from the nose to the mouth), for deep lines around the eyes and for cheek augmentation. These products give the best and longest lasting correction for the volume injected. Juvederm and Juvederm Ultra Plus are mostly used in the lips and some facial lines. Juvederm Ultra Plus is a very good product for natural lip augmentation that is soft and long lasting.

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