Celebrities such as Lindsay Lohan and Donatella Versace recently had fillers dissolved in their faces, and the internet is full of speculation about what they have done instead to look more natural. Have the needs in the field of aesthetic surgery changed?

Ms Adelsberger, a trend is emerging in Hollywood with Donatella Versace and Lindsay Lohan. Some operations are being reversed, everything is supposed to look more natural and simply fresher. How does that come about?

If I look at my customers, there has always been a desire for a natural look. This is slowly gaining the upper hand thanks to the prominent examples. Today, it's out to look artificial.

Was it once in to look artificial?

I think that's cultural. In Switzerland, cosmetic surgery was generally more discreet than in America. For example, if I were to operate on an American woman's breasts in the same way as a Swiss woman, she would be disappointed.

Why?

Because you wouldn't be able to see that the breasts had been operated on. In the USA, a visibly enhanced bust is also seen as a status symbol. That's why the trend towards naturalness, as with actress Lindsay Lohan, is now more conspicuous, because until now the focus has been on the artificial.

Why is it that things have always been a little different here?

Patients here don't want to look different after a treatment, they just want to look younger. It bothers most of them if the visual changes to their face are noticeable.

Do you also get people who want to dissolve their fillers?

That happens quite often, yes. For example, if it was injected elsewhere at a cheap price and incorrectly.

Is this perhaps also a reason why there are currently signs of a trend reversal? According to the Federal Council, beauticians are only allowed to use products that remain in the body for longer than 30 days under the responsibility of a doctor and with appropriate further training. However, there are now many providers who do not have this medical training.

Yes, that is certainly a deterrent. Anyone offering such treatments should be able to treat possible complications such as infections or - in the worst case - a vascular occlusion professionally. In this case, I have my doubts. But I think people are generally a bit more sensitive. They don't want to be injected too much. That's why my approach is always gradual.

How should fillers be injected so that it doesn't look artificial in the end?

That depends on the type of filler injected. Hyaluronic acid, for example, ensures that the skin becomes slightly thicker, which makes the wrinkles disappear. However, it does not tighten the skin. Many people have the feeling that injecting volume makes them look younger again. However, this is what makes the result look artificial. Too much filler can quickly look unnatural. Wrinkles can only be removed surgically.

What are the limits of fillers and Botox?

If someone has too much skin and therefore a lot of wrinkles, this can only be solved surgically, i.e. by lifting. Fillers temporarily make the skin look a little nicer and firmer. This creates a kind of "optical illusion" that temporarily conceals the excess skin. But this is where the limits are reached. The excess skin can ultimately only be removed surgically.

But even a facelift cannot stop the ageing process.

That is true. However, if the skin is cut away, it takes much longer for it to reach the same condition as before the procedure. After a facelift, you will still look better in ten years' time than if you hadn't had it done.

How do you achieve a good result with a facelift?

This requires precise technique and individualised planning. It is important that the face does not look distorted afterwards, but retains its natural radiance. The skin should not only be tightened, but the deeper layers of tissue should also be repositioned anatomically correctly. The aim is for the patient to look the same after the procedure as they did before. Only fresher, not altered.

And how do I know which of all the treatments that are being promoted these days, from fillers to lasers to a facelift, is right for me?

It depends on what you need. I always ask the patient to describe what is bothering her. I then show them the various options they have.

How do your patients react when you suggest a facelift?

It varies greatly. The idea is often rejected at first. Many initially prefer non-invasive treatments such as Botox or fillers. I am happy to offer them these. Provided they achieve a visible effect. It often helps to gradually approach the idea of a facelift. Ultimately, however, no non-invasive method can replace the results of a surgical procedure.

How long will I be out of action after a facelift?

Generally speaking, you will be fit again relatively quickly. If you work from home, you can return to work after three or four days. On the other hand, you will be off work for longer in social situations. Especially if you don't want the people around you to notice the surgical procedure. You can see the plasters on the scars for about two weeks after the operation.

It takes a lot of confidence to go under the knife. How do you gain this?

Confidence is built primarily during the first consultation. Firstly, I ask the patient what is bothering them. This is followed by a thorough clinical examination. If it also makes sense from a medical point of view, then patients gain confidence.

When does it make sense?

When the cost and benefit are right. A facelift takes about four hours. If someone young comes in who only has half a centimetre of excess skin, then these four hours are not worth it. Also considering the risk of injury.

So do you sometimes refuse procedures?

Yes. For example, I once had a patient with very beautiful legs. No cellulite, no dents, nothing. She still wanted liposuction. I didn't want to do that. I thought the risk was too great that she would end up with bumps and scars that would ultimately bother her more.

Conversely, is it sometimes strange to say to patients: "Yes, your legs really are too fat?"

Rather the opposite would be funny. You are certainly diplomatic in the way you phrase it. But if they have a good reason, you say yes.

"It's similar to looking after a car. If we always look after it well, it will eventually become a classic car." Rosmarie Adelsberger

Why do you think young people come to you?

Young people come to me because something is bothering them or they want a change. Social media certainly plays a role in this. If you see certain beauty ideals all the time, you often have the desire to realise something similar for yourself. However, caution is advised when it comes to surgical trends such as the "Brazilian butt lift". Not every fad makes medical sense.

How do you know whether it is your own wish or whether the patient has been influenced?

If it wasn't an overnight inspiration. Most of them have really thought about it for years before they finally come to us for a consultation.

Do you approach young female patients differently?

Not really. Most of them already have a few wrinkles. I think it's good if you always do a little bit. It's similar to looking after a car. If we always look after it well, it will eventually become a classic car.

Would you yourself be more inclined or reluctant to have a procedure done?

It always depends. If something bothers me every day, then I have to do something. I want to look in the mirror and like myself. I'm not averse to it.

Why are we ashamed of getting older?

Many people simply feel younger than they look. They want to bridge this gap. And that's exactly what aesthetic medicine and surgery are for. To make you look the way you feel.

Interview with NZZ Bellevue, author Claude Menzi

Source photo: Instagram profile @lindsaylohan