Hyaluronic acids, peptides, neuromodulators, fractional CO2 lasers — the tools in the plastic surgeon’s cache of youth enhancing products and techniques is ever evolving and it was one new product that found us sitting down to chat with Westlake Dermatology plastic and reconstructive surgeon Dr. Kristy Hamilton. Soon the conversation expanded to cover the many fascinating aspects of plastic surgery today.

What led to our meeting with the Baylor College of Medicine graduate, who offices in Westlake’s Bissonnet Street clinic in Houston, was the introduction of Daxxify, a longer lasting frown line product said to be the next generation of neuromodulators. What most of us know as Botox.

The excitement about the product, which received FDA approval last September, Hamilton says, is the fact that it has a peptide (a stimulator of cell regrowth) that’s connected to the neurotoxin. Studies show the product to last from six to nine months as opposed to Botox which has shorter effectiveness. And the full effects of Daxxify are immediate unlike other products that can take a week for maximum effect.

“It still has movement,” Hamilton says. “It’s new, but it’s a new iteration of something that is known and tested. So I was happy to be an early adopter of it. I really like it and I still am very natural in my movement but there are no lines.”

She adds that the neuromodulater is the foundation of her “non-surgical facial optimization.”

Non-Surgical Procedures at Westlake

“So how do we get a lifted effect with neuromodulators?” Hamilton asks. “You have to rebalance the vectors of the face. None of these toxins have anti-gravity technique. You don’t put it in your forehead to lift the brow. That’s not how it works. I have to soften the muscles that pull it down, pull the brow down. That’s how you get the nice lifted look, not by putting it in your forehead.”

Hamilton, who takes pride in being an artist as well as a scientist, explains that neuromodulaters are effective in softening the chin as well as in softening the muscles that pull down the corner of the mouth. Fillers, she explains, can provide higher cheek bones, make a stronger jaw line and soften the look of the jowls. No surgery required.

“A judicious amount of filler is very helpful because I can sculpt the face with it,” she says. “I have filler all over my face. I use myself as an example just to show that you don’t have to look like an alien if you’re having filler treatment. It can be very, very natural.”

I can report that this doctor is beautiful and looks beautifully natural.

As Hamilton writes on Instagram: “My signature non-surgical facial optimization makes tiny, finesse adjustments to bring your facial features into balance incrementally to maximize your beauty — a technique favored by models and celebrities alike. Through artistry, training and vision, I create beautiful, customized facial aesthetics with injectables.”

Improving the Jaw Line

Hamilton believes that refining the jaw line will be the top plastic surgery trend of 2023. Juvéderm Vollux, an injectable gel for deep injections to improve moderate to severe loss of jawline definition in adults over the age of 21, is her go-to product. It received FDA approval last August.

“If you have a weaker jaw line you can augment it,” Hamilton says. “But also if you start to have a little bit of a wavy jaw line a little jowling, you put a little bit here and a little bit behind it, you can straighten the look of it.

“It’s not a face lift. That is how we get that Hollywood really sleek, really sharp look and draw the attention away from the area under the chin without surgery. People love that because this is one of the areas that tends to go first.”

 A Game Changer in Breast Treatments

Heading into summer means mommy makeover season when patients are requesting tummy tucks, liposuction and breast augmentation.

“We are seeing a pivot in what people are asking for in breast augmentation,” Hamilton says. “It’s not the Texas size, really, really full look anymore. A lot of women are coming in to downsize their implants and they’re going for a more athletic look, more subtle.

“I think as a whole we’re shifting. I don’t know if it’s because there are more women in surgery now and we’re not just putting in the biggest implants we can, or what it is.”

Internal bras are the relatively new approach to breast augmentation.

“That’s the game changer,” Hamilton says. “We lift everything up to the sky and then we see a lot of sag occur depending on the quality of your tissues. So now we’re using a type of absorbable mesh, not the pelvic mesh you see in lawsuits. It’s dissolvable over the course of a year and it turns into a thin sheet of collagen and basically acts as an internal support for the breast just like you are wearing a bra.

“So we’re seeing a lot more longevity with breast reduction.”

In fact, Hamilton notes that one of the highest patient satisfaction rates for all of plastic surgery is breast reduction. The patient feels better with the weight of the breast higher up on the chest even if the patient doesn’t do a reduction.

Laser Resurfacing

Hamilton is such a disciple of laser resurfacing that she goes under the fractional CO2 laser four times a year, as does her mother.

“We have to continue to build collagen in our faces,” she explains.

This is not the same heavy-duty, intensive laser from a decade ago. Hamilton employs a lighter big gun laser that burns tiny micro dots all over the face resulting in improved quality, texture and tone of the skin. The recovery is about five days which makes it more feasible for patients to do on a more regular basis due to the reduced down time.

Body Sculpting and The BBL

“I ascribe to the Columbian style liposuction . . . high definition plastic surgery where I suck out every last fat cell,” Hamilton says. “I make it all one sheet, very smooth across.” She runs her hands across her middle.

“We’re creating hills and valleys,” Hamilton continues. “When you see an 18-year-old model, you can see their abs, a nice sleek figure. That’s what we’re trying to mimic. It’s not exaggerated. It’s shadow definition, hills and valleys, creating that little ridge between the abs.”

What about the Kardashian inspired Brazilian Butt Lift?

“You can do it safely,” Hamilton says. “I love liposuction with BBL for sculpting to give a very athletic look. If someone comes in and their butt is square we can add a little bit to create a nice round curve without making it overdone.”

Body Fat to Beauty

While there are many filler options, body fat is mother nature’s answer. When removed from the inner thigh the fat has several important uses, Hamilton notes. It is a solution for women wishing to remove their implants but still have volume. It will not be the same as a silicone implant but fat from the inner thigh does provide more volume.

“Fat is a great volumizer,” she says, adding that rather than fillers  to the face, a fat transfer is longer lasting. “We can put fat in all the places that we are putting filler in across the face.”

Fat can be used in the temples, the forehead and jawline but not the lips. Hamilton opts for hyaluronic acids for a more natural lip enhancement.

Full Disclosure

So why am I sharing all of this information? This interview turned into something of an office visit. I was so intrigued by the discussion that I signed on for fat injections and the fractional CO2 laser. I could not have been happier with the results. And, yes, I paid full price. This was no quid pro quo.