Advances in Facial Plastics and Cosmetic Surgery #3 – No down time skin tightening methods.

About Dr. Hootan Zandifar

Dr. Hootan Zandifar is board-certified in Otolaryngology and fellowship-trained in Facial Plastics and Reconstructive Surgery. Dr. Zandifar is the director of the Skin Center at the Osborne Head and Neck Institute based at Cedars-Sinai Medical Towers.

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With the recent down turn in the economy many find their future plans shattered. Now instead of planning their retirement, they are looking to working well into their 60s, 70s and even 80s. This has brought with it a host of new challenges. Individuals who did not care about their appearance as they were reaching the retirement age are now competing for their jobs with new hires.

Many have turned to cosmetic surgery in order to look as young and refresh as they feel. They find that their younger appearance along with their years of experience gives them the competitive edge that they need in order to continue to thrive in their chosen field.

Beverly Hills cosmetic surgeon, Dr. Raphael Nach, of the Division of Facial Plastic and Reconstructive Surgery of the Osborne Head & Neck Institute.

Because many of these individuals either don’t have the time to take off from work, or do not want others to know they have had any cosmetic procedures done, there has been an increase in non-surgical and no down time cosmetic procedures. Besides, BOTOX® and cosmetic fillers such as Juvéderm®, Restylane®, Radiesse® and Sculptra®, a new push in the field of cosmetic surgery has been in the field of non-ablative (non-damaging) skin tightening procedures and lasers.

Although this was initially popularized by Thermage, newer and more effective treatments have emerged in the market. One such treatment is The ReFirme skin tightening program. Dr. Raphael Nach of the Division of Facial Plastics and Reconstructive Surgery at the Osborne Head and Neck Institute has been using the ReFirm skin tightening for the past 5 years and has been very pleased with the outcomes. He took time to answer some of our questions regarding the ReFirm skin tightening procedure.

How does ReFirm skin tightening work?


The ReFirm procedure gently and effectively uses combined energies of

· Infrared Light

· Bi-Polar Radio Frequency (RF)

to gently and effectively stimulate new collagen in your skin.

What results can I expect?

· Improvement in skin laxity and sagginess in the face and neck

· Skin texture can be smoothed out and firmed

How long does each procedure last?

Each treatment approximately lasts 45 minutes

How many procedures will I need?

Although this varies, most will need at least 3-5 treatments 3-4 weeks apart, in order to see full benefits

What happens after each procedure?

· Temporary pinkness in skin may occur and lasts a very short time

· Patients return to normal activities immediately after treatment

Does the procedure hurt?

Most people are comfortable during the treatments without any need for skin numbing or topical anesthetics. However, if you desire steps can be taken to numb your skin.

A message from Dr. Raphael Nach of the Division of Facial Plastic and Reconstructive Surgery at the Osborne Head and Neck Institute.

“I have been practicing cosmetic surgery for over 30 years and in my years of experience I have seen many technologies come and go.  In general it is a good rule of thumb to think that the least invasive a treatment, the less drastic the results. Recently,  with the emergence of no down time procedures the field of cosmetic surgery has changed greatly.  I have used and believe in the effects of ReFirm skin tightening procedure because the science behind it makes sense.  Most of my patients have been very happy with the results and would recommend it to others.  The main reason they choose the ReFirm treatment is because they don’t have the time to undergo a more aggressive procedure that would require a 1-2 week time off.  If you find yourself, wanting to look younger but not wanting to undergo an extensive treatment, you owe it to yourself to learn more about this procedure.”

To learn more about Dr. Hootan Zandifar or facial plastic surgery, visit: