A visit to Dr Sebastiano Montoneri, number one plastic surgeon in Paris by reputation and by the number of operations performed, changed the life of so many patients feeling uncomfortable with their imperfect breast, nose, extra weight, or age. Besides the traditional clientele, Dr Montoneri cares more and more on still young businessmen tired by a full agenda, jet-lag and more, and who would like to get rid of the disgracing marks of exhaustion on their face. We are part of them and, before our interview, we experienced two kinds of light, quick and perfectly efficient treatment.

First of all, we received Botox injection. We spent a few minutes sipping a cup of espresso in the cool, elegant waiting room. We actually didn't feel like visiting a doctor, and entered his office totally relaxed. It took a few minutes to be advised a first treatment: light Botox on our forehead and around the eyes. The injection cabinet is just next to the consultation office (surgery is undergone in Clinique des Champs Elysées, for more comfort and full security). It took less than 20 minutes to have our Botox performed with skill. We were advised to avoid sun, sauna and steam-bath during fifteen days: this is the time it usually take to have the treated muscles relaxed, and see the complete result of the injections in a mirror. Tough Dr Montoneri suggested leaving a few very light wrinkles to allow a natural look, we must say that the result was impressive. You feel like, and actually look like, 5 till 10 years younger... Is it psychological or not, but we felt less tension in our face's muscles. Which is surprising at the first time; then quite pleasantly smoothing. Feeling like in a better mood!


Filler (hyaluronic acid) can be injected 24 til 48 hours later. Basically, that was a more stressing experience. We could read on the Internet that pain would be acute, and feared little bit the injections. Was it because our doctor was friendly and talkative, or maybe thanks to the painkiller mixed in the new generation of fillers? We felt nothing but a very slight discomfort in some regions of our face, when we felt like the hyaluronic acid correcting our face with something like a light, crispy sound when it came out of the syringe. Little bit spooky; then you get used of it, and just focus on the result. Which is immediate, and impressive indeed. This is like a slight lifting: cheeks are more prominent, skin spontaneously looks fresher and younger: you have just got rid of a few years in 30 minutes! We liked to see that Dr Montoneri was as satisfied as us by the results, and our interview started in a good and younger mood.





First Class Around The World: Doctor Montoneri, I am in my 50s. Though I personally don't mind that much my age nor my physical appearance, I need to consider the later more and more: look does matter for men, like me, working in business and communication. What would you like to suggest?

Sebastiano Montoneri: “-There is a response for each patient. Ageing is not equal to everybody. The first consultation consists in checking up how does your skin look like. Have you got wrinkles or not, did your face lose some volume... A tired face doesn't develop a positive impression to your partners in a job like yours, where social life is a consequent part of the business. Note well that we should seriously consider whether aesthetic medicine (peeling, Botox or further injections) is enough to make you feel satisfied or if, let's say after 50 – 55 years old, you would rather consider plastic surgery: consisting basically in reactivating some muscles and dealing with any extra volume of skin.”

First Class Around The World: Botox may be both dangerous and addictive. It has side effects, and injections should be repeated twice or thrice a year. I read it on the Internet.

Sebastiano Montoneri: “-The Internet is spreading so many correct and incorrect news. You always need to check the origin of the information. Actually, I would like to explain that Botulinum Toxin (BTX), manufactured by a couple of brands (Azzalure and Vistabel) had been initially used to cure efficiently eyelid, face and neck spams. Developing a softer, cleaner, rejuvenated skin, it was then used for aesthetic medicine purposes. The molecular concentration is so limited in Botox, and the recommended number of injections is so low (I would recommend 2 till 3 shots per month, for a perfect, visible result after 4 till 6 month) that there is no direct medical threat. Nevertheless, this is important to stress on the fact that eyelid ptosis may incidentally appear whenever the injection has not been done properly! This is why  you should systematically visit a well established, well trained plastic surgeon, dealing with injections expertly. When it comes to your question concerning addiction: don't worry, you can't get addiction with such a low volume of  Botulinum Toxin in a syringe, indeed.”

First Class Around The World:  What is the difference between Botox and hyaluronic acid? Can I mix both for a more efficient  treatment?

Sebastiano Montoneri: “-First of all let me insist on the fact that Botox was initially a trademark for a certain type of Botulinum Toxin, targeting mostly patients suffering from some specific neurological pathologies.  It commonly applies, by a somewhat incorrect extension, to define what I still prefer to call by its original and correct name  (Botulinum Toxin or BTX). In aesthetic medecine, it is injected in the muscles, inducing a relaxation of the forehead muscles, crow's-feet, middle of the eyebrows, and neck. Resulting in a much reduced muscular and skin demand and, as a matter of fact, a softer skin which makes you look younger and relaxed. Let's discuss hyaluronic acid, now. This a much different product, filling the wrinkles and reshaping the face. It complements well  Botulinum Toxin. Each patient should normally get a tailored made treatment mixing injections of both medicines.  I personally don't like to inject Botulinum Toxin  and hyaluronic acid on the same day. It could create some interaction, which I prefer to avoid. My method consists in dealing with Botulinum Toxin  first; waiting about 3 / 4 days, then injecting hyaluronic acid”.

First Class Around The World:  What about the price, per year, compared let's say with laser or a traditional lifting with a much longer lasting effect.

Sebastiano Montoneri: “-My answer will be very approximative, and just use it as a rough indication to your readers, as it all depends on the patient age, type of skin, etc. Let's say that very basically, depending on the number of syringes which I shall need to use, Botox would cost about EUR 400 and 600, maybe more, depending on how many areas would be treated. It should be normally repeated once or twice a year. Hyaluronic acid is a filler with long lasting effect (9 months). It costs less than EUR 1,000. Laser has no effect at all on muscles; it comes as a second treatment, most efficient in erasing spots over the skin and tightening enlarged pores”.

First Class Around The World:  So, basically, about EUR 2,000 per year, for Botox and filler.

Sebastiano Montoneri: “-Very basically, yes. That's not too much, calculated on a monthly basis; moreover, we have some payment facilities for our patients. My assistants are dealing efficiently with this matter”.

First Class Around The World:  Some pals told me: “-Don't get Botox injections! It will numb your face and your emotions, affecting your masculinity”.

Sebastiano Montoneri: “-Don't worry about this! We shall make it tailored made for you and your personal satisfaction. You won't like it too fixed, but very natural. I'd like to adjust the injections to your own request. Usually, men do prefer a very natural result, and this is what I shall provide: a cool, more relaxed face, indeed”.

First Class Around The World: Now, let's discuss prevention. I am maybe already too old for a first visit to your clinic, am I not?

Sebastiano Montoneri: “-No. But the younger, the better. First comes prevention. Unless you would like to rejuvenate suddenly when you are 65, I would recommend a first Botulinum Toxin and hyaluronic acid when you are 45. Just to keep with the example of somebody like you, dealing with business and communication. 50 would be the ideal age for blepharoplasty (eyelids surgery), and lipostructure (reducing bags under the eyes and/or remodelling cheekbones). Would you be a smoker, I would recommend a peeling. Between 55 and 65, if necessary, it might be time for a neck and lower-face lifting. But you know, age doesn't matter that much: some 45 years old patients will need a lifting, while injections will be enough to treat elder patients... Anyway, I would like to repeat that a first consultation is necessary to plan a tailored made treatment”.

First Class Around The World:  I have heard about great, cheap clinics in Tunisia and South East Asia...

Sebastiano Montoneri: “-Plastic surgery is all matter of culture. Demand from the client should cope with the reaction of the surgeon. I take one example: in the USA, all girls would dream of Pamela Anderson's generous breast, while my French patients would dislike it. Too “Bimbo”! That's the first point. Second point: choose the best surgeon, they decide where you would like to be admitted for operation... Last but not least, be aware that diplomas are not the same from a country compared with another. In Belgium, any general-practitioner can act as a plastic surgeon! In France: no way! It is strictly prohibited. Moreover, the compliance with standards of security varies a lot depending on the country where you decided to undergo a treatment. To make it easy, and safely, make sure to check first if, according to the French standards, your doctor is actually “Chirurgien Plasticien” (=plastic surgeon) is registered by the “Ordre des Médecins”, grade 1 (which means that his first specialty is plastic surgery, indeed). If he is grade 2, he used to be a general surgeon first, turning then into plastic surgery. A graduated plastic surgeon, I am also a specialist in hand reconstruction: this is micro surgery, indeed, and helps me very much in some delicate forms of plastic surgery.”

First Class Around The World:  Do you operate by yourself?

Sebastiano Montoneri:  “-I do. Always! My patients ask for a consultation with me (not an assistant), due to my personal reputation and skill. They trust in me, and I operate them accordingly. I simply have to do so: both in term of professional deontology and personal image.”

First Class Around The World: Like all your colleagues...

Sebastiano Montoneri: “-Some of them are sharing my philosophy... When it comes to "all"... let's skip the question, please.”

First Class Around The World: Does plastic surgery hurt?

Sebastiano Montoneri: “-When it does so, we know how to deal with the pain. Some discomfort can be experienced on short time with liposuction or breast augmentation, for instance. Now, when it comes to Botox or  hyaluronic acid filler, which you just experienced with me, you could feel by yourself that Botox induces no pain at all, while filler comes with a psychological sentiment of discomfort. A slight pain main occur when injecting the lips area. Else, most of my patients don't mind the treatment when the results meet their requirement and satisfaction.”