Articles

May 2005

A New You

A Look at Leading Cosmetic Procedures

By Kevin Benefield

It is virtually impossible to turn on a TV without coming across a show concerning cosmetic surgery. From Extreme Makeover and The Swan to Nip/Tuck and Dr. 90210, programming has inundated Americans with nearly every aspect of plastic surgery. As a result, we are all increasingly familiar with a growing range of cosmetic procedures, both surgical and nonsurgical, as well as the doctors, dentists and other specialists performing the work. And, of course, we have all seen the often dramatic results that cosmetic surgery has brought to so many. So it is not surprising that the number of total procedures performed in the United States increased a whopping 44 percent in 2004 to a total of nearly 11.9 million, according to The American Society for Aesthetic Plastic Surgery. Simply put, Americans are becoming more and more comfortable with the idea of plastic surgery and, as the numbers make clear, many are opting to have work done themselves.

The Non-Surgical Approach

The overall surge in popularity of cosmetic surgery has been driven, in large measure, by a huge increase in nonsurgical procedures (up 51 percent from the previous year) led by Botox®. Dr. Chip Cole has worked with thousands of patients to achieve a more youthful, rested look through Botox® injections, since its introduction. By combining Botox® with therapies such as skin fillers, Dr. Cole can produce incredibly fresh results. In addition to Botox® and fillers, Dr. Cole sometimes employs laser resurfacing to remove areas of damaged or wrinkled skin resulting in a smoother, tighter and younger looking skin surface. Another incredibly popular nonsurgical procedure, microdermabrasion, employs a device like a fine sandblaster to spray tiny crystals across the face, mixing gentle abrasion with suction to remove the dead, outer layer of skin. Dr. Michael Katopes says this is the most natural way to evenly and safely exfoliate skin without the use of chemicals or lasers. He adds that microdermabrasion is quick and affordable and requires no down time. Of course, as with other skin rejuvenation techniques, several treatments might be needed to reduce or remove fine wrinkles and unwanted pigmentation. The use of injectable fillers like Restylane and Radiance have also become more and more common, according to Alana Solomon, president of The Ageless Center. These fillers are used to combat wrinkles around the mouth and labial folds as well as to build up the cheeks and lips. Solomon says that the price of Radiance, in particular, has come down noticeably in the last year as it has increased in popularity, no doubt due to its relatively long-lasting effects, from eight months to a year.

Facing the Future

For those requiring more intensive work to rejuvenate the face, a range of new procedures and products are making the facelift a simpler and more effective operation. Dr. Marcia Byrd now utilizes contour threads for mid-face and brow lifts. The self-anchoring threads permit a minimally invasive surgical approach for elevation and fixation of the skin. The sutures are made of polypropylene, a material used for sutures within the body for decades. Byrd explains that this is the wave of the future, allowing for surgeries that require less procedural and healing time and no general anesthesia and result in minimal scarring and more immediate patient satisfaction.

Dr. John LeRoy, the first doctor in Atlanta to perform minilifts, has added several options to enhance his Band-Aid facelift. Dubbed the Band-Aid Plus, the mini-facelift may now be coupled with mini-blepharoplasty (eyelid surgery), mini-liposuction on the neck, or mini-dermabrasion around the mouth. The procedure is individualized, and any or all procedures are completed in one surgery under a local anesthetic. According to Dr. Mark Beaty, advances in mid-facelifting are some of the most promising in the field.

The mid-facelift addresses tissues in the lower eyelids and the cheeks- areas not usually included in facelifts. He explains that restoration to volume of this part of the face is very important to patients and can be done as part of a larger facelift procedure or, in some patients, may be performed as a stand-alone procedure. The mid-facelift has provided another option for early facial rejuvenation in younger patients and contributed to much-improved results in older patients.

Of course there are some who are looking for more marked and lasting results. A full facelift remains the best option, and medical advances have greatly improved most aspects of this surgery. Dr. Arnold Zweig performs a two-layer lift, working deep into the second layer of the face, tightening it and putting stitches in place. The elaborate technique requires a good bit of time and an attention to detail, explains Zweig; but it has been greatly enhanced through the use of tissue glue which fixes the skin in place. Patients experience minimal bruising, very little pain and a reduced healing time.

Getting Rid of Excess

While the facelift remains in the top five of most performed cosmetic surgeries in the United States, liposuction holds the top spot among both men and women. As a result, there has been a corresponding spike in the number of body lifts and tummy tucks performed. Whether the result of liposuction, weight loss, pregnancy or simply aging, redundant skin is left behind, explains Dr. Amy M. Ortega, who performs a lower body lift to address this problem. In the past, the lift was done on the front and back of the torso and included a tummy tuck and abdominoplasty, a butt lift and thigh lift, as well as a tightening of the vertical muscles of the abdomen. Ortega has improved upon the surgery by working on the sides as well. While this adds to the length of the surgery, Ortega says the quality of the results is dramatic, including a loss of inches and much better looking skin.

A far more commonplace procedure, the tummy tuck, has also continued to grow in popularity. Most women come to a tummy tuck after childbearing, says Dr. Lisa Bootstaylor. The surgery involves the removal of excess skin and fat below the navel, as well as the treatment of muscle damage. Requiring only seven to 10 days of healing and providing more permanent results than liposuction, the surgery has proven very satisfying for patients who regain a slender figure, often as part of their transition into a more mature phase of life, says Bootstaylor. The tummy tuck is also being combined with limited liposuction in some instances. Known as a marriage abdominoplasty, the procedure involves the removal of one to two liters of fluid and results in a slim and more shapely appearance.