Columbus Monthly / February 2011 / New year, new you: Your guide to cosmetic procedures

 Email  Print

New year, new you: Your guide to cosmetic procedures

As each new year begins, millions of people resolve to make changes in their lives. Chief among those changes are improvements to their appearances. Because the way we look on the outside can so strongly impact the way we think and feel on the inside, making changes for the better makes good sense. We all have some trait we would change if we could, whether it’s sun damage, laugh lines or fat that just won’t go away in spite of our best efforts. Thanks to advances in technology and techniques, today’s doctors, dentists and aestheticians are placing all of those little changes well within our reach.

Laser resurfacing

For sloughing away the years and revealing fresh, new skin, laser resurfacing is top in many people’s books. Laser resurfacing lessens fine lines, wrinkles, blemishes and visible capillaries, reducing the signs of aging. Lasers come in all shapes and sizes and can perform treatments at a variety of levels and with varying results.

Dr. Bivik Shah of the Columbus Institute of Plastic Surgery says laser resurfacing (also known as laser rejuvenation) is one of the most popular cosmetic surgery procedures performed in the nation. But with so many procedures being marketed by so many companies, it can be difficult to determine which procedure is the right one for you. “To find the best laser treatment, you will need to decide on how much recovery you are willing to go through,” Shah says.

Ablative laser treatments resurface the top layer of the skin and part of the second layer, with marked results, he says. Nonablative lasers cause only minimal damage to the top layer, so patients require less recovery time, but also produce less dramatic results.

“The latest are the fractional lasers,” he says. “Here, only a fraction of the skin is treated.” The entire face looks better after the procedure, but on a microscopic level, only about 25 percent of the surface is being touched by the laser. That means patients require less recovery time and enjoy fairly noticeable results over a series of several treatments.

A fractional laser treatment will require up to two days of recovery time, but some patients experience virtually no aftereffects. The process takes about an hour to complete and costs around $450. A minimally ablative laser peel will result in two to five days’ recovery. The procedure takes about one hour and will cost in the ballpark of $1,000. A deep laser peel will require up to 10 days of recovery. It takes only an hour to complete, but requires twilight anesthesia. The cost is about $2,500.

Potential risks of laser procedures include scarring, infection and pigmentation issues, Shah says.

Fractionated CO2 laser

Another incarnation of the laser repurposes a chemical laser that has been in use for three decades.

Dr. Stephen Smith, director of the division of plastic surgery at the Ohio State University Medical Center, says engineering advances in the fractionated CO2 laser mean better results and speedier healing. Gone are the loss of pigment and waxy appearance that were dangers with the traditional CO2 laser, along with the pinkness that lasted up to six months.

“Using bridge therapy, we leave intact bridges of skin, which allows the body to recover and heal very quickly,” he says. Pinkness may linger only for a couple of weeks. The laser can improve skin tone and texture, eliminate discoloration and modify facial scarring. Laser treatments also can be used on the hands and to repair sun damage on the neck and upper chest. “Today, it is absolutely, positively the best tool we have,” Smith says.

Dr. Sumit Bapna of Ohio Facial Plastics/ Ohio Sinus Institute also uses the fractionated CO2 laser, employing methods known as ActiveFX and DeepFX. The treatments can be done separately or together in one visit, Bapna says. The procedure recently received media attention when it was used in the treatment of burn scars on the Berns triplets, three 22-year-old women from Texas who were trapped in a house fire as toddlers.

“With ActiveFX treatment, a high-energy beam of laser light interacts with the skin’s surface, causing the upper layer to peel off and regenerate a layer of new, healthy skin,” Bapna says. “Effects of the treatment become visible right away, whereas others, such as new collagen formation, build up gradually and result in continued smoothing over time.”

“The DeepFX is a revolutionary fractional laser technology that uses CO2 laser resurfacing microbeams to precisely target the deep dermal layers of the skin,” he says. “This process stimulates a cascade of healing responses that leads to tissue regeneration and new collagen formation throughout the entire treatment area.”

Treatment of the entire face takes about 45 minutes. The potential side effects include infection or hyperpigmentation, but risks can be minimized by proper care following the procedure, Bapna says.

The majority of patients use no pain medication at all, Smith says, and people can return to wearing mineral-based makeup in five to eight days. Bapna says his patients can resume light exercise in three days and strenuous exercise in a week. The cost ranges from $1,800 to $5,000.

Mini facelift

While people still seek traditional cosmetic surgery, some doctors say they are noticing a trend toward less invasive procedures. A mini facelift tightens loose skin and jowls in the middle to lower part of the face. It is performed under local anesthesia in the surgeon’s office.

Dr. Timothy Treece of Columbus Aesthetic and Plastic Surgery says the procedure has a shorter recovery time and less discomfort than traditional deep facelifts, since the incisions do not cut across sensory nerves. Incisions are made just under the sideburn and in natural creases near the ear, so they’re not noticeable.

“A patient can wear their hair up or back without visible incisions along the lower part of the hairline,” Treece says. Skin and the underlying supporting structures are tightened, resulting in rejuvenation.

The procedure takes about two hours, and recovery time is minimal, he says. Patients can be back at work in seven days and resume rigorous workouts in three weeks. The price ranges from $4,000 to $15,000.

Rhinoplasty

Smith says rhinoplasty has changed over the years, and now combines function with form. “We don’t just take away features we don’t like,” he says. “We have to make sure we build the nose back up with cartilage so it can remain strong, straight and functional over a long period of time.”

During rhinoplasty, the surgeon shaves off or chips away part of the bone and cartilage in the nose. The same cartilage, or some taken from the septum, can be sewn into place to reinforce important structures so the procedure keeps its integrity over the years. The procedure takes 90 minutes to three hours and may be covered, at least in part, by insurance. “Often, patients seek rhinoplasty because they are not breathing well,” Smith says.

Patients can expect to use pain medications for a couple of days and to return to work in about a week, or even sooner if they have sedentary jobs. Routine workouts can be resumed in two weeks.

People should expect some swelling and possible bruising around the eyes for about two weeks. There will be slight swelling that lasts for as long as six months, but it will only be noticeable to the patient and the surgeon. The procedure costs between $3,000 and $5,000.

iGuide neck lift

Some people develop sagging skin in the neck as they age, while others may never have been happy with their necklines to begin with. A neck lift can help, and thanks to improved technology, the procedure is getting more precise all the time. Dr. Brian Dorner of Capital City Cosmetic Surgery says the iGuide tool allows surgeons to shore up lax skin very precisely and with minimal recovery time.

“The iGuide is a fiber-optic device that allows the surgeon to precisely place the suture at a given depth,” Dorner says. The device is used to perform a “trampoline” or “hammock” lift of the chin to help flatten and elevate the neck, he says.

“A suspension suture is crisscrossed underneath the chin through several small needle incisions,” Dorner says. In about 90 minutes, the procedure is complete. Chin bruising and swelling will subside in about 48 hours, and patients can return to work in three days. Vigorous workouts can resume in about two weeks. The neck lift with iGuide costs $4,000 to $7,000.

Liquid facelift

This procedure employs dermal fillers, which typically are used to fill small lines and creases and give a youthful, natural look. Dr. Carol Clinton of Timeless Skin Solutions says fillers can be used to do a full-face rejuvenation. Many patients plan such a procedure in preparation for a big event such as a wedding or reunion, she says, or in the wake of a major life change. The procedure requires little downtime and can give the appearance a real boost.

“You will leave feeling refreshed and looking like the best you—not overfilled, not pinched and pulled,” she says. “When you look in the mirror, you will feel like the down-turning of the mouth, the lines in the cheeks or crow’s feet are improved and you look natural.”

The procedure takes about 30 minutes and results in minor discomfort and possibly some bruising, Clinton says. Recovery time is about four days, and the cost typically runs between $3,000 and $4,000.

Ultherapy

Another nonsurgical facelift uses ultrasound waves to strengthen and build collagen.

Dr. Mary Beth Mudd of the New You Center for Beauty Medicine says Ultherapy is the only energy-based device approved by the FDA that actually lifts skin while also tightening and firming. It currently is approved for use on the face and neck, and doctors are hoping approval for the chest, abdomen, upper arms and thighs will follow.

“Ultherapy is totally noninvasive and has no downtime,” Mudd says. The procedure may result in temporary sensitivity along the jawline and a pinkness that subsides within two hours. Ultherapy is used to lift eyebrows, tighten upper and lower eyelids, decrease crow’s feet, tighten the neck, define the jawlines and lessen the nasolabial folds, the lines that run from the nose to the corners of the mouth. Costs range from $1,000 to $3,500.

Mesotherapy

Sometimes all the body needs are its natural processes and a little help from technology to renew itself in a visually appealing way. In mesotherapy, eyelash-size needles are used to inject natural vitamins, minerals and antioxidants. When exposed to these healthful elements, the skin begins to rebuild itself. The process minimizes the signs of cellulite and rejuvenates skin at the injection site.

“Mesotherapy was actually developed in France in 1952, so worldwide there is more than 50 years’ experience, although this is relatively new to the United States,” Mudd says. The procedure prepares the skin for other treatments, such as ultherapy or laser rejuvenation, and will enhance the effects of those treatments, she adds.

Mesotherapy typically is used on the face, neck, chest and hands, but can be applied to any area of the body. Patients should avoid strenuous activity for 24 hours following the procedure. Treatment takes around 30 minutes and costs around $400.

Microcurrent

This procedure uses a mild electrical current to give the facial muscles a workout. In use since the 1940s but gaining renewed popularity, the microcurrent has numerous benefits. It lifts, tightens and contours the skin of the face and neck, lifts the eyebrows, reduces the appearance of fine lines and wrinkles and leads to a clearer complexion and a radiant glow. The procedure stimulates the lymph system, which means increased circulation and better absorption of nutrients by the skin. It also stimulates the production of collagen and elastin and hydrates the skin.

“There is no downtime like with surgery,” says Jaclyn Peresetsky of Skin Perfect. “Many women do this on their lunch breaks.” Microcurrent typically costs about $125 per session, but may be less expensive when purchased in a series of treatments.

Obagi

When it comes to prescription-strength topical skin care, Obagi (pronounced oh-BAH-jhee) is one of the most respected products available.

Marsha Dooley, a cosmetic consultant with Bernacki Plastic Surgery, says Obagi’s NuDerm system provides early intervention in skin care and helps erase signs of aging.

The system improves cellular function, protects the skin from UVA and UVB rays and reduces acne outbreaks. The manufacturer says Obagi products protect, while helping the skin look and act younger. That means the signs of sun damage—fine lines, roughness, sagginess, redness, sallow complexion and age spots—can be lessened and future damage can be prevented.

“It is one of the few skin care lines that gets down below the dermis to the epidermis,” Dooley says. “It firms the skin and takes off the top layer. When you shed the dead skin, the newer, fresher skin can get to the surface.”

Obagi is offered only through doctors’ offices because it must be prescribed. The formulation is tailored to the individual. Each product performs a different function, from restoring to protecting. Products range from $30 to $45 per bottle, or up to $500 for a complete kit that represents an entire skin care regimen.

Lipotransfer

As we age, fat deposits break down in all the places we wish the fat would remain—the lips, the apples of the cheeks, the area beneath the eyes. They all can make us look older as the fat layer dissipates.

Smith says lipotransfer can erase the years using nothing but fat cells from the patient’s own body. It has numerous benefits, he adds. “Fat lasts much longer, you can put it in more places, the body tolerates it better and it is more cost-effective.”

The fat cell is a very primitive cell, Smith says. It survives easily and for long periods of time after transplantation. He says that while synthetic fillers may last six months before treatment is needed again, fat transfers are showing signs of lasting more than a decade.

The procedure takes about an hour and is done in the physician’s office with local anesthesia, or can be done in the operating room with IV sedation. Patients can expect to experience swelling and bruising for about a week, but both can be alleviated with ice and elevation. The cost runs $2,100 to $3,500.

Ultrasound assisted liposuction

Sometimes you don’t want to reuse the fat, you just want to get rid of it—but diet and exercise let you down.

Dr. Susan Vasko of Columbus Aesthetic and Plastic Surgery says ultrasound assisted liposuction can do the job. It is an advanced body contouring procedure that can be done under local anesthesia. The unwanted fat first is bathed in saline to facilitate removal, then liquefied using ultrasonic waves. Afterward, the liquefied fat is removed through a small tube called a cannula. “A skin-tightening procedure may also be used in conjunction with liposuction for the best aesthetic result,” Vasko says.

Ultrasound assisted liposuction takes between 30 minutes and two hours, depending on how many areas are being treated and how much fat needs to be removed. Patients can expect some bruising and swelling, along with saline drainage from the incision and temporary numbness of skin. They can return to work in three to five days and get back to vigorous workouts in a week or two. The cost for the procedure begins around $2,200.

LaserLipo

This procedure uses a fiber the size of a strand of angel-hair pasta to literally melt fat away. LaserLipo is less invasive than traditional liposuction and can be done in a physician’s office under local anesthesia.

Mudd says the heat created by the laser also tightens skin and encourages the production of collagen. A compression garment worn in the month following the procedure aids in this tightening process.

LaserLipo can be used on any part of the body where fat is below the skin, Mudd says, but the most often requested areas are the abdomen, neck, upper arms, back, bra line, inner and outer thighs and knees. A little soreness and some drainage can be expected following the procedure. Because the LaserLipo is gentler than traditional liposuction, recovery is quicker. Normal exercise and activities can be resumed within two days, and the patient will continue to notice improved appearance over the next three months. The cost ranges from $1,500 to $5,000, depending on the area treated.

Zeltiq cool sculpting

Another method uses not heat, but cold to shrink away fat. Mudd says Zeltiq is the only permanent, noninvasive fat elimination method available. “You can literally sit and remove fat by freezing it,” she says.

The technical name for the process is cryolipolysis. Cooling panels are applied to the skin, freezing and crystallizing fat cells, which then are absorbed by the body’s natural processes over time. The manufacturer says patients feel a tugging or pulling sensation, but are comfortable enough to read, check their e-mail or even sleep during the procedure. Mudd says patients do not feel cold. The process can reduce the fat layer in the affected area by 20 percent and can be repeated after several months, resulting in a further 20 percent loss. Results become noticeable about six weeks after treatment.

Zeltiq is now FDA-approved to treat fat deposits on the belly and back, but likely will be used for the upper arms, thighs and neck within the next year.

The treatment time is typically two to three hours. While there is some numbness that subsides within two to three weeks, there are no other side effects. Patients can go back to their regular activities the same day. The cost ranges from $1,500 to $3,000.

Laser bra

Lasers have been adapted to beautify many parts of the body, and breasts are no exception. The laser bra breast lift is a laser-assisted technique often used in combination with a breast reduction or augmentation. The laser bra procedure provides a more natural shape to the breast and long-lasting support. Dr. Robert Heck of Columbus Aesthetic and Plastic Surgery is one of just a few surgeons trained in the technique.

“While a traditional breast lift removes excess tissue in the lower portion of the breast, the laser bra preserves some of this tissue to be used as a support system for an improved shape,” he says.

A laser is used to prepare a segment of excess tissue for use inside the body. The tissue is used to support the bottom of the breast where it meets the chest wall, in effect creating an internal brassiere. Heck says the technique helps surgeons create a perkier breast shape.

The procedure takes about two hours and results in minimal discomfort. There may be slight blood loss, and bruising is rare, Heck says. Patients can return to work in three to five days and resume vigorous workouts in six weeks. The cost ranges from $4,000 at the low end to $8,000 when combined with breast reduction or augmentation.

Mommy makeover

Childbirth can result in a lot of physical changes, and some of them aren’t changes women want. A mommy makeover is a combination of procedures that address changes that have occurred as a result of childbearing and time.

“A mommy makeover can help mothers reverse many of the effects of pregnancy on their bodies and regain the look and shape of their bodies before children,” says Dr. John Wakelin of Columbus Aesthetic and Plastic Surgery.

A mommy makeover generally includes a tummy tuck and breast lift, either with or without augmentation. Wakelin says patients also frequently request liposuction to remove unwanted fat deposits in the thighs, hips and other areas.

Depending on the number of procedures performed during the makeover, the surgery typically takes between one and four hours. Patients generally return home the same day. They can return to normal daily activities within a week or two, and restrictions on vigorous activities are lifted after three to six weeks.

Patients are prescribed pain medications to alleviate discomfort associated with the procedure, and most patients use the meds for about a week. The cost of a mommy makeover ranges from $2,000 to $15,000.

Kristin Campbell is a freelance writer.