It happens subtly. You look at yourself in the mirror as you brush your teeth, style your hair or shave, but then one day, you really see yourself. You lean in closer to the mirror. Aah – that crease in the forehead wasn’t there yesterday, was it? The eyelids – hmm, maybe they are looking a tad droopy. You start to hear friends and colleagues openly discuss the merits of lasers, Botox® Cosmetic, liposuction, body contouring and breast augmentation. You’re intrigued, you do some research, and before you know it, you find you’re electing to have one of the almost 12 billion cosmetic procedures that will be administered this year, according to the American Society for Aesthetic Plastic Surgery (surgery.org).
After the age of 21, when you begin to notice signs of sun damage and the effects of general aging, stress and the environment, you become a prime candidate to join the ranks of those who enlist in the war against Mother Nature.
The good news is that you don’t have to fight alone. There are squadrons of skilled specialists who are trained to perform the very latest procedures in cosmetic and reconstructive medicine, armed with an array of innovative and ever-improving products to help you combat the cruel effects of the sun, the clock and gravity. And, amazingly, the results of this beautiful science can be practically imperceptible. To the unsuspecting eye, you simply look good – you appear refreshed and fit, and your skin has a healthy glow.
“Maybe it’s a commentary on our society and the way we are culturally bombarded with images and concepts of beauty,” says Charles Perry, M.D., (ChrysalisCosmetics.com), a Sacramento plastic surgeon in East Sacramento who offers a full array of body, face, breast and skin services. “My patients tell me they’re ready to change something because they know someone who’s had successful procedures. They’ve done some studying and realize it’s less invasive, there are more options, they can correct a problem they once thought they had to live with and they can finance it. Also, big business is now involved in what was once a cottage industry, and we see direct marketing of products to the consumer has heightened the demand.”
Need a Lift?
If gravity is your enemy, take comfort in knowing that just about everything can be lifted – from your forehead, earlobes and eyebrows to your buttocks and thighs. If there’s too much skin, it can be snipped away or tucked neatly into place. If excess fat is the problem, liposuction can siphon off what diet and exercise miss in those hard-to-lose areas. Does it sound too good to be true? It’s not.
Jon G. Finkler, M.D. (accent-esthetics.com), a plastic surgeon in Gold River who stresses education before surgery, says some patients start coming to him before they turn 30.
“My female patients who are in their 20s and mid-30s are mostly interested in abdominal or breast surgeries, and that includes the post-childbirth procedure that has become known as a ‘mommy-makeover,’” says Finkler. “About age 40, the focus is more with the eyelids and other facial areas as a result of time and gravity. With the latest procedures and technology, the work is done more inside with fillers and implants to lift the skin and more gently drape it over the contour of the face so there is no ‘over-pulled’ look.”
Tummy tucks, breast augmentation, liposuction – a little laser here, some cream over there, and maybe just a bit of a filler around those smile lines. This is where science and art meet. In cosmetic medicine, there’s no one singular recipe for how to improve your looks or when to start, and the menu of choices is extensive. With your surgeon’s or dermatologist’s recommendations, you become the chief designer of what you’d like to repair or improve and to what extent. Web sites are key resources where the patient/consumer can become familiar with various doctors, their procedures, special services, recovery times, documented results, medical board certifications, surgery locations, medical costs and financing options, all before meeting with the physician for a formal consultation.
“I ask my patients, ‘What is it that bothers you?,’” says Bill McClure, M.D. (NVPSA.com), a plastic surgeon in Napa, Sonoma and Vacaville. McClure practices with his partner, Rebecca Jackson, M.D., focusing on cosmetic and reconstructive surgery, as well as covering the emergency room at Napa’s Queen of the Valley Hospital. In addition, both McClure and Jackson spend six weeks a year as volunteer surgeons for cleft lip and palate operations in underdeveloped countries around the globe through Rotaplast, a nonprofit humanitarian organization (Rotaplast.org). “In our practice, we concentrate on our patients’ key concerns and offer them different approaches to meet their goals. For example, we can tighten skin sometimes by just using an implant, and we use an endoscopic technique that is easier on the patient with a small incision, less than an inch in size, which makes for a quicker recovery,” says McClure. “With so much out there to choose from, we help patients narrow it down and determine their goals.”
Not Your Grandmother’s Facelift
The elective cosmetic surgery that was once the very exclusive, age-defying custom of the ultra elite, has now become de rigueur for the masses because the options and opportunities are almost limitless. Minimally invasive procedures, such as chemical peels, lasers or injectable fillers, have kept the more drastic measures from your grandmother’s era at bay. Small, incremental procedures are kinder, less expensive, have less or no downtime for recovery and often provide obvious, immediate results.
“Minimally-invasive, non-surgical procedures for facial rejuvenation are effective preemptive strikes against the aging process,” says Granger B. Wong, M.D., (TheCentreForPlasticSurgery.net), a plastic surgeon in private practice in Roseville, an associate professor of plastic surgery at the UC Davis Medical Center, and an expert in craniofacial and pediatric plastic surgery. Wong also volunteers his time as a surgeon and board member of Rotaplast. “In my practice, I see younger patients in their 20s and 30s intervening earlier with minimal procedures, so they don’t have to have fullblown procedures when they’re 60 or 65,” says Wong.
Dermatologist and laser guru, Suzanne Kilmer, M.D., is the founder of the Laser & Skin Surgery Center of Northern California in Sacramento (skinlasers.com), one of the world’s leading centers on skin laser surgery. She and partners – Vera A. Chotzen, M.D., Marla L. McClaren, M.D., and Susan K. Silva, M.D. – incorporate a full spectrum of 27 different lasers into their medical practice and medi-spa services. Whether it is fractional skin resurfacing with a laser of microscopic thermal light, or a low energy laser for hair removal, or another to treat sun damage and acne scars, services like these are so efficient that they can be administered during a lunch hour and require less time than a haircut.
“We lose volume in the face – fat, muscle, collagen and bone – as we age; and from gravity and sun damage, we start to hollow out,” says Kilmer. “I have one patient who is 83 years old and started getting fillers 15 years ago because she didn’t want to look as old as her age. Another patient is on the cusp of 30 and wants to hold back time now because she doesn’t ever want to look 50.”
Kilmer, who has patients that range in age from their 20s to their 80s, also treats several sets of three-generational family members – moms, daughters and grandmothers – who are trying to turn back the clock.
“Sun and aging are driving patients to our practice. I tell my patients, ‘I can hold you in place easier than I can back you up in time, with Botox to relax the wrinkles, injectables to fill hollow areas, some creams and lasers to reverse sun damage, and zinc oxide sun block products to prevent future damage,’” Kilmer says.
With so many ways to participate in elective cosmetic medical procedures, it’s important for the consumer to research thoroughly and choose a physician based on his or her experience, specialties, philosophy, procedures, service and the facilities where the surgery will take place.
Alan Lim, M.D., is a plastic surgeon with Sutter General Hospital in Sacramento (CheckSutterFirst.org), who also donates his surgical skills to needy patients at the county’s various clinics. He provides cosmetic medical services at the Fort Sutter Surgery Center across the street from Sutter General Hospital. Lim recommends that patients undergoing elective surgery ask important questions of their would-be providers.
“Make sure the physician is a member of one of the legitimate medical boards related to plastic surgery, ask the doctor where he/she has admitting privileges if needed, since the trend is to use off-site surgery centers to keep costs down and competitive, and check if the off-site has current accreditation,” says Lim. “If the procedure is going to be lengthy with work to be done on multiple body sites or if there are extenuating medical issues involved, it’s important to know if there will be an adjacent facility for overnight observation or potential complications.”
Who’s Getting What Done?
According to the 2,400 members of the ASAPS, more than $13 billion was spent last year in the U.S. on cosmetic surgical and nonsurgical procedures, an increase of eight percent from 2006. Liposuction topped the list of the five most popular surgical treatments people sought (456,828); followed by breast augmentation (399,440); eyelid surgery (240,763); abdominoplasty or tummy tuck (185,335) and female breast reduction (153,087). For those who wanted something less invasive, the most frequently performed procedure was a Botox injection (2,775,176); followed by injections of soft tissue fillers like Restylane and Juvéderm, (1,448716); laser hair removal (1,412,657); microdermabrasion (829,658) and laser skin resurfacing (647,707).
Who’s getting most of this work done? Women were still the top consumers with more than 10.6 million of those procedures in 2007, or 91 percent, and an increase of one percent from 2006. Men elected to have nine percent, or a little over one million of the cosmetic procedures last year, which was up 17 percent from the prior year.
