Body of Evidence Despite the Recession, Cosmetic Treatments Remain in Demand
To hear Dr. Lisa Emirzian tell it, there’s nothing frivolous about flashing a perfect set of teeth.
“I like to dispel the notion that cosmetic treatment is simply an extravagance,” said Emirzian, an esthetic dentist and owner of Emirzian, Mariano & Associates in East Longmeadow. “In today’s society, an attractive smile is generally understood to build confidence, and this relates to career and personal advancement.”
The question for dentists who focus on cosmetic improvements — as well as plastic surgeons and anyone who practices the medicine of looking better — is how much people are willing to pay for that personal and career boost when so many people in today’s economy are struggling just to keep their jobs and make ends meet.
“From what I can see in the business, traditional plastic surgery has come down with the economy, where our business is booming; weve increased tremendously,” said Suzanne Sullivan, manager of Feeding Hills-based Dermique Medical Laser Skin Spa.
She was referring to a range of services — from fat-zapping laser liposuction to skin-rejuvenating treatments — that are less invasive, costly, and time-consuming than traditional plastic surgery, and hence attractive options for individuals looking for, well, options to be more attractive.
“I got nervous back in December, wondering, ‘is my job going to hold out? Will we keep working?’ You’d think this is one of those things people give up,” she said of the faltering economy. “But what they’re giving up is traditional facials in the salon. That’s more daily maintenance — getting a deep clean and relaxation. And plastic surgery is much more of an investment, more costly. But people coming to us are getting great efficacy and minimal downtime at less cost.”
True, plastic surgery that involves going under the knife has suffered, by some accounts, as the economic clouds have darkened. But there are still pockets of growth, said Dr. Simone Topal, a plastic surgeon who operates a practice in Florence and is affiliated with Cooley Dickinson Hospital.
“Strangely, my practice has been growing,” she told The Healthcare News. “I think it’s mostly because I’m a fairly new practice; word-of-mouth is getting around, and I’m getting more and more busy. I know that I provide services here that weren’t available before — for example, breast reconstruction wasn’t available at Cooley.
“But I have been getting more cosmetic cases also, which is not the national trend during the recession,” Topal continued. “From what I’ve been reading in my professional magazines, people who depend solely on cosmetic cases for revenue are having problems right now. I’ve been fortunate in that I do at least 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} reconstructive and 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} cosmetic — but that 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} has been growing recently.”
Overall, however, patients seem drawn to procedures that offer results in less time at the doctor’s office and less downtime in recovery. Fortunately for practitioners, that’s exactly the main trend that has emerged across the diverse spectrum of improving the appearance of faces, bodies, and teeth. In this issue, The Healthcare News examines some of these services, and why many business owners are smiling right along with their patients.
Small Wonders
It’s no wonder patients are looking for simple, yet effective options, Topal said, considering that cosmetic surgery is a significant medical decision, not to be taken lightly.
“I have to make sure they understand what the risks are, what the recovery time is, what the complications could be, and what’s safe and appropriate for each patient,” she said. But for those who want to improve their looks but are apprehensive about surgery — and those who are cost-conscious these days — a series of non-invasive options has soared in popularity over the past decade.
These include Botox, which essentially involves injecting botulinum toxin under the skin of the face to prevent the muscles from contracting, thereby eliminating the appearance of wrinkles.
“The trend is toward minimally invasive treatments, procedures that can be done quickly and have a quick recovery time,” Topal said. “Botox and injectable fillers are very popular right now because they’re reliable and people like the effects. Sometimes, it’s a way to ease into surgery, or to fend off surgery and do something else instead.”
That said, Topal is still busy with face lifts, breast lifts and augmentations, tummy tucks, and removing excess skin after massive weight-loss surgery, to name a few popular surgical options, along with more medically necessary procedures such as hand surgery, pediatric plastic surgery, and breast reconstruction after cancer surgery.
“It’s a whole range,” she said. “People may see me about problems with a deformity, or they may just want to look better. For some people, it stems from societal pressures or low self-esteem, and some people are just very energetic and say they want to look as young as they feel. I see everyone from teenagers to people in their 60s, depending on what they’re coming for.”
Just as Topal touted a dual focus on restorative and cosmetic surgery, diversification has been a benefit to Dr. John Frangie as well. As the owner of NorthEast Laser Center in West Springfield, he offers a range of vision-correction treatments, from no-blade Lasik to intraocular lens implants for patients with cataracts — which typically stems from a more urgent medical need than laser vision correction.
“We have a very successful, higher-end ophthalmology practice, and for the cataract practice, times have never been better,” Frangie said. “If you ask about Lasik, well, that more closely mirrors consumer confidence — and, again, we’re fortunate that we have a higher-end practice, so our core clientele is there. We have a steady stream of patients for Lasik, but we’re not setting records right now.”
Lasik, although its medical benefits are obvious, is affected by the same economic factors as plastic surgery and esthetic dentistry in that it can be put off when money is tight without much of a health impact; indeed, most candidates already wear glasses or contact lenses. But that’s not the only area in which Frangie is changing people’s appearance; he also offers injectable cosmetic treatments such as Botox — and those, as in Topal’s practice, remain popular.
“This economy seems to offer an opportunity for minimally invasive cosmetic treatments,” he said. “Patients seem to be less interested in the surgical options. Injectables like Botox are small, incremental improvements that don’t require a big investment or any post-operative convalescence. It’s almost as if economic pressures have made people look at this in a more discriminating manner.”
The recession has also presented Frangie with an opportunity on the Lasik side, he said, explaining that the practice has committed capital and time to improving its Lasik treatment by purchasing a new, state-of-the-art laser largely unavailable at other area vision centers. Such an investment makes sense, he told The Healthcare News, because Lasik will clearly remain popular for the long haul.
“It’s old news for us, but patients are now realizing the value of no-blade technology — again, a minimally invasive scenario. We now have the ability to treat more patients, and within a day or two the patient is highly functional.
“Patients planning to do this have their own calendar,” he added. “We tend to serve a higher-end clientele, so you don’t see them as subject to the capricious swings of the economy. That being said, though, we’re not seeing people walk in and say, ‘give me your next available appointment.’ The impulse buyer doesn’t seem to be as evident.”
Fat Chance
It’s difficult to find any cosmetic procedure not being revolutionized by the emphasis on minimal invasiveness that pervades health care today. Take SmartLipo, for instance.
Dermique offers this treatment, which employs a high-powered laser to remove fat, sculpt the skin, and simultaneously tighten skin and seal blood vessels, resulting in less swelling, bleeding, and bruising than with traditional liposuction, Sullivan said. SmartLipo also requires only a local anesthetic, not general anesthesia, and the recovery time tends to be shorter.
“Liposuction is the most popular cosmetic surgery performed today, and people are switching to SmartLipo,” Sullivan said. “In this economy, it’s less expensive and less aggressive, and they can get back to work in less time. Everyone is so busy nowadays.”
Even Baby Boomers, many of whom are retired or soon will be, are averse to any downtime in their schedule, and are seeking out minimally invasive, natural cosmetic improvements, she explained. To that end, Dermique offers a range of treatments that emphasize quick recovery.
A service called Pearl, for instance, treats the top layer of skin with pulses of light. A portion of the epidermis is removed, and a natural, protective dressing is formed on the skin’s surface. It peels off within three to four days, revealing new, healthy skin underneath.
“This is a process of turning back the hands of time rather than cutting things out,” Sullivan said. “People don’t want to hide out for weeks. This is four days of downtime rather than two weeks, and it removes fine lines and pigments and smoothes the skin’s texture. It makes a huge difference.”
Some of these same trends toward ease and convenience have permeated esthetic dentistry as well, Emirzian told The Healthcare News. “Minimally invasive is definitely the trend at the dentist today, as well as accelerated treatments,” she said, “and conservation of the tooth structures is important, too.”
All that is possible through a host of restorative treatments, from bonding, to restore broken teeth and eliminate spaces, to ceramic veneers that retain more of the tooth’s natural enamel surface than in the past, which results in a stronger bond.
Ceramics has also contributed to a more natural look throughout the mouth, in a host of different procedures, Emirzian said. “It’s very exciting — we use it even for bridgework or posterior teeth. We’ve always had metal reinforcements, and now we have the ability to do all-ceramic bridgework without the metal. It’s very strong and beautiful; essentially, the goal is to have the teeth look like teeth and not a restoration.”
That’s a concept in play with Invisalign, a product that takes the place of braces for the purpose of straightening teeth. Instead of metal bands, patients are fitted with a series of clear, plastic molds that fit over the teeth and gradually bring about the desired changes, usually within a year’s time.
It’s ideal for adults who are wary of a product — braces — so closely associated with the teenage years, and emblematic of people’s desire to improve their smile. Also on the non-invasive side, Emirzian said, teeth whitening has only increased in popularity over the past decade or so.
“That’s a starting point for a lot of people,” she explained. “There are different ways to do it, based on a patient’s needs and goals. Whitening is when you remove surface stains and polish the teeth to bring back the original color. Bleaching is going from the original color to something even lighter. Bleaching is nothing new — it’s been around at least 15 or 20 years — but it remains highly effective, and if you speak with people, you’ll find that it’s certainly not considered an extravagance.”
Agents of Change
Whether patient demands are driving a new emphasis on quick, minimally invasive cosmetic treatments or the public is simply responding to new advances, everyone who spoke with The Healthcare News agreed that both our fast-moving culture and economics have contributed to a demand for such products and procedures.
“Some patients are looking to do these things as they change careers,” Frangie said. “They’re trying to reinvent themselves, and they want to look a little younger.”
And it’s up to practitioners to keep up with this upwardly mobile crowd by picking up on the latest trends. Sullivan said everyone at Dermique is constantly researching what’s new, taking continuing-education classes, and trying out new equipment to make sure they meet the demand for the next big thing, whatever that might be.
And, make no mistake, many are still opting for more-invasive surgical procedures, and are benefiting from advances in technique, instrumentation, and drugs that help patients get back on their feet faster than they used to, Topal said.
Still, “trying to do the least-invasive thing to correct the problem may be the new way of thinking,” she added. And in the end, it’s all about making people feel better about themselves.
“My work is very satisfying,” Topal concluded. “Body image is very important to people. This can be a major life change, and it’s really exciting when they’re happy with what they’ve done.”
