Searching For A Quick Fix Non-surgical Cosmetic Procedures Are Catching On With Women And Men
In decades past, the term ‘cosmetic surgery’ evoked images of going under the knife and hoping things turned out for the better once the bandages came off.
Nowadays, however, it’s a different world in this fast-moving field, one highlighted by quick-fix solutions. Sure, surgical facelifts are still a common occurrence and have become less invasive with the development of more advanced tools — but the rage these days in plastic surgery can hardly be called surgery at all.
Botox. Microdermabrasion. Collagen injections. Every month, it seems manufacturers are promoting new products to improve one’s appearance in an easy, relatively pain-free visit.
“I do think the whole thing is being driven by manufacturers in a sense,” said Dr. Phillip Stone, who practices cosmetic and reconstructive surgery at the Esthetic Plastic Surgery Center in Springfield. “I think there’s a lot of that.”
But as the economy slowly awakens from a few years of malaise, appearance-enhancing medical procedures — which are very much a luxury item for most patients, and one not covered by health insurance — are expected to ride that upward trend as well.
This synergy between economics and technology has purveyors of cosmetic surgery smiling — as they improve the smiles, faces, and bodies of women … and, increasingly, men.
Looking Young
When it comes to improving appearance, no products are as hot as wrinkle reducers. According to the American Society of Plastic Surgeons (ASPS), more than 1.5 million Americans smoothed wrinkles with injectables in 2002, a hefty percentage of the 5 million Americans who had some sort of non-surgical cosmetic treatment.
The name on most patients’ lips is Botox — the brand name for a treatment that applies a small amount of botulism into wrinkled areas to flatten them.
Originally used to treat nervous twitching of the eyelid, Botox has become, over the past decade, a popular treatment for wrinkling. In 2000, the first year for which the ASPS has statistics, 786,911 Botox treatments were administered. That number jumped to more than 1.1 million in 2002, a 43{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} increase.
Botox, injected with a tiny needle, relaxes muscles and smoothes out the skin over a five-day period, and the effect lasts about six months per treatment.
Stone cautioned that not all Botox treatments are equal, and patients need to know what dilution rate the doctor is using. “You should be careful what you’re getting,” he said.
Meanwhile, “Botox is a lot more than a wrinkle cure,” said Dr. Rod Rohrich, ASPS president-elect. “By itself, the off-label uses of Botox include relieving migraine headaches and decreasing sweating in a patient’s palms and armpits. We’re using it to reshape the lower face from square to oval, a procedure requested by some Asian patients.”
But by no means is Botox the end-all in wrinkle reducers.
“As surgeons continue to pioneer other uses for Botox, we’re finding that it relaxes muscles while injectable fillers keep the shape or add volume,” Rohrich said. “With the revolutionary fillers coming to the market, plastic surgeons will have access to safe and effective injectables that last three times longer than previous collagen products.”
For example, an advisory panel of the U.S. Food and Drug Administration has recommended conditional approval of Restylane and Hylaform, two non-surgical wrinkle fighters that boast longer-lasting effects than Botox.
Both products are hyaluronic acid-based soft tissue fillers that are already used in Canada and Europe to plump wrinkles. Hyaluronic acid is a sugar molecule that occurs naturally in the body, so allergic reactions are rare.
“This is the first time in more than a decade that patients and physicians have the option of new fillers,” Rohrich said. “People want to look as good as they feel using modern techniques and technologies. These wrinkle fillers are safe, do not require a skin test, and are two to three times longer-lasting.”
Dr. Kristin Stueber, chief of Plastic Surgery for Baystate Health System, said she expects an upswing in wrinkle-reducing procedures as the available options become longer-lasting and more reliable. But the economy is just as important a factor.
“It kind of waxes and wanes with the economy,” Stueber said. “As things become more stable, there will probably be a little more comfort with spending discretionary income.”
Facing the Future
The explosion of interest in cosmetic surgery — which, to be accurate, has slowed somewhat in the past two years, but is still growing (see chart) — has something to do with members of the Baby Boomer generation trying to match their body image with their general fitness and healthy state of mind, Stueber said. And in the realm of surgery, the trauma related to the procedures is being minimized like never before.
“For both women and men, the buzz is all about smaller-incision approaches and still obtaining the big-incision results,” Stone said. “Because of the newer instrumentation, use of the endoscope, use of the subperiosteal approach, things have changed to allow for better brow lifts, better mid-face lifts, and better neck definition.”
That trend has “absolutely” led to a surge in interest, he explained. “Now, you can get a result that looks good and doesn’t look like you just got out of your plastic surgeon’s office. Anything you can do to achieve a nice, natural result safely and with less morbidity is bound to be favorable.”
Still, non-surgical procedures continue to make the most news, especially considering their popularity among women. While 77{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of all cosmetic surgeries are performed on women, they undergo 88{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of non-surgical techniques, according to the American Academy of Facial Plastic and Reconstructive Surgery.
These procedures go well beyond Botox.
Microdermabrasion, which some have called the “lunchtime peel” because of its ease, uses a focused laser spray of corundum crystals, which resemble fine sand particles, to exfoliate the skin, removing about 35 microns from the skin’s surface (about one-fifth the total depth) to open up blocked pores, remove dead cells, and expose the healthier skin cells underneath — all in a half-hour to 45 minutes, the length of a lunch break.
Other non-surgical techniques include laser skin resurfacing, which uses a carbon-dioxide laser to exfoliate the skin, achieving an effect similar to that of microdermabrasion; chemical peels, which employ acids of varying strengths to basically burn away dead skin; and injections of collagen or fat into the face to fill out wrinkles and depressed areas.
“Fat injections are looked upon more favorably, especially with the new methods for injecting fat,” Stone said. “People do it as a result of age, hollowed-out cheek depression, scars, or trauma. You can usually have fat injected two or three times over the period of a year and can expect to have 30{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of it take in each injection. Before you know it, you’ve corrected the defect with your own tissue.”
Meanwhile, doctors are finding other benefits to certain procedures. Stone has been involved in research that shows that chemical peels might reduce the instance of skin cancer. “We’ve been doing these peels since 1962,” he said, “and it’s taken a long time to get that information, but it’s becoming apparent now that you can slow down, if not obliterate, the incidence of new cancers by doing a chemical peel.”
Procedure 2000 2002 {06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} Chg.
Botox Injection 786,911 1,123,510 + 43{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Cellulite Treatment 23,952 54,464 + 127{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Chemical Peel 1,149,457 920,340 – 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Collagen Injection 587,615 441,718 – 25{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Dermabrasion 42,218 64,678 + 53{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Fat Injection 65,270 54,823 – 16{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Laser Skin Resurfacing 170,951 194,808 + 14{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Microdermabrasion 868,315 900,912 + 4{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Sclerotherapy 866,555 511,827 – 41{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}
Women and Men
Still, when people think of the quick-fix cosmetic options available to them, they’re thinking mainly of appearance. Injectables are even being used in conjunction with facial surgery, with 47{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of ASPS physicians saying they can enhance the results of surgery, and 43{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} saying injectables can postpone the need for facial surgery.
The popularity of injections, peels, and other on-the-run treatments has also had another effect — more men are wading into the pool of cosmetic treatments, more willing to try something non-invasive than they had been to attempt surgery.
“I don’t think there has been, in the last two or three years, any significant upswing in a particular treatment,” Stueber said, “but there has been a gradual increase in the number of male patients looking to have procedures done. I think it stems from the general acceptance of it — it’s not something you hide from anymore.”
In that sense, the face of cosmetic treatments — both surgical and non-surgical — is an optimistic one indeed.
Body Of Evidence
This chart shows the number of patients who underwent nine common, non-surgical cosmetic procedures in 2000 and 2002, according to the American Society of
Plastic Surgeons (ASPS). Complete figures for 2003 are unavailable, but the ASPS
predicts an upswing as the economy improves and more products become
available. All statistics reflect only work performed by board-certified practitioners.