Skin-Deep Treatments for a Younger You

Increasingly more Americans are turning to cosmetic surgery, from simple procedures such as Botox to more complex “mommy makeovers.” Discover the latest in maintaining a youthful appearance.

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An old advertising adage declares, “It’s what’s up front that counts.” Americans appear to be taking this slogan to heart in increasing numbers. Despite a still-slow economy and the elective nature of cosmetic surgery, demand continues to rise.

Last year, American physicians performed more than 15 million cosmetic procedures, both minimally invasive and surgical, up 3 percent from the year before, according to the American Society for Aesthetic Plastic Surgery (ASAPS).

Dr. Landon Pryor, a board-certified plastic and reconstructive surgeon, who owns Transformations Plastic Surgery in Rockford, says there are several reasons for the increasing interest.

“Now that the economy is rebounding, we’re seeing a lot of patients who postponed elective treatments for financial reasons, over the past few years,” Pryor says. “Also, because of the economy, the workforce has become extremely competitive. We live in a very image-conscious society where appearance definitely plays a role. Patients feel the need to maintain a more youthful appearance in order to level the playing field. In addition, I think a lot of people are more aware of their appearances in this age of digital cameras, smartphones and social media.”

Nationally, the top five surgical procedures in 2013 were breast augmentation, nose reshaping, eyelid surgery, liposuction and facelift. Pryor says he has found similar trends in the Rockford population, plus an emphasis on body contouring. One example is the so-called “mommy makeover,” a combination of breast augmentation (increasing fullness and improving symmetry) and abdominoplasty (“tummy tuck” that removes fat and skin).

“We hear a lot of requests for the ‘mommy makeover’ package after completion of having children,” Pryor says. “Part of it is related to its portrayal on the Internet and in the media, but it’s really an effective way to comprehensively rejuvenate the body following pregnancy.”

Last year, about 290,000 breast augmentations were performed in the U.S., topping the list of requested surgeries. Liposuction, which was surpassed in 2012 as the most popular procedure, is common among women and men.

“We don’t see as many men in our practice as women, of course, but it’s becoming more popular for men to seek treatment for many of the same reasons as women,” Pryor says. “I think it’s also much more acceptable nowadays for men to get something done than previously. With the increasing trend for bariatric procedures, we commonly see men looking for body contouring options such as gynecomastia reduction (male breast reduction), and skin tightening procedures following massive weight loss.”

Minimally invasive procedures are increasing, too, especially botulinum toxin Type A, soft tissue fillers, chemical peels, laser hair removal and microdermabrasion.

Pryor says the most popular nonsurgical procedure is the injection of Botulinum Toxin Type A (including Botox and Dysport).

“The neurotoxins such as Botox have always been very popular among a large age range of patients,” says Pryor. “Actually, Botox injections are up 700 percent since 2000. These are typically used to treat fine lines and wrinkles in the upper face and around the eyes. When performed by an experienced injector, these products are extremely safe and relatively affordable, with each treatment typically lasting about four months.”

The technology for noninvasive procedures continues to evolve and improve. Compared to even five years ago, Pryor says, patients can get a much better outcome from a nonsurgical technique by utilizing the most state-of-the-art equipment.

“Ultrasound, radiofrequency, cryolipolysis, and Light Amplification by Stimulated Emission of Radiation (LASER) each have a role in today’s cosmetic industry,” Pryor says. “Used in combination, these can yield synergistic and powerful improvements for skin resurfacing, skin tightening, cellulite and fat reduction.”

For Dr. Sarah Hagarty, a board-certified plastic surgeon at OSF Cosmetic & Reconstructive Plastic Surgery, a division of OSF Saint Anthony Medical Center in Rockford, the evolution of techniques in minimally invasive procedures is good news. Today, patients experience substantially fewer problems and less discomfort.

“Patients can reclaim a natural, more youthful look without the downtime and with less pain,” Hagarty says. “As we age, our skin naturally loses elasticity and becomes slack. Depending on a lot of factors – genetics, weight change, smoking, sun and exposure – this process begins as early as your 20s and early 30s in many people. Healthy living can help put off a lot of these changes, but at a certain point, everyone can use a little help. The underlying soft tissue matrix gets diminished, contributing to wrinkles.”

The use of peels and lasers to stimulate removal of damaged or aging facial skin has evolved swiftly in the past two decades. Peels are now among the most frequently requested treatments for removal of dark spots, rough skin patches and other superficial conditions. These peels are often less painful than many of the laser treatments, and don’t require additional pre-treatment time for numbing.

“The peels cause sloughing of damaged skin, and a little inflammation as the skin reacts,” Hagarty explains. “But then the patient’s body repairs itself. Old, dead skin cells are exfoliated, bringing new cells to the surface and giving the patient a uniform, firmer skin tone by stimulating collagen production.”

Most peels are not too painful, but a mild, temporary burning sensation is common, Hagarty adds. A combination of agents works at different levels to improve the skin overall. Hagarty says she likes the VI peel, and uses a booster when patients have troublesome melasma. During recovery, special creams can moisturize and protect the new skin, helping to minimize the side effects of itching and flaking.

“The face will look a little tight and shiny for about two days and then the peeling starts,” Hagarty says. “The whole process lasts about a week, but throughout, it looks no worse than if you had just gotten a bit too much sun on vacation.”

Some stronger TCA chemical peels require numbing ahead of time. Some of the lasers are even stronger; the mild Intense Pulsed Light can still be a zinger.

“Some patients have described the sensation as being similar to an elastic band snapping against their skin,” Hagarty explains.

Chemical peels target the quality of the skin; afterward, good skin care products are a must.

“Right now there are so many more good products at our fingertips,” Hagarty says. “Most are based on a substance that is already present in our own tissues – hyaluronic acid – but we lose it with time. This gel-like material keeps skin naturally soft and youthful. Through technology, this gel is synthesized in a lab by bacteria, instead of the old-fashioned collagen injections that came from cows. There is a much lower risk of hypersensitivity reactions, and the actual injection process is much less painful. It also lasts much longer, anywhere from six months to a year.”

Also, the gels are available in various structural strengths, to target certain areas of the face. Hagarty says that Radiesse, a softer gel, is often used for lips. A stronger, more supportive material, Restylane, is used in the cheeks and nasolabial folds.
Thicker materials have even been used to smooth out abnormalities in noses.

“For example, the thicker material is used to address an irregularity after a rhinoplasty surgery, or trauma to the underlying cartilage or bone. This is much easier on patients who thought they needed a revisional surgery,” Hagarty says. “It’s really an exciting and fun time for rejuvenative therapies. We can simply do so much more. We can actually sculpt the face.”

The future of cosmetic plastic surgery appears to be limitless. Along with looking their best, patients also feel better about themselves and have more confidence in their public appearance when they choose to enhance their face and body images. Used judiciously, cosmetic plastic surgery can lift a person’s spirits, brighten his or her outlook on life and strengthen self-esteem.