Nip and Tuck for Less

There’s a bevy of beauty options that are easy on your wallet — and your bodyIf the very rich are different from the rest of us, as F. Scott Fitzgerald once observed, advances in cosmetic surgery might help lead us all to a patch of common ground. There was a time, after all, when having facelifts and “work” done to the face were pretty much the purview only of the wealthy. But now, less-invasive treatments are opening up the world of cosmetic enhancement to the masses as lasers, dermal fillers and Botox lure a new, not-so-well-heeled clientele to cosmetic surgeons. “I think the total pool of patients has increased a lot,” says Khalil A. Khatri, M.D., dermatologist and cosmetic laser surgeon at the Skin and Laser Surgery Center of New England in Nashua.Even in a shaky economy, patients want to look their best. “The volume of Botox and dermal fillers has not decreased with the economic downturn,” says Wayne K. Stadelmann, M.D., plastic surgeon at Stadelmann Plastic Surgery in Concord. Patients recognize these treatments as being relatively affordable, he says.So, the good news is that many of today’s cosmetic options have bargain-basement price tags compared with traditional surgery. The downside? Their results are temporary. Botox, which subdues muscle action so that wrinkles are less apparent, usually lasts about three to five months, and dermal fillers, used to plump up sagging or wrinkled skin, can last from a few months to two years, depending on which kind is used. There are permanent fillers, but they tend to have a higher complication rate than the shorter-lived treatments, Khatri says, leading some to favor lower risk over longevity.Fillers in general have come a long way, though. Some of the earliest fillers were animal-based and could cause allergic reactions, Stadelmann says, but the varieties that have been on the market for the last decade or so are not animal-derived; they are based on a substance that occurs naturally in human skin.Other benefits of newer, less-invasive options include the minimal downtime they require post-treatment. Traditional surgical treatments can require general anesthesia, which carries its own risks, plus weeks of self-imposed exile as the patient waits out swelling and bruising and removal of stitches, Khatri says.The newer techniques are a breeze in comparison, although patients might experience some mild and temporary side effects, such as redness or brown discoloration where a laser has been used to lessen spider veins, says Stadelmann.Beauty knows no ageAlthough most consumers seeking less-invasive cosmetic options are middle-aged, older patients can benefit from the treatments, too, Khatri says, adding that he recently used laser resurfacing to treat a 72-year-old woman who had plentiful jowls and her fair share of wrinkles. The results were “amazing,” Khatri says.Still, some experts say that less-invasive cosmetic procedures can only go so far in producing results similar to more drastic treatments such as a facelift. “There will always be a market for facelifts,” Stadelmann says, as long as there are patients willing to handle the $10,000 or so bill, the risk of complications and the downtime following surgery — it all comes down to individual thresholds, he says.Calling Obi-Wan KenobiPatients wishing for a way to present a more svelte profile also have a less-invasive option now: laser-assisted liposuction. Traditional surgery remains the best cosmetic treatment for some individuals, such as patients with a lot of loose skin, but laser liposuction provides patients who are good candidates with a procedure that is quick and easier on the wallet than some of the traditional surgical methods.In a laser liposuction procedure, the doctor inserts a thin laser fiber into small incisions in the skin, where the heat of the laser basically melts away the fat in the area. Fat suctioning, the hallmark of traditional liposuction, might be necessary, depending on how much fat is present. Liposuction performed on the neck, for example, usually does not require suctioning because there typically is only a limited amount of fat there, Khatri says.Laser liposuction can offer several advantages over traditional liposuction, including speedier recovery and stimulation of collagen and elastin growth, which leads the skin at the liposuction area to tighten.And, as with other less-invasive cosmetic treatments, another big plus is the price. Laser liposuction patients can achieve the same results as traditional liposuction patients, but often at a lower cost because no hospital visit is required, says Khatri. “And there’s no general anesthesia involved, it’s all under local anesthesia,” he says.Once you kiss that fat goodbye, should you worry about it coming back? “We are all born with ‘x’ number of fat cells,” Khatri says. “We don’t grow new fat cells, the cells just get bigger or smaller” depending on how much fat you put into them. If a patient undergoes liposuction — with or without a laser — for her abdominal area, for example, fat cells in that area are removed. If the patient gains weight, most of the fat will not appear on her abdomen, Khatri says. The liposuction will not have removed all of the fat cells in the area, so some of the fat will go there, but most of the fat will accumulate somewhere else on the patient’s body.Lasers are super-safe, Khatri says, especially when wielded by an experienced and trained professional. As a general rule for any procedure, patients should be sure to check out a doctor’s credentials and experience rather than just calling around and going with a place that offers the most appealing price, Khatri says. Reputable doctors will insist on seeing the patient before quoting a treatment price, he adds. NHCellulite Solution?Just in case you’re dreaming about a way to smooth away cellulite, the bane of many women … keep hoping. There is currently no quick and easy way to truly get rid of it, experts say, although there are treatments for it, including some that sound a bit tortuous, featuring vacuums and roller pins. Anyway, they don’t work that well, says Wayne K. Stadelmann, M.D., of Stadelmann Plastic Surgery in Concord. However, device makers are inching closer to a real cellulite solution, we hear.On the unfurrowed horizonWant the latest thing for wrinkle treatment? Dysport is a new Botox-like product recently approved by the FDA and available now at some treatment centers. Botox and Dysport are both botulism toxins that are used to temporarily paralyze muscles to reduce wrinkles. Dysport is advertised as being just as effective as Botox but cheaper, says Wayne K. Stadelmann, M.D., of Stadelmann Plastic Surgery in Concord. The verdict is still out, though. Stadelmann hasn’t used it in his office yet.