Cosmetic Surgery Today: Simpler, Safer, and Cheaper

From the WebMD Archives

Aug. 3, 2000 (Nashville, Tenn.) -- Cosmetic surgery procedures to improve the skin's appearance seem to be changing faster than crow's feet on a baby boomer. And it's no wonder. "It's market driven, and everyone wants to look younger," Gary D. Monheit, MD, reported here today at an international meeting of the American Academy of Dermatology. "Baby boomers want results with no downtime. They want little things with big results," he adds.

Monheit and other skin surgeons gathered to discuss, among dozens of topics, the latest and most effective treatments and procedures to soften wrinkles and rejuvenate skin.

While technological advances have allowed the procedures to be performed more simply, safely, and less invasively than ever before, the booming economy and lower costs of many procedures are making them a reality for millions of Americans.

"Cosmetic surgery has changed from the big surgical procedures requiring anesthesia, operating rooms with surgical risk, and significant postoperative recovery periods to simpler, less invasive procedures," Monheit says. He is an assistant professor in the department of dermatology at the University of Alabama at Birmingham.

So what's hot? Microdermabrasion -- a procedure that "blows" crystals of aluminum oxide onto the skin and removes them with a vacuum -- is currently the most popular cosmetic procedure in the U.S. Although the procedure lacks scientific evidence to show it works, both patients and physicians have reported younger looking, smoother skin.

James M. Spencer, MD, reported results of a small study that tested the "sand-blasting" technique. Six out of 10 of his patients reported "mild improvements," and "no one was unhappy," he says. But are results long lasting? That has yet to be proven, he says. Spencer is director of the division of dermatologic surgery at Mount Sinai Medical Center in New York.

Laser treatments, another popular procedure, have undergone vast improvements for cosmetic purposes as well as skin diseases. Psoriasis and vitiligo -- two disfiguring skin conditions that affect millions of Americans -- are being effectively treated with the excimer laser, which provides the benefit of UV light therapy without increasing the risk of skin cancer.


Other new lasers include the YAG, which successfully removes pigmented lesions, tattoos, and excess hair, and the erbium:YAG, which removes the outer layer of skin. Another new laser technique is a procedure that improves wrinkled skin while cooling the skin's surface to minimize visible damage.

To rejuvenate aging skin, chemical peels are one of the most flexible treatments, according to Monheit. Peels range from very superficial to deep, and provide a vast number of ways to remove lesions and improve skin. Superficial peels treat early aging skin with a 48- to 72-hour recovery period. For more advanced aging skin, deeper peels are required, with up to a one-week recuperation time.

While Monheit admits that over-the-counter products can provide similar, temporary skin improvements, there's something about "the psychological effect of having someone else pamper our skin" that prompts us to seek professional attention.

If you're considering a cosmetic procedure, Spencer suggests seeking a good consultation with an experienced dermatologist or cosmetic surgeon. "Ask to talk to some of their patients," he advises.

And check out the background of whomever you chose, Monheit warns. "Experience is what counts, especially with the deeper procedures," he says.

Thirty years ago, the facelift was the only option for a more youthful look -- and you didn't talk about it, Monheit tells WebMD. "We've opened up the possibility of cosmetic procedures to everyone. With prices coming down and the variety of procedures increasing ... we're entering a whole new era of dermatologic surgery."

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