By Chris Watson
Would you spend a thousand dollars to get rid of wrinkles? Would you spend the same amount to get a tattoo? How about routinely being charged a hundred dollars to dye your hair? Would you dye it magenta? Are you willing to allow someone to use a needle to get rid of crow’s feet but cringe at a lip piercing? These decisions are not about age or current fashion; they are about what we perceive as beautiful. Beauty, it turns out, is much more than skin deep. Beauty, or our perception of beauty, strikes at the core of how we view our culture, our neighbors and colleagues, and ultimately how we view ourselves.
Although concepts of beauty and aesthetics may vary from decade to decade, the desire to be attractive never wanes. More importantly, as we age, the desire to feel and look young is universal. “Looking younger is the number one reason our clients come to us,” states Julia Smirnov, owner and operator of Refresh Center for Wellness and Cosmetic Therapy. “There is no such thing as anti aging. However, there are treatments we can do to slow down the process.”
Dr. Craig Colville, a Toledo based plastic and cosmetic surgeon, agrees. “People rarely talk about their looks in terms of procedures. They talk in feelings,” he explains. “My patients will say ‘I look tired’ or ‘I hate this extra skin’ or even ‘People look at me like I am old.’” It is a myth that only women are seeking cosmetic treatments. According to the American Society of Aesthetic Plastic Surgeons, procedures for men are on a significant upswing, growing more than 40% in 2014 alone.
An Industry on the Move
Slowing down the aging process is certainly not a new desire. Topical treatments have been around since recorded history. Cosmetic surgery isn’t a new innovation either, with the first recorded face lift in 1901 and the first textbook about face lift surgical technique published in 1907. The techniques for surgery and added procedures have been steadily improving ever since. The first documented breast augmentation surgery was as early as 1895.
Besides enormous leaps for surgery in general and aesthetic surgeries in particular, less or minimally invasive treatments have been rapidly appearing on the market and represent the largest growth in the industry. “The entire industry is moving to less invasive techniques,” claims Smirnov. “The significant factor is down time. For most people, time away from normal activity after any treatment, surgery or otherwise, is a primary concern.”
Botox, the first “injectable” treatment for wrinkles was approved by the FDA in 2002. “Neural modulators, or Botox, was first introduced by eye surgeons,” explains Dr. Bennett (Buzz) Romanoff an Opthalmologist at Romanoff Vision. “It was used to relieve conditions like cross eyedness and other problems with eye contraction. It was noticed that it also relaxed wrinkles in the forehead.”
Since then a vast selection of less invasive techniques for cosmetic rejuvenation have been introduced to the market. “Hyaluronic Acid, which is the basis of many filler style treatments also has its roots in Ophthalmology,” Dr. Romanoff continues. “It is still used in cataract surgery.” These classes of injectable treatments, along with other techniques including chemical peeling, microdermabrasion, restylane, hair removal, and various laser treatments, have vastly expanded the cosmetic treatment industry. According to the American Society for Aesthetic Plastic Surgery (ASAPS) in its most recent report, there were over 10 million surgical and nonsurgical procedures performed in 2014 alone generating $12 billion dollars in revenue.
There are basically the same amount of face lift procedures done today as done a decade ago, according the the ASAPS survey. The minimally invasive procedures have expanded the entire industry, not just shifting dollars within the industry.
Variety of Options
“One of the largest dilemmas is where to start,” states Dr. Craig Colville (FACS, American Board of Plastic Surgeons, Member American Society of Aesthetic Plastic Surgeons). “Reading something in a magazine or seeing it on TV gets people thinking that they might want to change something about how they look. The question is how do you pursue your interest with confidence?”
Up until the last 15 years, surgery was almost the only option. For many cosmetic changes surgery remains the only option. Breast augmentation, lifting and or reduction can only be accomplished through surgery. Average costs run from $3000 to $5000, with additional fees for anesthesia, hospital, testing, and prescriptions. Average costs for a full facelift varies from $6000 to $8000 with the same additional fee structure.
Body contouring is most often used following dramatic weight loss, body contouring involves arm lifts (saggy skin under the arms), tummy tucks (apron of excess skin around the abdomen), Lower body and thigh lifts (sagging skin around the thighs, groin and abdomen) along with breast and face lifts. There is no easy way to quote a cost for these procedures as the extent of the procedure is entirely dependent upon the person and the amount of weight loss achieved.
There are many myths and prejudices to cosmetic surgery. The image of the ridiculously large breasts or faces pulled back giving the appearance of a stretched cartoon are common. Kelly Creech, Patient Care Coordinator at Reconstructive & Aesthetic Surgeons Inc. puts it succinctly. “The number one fear that is voiced is that post procedure our clients will look fake or unnatural. That, of course, is the exact opposite of what we want to achieve.” Dr. Romanoff continues. “My number one objective is to have a patient’s close friends or family remark that they look fresh, relaxed, or healthy. No one should get a questions such as ‘What did you have done?’”
“In considering surgical options patient goals are the driving factor,” continues Colville. “Any surgery consult should consider the entire gambit of what the client’s goals are, a full explanation of all of the options available to achieve those goals, what those options cost, the risks, and finally, the recovery time.” That consult he explains should include non-surgical options as well as surgical ones, giving the client a full menu of choices. “Above all a surgeon should explain his qualifications and experience in the procedures he is proposing to do.” Certifications from the American Board of Plastic Surgeons and membership in ASAPS are important first indicators of a surgeon’s qualification. Dr. Romanoff agrees. “Training, certification and experience are important. Patients should know how long the provider has done a procedure and how many they do in a year. A provider should be able to provide before and after pictures of their work.”
Ancient Problem, Modern Solution
There are now many treatments that enhance, rejuvenate, or correct how we look that are not surgical in nature. Although these procedures are not surgery they are still considered invasive procedures. They involve moving below the skin with needles. chemicals, and machines like lasers and intensive light generation. “Unlike the weeks of potential downtime in classic surgery, there are little to no physical restrictions after the treatment and the effects are often observed quickly,” Smirnov explains.
Botulinum Toxin injections, commonly referred to as Botox, remain the most performed of the less invasive treatments. Used to smooth or eliminate wrinkles around the forehead (frown lines), crow’s feet, brow furrow, and other forehead lines by relaxing the muscle under the wrinkle. The injections can be done quickly and take up to a week to become fully effective. Small side effects may include a drooping eyelid, headache, and slight bruising. Although noticeably effective, these injections are not permanent. Typically lasting three to four months and in some people up to six months they cost between $10 and $15 per unit.
The fastest growing procedures are Hyaluronic Acid treatments often referred to as Dermal Fillers. Wrinkle fillers fill in the wrinkle line, crease, or area of concern. They can also be used as volumizers, plumping and lifting cheeks, jawlines, temples and lips. Costing between $500 and $800 per syringe, the treatments typically take 30 minutes and last between four months up to a year. Brands include Juvederm, Voluma XC, Restlyane, and Perlane.
Chemical Peels and Microdermabraision are also highly sought after non surgical procedures. Chemical peels can help reduce fine lines around the eyes and mouth, treat wrinkles caused by aging and sun damage, improve the appearance of mild scars, and reduce age spots freckles and some dark patches (melasma). Microdemaabrasion is a mechanical form of exfoliation, primarily used for bumps, dry skin, and hyperpigmentation due to sun damage, brown or age spots. Both treatments cost between $70-$170. Both procedures have minimal down time but Chemical Peels have sun exposure restrictions after completion.
Rounding out the less invasive procedures is permanent hair removal. The two prevalent methods are Laser/Pulsed Light treatments and Electrolysis. Laser/pulsed light is one of the most effective methods of hair removal but has its drawbacks. It in general won’t work on white hair and isn’t as effective on blonde hair. It usually takes 6-12 treatments and people often go back for additional touch up treatments at yearly intervals. The average costs start at around $200 but vary widely based on the size of the area to be treated and the number of treatments required. Medical Grade Electrolysis works best for smaller areas and people with white or blonde hair may see better results. Like laser treatments, costs vary based on size of area and number of sessions required but in general treatments run between $40 and $60 per session.
“Of course, you should be sensitive to cost,” claims Dr. Colville. “Cosmetic patients run the full spectrum of the population.” There are a wide variety of means to pay for surgery including something as simple as a savings plan to a wide variety of financing. “Cost is a factor but not the only factor,” states Colville. “The overall cost should be blended with the patient’s desired result. One procedure might be less expensive but does not achieve the desired goal of the patient.”
People invest in the way they look. Kelly Creech, Patient Care Coordinator at Reconstructive & Aesthetic Surgeons Inc. states, “People are living longer, spending more years in a career, and finding themselves single at older ages. Add in social media and the prevalence of ‘selfies’ and it is no surprise that we want to look youthful and healthy.”
“A deal is not always a deal,” says Lori Mandrey – FACES Skin Health Experts – Dr. Marlene Welch. “If you do not use authentic products you may be paying twice to make up for the mistakes made”. “You need to use board cerified Plastic Surgeons or Dermatologists because less training or less concentration of the actual product, can prove to be disasterous, causing you to live with a mistake for 4-6 months.” All of these issues can factor into the cost of a treatment. Research and education is the absolute key before you buy into any treatment plan. Dr. Colville agrees. “A filler or Botox injection is not a flu shot. It should be part of a comprehensive treatment plan to achieve a look consistent with the client’s goals.”
Hitting a Moving Target
“You can not stop the clock” Mandrey says emphatically. “With the products today we can slow down the effects of aging process 5-10 years both with procedures and at home. But we can’t stop it.” With its dizzying array of procedures, surgeries, home care options, and even evolving definitions of beauty, it is easy to get lost in the maze that is beauty enhancement and restoration.
“Philosophy is paramount,” explains Dr. Colville. “First, ask what the clients concerns are about their appearance. Second, explain fully all of the options available for addressing those concerns. Finally, develop a treatment and financial plan to achieve those goals in a safe and confidential environment.” He continues emphatically, “Above all seek a provider that is willing to develop a long term relationship. The goal is to achieve a natural appearing result that pleases the client and accomplishes the resolution of the issues that brought them to the industry in the first place.”