Cosmetic surgery means more than nose jobs and breast implants. There are now hundreds of different procedures designed to take care of everything from wrinkles and scars to sagging skin and loose jowls.
Deep vertical lines between the eyebrows can usually be eliminated with Botox, a toxin derived from the same microbe that causes the deadly ailment botulism.
Injected between the brows, Botox paralyzes the facial muscle causing the wrinkles. The procedure takes about 10 minutes. Results last for three to six months. Cost: $200-$400 per injection.
Although collagen injections work well for isolated facial wrinkles, they are not very effective for a face that is “tired-looking” all over. The best remedy for such a face is usually laser therapy.
Laser light causes collagen in the skin to shrink, eliminating wrinkles for about nine years. That’s how long it takes facial wrinkles to form.
Several different kinds of lasers are now in use. For mild wrinkling, the best bet is the newly approved erbium laser. It combines good results with a brief recovery period.
The skin is red for three or four days. You can go back to work within a week. Cost: $100 to $3,000.
Avoid: Dermabrasion and chemical peels. These once-popular treatments for removing facial wrinkles yield unpredictable results. They can also cause scarring or lightening of the skin.
Deep wrinkles or scarring
For acne scars or deep wrinkles caused by years of smoking and/or sun exposure, the best approach is once again laser therapy. But instead of the erbium laser, it’s better to use the more powerful carbon dioxide laser.
Carbon dioxide laser therapy takes only 90 minutes, but the recovery period often lasts up to 10 days.
During the first week of this postoperative period, it’s a bit like having bad sunburn. The skin peels and crusts over. Pain medication is often needed. After seven to 10 days, the crust falls off, leaving behind new, pink skin. Cost: $2,000 to $6,000.
Sagging jowls or neck wattles
For loose skin on the face or neck, the best treatment is a face-lift or neck-lift. In this four hour operation, the surgeon makes an incision in front of and behind the ears.
Then he/she lifts the skin off the underlying muscles and fat of the face and tugs it back till it’s snug.
Face-lifts are done on an outpatient basis. The recovery period lasts seven to 10 days. At that point, the stitches are removed, and you can return to normal activity. Cost: $7,500 to $30,000.
Good news: A new variant of the traditional face-lift procedure reduces the slight risk of nerve damage associated with the older procedure. Supra-platysmal face-lift involves repositioning only the superficial layers of skin.
The surgeon repositions the cheek fat and removes some fat around the jaw. Cost: $3,300.
Since neither type of face-lift can completely eliminate wrinkles, many patients opt to have laser therapy approximately six weeks after the face-lift
Flabby hips, thighs and arms
With America’s obesity problem continuing unabated, liposuction has become the most popular cosmetic surgery procedure.
In conventional liposuction, the surgeon sucks out fat using a thin tube (cannula) inserted through the skin. Most surgeons now use tumescent liposuction, in which fluids containing essential salts and sugars along with a local anesthetic and epinephrine to control bleeding are injected into the area being suctioned.
Unlike conventional liposuction, tumescent liposuction allows safe removal of lots of fat up to 22 pounds at a time. Cost: $2,500 per site.
Some surgeons are starting to use ultrasonic liposuction instead. It involves use of a special probe that “melts” fat before it’s sucked out of the body.
Enlarged breasts in men
The standard approach to this problem is to make an incision around the outside of the nipple and then cut away the excess fat.
This method generally yields good results, especially when used in combination with liposuction. Cost: $2,500 to $3,000.
Finding a good cosmetic surgeon
Picking a surgeon certified by the American Board of Plastic Surgery is not enough. You must also look for a surgeon who has
- Treated someone you know, with good results and
- Performed the procedure several times
Best strategy: Consult two or three cosmetic surgeons. Listen to their recommendations, and see how your personalities mesh.