Seeking a new look
Non-invasive, nonsurgical procedures are becoming increasingly popular.
Looking younger, thinner and more relaxed is something to which many aspire. Cosmetic surgery is the answer for millions of Americans wanting to eliminate wrinkles around the eyes and mouth, lumps around the thighs or unwanted hair.
Board-certified plastic surgeons, dermatologists and otolaryngologists performed more than 11 million cosmetic procedures in the United States in 2013, according to the American Society for Aesthetic Plastic Surgery’s (ASAPS) annual multi-specialty statistical survey.
But like any surgery, cosmetic procedures come with risks. That’s why cosmetic surgeons say it’s important to know what to look for in a surgeon, what to expect out of the surgery and to understand why you want to change something about your appearance.
What are plastic and cosmetic surgery?
Though some people think the term plastic surgery was derived because doctors use plastic materials to transform the body, Dr. Bradley Garber says it stems from the Greek word plastikos, which means to mold, shape or give form.
Cosmetic procedures are elective and include procedures like face lifts, tummy tucks and breast augmentations — “We’re taking someone that is fairly normal and we’re trying to make them better,” Garber says — while reconstructive surgery typically involves some sort of trauma to the body, such as a burn or cancer, and reconstructing the area to help restore the patient’s original appearance.
Trained dentists should handle cosmetic dentistry, which can include procedures such as teeth whitening, dental implants and fillings.
Invasive vs. non-invasive procedures
In recent years, non-invasive procedures, including Botox, hair removal and microdermabrasion, have grown tremendously in popularity. Nonsurgical procedures increased by more than 13 percent in 2013, according to ASAPS.
The newest procedures tend to be less invasive, Garber notes, because fewer people have the time to devote to a full post-operation recovery. And many people are looking for similar results without the pain and suffering that can come from traditional cosmetic surgery.
“A lot of people now don’t want to go through major surgery and take off two weeks after having a laser resurfacing of their face and having all the scabbing and redness,” Garber says. “We’re busy. We’ve got a lot of things going on in life. To take out two weeks from your social activity, it’s tough.”
Dr. Arch Miller III echoes that statement, saying more people want to have a procedure done one day and be ready to attend a weekend function a few days later.
New procedures are being developed to help patients transform their bodies through nonsurgical methods.
CoolSculpting is a new non-invasive procedure that eliminates bulges of fat, says Dr. Greg Ratliff. “Its advantage is that the target group is really people who are in pretty good shape and just have a bulge they can’t get rid of,” he says. There is no incision and no surgery involved, meaning downtime is minimal, so people can continue to work out after the procedure.
“It’s not for everybody,” Ratliff says. “People who are overweight or have big rolls of fat — it won’t work for that.”
The procedure works by freezing and killing fat cells on the stomach, hips, and inner and outer thighs. It takes two hour-long sessions, done about six weeks apart, Ratliff says.
Another new non-invasive procedure is called UltraShape, which uses a machine to act like liposuction but with sound.
“The sound literally penetrates your skin and vibrates the fat cells and kills about 15 percent of the fat cells underneath your skin,” says Miller, who was one of the first in the country to utilize the machine. He is the only doctor in Oklahoma to offer UltraShape. The average reduction is about 1.5-2 inches around the waist after three procedures.
According to the ASAPS annual survey, the most popular surgical procedures in 2013 were liposuction, breast augmentation, eyelid surgery, tummy tucks and nose surgery. The most popular non-invasive procedures were Botox, hyaluronic acid, hair removal, microdermabrasion and photo rejuvenation.
For some surgeons, an upswing in a certain procedure can be related to the time of year. Ratliff says he sees more tummy tucks and liposuction in the winter and breast implants and lifts in the spring.
“As clothes become more revealing, the body procedures and breast procedures become more important,” he says. “We do a lot more facelifts in the winter because people can stay at home and hide while the bruises fade.”
Surgical procedures can help even the most delicate issues. Dr. Nicole Patel says she regularly sees women wanting a labiaplasty, which alters the inner and outer labia around the vulva.
“I think because there is so much out there in the media with pictures of every part of the body, and women feel that if their labia minora is hanging down lower than the majora — which is normal ... they want it reduced,” she says. “And sometimes there is asymmetry. They might feel that it shows in tight clothing or it might interfere with sexual intercourse.”
The American Society for Aesthetic Plastic Surgery survey revealed that the number of labiaplasty procedures jumped by 44 percent from 2012-2013. Buttock augmentations — another previously uncommon procedure — jumped by 58 percent in the same timeframe.
What to expect
When considering cosmetic surgery, the first step is an initial consultation with the doctor. Research at this point is key, several of the doctors say.
Miller recommends potential patients ensure their doctor is board-certified by inquiring with the Oklahoma Medical Board of Licensure.
Once a doctor has been selected and a consultation appointment made, the doctor will ask the patient what they want to change about themselves and why. This is when, doctors say, there can be a little bit of psychological work involved: What do they want to change about their bodies? And why do they want to change it?
The motivations of cosmetic surgery
The reasons behind wanting cosmetic surgery are varied, according to local doctors. Often, people see themselves in a photograph, in a mirror or on TV and start to notice a slight sag here and a wrinkle there, Garber says.
“They want to look natural and basically look as good as they feel,” he says, not necessarily reverse time to when they were 18 years old.
It’s key, Garber says, that people understand getting a tummy tuck or breast lift will not save a marriage or relationship, and that the procedure must be done for the patient alone — no one else.
The next step is making sure that the patient has a realistic expectation for the results of the procedure. Thinking a breast lift will suddenly make someone look like Scarlett Johansson on the cover of Cosmopolitan magazine is not a realistic expectation. But once the doctor and the patient understand expectations, the physician can discuss the details of the procedure and the possible complications that can arise.
Finally, Garber says sometimes his job actually involves focusing outside a patient’s perceived flaws. Sometimes, he says, a patient needs a little encouragement because they see major flaws or abnormalities that aren’t there.
“I think any good plastic and reconstructive surgeon will know they have to be ethical and honest with the patient, and they have to make sure that they don’t start talking patients into surgery, and make sure they give the patient some positive reinforcement.”