Doctors offer new options for eliminating tired faces, flat backsides and smelly underarms 

July 20, 2004
BY PATRICIA ANSTETT
FREE PRESS MEDICAL WRITER

They're old problems, but they're being solved by new approaches. New products are on the market, and innovative procedures are gaining acceptance in the United States, which tends to lag behind Europe and South America when it comes to plastic surgery.

One important caveat: The treatments are cosmetic or elective, so don't even think about whether your insurance covers it. It won't.

But if you want a lift, in more ways than one, here's what you need to know about five emerging trends for the face, butt and underarms.

Photos by RICHARD LEE/DFP

Beverly Lay, a meeting planner for the
Ford Motor Co., is examined by
Dr. Michele Hardaway, a Farmington Hills
plastic surgeon who recently performed
thermage on Lay. The goal was to tighten
the skin around Lay's eyelids and the bags
under her eyes. Thermage, a noninvasive procedure, is gaining popularity in the
United States.

Injectable fillers

Restylane and Hylaform are two new, federally approved injectable fillers that help temporarily reduce facial folds and wrinkles. They last up to six months, adding fullness and volume to the skin. 

These dermal fillers are particularly helpful for the treatment of nasolabial folds -- lines from the side of the nose to the mouth that accompany aging -- and wrinkles or marionette's lines on the chin, says Dr. Lorna Thomas, a Detroit dermatologist with many African-American patients. Minority groups are not well represented in clinical studies conducted to gain federal approval, and Thomas' work gives African Americans insight into how well the procedures work. 

She calls injectable fillers a great option for the aging face. "People really, really like the results," she says. 

The downside is the cost, which varies widely throughout the United States. 

A treatment using two syringes of the injectables, a typical dose, might cost $900 in Detroit but $2,000 or more in California, New York or southern Florida, Thomas says. 

Restylane and Hylaform, administered during simple, 10-minute office visits, are made of hyaluronic acid, a non-animal product. They provide an advantage over collagen, an animal-derived product that plastic surgeons have used for years for wrinkle treatments. 

Before it can be used, collagen typically requires two skin tests to determine whether patients will develop an allergic reaction, Thomas says. Collagen also "only lasts about three months maximum," she says, compared with up to six months for the new fillers.

Side effects include possible bruises, pimple-like formations and temporary swelling or redness at the injection site. The swelling and redness usually subside within three days.

Sometimes doctors don't inject enough solution, says Dr. Steven Fagien, a Boca Raton, Fla., plastic surgeon, who spoke at the Vancouver meeting. "The biggest problem with Restylane is under-correction."

Diana Zuckerman, president of the National Center for Policy Research for Women & Families, a Washington, D.C., resource organization, says she urges caution about the products because little is known about long-term risks and little study was done in Asian and African-American patients.

For more information, visit www.restylane.com, or www.inamed.com.

Thermage

A noninvasive procedure to tighten loose skin also is gaining popularity in the United States.

Thermage uses heat, or radiofrequency waves, delivered by a computer-driven machine that takes the guesswork out for doctors. It uses grids to mark the face, much like a paint-by-numbers kit and a preset number of pulses to deliver the energy.

It's federally approved for treatment of wrinkles around the eyes, but doctors use it for other purposes, including tightening the butt, says Dr. Michele Hardaway, a Farmington Hills plastic surgeon. Doctors don't know yet how long results last because the procedure is new, but they expect them to last at least 1 1/2 years, perhaps much longer, Hardaway says.

Last week, Beverly Lay, a meeting planner for the Ford Motor Co., underwent a 45-minute procedure to tighten the skin around her eyelids and the bags under her eyes. She wanted a noninvasive procedure like Thermage instead of a conventional face-lift or the eyelid surgery known as belpharoplasty. Thermage uses only topical anesthesia, requires no stitches, causes no bruising and involves no recovery time.

The procedure is slightly painful, "a burning feeling," but tolerable, says Lay. She returned to work the next day with only a slight redness under her eyes. "Did it take 10 years off?" she asks. "I should be so lucky."

For more information, visit www.thermage.com / To read the rest of the article, click here.