Refresh & Renew: Popular Procedures for the Face and Body
“Dahling, I have to tell you something. And I don’t say this to everybody. You look mahvelous!” Actor Billy Crystal made this a catchphrase of the ’80s through his portrayal of legendary star Fernando Lamas on Saturday Night Live. Today, looking fabulous is more accessible than ever, thanks to continuing advancements in medicine, surgery and technology. More than $16 billion is spent annually on cosmetic plastic surgery and minimally invasive or noninvasive procedures, according to the American Society of Plastic Surgeons.
The use of noninvasive fat reduction procedures that involve special technology increased 7 percent last year, as reported by the American Society of Plastic Surgeons. Emsculpt is included in that group. The new technology takes noninvasive body shaping to a new level, says Dr. Richard Moore, medical director and owner of The Lifestyle Center and The Edge for Men in Ladue. “It uses highintensity, focused, electromagnetic technology to stimulate motor neurons,” he explains. “When we voluntarily do a muscle contraction, we stimulate about 50 percent of the muscle’s fibers. Emsculpt creates a ‘supramaximal’ contraction of 90 percent of the fibers. In a half hour, it does 20,000 of these contractions.”
This can build bigger muscles and encourage fat cells to disappear. “The contractions stimulate the fat cells to go into a hyper-metabolic state and programmed death,” Moore says. After one month, about 19 percent of the fat cells are destroyed and by three months, 23 percent. One popular area it is used is the abdomen to firm, flatten and create muscle definition. “The average person is going to lose an inch and a half in that area,” Moore says.
Emsculpt also can tighten abdominal muscles stretched by pregnancy. “Previously, the only solution was a tummy tuck,” he notes. “With Emsculpt, we get tightening of about 11 percent of the muscles in the center of the abdomen.”
For abdomen sculpting, four treatments over two weeks are recommended. The package costs $3,000. Emsculpt also is useful for shaping the glutes; the muscles are stimulated, but the procedure doesn’t affect fat cells in this area. “You want to lift the buttocks, but you don’t want to lose volume back there,” Moore says. “Soon, we’ll start doing legs and upper thighs.”
The manufacturers of the ARTAS iX Robotic System estimate that 1.2 billion men around the world suffer from genetic hair loss. In other words, most men are potential consumers of hair transplant services. This device uses a computer-guided robot arm, three-camera stereoscopic imaging and artificial intelligence to identify and remove healthy hair follicles, select needy territory and replant them.
“It gives us a higher degree of precision with less risk for human error and fatigue,” says Moore, who operates the Midwest’s first ARTAS iX at The Lifestyle Center. A typical hair transplant session handles 2,000 follicles, which can be tiresome for the doctor as well as the patient. ARTAS iX cuts one or two hours from the session, he says.
Follicles are selected from the back and sides of the scalp, where male hereditary hair loss apparently fears to tread. The computer imaging software selects the neediest gaps on top of the head for implantation. “It selects the best quality follicles,” Moore explains. “This is permanent hair that stays for a lifetime. Patient satisfaction is reported to be 96 percent.”
Male hair loss can begin in the teen years but usually arrives in the 30s, Moore says. “By the age of 50, 86 percent of men have thinning hair,” he notes. “About 40 percent of women will experience hair loss during their lifetimes, too.”
His practice charges $8 per follicle for ARTAS iX services. “You can resume usual activities in a couple of days, but we don’t want you doing strenuous exercise for seven to 10 days,” Moore says. “You might have tiny scabs at both the harvesting and implant sites for three to five days, and there can be minimal swelling and discomfort, but it is rare for a patient to need anything beyond Tylenol.”
Hyaluronic acid fillers rank second in popularity among noninvasive cosmetic treatments—about 2 million procedures averaging $644 each add up to a $1.3 billion market. Some of that money has been reinvested in refinements. “In the last five years, there have been changes in filler compositions,” says Dr. Scott Walen, a SLUCare facial plastic and reconstructive surgeon. “Companies are engineering their products to make them specifically suitable for certain parts of the face and to make them last longer. If a patient who is 40 or 50 years old wants to look younger, fillers and Botox are a really good start.”
Hyaluronic acid is naturally found throughout the body. Products based on it used to be utility fillers that were limited in ideal applications, and they would only last three to six months, Walen says. “Now, they are specialized for deep and superficial parts of the face and for certain features like lips,” he notes. “And companies can modulate the length of time they last.”
For example, a hyaluronic acid used to plump cheeks is a little heavier, which allows it to keep its form over time and last longer. “We can expect it to last one to two years, which is a pretty big deal,” Walen says. Other products designed for smaller areas like the lips are thinner and more pliable, which allows for a much more natural shape.
Fillers now are available based on deoxycholic acid, another natural substance found in the body. “We put this kind of filler in the submental fat under the chin,” Walen says. “It’s fat that is tough to get rid of, even if you lose weight. It usually takes two to three treatments and about a month to see results.”
Wrinkle reduction is a $2.7 billion annual business and the most common noninvasive cosmetic category. “Neuromodulators, best known by the product names Botox and Dysport, work by weakening the muscle where they are injected,” says Dr. Gregory Branham, a Washington University plastic surgeon. “In general, these neuromodulators are very safe.”
The U.S. Food and Drug Administration first approved botulinum toxins for cosmetic use in 1989. “They first were approved for limited use, such as to treat lines between the eyebrows and crow’s feet next to the eyes,” Branham says. “Obviously they are used in lots of other places now, like around the mouth to get rid of a pouty or bitter look.” The latest application for neuromodulators is treatment of thickened, pitted skin surfaces. “Some people get a condition called peau d’orange, or orange-peel skin, on the chin,” Branham says. “Some of it is caused by muscle contraction. Using Botox there can help to smooth the skin and improve some of the dimpling.”
Neuromodulator toxins are gaining use as early tools for routine maintenance, he adds. “There is a trend toward younger patients using Botox to prevent lines and wrinkles,” he says. “People are intervening earlier and doing less invasive things that help to stave off the surgeon’s knife. If you start in your 30s versus your 40s or 50s, there should not be any adverse effect for prolonged use because the product wears off in three months.”
While new fillers offer a more natural look, you can’t expect them to treat every issue of an aging face, Branham points out. “The most important thing to remember is that you need the right treatment for the right issue,” he says. “You are never going to appear 40 years younger, but in order to look great for your age, you must address texture changes, fine lines and wrinkles, and sagging and drooping tissues. All have equal weight in getting you back to looking healthy, youthful and successful.” And marvelous!