Now that the holidays are over, our thoughts just naturally turn to … spring break! Then panic sets in: Can we be ready in time? And I’m not talking about packing. With swimsuit season looming in the not-too-distant future, it can be an uphill battle to prepare for long, lazy, and bare-it-all days in the sun.
mind the midsection
If there is one ‘problem area’ most women would single out, it’s the midsection—somewhere between the top of the rib cage and the hips. Fortunately, the medical world has come to the rescue with all kinds of innovations to meet the demand for trimmer torsos.
start early and start thin-ish
Cosmetic surgeries come with a downtime period, so plan ahead, doctors caution. “It’s not necessarily a quick fix, like something to do two weeks before spring break,” points out Dr. Marissa Tenenbaum of West County Plastic Surgeons of Washington University. Diet and exercise she says, are the most effective front-line strategies because most midsection-tweaking procedures are just that—tweaks. “There aren’t a lot of great procedures for somebody who is very overweight,” Tenenbaum notes.
“Body sculpting surgery works best if the patient is at or near their best weight,” concurs Dr. William Hart of Hart Cosmetic and Reconstructive Surgical Institute of St. Louis. “It is a treatment for selected problem areas and not a method of losing weight.” Trimming weight and trimming inches are two entirely different issues, points out Dr. Michele Koo of St. Louis Plastic Surgery. “If a patient is interested in weight loss, we have an entire program of nutrition and exercise therapists who can work with our patients to get them on track first,” she says.
excess fat vs. excess skin
The first determination when trimming problem areas is whether the problem is excess fat, excess skin or both. If fat is the issue and the skin quality is good and reasonably tight, CoolSculpting is a non-surgical possibility, says Tenenbaum. “CoolSculpting works really well for the love handle region or the lower and upper belly,” she says. Sessions are one-hour and done in-office with no anesthesia, and most people will need two to three treatments. “It takes a few weeks to a few months to see your final results, but you start seeing some results within a few weeks,” Tenenbaum says.
Liposuction remains the gold standard for fat reduction. Incisions are small, but it is a somewhat invasive procedure. Typically it is done on an outpatient basis in the hospital, and post-procedure discomfort is moderate. “Patients are going to feel very sore, kind of like they went to the gym and did a million sit-ups,” Tenenbaum says. “Usually it’s tolerable and most people don’t miss much work. But they definitely will feel it.” The type of liposuction depends on the area and how thick the fat is, explains Koo. She says she uses all available options, but isn’t a proponent of external liposuction with ‘fat freezing,’ or fat smoothing via external ultrasound. “There has not been enough evidence of significant reproducible results,” she says.
Hart uses a technique called ‘power assisted liposuction.’ “This allows for removal of more fat safely with less bruising and a quicker overall recovery,” he says. “The amount of fat is estimated beforehand in terms of how much will be removed.” Hart also employs a technique called BodyTite, which uses radiofrequency heat to liquify the fat and cauterize small blood vessels and fibrous tissue. “This has worked extremely well for patients who have excess skin but not so much that they would require a tummy tuck,” he says. “It can be used for any area of the body where we would normally do liposuction, and in some cases it can avoid large scars.”
face facts
Laugh lines, crow’s feet and age spots can make you look in the mirror and wonder who’s staring back. But from peels and dermabrasion to Botox and filler, there are many options for returning to a fresher look.
help yourself
“There are a lot of different things you can do—exfoliating is helpful to refresh the skin and bring back a little glow and brightness,” says Dr. Natalie Semchyshyn, a SLUCare dermatologist and associate professor of dermatology at Saint Louis University School of Medicine. Without even going to the doctor’s office, topical creams containing lactic acid or glycolic acid and prescription retinoids can help exfoliate the skin, she adds. “It’s going to gradually give you some improvement over several weeks to months.”
Face protection and skin improvement start at home, agrees Dr. Joseph Muccini of MidAmerica Skin Health & Vitality Center. “As we get ready for spring, we need to be smart in the winter months,” he says. “We should be using gentle cleansers and moisturizing.
peels & tightening
In-office monthly microdermabrasion helps exfoliate the skin and even its tone. Depending on the level of discoloration, chemical peels with glycolic acid can range from superficial with little down time to more intense with three to five days ‘social’ down time, doctors explain.
“The peels are good for smoothing, helping with skin texture and brown spots, and evening the skin tone,” Semchyshyn says. Radiofrequency skin tightening and ultrasonic skin tightening are gentle techniques, Muccini says. Microneedling is a good way to repair skin in a noninvasive way, he adds, and when paired with vitamin C serum infusions, it rejuvenates the skin.
“As spring comes, it’s sort of like pulling your car out of the garage,” Muccini says. “You’re going to wash it and wax it and buff and polish it and make it all nice and pretty. But with your skin, you’re not just making it look good, you also want to promote health.
laser treatments
Less intense laser treatments will help with skin texture and skin discoloration and have a shorter recovery time. Stronger laser treatments with deeper skin penetration will help with wrinkling, sun-damaged skin and discoloration, but recovery takes longer.
Semchyshyn prefers fractional lasers, which treat tiny sections of skin while leaving other sections untouched—she describes it as like aiming a laser through a sieve. The fractional untouched skin allows the face to heal faster.
Muccini says winter is a great time for laser treatments because people aren’t in the sun as much, so avoiding sun is that much easier. After laser treatments, both doctors recommend using sunscreen and sun protective clothing, including hats and long-sleeved shirts—not a bad idea at all times, doctors advise.
botox & fillers
Botox and injectable fillers are other resources to address frown lines and sagging brows. Botox takes two weeks to realize the full effect, but lasts three to four months. “There’s never a bad time to do Botox,” Muccini says. “But the winter is a good time because you aren’t outside as much.” And remember: “Don’t wait until March 31 if you want to be ready for May 31,” he says.
hair help
When the weather warms, we shed layers. That means we bare more, including embarrassing hair in unwanted places. No woman wants a mustache or a messy bikini line, and men aren’t usually crazy about back and shoulder hair. thankfully These are easy to remedy with advances in laser hair removal.
less is more
“For women, facial hair is probably their No. 1 priority,” says Dr. Richard Moore, owner of The Lifestyle Center. “Probably the biggest seasonal peak in business for us is after the first of the year. People are starting to think about spring and summer.”
Laser hair removal, however, does not work for everyone, as people with white, gray, red or blond hair won’t get the desired results. “It only works on dark hair,” says Dr. Caroline Mann, a dermatologist with Washington University. “Women who have excess or increased hair growth don’t want to deal with it over and over.”
People with darker skin once had a problem with hair removal, because the laser heat could increase pigment in the area. But that’s not the case any longer. “Laser hair removal is safe and effective for all skin types, but for darker skin it requires less aggressive settings,” Moore clarifies.
And improvements have changed how heat is delivered to the skin and the discomfort levels. “It’s even safer now than it was 20 years ago to do laser hair removal for darker skin types,” Mann says. And with much of the new equipment on the market today, “Laser hair removal is nowhere near as uncomfortable as it was in the past,” Moore says. “Now we’re able to supercool the skin before, during and after treatment.”
permanent & convenient
“Laser hair removal can be curative after a number of treatments,” Dr. Mann says, “and you don’t have to shave or use creams. You’re just done with it.” The process sends laser energy down the hair shaft to the bulb of the follicle, destroying the bulb so it can’t generate a new hair follicle. Clearing an area of hair permanently can take several treatments, up to 10, Dr. Moore estimates.
“You don’t get rid of hair in one sitting,” Mann adds. “The hairs have to be in a certain growth phase, and not every hair is in that growth phase at the same time. We always warn patients they may need several treatments to get the end results.”
Treatments need to be spaced six to 15 weeks apart, depending on the body area, to allow the body to heal. “With laser hair removal, you look a little red around the hair follicle,” Mann says. “But mostly you don’t want to keep hitting the skin repeatedly with heat like that because it could cause hyper-pigmentation or blisters. You have to give time for the skin to heal.”
It’s also important to avoid the sun after laser treatment, as hyper-pigmentation could result. Mann reminds about the imperative to use sunscreen, even in winter. “We’re really big on sunscreen every day, no matter what,” she says, “but especially with laser.”