Style :: Grooming
Anti-Aging :: In-Office Procedures by David Andrusia
EDGE ContributorTuesday Sep 15, 2009
There comes a time, somewhere after forty, that the inevitable pulling and tugging-of eyes, neck, cheeks-begins. In Los Angeles, this happens first in car mirrors (in combination with the glaring sun, a most unforgiving reflective apparatus). But wherever you first start lifting and tugging, the effect is the same: How did I get to look like THIS?
About the same time, we inevitably start looking seriously at the media coverage (and, yes, ads) for in-office procedures-but the dizzying array of treatments available can confuse even the initiated. As someone who’s spent 20 years writing about beauty, I couldn’t myself discern the best options available; how, then, can anyone else?
Compounding the problem is that the FDA regulations are murky: MDs, DDSs, and nurses alike can administer Botox, and aestheticians without a high school diploma can treat patients with lasers. Even within the realm of doctors, confusion ensues when faced with the choice among specialties.
Demystification is de rigueur. What, then, are the in-office anti-aging procedures currently available, and how to choose?
We talked at length with Stuart H. Kaplan, M.D., a dermatologist in private practice in Beverly Hills. Dr. Kaplan, who has treated a long list of celebrities-including members of the Red Hot Chili Peppers and Guns ’n’ Roses, as well as Oscar winning actors and actresses-is warm, empathetic, and patiently provided a kaleidoscopic view of the in-office treatments available today.
Above all, Dr. Kaplan offered a very convincing rationale for seeing a dermatologist for these procedures. "Many plastic surgeons offer similar ranges of services as part of their practices. However, even when they themselves administer the procedures-and you must keep in mind that sometimes it is nurses who do so, not the doctors themselves-their field of specialization involves cutting of the skin, rather than treating the skin itself. Treating skin is the exclusive province of dermatologists, who spend four years in medical school, then four additional years in residency."
Further, Dr. Kaplan advises, "Anti-aging treatment of the skin cannot be separated from overall medical treatment of the skin." He himself has seen cases of patients who go to so-called medi-spas (where a doctor’s name may be associated with the business, but his/her presence is not constant) in which nurses or aestheticians misdiagnose serious skin problems such as shingles-and can actually cause further skin degeneration. Certainly, nurses and aestheticians are "not trained in the musculature and anatomy of the skin and face," another argument against seeing lesser trained practitioners. Likewise, "only a dermatologist is trained to recognize and treat skin cancers, melanomas, and other conditions; thus, it would be very ill advised to have any aspect of your skin health-preventive, anti-aging, or otherwise-treated by someone outside the specialty."
This said, there are certainly plastic surgeons who have conscientiously added in-office, non-invasive anti-aging programs to their practices. How to discern their respective level of commitment to these practices? A consultation is requisite. Most important is to find out who in the office performs procedures: the physician him/herself or a nurse associate? Approximately what percentage of the doctor’s practice comprises these procedures, as opposed to in-office or in-hospital surgeries?
Perhaps most vital of all: What is their general outlook about these options vis-�-vis surgery? If you get the feeling that the physician performs these as an adjunct service, or as a de facto money-making vehicle-one surgeon we spoke with all but scorned non-surgical procedures, so deprecatory was his tone-our advice would be to find another doctor. Finally, if these procedures are administered by a nurse, find out what kind of training he or she has had. In many cases-and especially in today’s economy-you’ll be able to find a doctor who performs these him/herself; given their greater body of knowledge, we ourselves would be hard-pressed to recommend undergoing these procedures with someone who does not possess a medical degree.
What, then, are the key categories of in-office anti-aging procedures available in physicians’ offices? To demystify the process, we would group these into several key treatment areas:
Relaxers
In a word, relaxers freeze muscles so that they relax- and therefore don’t turn into the furrows and frown lines that form on the forehead, around the lips, and between and around the eyes. Botox is the primary product here, and still the most widely used.
A typical treatment runs $300-600, depending on the amount of product used and your doctor’s fees. You can expect the results to last about four months, though every patient experiences slightly different results.
In terms of pain, we’ve seen the procedure performed; more stoic patients don’t wince, though some do, but the pain level doesn’t seem to be anything more intense than that of a Novocaine injection.
It’s also worth noting that the full results of Botox can take several weeks to appear, as muscles relax following treatment. Results also differ from patient to patients, and as a consequence of whether this is an initial or follow-up injection program.
Dr. Oscar Hevia, a board-certified plastic surgeon at Dr. Brandt’s Cosmetic & Skin Associates, a comprehensive laser and cosmetic dermatology practice in Coral Gables, FL., is excited about Reloxin, slated for FDA approval in April. Although the price has not been confirmed it’s predicted that Reloxin will be less expensive than Botox, and it has several advantages as well. First, while Botox can take up to one week to show a cumulative effect, Reloxin works within a day or two; thus, it’s perfect for an important event as soon as 24 hours away from the procedure. Second, Reloxin lasts slightly longer than Botox- typically, up to
5-6 months.
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