COSMETIC SURGERY HELPS PATENTS TIGHTEN AND TUCK FOR YOUNGER LOOK

During the initial consultation, Dr. Tom Critchlow will have clients gaze into a mirror, then he'll ask them, "What do you want improved? What will make you feel better about yourself?"

The answer from a growing number of clients seeing Critchlow and other physicians is that they want cosmetic procedures to smooth out wrinkles, fill in acne scars and eliminate discolorations.

"People get their hair dyed. Now they are saying, why not get rid of the wrinkles. It's all a matter of degree," said Critchlow, a general and vascular surgeon who performs cosmetic procedures at Elan Day Spa and Esthetic Centre.

In the cosmetic surgery consultation room at Dr. David Deisher's office is a three-sided, full-length mirror that Deisher uses to help patients communicate to him where their problem areas are and help him communicate to patients what he can do to help.

If the client is interested in liposuction, the most common cosmetic procedure nationwide, Deisher can show them what he can take away. If the client is thinking of having breast augmentation, the client, wearing a tight T-shirt, can see what can be added. If the client is thinking of a face lift, Deisher can physically pull back the skin to give the patient an idea of what he or she can expect.

"The number of people seeking cosmetic surgery is increasing dramatically locally and nationally," said Deisher, a board-certified plastic surgeon at Heartland Plastic and Hand Surgery.

According to the American Society of Plastic Surgeons, the number of cosmetic surgery procedures performed by board-certified plastic surgeons increased 153 percent from 1992 to 1998, the last year for which figures are available. That includes a 264 percent increase in liposuctions, a 306 percent increase in breast augmentations, a 246 percent increase in chemical peels, a 177 percent increase in tummy tucks and a 102 percent increase in eyelid surgery.

"We live in an image-conscious society," said Dr. Trenton C. Jones, a plastic surgeon with Midwest Physicians and Surgeons. "Cosmetic surgery helps them look more youthful. They feel that it gives them a competitive edge in business, especially in professions where they meet with the public."

Deisher said he's had women executives come in who thought they were losing business because they were starting to look more mature. They want a younger appearance, he said.

Men, Deisher said, often feel wrinkles around the eyes give them a tired look, and they want a more vibrant expression to compete with younger colleagues.

The increase in the popularity of cosmetic surgery also can be attributed to the health and fitness trend, Deisher said.

"People are feeling better and they want to look better," Deisher said.

"Wrinkles and sagging eye lids can give people a tired look when they don't feel tired," said Dr. Joseph Davidson, an ophthalmic plastic and reconstructive surgeon at Eye Care Specialists. He said procedures such as blepharoplasty, or eye lifts, which remove excess skin in the upper eye lids, can change a person's facial expression, which is an important part of the impression people make on others.

There are also lifestyle issues, said Brenda Samons, director of patient and professional relations at Eye Care Specialists, which handles LASIK corrective vision procedures and cosmetic eye procedures.

Many people have such busy, active lives, they don't want to have to bother with glasses or contacts, she said.

Another major reason for the increase in numbers of cosmetic surgeries in the last few years is the economy, Critchlow said.

"There's a lot of disposable income out there and people choose to spend it to make themselves feel better," Critchlow said.

And it takes money, because not only do these procedures run from the hundreds to the thousands of dollars, the cost usually is not covered by insurance, the doctors said.

Laser procedures to get rid of varicose or spider veins can cost several hundred dollars. Collagen injections to fill in wrinkles or round out lips can cost more than $100. Liposuction can cost $3,000 to $5,000. Breast augmentation can cost $4,000. LASIK can cost more than $2,000 per eye to correct vision, though Samons said some people look at it as investment since they will no longer be spending money on glasses or contacts.

Still, local doctors say, cosmetic surgery patients are not all affluent.

Locally and nationally, people getting cosmetic surgery are increasingly from middle-income families, Deisher said.

"A lot of families have dual incomes so there is more money available to splurge and pamper themselves," he said.

Some patients are from wealthy backgrounds and have money to spare, Jones said. Others save for the procedures they want to have, borrow money from family members or finance the procedure through a loan.

While middle-class, working clients can save or finance procedures, they can't afford to take off a lot of time to recover from these elective procedures, Deisher said. So he thinks advances in techniques and technology that allow shorter recover times also has contributed to the increase in cosmetic surgeries.

"There are different techniques for cosmetic surgery allowing good results with a quick recovery time," Deisher said.

The liposuction techniques used today cause less bleeding, bruising and swelling than those used in the 1980s. That means people can get back to work more quickly.

With the LASIK procedure, which corrects vision using a laser, most patients can have both eyes done on Saturday and be back at work on Monday, Samons said. With earlier vision correction procedures, like radial keratotomy and photo-refractive keratotomy, recovery time took weeks and only one eye could be done at a time.

With laser treatments for lines, wrinkles and acne scars and skin product programs for smoother skin, patients can often have the procedure during the day then go out that evening.

Critchlow uses a Vasculite machine that is similar to a laser to damage the outer layer of the skin to stimulate the under layers to grow new cells, producing a fresh look and younger skin, he said. After a treatment, he said, patients can put on their makeup and go back to work.

"People want to feel better and look better but they can't afford to take off four to six weeks for cosmetic surgery," Deisher said. "We've found ways to get good results with less recovery time."

But cosmetic surgery is still surgery, Deisher emphasized. It's not something the surgeon or the patient should take lightly.

He said most patients don't take it lightly and do their own research through television, the Internet, talking to others before scheduling a consultation.

"Most people think about it and find out all they can about it," Samons said.

Local doctors say those seeking cosmetic surgery should ask questions about the procedure and their doctor's experience with the procedure.

"Patients need to feel fully informed," Jones said, adding they need to know the risks as well as the benefits.

Deisher suggests asking the physician how many of these procedures he or she has performed, what kind of training he or she has had and whether they are certified in the specialty.

Doctors say most patients think about cosmetic surgery for a while before they commit to it. But once patients have had a procedure done, Critchlow said, most wonder why they waited so long.

Cosmetic procedures can open up people's lives, Critchlow said. For example, he said, many of his patients who have varicose veins removed are able to wear shorts for the first time in years.

"It seems superficial," he said, "But having cosmetic surgery can affect how people live."