Fourth Quarter 2008, Volume 22, Number 3

Ask the Surgeon | What’s New | Health Tip


The increase in popularity of cosmetic surgery over the last decade

Laser surgery, treatment and options

Ask the Surgeon / Health Tip / What’s New

Hospital, surgical center, office, does it matter?


Help! My 19-year-old daughter would like to have lip enhancement, what should I do? I think she is too young; however, she insists it would positively change her life and should be done as soon as possible.

Whenever a young adult is considering surgery, it is important to ensure the person is educated regarding options, procedures, and the extent of recovery.

Ask your daughter if she has done any research on the procedures that interest her. Direct her to information from reputable sources (doctor’s Web site, journals, association/society Web sites). Then explore what your daughter’s motivations are for surgery. Is she trying to look like a movie star or does she feel that enhancing her lips will improve her self-image and confidence? If you feel your daughter has learned about her options and appears to have the right motivations, schedule a consulta-tion appointment with your facial plastic surgeon. This is the best time to ask questions and create an optimal plan with an expert. !


Make sure you know your anesthesia options and who will administer it. Anesthesia can be local (topical or injectable), local with sedation (intravenous or oral), regional, or general. Your physician will go over in detail what he or she recommends and who will be overseeing its administration. Do not be afraid to ask for the qualifications of the person that will be giving the anesthesia.

The following healthcare professionals may provide anesthesia depending on your circumstances: your doctor, anesthesiologist, anesthesi-ologist physician’s assistant, and certified registered nurse anesthetist (CRNA). Your facial plastic surgeon may apply a topical or local anesthetic in conjunction with oral sedation. Additionally, your doctor may prescribe medication to take before the surgery.Some doctors will also administer intravenous sedation. An anesthesiologist is a medical doctor with an accredited residency in anesthesiology and qualified to apply all types of anesthesia.An anesthesiologist physician’s assistant supports an anesthesiologist and may provide anesthesia only under the direct, on-site supervision of a board certified anesthesiologist.

A CRNA is a registered nurse with 24 to 36 months of graduate coursework-including classroom and clinical experience-in addition to the testing required for certification. Depending on your state laws, a CRNA may or may not be able to provide general anesthesia independently. !


Proven rejuvenation treatments that have been around for a while are now being asserted as “new” with the liquid lift. This treatment can improve wrinkles, volume loss, nasolabial folds, thin lips, under-eye hollows, and more. Often referred to as “injectable facelift,” areas of concern are plumped up with injectable fillers.

If you are looking for fullness, you may be a good candidate; if you are looking to lift or tighten sagging skin, a traditional facelift may be the better option. Although the procedure is non-surgical, with immediate results and very little recovery time, the disadvantage is that the results are not long-term. !

Common problems improved by lasers

Lasers can be used to improve active acne and reduce the appearance of acne scars. Multiple treatments may be necessary with a non-ablative or Fraxel laser. The laser works by shrinking the sebaceous glands that feed acne bacteria and stimulating collagen production. An ablative laser can be used to remove the outer layers of the scar tissue and stimulate collagen to tighten and reduce the visibility of the scar. Tattoos. A non-ablative laser can be used to target the colors of ink most common in tattoos. Blue and red inks are the easiest to remove. It may take between six to 12 treatments over a period of two months to see noticeable improvement.

Fine lines and wrinkles
Various lasers can be used to improve the appearance of lines and wrinkles. It will depend on your skin type and the extent of wrinkles. The treatment will promote the growth of new, smoother and supple skin. The non-ablative and Fraxel treatments are less invasive, but require repeated sessions. The ablative laser is more invasive and requires additional healing time.

Port-wine stain birthmarks respond remarkably well to laser treatment. The abnormal blood vessels that cause these marks are reduced in size by the laser. This results in a lightening of the treated area. Skin growths, facial “spider veins,” and warts also respond to laser surgery.

Pigmented lesions
In order to treat pigmented lesions or sun spots, a laser that absorbs black or brown pigment is used to destroy the unwanted cells, while leaving the healthy cells intact. Most situations take more than one laser treatment, but some respond to a single treatment.