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Medispas growing in numbers; proper medical supervision key

There has been a recent trend towards “medispas,” some of which provide cosmetic treatment such as Botox injections or glycolic peels to reduce wrinkles. But buyer beware. Potential customers should do their homework before taking treatment at a medispa.

“I think medispas do well if they have trained plastic surgeon oversight,” said Dr. Scott Runnels, Runnels’ Clinic of Plastic Surgery, Flowood. “But the trend in the past three to five years is people are saying they are trained, but their training is by company representatives who come to town and teach them how to use their products.”

Exaggerated results?

Medispas don’t have same responsibility in advertising as board-trained plastic surgeons. So it is possible that advertising can exaggerate the positive benefits of treatment. Safety can also be an issue.

“When someone opens a spa doing things that should be done by plastic surgeons and don’t have the training, it won’t work as well or it won’t be safe,” Runnels said. “Efficacy versus safety is a big issue in plastic surgery. What we are doing here are things that are safe and do work. That is really what the American Society of Plastic Surgeons is trying to promote. To be sure you are getting what you are after, you need a consultation with a board-certified plastic surgeon.”

Some of the treatments offered are not proven. A spa might tout technologies that are untested and of dubious quality.

“There is a lot of technology out there, not all of which works and not all of which is good,” Runnels said. “Unfortunately, there has not been a scientific basis for a lot of the things that are being done in terms of efficacy — how well it works — and in terms of safety. People who are not plastic surgeons are doing procedures. There is an increase in the number of spas that claim to have these procedures.”

People wouldn’t buy a house without an appraisal. So Runnels recommend not getting a cosmetic procedure done with out thoroughly checking it out.

Safe and effective?

Cosmetic procedures are improving over time with a movement towards superior results with minimal healing time needed and minimal risk. For example, there have been improvements with the latest generation of facial rejuvenation options. But how is a patient to know if the “latest and greatest” thing being touted is both safe and effective?

“There are things that work and things that don’t work,” Runnels said. “The real question is, ‘How do you know?’ What you hope to find is a board-certified plastic surgeon who has bought into the idea that he is not trying to market services, but something that will actually improve your quality of life.”

Except for cases such as breast reconstruction after a mastectomy, most cosmetic procedures are electives and not paid for by insurance. So the current downturn in the economy could have an impact on the demand for cosmetic procedures.

“I think the economy, whether it is good or bad, permeates everyone’s business,” Runnels said. “It would be hard to say plastic surgery is booming. It is not so different from other businesses. I’m not sure it is insulated from fluxes in the economy.”

The demand is related to economic times, said Dr. Phillip Blevins, a professor of surgery, Division of Plastic Surgery, University of Mississippi Medical Center, Jackson.

“People having cosmetic surgery have to put that into their budget because it isn’t an insurance covered procedure,” Blevins said. “It is an out-of-pocket expense. As a consequence, demand is related to the economy and whether people feel they can afford to spend money on it.”

Stable demand

But in general he has seen the demand for plastic surgery remain stable or even increase some in recent years. The most common procedure he has requests for is eyelid lift surgery (blepharophasty) to improve the appearance of the eyes. He said that is particularly popular with businesswomen who have excessive skin and fat around their eyes that can be a normal consequence of aging. While usually seen in older people, it can happen at younger ages, too, depending on genetics. At any age, it can give the appearance of being tired or not feeling well.

“Most people who have blepharophasty done will say when they get back into circulation that the most common comment is, ‘You look rested’,” Blevins said. “Women can use light makeup and get into circulation fairly quickly. This procedure can be particularly important for business women who want to give the appearance of being rested and ready to take on the task that is being asked of them.”

Another popular option is the facelift for removing wrinkles and making someone look younger. Both a facelift and eyelid surgery can be done as an outpatient, but a facelift requires a longer recovery time.

Breast surgery also continues to grow in popularity with younger women often opting for implants and older women choosing breast lifts.
“Breast implants have been very popular,” Blevins said. “The operation has been available since 1962 or 1963. The implant was the focus of a lot of concern in the early 1990s, and most of those concerns have been addressed and put into perspective. It is a good operation. The popularity of its has stayed relatively even, and has increased a bit over the past few years as have all cosmetic surgery elective procedures.”

Other types of cosmetic surgery include “tummy tucks” to remove excessive abdominal skin. Liposuction is also extremely popular and there have been successful efforts to minimize the risk and improve the results, Blevins said.

Will Wood, executive director, Plastic & Hand Surgery Associates, PLLC, Jackson, said breast surgeries take the practice’s top surgical spot. The surgeries are particularly popular for women in their 20s. In 2006, they experienced a significant increase (14.8%) in augmentations for women in their 20s, and 2007 saw a 4.5% increase over 2006. According to the American Society of Plastic Surgeons (ASPS), members nationwide experienced a 13% increase for patients’ in this age group in 2007.

Nationally there is some debate over whether it is worth the risks to do cosmetic surgery, which can sometimes result in complications and in rare cases can even cause death. To have the greatest assurance of safety, it is important to use a doctor with the proper credentials.

“Whether or not the surgery is safer than in the past depends on the physician,” Wood said. “All plastic surgeries should only be performed by a physician certified, or in the process of being certified, by the American Board of Plastic Surgeons.”

What is the importance of cosmetic surgery to businesswomen?

“That is a tough question,” Wood said. “I am not saying it is right, but looks can be very important depending on a person’s position. Hollywood has influenced society to expect perfection. If someone has a ‘flaw’ in dress or appearance, it may be interpreted as inferior knowledge, service or product quality. Attractive, well-dressed professionals are more successful whether male or female.”

While the majority of cosmetic surgery patient are female, ASPS reports men make up 9% of plastic surgery patients. Wood said their male patients are most interested in liposuction, eyelid surgery and facelifts. Gynecomastia, a condition that causes abnormal breast growth in males, has created increased demand for male breast reductions

Contact MBJ contributing writer Becky Gillette at 4becky@cox.net..

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