Las Vegas Sun

March 28, 2024

Cutting edge: Plastic surgeons convene in Vegas to discuss latest procedures, trends

In Oscar Wilde's 1891 novel "The Picture of Dorian Gray," a man is so consumed with his youth and beauty that he sells his soul to ensure both will be everlasting.

It was a sticky deal that led to a tormented life.

Clearly Wilde's famed character was born during the wrong century.

After spending a few hours at the American Society for Aesthetic Plastic Surgery's meeting this week at Caesars Palace, this could not have been more evident.

The national professional organization based in New York City, which consists of 1,900 members who specialize in cosmetic plastic surgery, strives to advance the science and art of aesthetic plastic surgery.

Its annual convergence of members this week drew more than 100 exhibitors and several hundred doctors from throughout the country to discuss new trends and technologies in such procedures as nonsurgical fat removal, fat recycling and Botox injections.

The event, which was closed to the public, was dubbed by the society as "the most exceptional educational event" in the 35-year history of the ASAPS.

To the outsider, it was reality merging with science fiction.

On display were the latest in silicone chin and cheek implants, and tools used to extract unwanted fat during liposuction procedures, then reinject the fat into areas in need of rejuvenation such as the face, neck and hands.

Surgeons discussed experimental procedures and emerging techniques that are being studied, such as molecular biology and the genetics of hair growth, lip implants, and the harvesting of fat cells containing adult stem cells that can be frozen and used later in life to combat medical problems.

"We have more tools in the box," said Dr. Richard D'Amico, referring to the diverse availability of surgical and nonsurgical cosmetic procedures.

And according to statistics provided by ASAPS, more people are willing to undergo surgical and nonsurgical procedures to make them younger and more beautiful.

The society reports that last year 8.5 million procedures were performed in the United States an increase from 5.7 million procedures the year before.

Some surgeons attribute the growth of cutting-edge technology and an increase in social acceptance of plastic surgery to the rise in numbers. Others say that an aging society is a contributing factor.

"Every 30 seconds someone turns 50," said Dr. Malcolm D. Paul, a society member whose practice is in Newport Beach, Calif.

"Most people want to look younger," Paul said, referring to cosmetic-procedure patients. "Most people want to turn the clock back 10 to 15 years ... In some ways it's necessary as you maintain control at the top of the corporate ladder."

There are also patients who are looking for a change in their appearance. For example, Paul said, someone may have never liked his or her chin and want to see it augmented.

Advancements in facial procedures have been among the major industry changes in the past 10 years, Paul added.

"Tightening skin alone is not the only answer to retaining a youthful face. Now it's reconstructing the face."

Implant, inject, sculpt

According to the society, last year more than 27,000 men and women had their chins augmented. The one-hour procedure costs less than $2,000.

"We sell more chins than anything," said Cheryl Strieby, a representative from the Ventura, Calif., company Implantech, an exhibitor at this week's meeting.

The company manufactures such facial implants for aesthetic and reconstructive surgery, which are roughly the size -- or smaller -- of a half dollar and made of solid silicone elastimer (a type of rubber).

The implants are used to augment cheeks for a more youthful appearance and in reconstructing facial damage, such as damage resulting from a car accident or other types of injuries.

But the cheek implants, which have been around since the 1970s, are not as popular as fat injection procedures used to fill out the face and remain soft and feel natural, said James L. Baker Jr., a doctor from Winter Park, Fla., and clinical professor of plastic surgery at the University of South Florida.

ASAPS reported that last year there were only 6,000 people nationally who had cheek implants. The number of cheek implant procedures has reduced since 1997, when 11,000 procedures were performed.

"One of the problems with cheek implants is that they were too big of an implant to begin with," Baker said. "They can shift. They didn't look natural."

Today, Baker said, the results of cheek implants depend on which surgeon performs the procedure. He adds that before undergoing any type of plastic surgery, a patient should consider whether a surgeon has experience doing the type of procedure being sought.

Some popular implant alternatives for filling out the areas of the face are injections of Botox (botulinum type A, which paralyzes muscles and therefore smooths wrinkles), fat and collagen (a fibrous protein that fleshes out the soft tissues).

But the results of such injections are temporary and often must be maintained with more procedures.

Liposuction, a procedure in which a surgeon is able remove unwanted pockets of fat and create more definition on a body, can also be applied to the face.

Liposuction procedures last 45 minutes to two hours and usually cost between $2,000 and $2,500.

"With (liposuction), the results are getting better and better," Baker said.

Botox bonanza

A recent approval by the Food and Drug Administration of Botox injections for cosmetic purposes, to temporarily alleviate lines and wrinkles, has created Botox buzz throughout the country.

Some surgeons are throwing so-called "Botox parties," where the substance is injected into patients during a cocktail party-style atmosphere.

According to ASAPS, Botox injections last year were the fastest-growing cosmetic procedure in the United States. The procedure can cost from $350 to more than $500 per treatment. Injection results typically last three months.

Between Botox and a similar product, called Myobloc, there were 1.6 million injections performed last year.

But the hype of Botox parties is something at which many surgeons scoff, as the parties trivialize the actual medical procedure surrounding the nerve toxin.

"It's a big marketing ploy," said Rod Rohrich, a doctor from Texas who is also a professor and chairman of the Department of Plastic Surgery at the University of Texas Southwestern Medical Center.

"With Botox parties, there's no chance to establish a doctor/patient relationship," Rohrich said.

The parties are also a convenient way for physicians to perform Botox injections.

Botox arrives at a doctor's office as a freeze-dried product. To administer the toxin, it must be reconstituted with preservative-free saline and, once diluted, it must be used within four hours.

Rather than hold parties, Rohrich said he holds Botox injection days at his office, where patients wanting injections can schedule an appointment for that day.

"Most of us are still uncomfortable with Botox parties," Franklin DiSpaltro, a doctor from West Orange, N.J., and president-elect of the society, said of his colleagues.

"You need interaction with the physician," DiSpaltro said. "This is something you don't really get at a party."

Fat is where it's at

Using one's own fat to smooth out wrinkles goes beyond the face. The hands and neck can also be injected with fat removed during liposuction procedures to reduce the signs of aging.

Some doctors are also getting excited about recent studies regarding adult stem cells taken from fat.

Some researchers are saying that the cells extracted during liposuction can be stored to later treat bone fractures, heart disease and such neurological diseases as Parkinson's disease.

Stem cells can be harvested from fat cells, saved indefinitely and because they are a patient's own cells, the body won't reject them, D'Amico said.

StemSource Inc., a laboratory in Thousand Oaks, Calif., will store a person's stem cells (which are frozen) for a fee that is set by the surgeon who conducts the procedure.

The fee includes five years of storage. After that time, an annual fee of $100 is charged for storage.

Additionally, the patient has the opportunity to donate 10 percent of his or her cells for medical research, D'Amico said.

Liposuction is the most common cosmetic surgical procedure. Last year nearly 385,000 people underwent the procedure. For now, DiSpaltro said, patients' fat is being discarded.

DiSpaltro said that using adult stem cells for research and future applications steps away from the moral and ethical issues related to the controversy surrounding embryonic stem cell research. Human embryos are created in a laboratory through in-vitro fertilization and must be destroyed by removing the stem cells.

With millions of cells widely available following cosmetic procedures, the possible application of the cells in the medical industry seems limitless.

"Our imagination is the limiting factor," DiSpaltro said.

archive