Knifeless Plastic Surgery Possible

Sculptra,Titan Laser Among New Cosmetic Treatments

Plastic surgery has been around for thousands of years. Written accounts from more than 4,000 years ago describe medical practices to correct facial injuries. As early as 800 B.C., doctors in India were reconstructing bodies using skin grafts.

Today, plastic surgery is a much different experience and is often done for aesthetic purposes: to fix a crooked nose, to enhance lacking cheekbones, to lift sagging breasts. Many of these procedures involve invasive surgery, but the practice has become so advanced that now some don’t even require patients to go under the knife.

Sculptra is FDA-approved for lipoatrophy, a condition where fat tissue is lost in localized areas underneath the skin, which may result in hollow eyes or sunken cheeks. Lipoatrophy can occur in diabetes patients from insulin injection, in multiple sclerosis patients from injections of glatiramer (Copaxone), or in HIV patients as a result of antiretroviral drugs.

Sculptra is also used in cosmetics as a filler for wrinkles and to stimulate collagen production.

"It can change the shape of your face," said Leslie Baumann, M.D., the director of the Institute for Cosmetic Medicine and Research at the University of Miami. "That's why it's called Sculptra ... because you are like a sculptor when you use it."

In addition, it has been used to improve the appearance of aging hands. Sculptra is made from poly-L-lactic acid, the same compound used in absorbable stitches.

The cost of Sculptra varies by practice. Baumann charges $200 per syringe.

How many syringes a patients needs depends on how much the person has aged. For example, someone in their 60s may need six syringes while someone in their 30s would only need three.

Baumann said the results can last two or three years, but insurance doesn’t cover the cosmetic procedure. Treatment is once a month, every four weeks for a series of three to five times. Some of the risks of Sculptra include developing tiny bumps around the mouth or eyes, bruising, swelling, tenderness or pain and bleeding.

Lasers are used on the skin to treat a variety on problems including dark spots, redness and loose skin.

"Lasers can't replace surgery but there are lasers that can really achieve great cosmetic results," said Heather Woolery-Lloyd, M.D., a dermatologist at the University of Miami Cosmetic Center.

The Titan laser is used to tighten the skin.

"It uses infrared light to heat up the collagen, which is material in our demis that gives our skin volume. Long term, it kind of tricks your skin into thinking it's injured and then you produce new collagen, just like if you cut your skin."

The treatments are once a month and can last between 40 and 60 minutes. At least three treatments are required to see initial results. Titan can also be used to tighten the abdominal skin of new mothers, as an alternative to a tummy-tuck. Depending on the area being treated, the cost of Titan can range from $600 to $1,200 per treatment.

Baumann said prevention is key to anti-aging. She recommends wearing sunscreen every day, eating a diet rich in antioxidants, and using retinoid creams. Other nonsurgical cosmetic options include mesotherapy, which involves injecting natural extracts, vitamins and pharmaceuticals into the skin to create a more youthful appearance.

Additional Information: University of Miami Cosmetic Medicine and Research Institute Miami, FL (305)

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