Cosmetic surgery

  • The American Academy of Dermatology urges patients considering cosmetic surgery to choose a board-certified physician. Dermatologists are board-certified doctors who have expertise in the medical, surgical and cosmetic treatment of skin, hair and nails.
  • While non-physicians performing cosmetic procedures in spas, shopping malls and walk-in clinics may offer convenience, the limited equipment, training and supervision available to handle complications or medical emergencies can jeopardize patients’ health and appearance.
  • The American Academy of Dermatology recommends that patients do their homework and consider a doctor’s training and credentials before deciding if a particular physician is the right choice for them. 

Questions to ask when considering cosmetic surgery

  • As with any surgical procedure, there are risks associated with cosmetic surgery. However, patients can reduce those risks by asking the right questions:
    • What are the doctor’s credentials? Is he or she a board-certified dermatologist or another appropriately trained physician? Ask to see his or her credentials.
    • Who is going to perform the surgery? How many of these procedures have the physician performed? The procedure should be one that the doctor performs regularly.
    • What results can be expected? How long is the recuperation period? Ask to see before and after photos of the physician’s previous patients, but remember that results may vary from patient to patient.
    • What are the risks? What type of anesthesia will the physician use? Do the benefits of my cosmetic surgery outweigh the risks?
    • Where is the procedure being performed? The procedure should be performed in a medical center or doctor’s office, not a nonmedical spa, shopping mall or private party.
    • What is the cost?

 Wrinkle fillers

  • Wrinkle fillers, commonly known as fillers, can help restore a plump, youthful appearance to the skin.
  • Fillers are commonly used to treat facial lines and wrinkles, hollow cheeks, sunken eyes, receding chins, thinning lips and deep wrinkles between the eyes.
  • Filler substances are placed just below the surface of the skin to increase the skin’s volume.
  • Selecting the proper filler is an important part of the process, and dermatologists have the knowledge and expertise to help you decide which is best for you.
  • Remember: Injecting a filler is a medical procedure. Fillers need to be injected by an experienced and well-trained physician, such as a dermatologist, in order to achieve the best results and reduce the risk of side effects. Getting a filler injected in a nonmedical setting can be extremely dangerous.

Botulinum toxin therapy

  • Botulinum toxin weakens the affected muscle to soften wrinkles.
  • It also can effectively treat excessive sweating in the palms or underarms.
  • A dermatologist can provide botulinum toxin treatment during a single office visit. The improvements last about three to four months — sometimes longer.
  • No serious side effects (e.g., problems breathing or swallowing) have been reported in connection with botulinum toxin injections administered by trained physicians, such as dermatologists, to treat signs of aging or excessive sweating.1-2
  • Getting botulinum toxin therapy in a nonmedical setting or buying it online can be extremely dangerous. This product should require a medical license to purchase. To protect your health, you should never get botulinum toxin injections at a nonmedical spa, salon, party or someone’s home.

Laser skin resurfacing

  • Laser skin resurfacing is a procedure specifically designed to remove superficial and moderately deep wrinkles of the face.
  • Lasers work by producing an intense beam of bright light that travels to the affected area of the skin.
  • Laser resurfacing treatments generally fall into one of two categories: ablative lasers and nonablative lasers.
  • Ablative lasers, which tend to be more invasive and require more recovery time, vaporize the outer layers of the skin.
  • Nonablative lasers, which are less invasive and require less recovery time, heat up the targeted tissue without actually destroying it.
  • Both types of lasers have potential risks and side effects.
  • Advancements in laser skin resurfacing allow healing to occur much more rapidly and with minimal discomfort to the patient. In addition, improvements in laser technology have allowed dermatologists to treat people of color safely and effectively.

Liposuction

  • Liposuction is a surgical procedure to remove localized pockets of excess fat that do not respond to diet or exercise.
  • Dermatology is one of the only medical specialties that include liposuction training in residency requirements.
  • The tumescent liposuction technique, which was developed by a dermatologist and uses local anesthesia, is the standard of care for the procedure due to its safety and effectiveness in office setting.3-5 Ask your physician whether your liposuction will be performed using tumescent anesthesia.
  • Some of the aggressive approaches that are not recommended when selecting a physician to perform any kind of liposuction procedure include:
    • Using general anesthesia or conscious sedation.
    • Extracting excessive amounts of fat.
    • Performing multiple procedures during the same surgery.

 Varicose and spider veins

  • Varicose veins are abnormally swollen or enlarged blood vessels caused by a weakening in the vein’s wall, which often leads to pain and swelling in the leg.
  • Spider veins, most commonly found on the face and legs, are formed by the dilation of a small group of blood vessels located close to the surface of the skin. For many people, varicose and spider veins are simply a cosmetic concern. But for others, these conditions may cause pain and discomfort, or even lead to more serious problems.
  • The exact causes of spider and varicose veins are unknown, although heredity, pregnancy and hormonal changes are believed to be contributing factors.
  • Treatments include:
    • Laser procedures.
    • Endovascular laser surgery.
    • Radiofrequency closure.
    • Ambulatory phlebectomy.
    • Sclerotherapy.
    • Intense Pulsed Light.
  • Be cautious when choosing a treatment: Advertisements claiming to offer “permanent” or “painless” procedures may be misleading. Ask your physician about any health risks and possible side effects.

References

1. Carruthers JA, Lowe NJ, Menter MA, Gibson J, Nordquist M, Mordaunt J, et al. (2002). A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. J Am Acad Dermatol 2002;46: 840-49.

2. Lowe NJ, Glaser DA, Eadie N, Daggett S, Kowalski JW, Lai PY, North American Botox in Primary Axillary Hyperhidrosis Clinical Study Group. Botulinum toxin type A in the treatment of primary axillary hyperhidrosis: a 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety. J Am Acad Dermatol 2007;56:604-11.

3. Hancox JG, Venkat AP, Hill A, Graham GF, Williford PM, Coldiron B et al. Why are there differences in the perceived safety of office-based surgery? Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al] 2004;30:1377-9.

4. Starling J, 3rd, Thosani MK, Coldiron BM. Determining the safety of office-based surgery: what 10 years of Florida data and 6 years of Alabama data reveal. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al] 2012;38:171-7.

5. Klein JA. Tumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction. The Journal of dermatologic surgery and oncology 1990;16:248-63.