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Putting Your Best Face Forward: Seattle-Area Women Embrace Less Invasive Facial Rejuvenation Treatments
by Roberta Greenwood

“I just didn’t think I looked as good as I felt.” My 50-ish friend smiled as I admired her smooth, unlined, recently “resurfaced” face. It’s a common theme, repeated in hundreds of medical offices, salons and spas throughout the Seattle area each day. Light therapy, laser and CO2 resurfacing, endoscopic surgery, and even acupuncture are part of an array of new facial treatments promising rejuvenation and youthful good looks to a growing number of women each year. According to the American Society for Aesthetic Plastic Surgery (ASAPS), nearly nine million patients had procedures completed in 2004 – an increase of 51 percent over the previous year. Ninety-five percent of those procedures were completed on women.

A Bit of Background

For decades, cosmetic surgery was available only to the wealthy. In fact, it wasn’t until the 1960s that the first professional society of cosmetic surgeons was established. Until then, surgery for anything but reconstructive reasons was rare; today, according to ASAPS studies, more than 79 percent of Americans say they wouldn’t be opposed to undergoing cosmetic surgery.

Although traditional cosmetic or plastic surgery is still performed on a large scale, alternative treatments are on the rise. These “less invasive” procedures were discovered through medical and technological advances often intended for other purposes. Botox, for instance, was first approved for use by ophthalmologists, and light therapy was developed by NASA to speed the healing of wounds. Here’s a look at some beauty treatments involving little pain and a short recovery.

Infra-Red Light Therapy

Like many patients seeking to enhance their looks, former Eastside resident Diana Love felt her skin was losing elasticity and tone. A holistic practitioner, she decided to try light therapy. “I could see a visible difference in the elasticity of my skin, particularly the neck where it tends to get a bit droopy,” Love says. “It was comfortable and very reasonably priced.”

Love adds that a large body of research on infra-red light therapy supports its value in treating soft tissue. “I want to retain my youthful appearance as long as possible,” she continues, “and I want to use safe, non-invasive techniques to achieve that goal. I feel comfortable recommending it to clients seeking a subtle but effective approach to facial aging.”

Light therapy or photo rejuvenation is said to increase circulation, reduce puffiness, lessen hyper-pigmentation, and improve the appearance of fine lines. Hand-held wands are passed over selected areas of the face and neck, emitting a warm infra-red light pulse to the surrounding tissue, stimulating new collagen production. Each treatment lasts about 20 minutes, and most patients say it’s extremely relaxing. NASA has used light therapy for decades to treat scars and heal wounds. It’s been used in Europe for cosmetic purposes for more than 25 years, but has only been recently introduced in the United States for facial rejuvenation treatments.

Susan Armstrong, another light therapy patient, notes that the process smoothed, tightened and refined her sun-damaged skin. But she really appreciated its healing properties after a serious injury to her jaw required surgery. “My doctor was amazed; my bruising and swelling was gone after five days of treatments,” she says.

Convinced by the results of her sessions, Armstrong now trains operators throughout Washington and Idaho on the correct use of light therapy equipment. “Our clients want to look younger and fresher, quickly and without pain – they want the outside to match the inside.”

Infra-red equipment can cost an operator as much as $22,000, according to Armstrong, with some high powered Thermage machines costing as much as $100,000. Costs for treatments can run as much as $300 per session, with six to 10 sessions required for successful results. Monthly maintenance treatments are also suggested, and some practitioners include microdermabrasion for additional smoothing of the skin.

Laser and CO2 Resurfacing

Dr. Peter Jenkin, lead dermatologist and laser specialist at Virginia Mason Clinics, sees a steady stream of patients interested in turning back the effects of sun and age on their skin. Trained and board certified for more than 20 years in laser procedures, Jenkin begins each consultation by asking patients, “What bothers you the most?”

“The common answer I hear is, ‘I don’t mind aging, but I want to age gracefully,’” Jenkin says. “The majority of my patients say, ‘I’m doing this for me,’ and that’s the appropriate mindset; the person having these procedures done ought to be doing it for themselves – not for others.”

Non-ablative laser procedures (sometimes referred to as lunch-hour treatments) work best on younger patients. The least aggressive of treatments, a laser beam is directed at the upper layers of skin, vaporizing brown spots, creases and fine lines. With little downtime and virtually no pain, they’re by far the most popular laser treatment.

CO2 (carbon dioxide) laser resurfacing penetrates deeper layers of damaged skin, offering a more dramatic improvement for wrinkles and acne scarring. Requiring general anesthesia, resurfacing results in longer downtime, averaging one to two weeks; and as with any facial procedure, protection from sun exposure is paramount to its success. “I advise my patients that the minimum of self-care is to start the daily use of sun screen,” says Jenkin. “Sun exposure is the cause of skin damage, not aging. The skin on the back of your knees is the same age as the skin on your face – because it’s protected, it’s smooth and unlined.”

Although non-ablative laser and CO2 procedures offer exciting possibilities unheard of a decade ago, they’re not without some risks. “The skin is wounded in any of these treatments,” Jenkin explains. “The risk of temporary or permanent discoloration, scarring, or even skin infections exists for all treatments; the likelihood of complications rise with the aggressiveness of the treatment.”

Costs vary, based on the type and number of treatments, usually ranging from $2,000 to $5,000. The American Board of Plastic Surgery strongly recommends asking what is covered in each procedure and understanding if additional costs will apply. Jenkin stresses caution in selecting a practitioner. “It’s important to understand what they intend to do; ask what training and certification they have. It’s a wise decision to start with a dermatologist.”

Cosmetic Endoscopic Surgery

“People are living a lot healthier,” says Dr. Sam P. Most, head of the Division of Facial Plastic Surgery and Reconstructive Surgery at the University of Washington Medical Center. “Folks in their 60s don’t ‘feel’ their age. Some want a competitive edge in the workplace, some want to look as fit as they feel. Endoscopic surgeries allow us to continue moving towards doing procedures that are less painful for patients.”

There are many advantages to endoscopic procedures: Smaller incisions equate to less swelling, bruising and, in most cases, pain. Two small incisions are made in the hairline, allowing a miniature camera and scalpel to be inserted, enabling the surgeon to lift the skin. Recovery is in the range of five to six days and the overall results are similar to those from more traditional surgeries. “Past procedures might require an incision from ear to ear, with several weeks of downtime and severe bruising and swelling,” Most says. “Sometimes patients were left numb in the entire area above the incision. Now, using minute scopes and smaller incisions, we can make these procedures easier for patients and achieve excellent results.”

Linda Bateman was delighted with her recent endoscopic brow-lift and blepharoplasty (eyelid surgery). “I have a family history of bags under the eyes; my memory as a child was that my grandmother scared me because her bags really protruded,” she recalls. “In the last few years, I was distracted by my eyes, always using concealer to hide my bags. My family and friends said they didn’t even notice, but I did.”

After almost two years of research, she made the decision to seek out a minimally invasive surgery. “The result was immediate – the bags were gone,” she says. “The remarkable thing was I had no pain from the procedure; I only needed a couple of pain pills on the first day.”

Echoing the comments of many patients, Bateman says it was the best thing she’s ever done. “I wasn’t searching for a youthful look; now, I look refreshed. People are surprised I’m 60 and that’s a nice aside.”

Most says that’s a common outcome of the procedures he conducts at the UWMC and Roosevelt Center in Seattle. “I hand my patients a mirror and ask what they see; they often say ‘I look tired, older than I feel.’ After the procedure, they feel as if their reflection is a better fit.” He explains that patient needs vary according to age: Patients in their 30s struggle with furrows and fine lines, while those in their 40s seek help for puffy eyelids and deepening creases. Many patients 50 to 60 years old want a tightening of the neck and jowl line, giving a lifted, more refreshed look.

The cost is approximately $4,000 to $5000 and, like almost all cosmetic procedures, is not covered by medical insurance. “The results are permanent,” Most observes, “but aging continues to occur. A patient can ‘turn back the clock’ seven to ten years – about the same outcome as a traditional procedure – but nothing stops the aging process.”

Acupuncture

Connecting the components of internal health and radiant appearance is what Howie Sun, a third-generation and nationally board certified acupuncturist, attempts to deliver to his patients. Holding dual degrees in biochemistry and molecular cellular development biology from the University of Colorado, he received a Master of Science degree in Oriental Medicine and began his practice in the Bellevue area a little more than a year ago. He administers “constitutional acupuncture facial rejuvenation,” beginning each session with a series of lifestyle questions. “Often times, women want to look young but they forget they must first be healthy,” Sun says. “Constitutional acupuncture begins with a lifestyle history because everything you do in life affects your body.”

Acupuncture uses very thin needles, inserted into specific points on the body to encourage and promote healing. The needles stimulate various sensory receptors that transmit impulses to the brain. “Oriental medicine emphasizes the need for balance; we look for internal organs that are out of balance or over-acting,” explains Sun. He uses acupuncture to stabilize and open up the Qi (pronounced chee) energy that connects all major organs.

He often sees patients who are skeptical and have little understanding of the procedures he grew up with in Taiwan. “The American public is often doubtful and fearful of practices that differ from traditional Western medicine; I hope people will remain open-minded and listen to different schools of thought,” Sun notes. “I’m concerned with health and well-being; when a patient is healthy inside, their beauty shines to the outside.”

Client Ellie Krajewski couldn’t agree more. After three acupuncture sessions with Sun, she feels her skin has a healthier glow, fine lines are aren’t as visible and her face looks fuller – “like a teenager’s might.” A 53-year old professional, Krajewski cites a pending job change as the final impetus to try acupuncture. “I was starting to feel like one of the ‘invisible generation’ – several colleagues have experienced age discrimination, and I didn’t want to face that issue.”

Characteristically open-minded, Krajewski said she didn’t know what to expect but valued the whole-body approach to her problem. “My mother had acupuncture for arthritis pain and it was very successful for her, so I knew it worked. I just didn’t know what effects I would see on my skin. I was very surprised and pleased – by the second visit I could see visible differences.”

A series of ten sessions costs $2000, including Chinese herbs and the first “maintenance” session. Additional sessions run $150 and are required to maintain the effect. Krajewski says she’s pleased with her results and intends to continue. “I’ve always been concerned about my health, and the holistic approach of acupuncture really appeals to me – this is a time of re-examination for me. I still feel youthful and I want to age gracefully.”

A Last Caution

As varied as these procedures are, practitioners and patients agree on one thing: Know who’s performing your treatments. It’s important to find a practitioner you like and trust. There’s abundant information on the Internet, but Most cautions, “Do your research carefully. Visit more than one doctor and don’t feel uncomfortable asking questions. Be clear about what you hope to achieve.”

“There are two words that don’t exist in this field: always and never,” adds Dr. Jenkin. “The procedure you select must match your expectations.”

©2005 Caliope Publishing Company