Chicago Facelift Chicago Plastic Surgeon

No Knife Cosmetic Surgery

Non-surgical options to facelifts and other procedures have become the latest trend in the plastic surgery world.

September 14, 2004 -- 55-year-old P.J. holds a high-level directors position at one of Americas largest high-tech firms in Californias Silicon Valley where she is extremely busy. But P.J. -- who asked not to be identified -- had terribly sun damaged skin and a bad case of rosacea that made her look like she was blushing most the time. Ruddy, flushing skin on her face, neck and chin often troubled her because new clients and others meeting her for the first time often assumed they had just said, or done, something to embarrass or cause her upset. Or, they assumed she was shy or incompetent. And that was a big mistake for anybody to make.

My red, red nose looked like it belonged to a serious drinker, P.J. told

To cope, she often used green makeup under her regular makeup and wore as many high collar garments as possible to mask her flushing. She wanted the condition repaired but had little enough time for treatment, let along recuperating at home while incisions healed. She additionally thought chemical peels were pretty nasty stuff and not at all for her.

Then, while researching cosmetic surgery online, P.J. read about a laser treatment intense pulsed light -- that could be performed during lunch, was reasonably priced and required virtually no time off from work.

P.J. had her first treatment and left the doctors office on a Friday with some additional redness in her face. A week later, she reports, people were asking with surprise, What have you done? Youve gone from red to pale.

Millions like P.J. are seeking quicker facelifts without scalpels or downtime.

Thus, short, no-knife procedures (known to doctors as minimally invasive) are now the fastest growing segment of the booming scene in U.S. cosmetic surgery.

Just look at the numbers: According to the American Society of Plastic Surgery (ASPS) in Alexandria, Virginia, 76 percent of the 8.2 million cosmetic procedures done in 2003 (the most recent year for which the organization has statistics) were low budget procedures done in a doctors office in one hour, or less, appointments.

Driven by burgeoning numbers of rapidly aging Baby Boomers who are taking to heart that old saw about how time marches on. But in many cases, Boomers are finding that march is usually across ones face. Thus, millions are indulging in defensive aging, getting a nip here and a tuck there during short appointments rather than splurging for a full facelift.

Mini procedures are often done in as little as one-quarter hour and sometimes include slightly more invasive procedures like a chin or cheek implant (one hour,) laser eye bag reductions and liposuction of the face, performed with micro-canola, small vacuum devices that suck out facial fat.

Thus, many more people are getting nearly the same results as with major cosmetic surgery but without incisions and long recovery times while paying about one quarter the cost. The downside is, you need to go back anywhere from every three to eighteen months for the injectibles to continue working.

The motto for cosmetic surgery in the near future will be Less is more, says Ronald L. Moy, M.D., associate clinical professor at the University of California, Los Angeles. Patients in their 20s, 30s and 40s are opting for less invasive, mini or lunch time procedures to avoid major facelifts later on in life.

Already, a few cosmetic and plastic surgeons have declared the handwriting is on the wall and have consequently moved their offices to shopping centers and strip malls, driven by the mini procedures trend. Those physicians also want to be seen where crowds gather.

Improving your looks without the knife includes the use of lasers, soft tissue fillers, light chemical peels and wrinkle removers.

Among the more popular:

*Botox. Botox injections -- at a national average of $497 per session -- are an extremely popular way to reduce crows feet, furrowed brows and soften wrinkles around the mouth. Downside: Botox is only effective for about three months so it must be redone. But compare it with CO2 laser resurfacing which may take many months to heal and costs about $3,125.

Patients are told they must have the injections again and dont mind coming back because it is minimally uncomfortable, says Marie Nassiff, M.D. in Green Bay, Wisconsin. Anesthesia is usually not required because the Botox needle is finer than a human hair.

In 2003, Americans received almost three million Botox injections, according to the American Society of Plastic Surgeons.

*Hylaform, Restylane, CosmoPlast and Sculptra (about $400 per injection) are substances used to fill in deep wrinkles (like the nasolabia fold) and to fill in thin lips, wrinkles around the mouth, and some scars. However, when injectibles go into deeper tissues, an anesthesia is more often used.

Says R. Stephen Mullholand, M.D., a plastic surgeon in Ontario, Canada. Many patients near 40 become concerned about smile lines, lip lines, crows feet and their damaged skin which starts showing the excess of sun exposure, smoking and the ravages of aging and heredity.

Other injectable fillers include Hylaform gel, which requires no allergy tests.

Injectable procedures require about half an hour and no downtime for the patient afterwards, says Dr. Marie Nassiff in Green Bay Wisconsin. The most common side effect is some swelling and some redness that goes away in about half an hour.

*The Feather Lift and Thread Lift. Special sutures with hooks or loops are used to pull a drooping jowl, brow or cheek back to where they once rested in youth. Knot-like barbs on the thread pull the features back into place by anchoring the thread to muscles deeper in the face. A feather lift can usually be done in about thirty minutes using local anesthesia in the surgeons office. Plus, according to Stephen Margolis, M.D. in Concord, Massachusetts, theres a bonus: As you age, you can go back and have the physician adjust the threads to allow for additional drooping. Proponents of the thread procedure say it provides 60 to 70 percent of the look delivered by an invasive facelift.

I wanted to look better but did not want to be put out by anesthesia, says 52-year-old Carol Wilson, a homemaker in Toronto, Canada. So I had the thread lift because I spent my youth in the sun of South Africa, and had extremely sun damaged, saggy skin in my face. People now think I am much younger.

*Dermabrasion. The top layer of skin (epidermis) is ground, or sanded, down to allow new, fresher skin to regrow. The average national cost per dermabrasion treatment is about $400 but compare that to a full face laser resurfacing which ranges between $4000 and $8000.

Thats what Barbara Carroll did. A 45-year-old paralegal who moved from England to the San Francisco Bay area, Barbara used to worship the California sun because her native land is notorious for a lack of strong sunshine.

I was starting to get brown spots on my face from so much sun bathing but I did not want to be put under anesthesia. So I opted for microdermabrasion, Barbara says. The treatment took about fifteen minutes and now my skin looks clean and fresh.

*Chemical peels. Lighter chemical peels use acidic solutions to take away the outer layer of skin and bring fresh, newer skin to the surface. The American Society of Plastic Surgeons, after surveying their physician members says the average cost of a chemical peel is $607.

*Thermage: Tighter, more youthful skin is also done during the lunch hour through a technique popularly known as Thermage (radiothermoplasty) during a lunch break. Physicians say its best use is on the neck. The treating instrument heats the deeper layers of the skin and works by tightening the internal collagen in the skin (the top layers of skin are protected with a cooling spray) making the internal skin grow back firmer and tighter. The number of treatments depend on the patients age, skin type, health habits and other factors. Results appear within the first two to six months. The procedure may cause some patients to show minor redness, like a mild sunburn, in the treatment area. It is most commonly used for wrinkles around the eyes.

There are so many potential approved and non-approved, sound and unsound cosmetic treatments, the physician first of all becomes an advisor to help patients find their way through a literal forest of options, says Michael G. Ledbetter, M.D., in Cincinnati, Ohio.

Thus, the day is already here when you can leave your office at noon and return looking younger.

Your biggest worry then might be explaining what you ate for lunch that enhanced your looks so well.

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A facelift is a surgical procedure to repair sagging, drooping, and wrinkled skin of the face and neck. It is performed to improve visible signs of aging, poor diet, or heredity; it is performed by removing excess fat, tightening underlying muscles, and redraping facial and neck skin.


Sagging or wrinkled skin occurs naturally with increasing age. Folds and fat deposits appear around the neck, and deep flexion creases form between the nose and mouth. The jawline grows "jowly" and slack. Heredity, poor diet, smoking, or obesity may contribute to early or severe skin problems.

A facelift can help repair some of the visible damage to skin, fat, and muscles and can restore a "younger" look. A facelift can be done alone or with nose reshaping, a forehead lift, or eyelid surgery.

While the patient is sleepy (sedated) and pain-free (local anesthesia) or deep asleep and pain-free (general anesthesia), the plastic surgeon makes incisions above the hairline at the temples, behind the earlobe, to the lower scalp.

The surgeon removes some of the fat tissue and loose skin, then stitches (sutures) the incisions closed. The fat tissue is called the SMAS layer and is the primary lifting portion of the facelift.