Each year at this time, we try to update some of the confusing terms that have cropped up in advertising and physicians offices over the past year. Some trends have come and gone. Other procedures have been accumulating some effective data and are stronger than ever. What do all those technical terms mean when it comes to our bodies and the new procedures that can transform them? Although by no means an exhaustive list, the following may help decipher some alien terminology and help us be more aware of our options.
PROBLEM: THINNING HAIR
• Hair stimulants: Medications such as Rogaine may help regenerate hair if used consistently and started when thinning is first noticed.
• Hair systems: These high-tech variations on hairpieces are invisibly secured to the head. Clients can do everything they do with their natural hair, including swim. Once-a-month service visits keep the replacement hair firmly attached.
• Follicular unit transplantation: This surgical procedure takes hair from the back and sides and inserts it into the bald top, where it will continue to grow. Micrografts, small grafts of two or three hairs are placed behind the hairline to provide gradually increasing hair density.
• Scalp reduction: Balding areas of the scalp may be surgically removed to decrease the appearance of baldness and give you a brow lift in the process.
PROBLEM: AGING FACE
• Rhytidectomy (face-lift): Improves sagging facial skin and loose neck skin by removing excess fat, tightening muscles and re-draping skin.
• Deep plane rhytidectomy: This also can correct deep nasolabial folds by dissecting the fat layer more completely off the muscle and re-draping the skin. It avoids the stretched appearance sometimes detectable with traditional face-lifts.
• Mini-lift: These can be done to correct an area of the face that may be aging before others. Includes brow lift and lower face-lift.
• Lifestyle Lift™: This mini-lift involves the SMAS muscle layer. Through incisions at the ear, the muscle is pleated and the skin re-draped to give a stronger lift.
• Forehead (brow) lift: Cosmetically corrects drooping brows, upper eyelids and sagging skin on the forehead; can dramatically improve lines and furrows by removing excess tissue, altering muscles and tightening the forehead skin. The traditional technique is an incision across the top of the head just behind the hairline.
• Endoscopic brow lift: This is a mini-lift done through an endoscope, with three to five very short incisions.
• Blepharoplasty: Surgery to correct drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin and muscle. The upper lids may be covered by insurance if surgery corrects visual field defects. Newer techniques favor relocating the fat bags under the eyes into the hollow ‘tear troughs’ that can develop with age, called peri-orbital volume replacement.
• Rhinoplasty (nose job): It reshapes the nose by reducing or increasing size, modifying a hereditary hump, changing the shape of the tip or bridge, or narrowing the span of nostrils. It may also relieve breathing problems caused by a deviated nasal septum or a previously broken nose.
• Otoplasty: This can set prominent ears closer to the head or reduce their size. Most often done on children, it may require two procedures on adults.
• Cheek implants: Silastic soft implants can be inserted through the mouth or lower eyelid to replace lost cheek volume.
• Mentoplasty: Augmentation of the chin either by reshaping the jawbone or adding a chin implant.
• Dimples: these can be created from inside the mouth with sutures put in under local anesthesia.
• Fillers: These are injected under the skin to plump up troughs and wrinkles and give the skin a smoother appearance. Combinations of different substance and consistency are called ‘Filler Cocktails.’ Some of the most common fillers include:
• Radiesse: a firmer filler made from calcium hydroxyapatite, a building block in our bones and teeth used for filling in hollowness and bony defects.
• Sculptra: a suspension of poly-L-lactic acid particles—the same material found some dissolvable sutures. The body forms a collagen scar capsule around it, preserving the effect of the filler for up to two years.
• Restylane and hylaform: Made from hyaluronic acid, a substance naturally occurring in most body tissues, Restylane is synthetic and requires no allergy testing. Hylaform is made from rooster cocks, so test for an allergy to chickens. These fillers last six to 12 months.
• Juvederm: The newest hyaluronic acid filler on the market is non-allergenic and may last longer. Can be used in lips.
• Autologous fat injections: Fat from another part of the body—usually the abdomen, thighs or buttocks—is purified and injected into the lips, cheeks, back of the hands, anywhere that needs lost volume replacement. While it causes more tenderness and swelling than other fillers, it lasts up to two years, and part of it will become permanent.
• Collagen: A naturally occurring substance in the body, it has been around quite a while. Bovine collagen requires allergy testing; human collagen, like cosmoderm (for fine lines) and cosmoplast (for deeper lines and lips), does not. Lasts about three to five months.
• Botox: This can be injected into any area where overactive muscles create wrinkles: at the corners of the mouth, crows feet, frowning muscles between the eyes, etc. It can also be injected into the palms of the hands, soles of the feet and underarms to control excessive sweating.
SKIN CARE SOLUTIONS:
• Cosmeceuticals: Facial products that marry cosmetics and pharmaceuticals. Applied like cosmetics, they contain ingredients that improve appearance by delivering healthy nutrients.
• Laser tattoo removal: A laser beam passes through the skin and is absorbed by the ink, causing the ink to break down and be removed by the body’s lymphatic system.
• Skin resurfacing or rejuvenation: These are catch-all phrases that can include chemical peels, microdermabrasion and laser resurfacing; all involve removing the outer dead layer of skin cells and, to different degrees, part of the dermal layer to eradicate age spots, fine wrinkles and other sun damage.
• Chemical peels: Chemicals applied to the skin to cause it to slough off age spots, fine wrinkles, even pre-cancerous skin growths. They can soften acne facial scars and even control acne. Chemicals used include:
• Alphahydroxy acids (AHAs): Glycolic, lactic or fruit acids are the mildest formulas, called light peels. These provide smoother, brighter-looking skin and minimal downtime.
• Trichloroacetic acid (TCA): Used for medium-depth peeling, including fine surface wrinkles, superficial blemishes and pigment problems.
• Phenol: This is the strongest. A deep peel, it is used mainly to treat coarse facial wrinkles, skin damaged by sun exposure or pre-cancerous growths.
• Laser resurfacing: It peels the skin by concentrating large amounts of heat on skin cells. Usually done under local anesthetic, it may require IV sedation. Redness may last for eight months, but the effects will last years.
• Intense pulsed light (IPL): Skin therapy based on high-intensity pulses of light (not lasers) that penetrate the skin to treat photo aging of the face, chest and hands, wrinkles, and vascular lesions like spider veins, rosacea or unwanted hair. Fotofacial RF: A brand of intense pulsed light that uses the heat of radiofrequency energy. Invisible micro-injuries repair themselves by producing new collagen, which, over time, smoothes and softens wrinkles and decreases pore size and textural irregularities.
• Microdermabrasion: Highly controlled spray of fine crystals on the skin to remove dead cells. No downtime. May look pink for a day or so but usually doesn’t peel.
• Fractionated laser treatment, such as Pixel: Laser resurfacing in a dot pattern on one area, so healing is faster. Takes multiple treatments, but can improve wrinkles, texture and acne scars without the downtime of current lasers. Can be used anywhere on the body.
• Non-ablative (cold) laser: Unlike ‘traditional’ laser resurfacing in which the epidermis is heated, leaving a raw surface that must heal, this uses light energy to stimulate collagen remodeling and/or remove irregular pigmentation and enlarged blood vessels without downtime. It is often used as a follow-up to other procedures to stimulate collagen.
• SkinTyte™: A type of non-ablative laser that tightens and stimulates collagen growth. Some surgeons use it to firm up the skin and collagen after a mini-lift.
• Thermage: Lower layers of skin are heated with radio waves, while outer skin is protected by a cooling spray. The result is gradual tightening of the skin. Results can be dramatic in some people. It was approved by the FDA in 2002 to remove wrinkles around the eyes and saggy skin on the eyelids, and is now used on the whole face and other parts of the body.
PROBLEM: EXCESS BODY HAIR
• Laser hair removal: A laser generates a single wavelength of light absorbed by the color, or melanin, in the hair follicle. The hair will fall out in one to seven days. Because it is effective only on hair in the active growth phase, it takes four to six treatments. Can’t completely remove blond or white hair.
• Electrolysis: Will treat hair of any color or coarseness in the active growth phase because it does it one hair at a time. A tiny electrode grasps a hair and sends an electrical current into the follicle to kill it.
• Chemical depilatories: These contain a highly alkaline chemical—usually calcium thioglycolate—that dissolves the protein structure of the hair. May cause a rash or irritation.
• Vaniqa: A prescription cream that retards new hair growth by prohibiting production of a key enzyme, but only as long as you keep using it.
PROBLEM: BREAST SIZE OR FIRMNESS
• Mammoplasty: Any reconstructive or cosmetic surgical procedure that alters the size or shape of the breast.
• Breast augmentation: Surgery that increases breast size, usually with saline or FDA-approved, silicone-filled implants.
• Breast reduction: Decreases the size of the breasts and takes pressure off the shoulders and chest.
• Mastopexy: Also called a breast lift, this removes excess skin in order to lift sagging breasts.
PROBLEM: BODY FAT
• Liposuction: Also known as lipoplasty or suction-assisted lipectomy, this uses a cannula to break up and suck out fat. It can be performed using the tumescent technique, in which targeted fat cells are infused with saline solution containing a local anesthetic and a vasoconstrictor to reduce bruising and swelling.
• Ultrasound-assisted liposuction (UAL): Uses sound waves to loosen fat, making it easier to remove. Pulsed ultrasonic liposuction (pUAL): Cycles power on and off very quickly, reducing treatment risk. Micro-pulsed ultrasonic liposuction uses very small (2mm) diameter probes to allow treatment in the cheek, jowls or neck and to collect fat for fat injection.
• Power-assisted liposuction (PAL): A new technology in which the tip of the suction tube vibrates at a rapid speed to loosen fat cells so they can be suctioned with less trauma to surrounding tissues.
• SmartLipo: Laser lipolysis, or fat removal.
• BodyTite: Radiofrequency liposuction that breaks up fat, suctions it out and heats skin and connective tissue to tighten them, all in one step.
• Back scooping: Liposuction of the lower back to accentuate the buttock curve.
• Cankles: Lack of tapering and definition from the lower leg to the foot. Ankle definition can be created by contouring liposuction.
PROBLEM: SAGGING SKIN FROM AGING OR WEIGHT LOSS
• Abdominoplasty (tummy tuck): Flattens the abdomen by removing excess fat and skin and tightening the muscles of the abdominal wall, usually through an incision below the bikini line from hip to hip.
• Brachioplasty (arm lift): Fixes ‘bat wings’ by removing loose skin and excess fat deposits.
• Body lift: Also called a circumferential body lift, this may involve a tummy tuck, thigh and buttock lifts through an incision all around the body at the bikini line.
PROBLEM: SPIDER OR VARICOSE VEINS
• Spider veins: There are several new ways to treat vein problems, including IPL and laser surface treatment for small veins, especially on the face.
• Varicose veins: These are enlarged, twisted veins with valves that don’t work effectively, causing pooling in lower extremities and ‘rope-like knots.’
• Sclerotherapy: Used on small varicose and spider veins, a solution (generally saltwater) is injected into the vein to make it collapse.
• Stab phlebectomy: Multiple small stab punctures are performed on an outpatient basis under local anesthesia. With special hooks, the varicosities are extracted through the punctures. When fully healed, no scars are visible.
• Endovenous ablation: A new treatment for varicose veins, a thin catheter is placed into the saphenous vein through a pinprick incision. The radiologist applies heat, either from a laser or radiofrequency energy, causing the vein to collapse as the catheter is withdrawn.
PROBLEM: TEETH & SMILE ISSUES
• Laser whitening: A dental office procedure in which a bleaching gel is applied to the teeth and activated by laser heat. Home whitening kits can also give some results
• Composite fillings: Tooth-colored fillings that have largely replaced metal fillings and are considered better for tooth structure and more aesthetic.
• Porcelain veneers: Veneers are bonded to the front and/or biting surface of the tooth to fill in gaps, replace lost height and give teeth the appearance of being more evenly spaced.
• Smile Lift: Veneers are contoured to lift the outer edges of the lips and reduce wrinkling around the mouth.
• Crowns: Placed over a tooth that has been reduced in size, crowns can also serve as artificial teeth over a dental implant.
• Dental implants: Posts inserted and integrated into the jawbone that serve as a foundation for a permanent-fixed bridge or a single tooth made of porcelain.
• Invisalign®: Clear trays that fit over the teeth to straighten them by gradually changing the fit. They are much less noticeable than traditional braces and can be removed for eating.
• I-Braces®: Fit on the backsides of the teeth, they are invisible from the front. A computer-generated design customizes each bracket and wire to the individual tooth.