By Leslie Quander Wooldridge | January 11, 2016 | Style & Beauty
The future of cosmetic procedures is now, and it looks bright. With advances in laser and ultrasound therapies as well as dental veneers, the latest generation of treatments is helping DC men and women look and feel their best.
In March 2015, Heather Soubra visited her doctor for a Clear+Brilliant laser treatment to enhance the tone and texture of her skin. During her appointment, her board-certified dermatologist, Noëlle S. Sherber, MD, noticed something out of the ordinary. “It was a very faint mark on the tip of my nose that I never really thought twice about,” says Soubra, 38, who directs special projects at a DC trade association. “I had just been putting concealer on it.” Seeing the growth for what it was—a precancerous actinic keratosis, or AK—Sherber, cofounder of Sherber+Rad (1101 15th St. NW #100, 202-517-7299), prescribed Picato 0.015 percent gel and told Soubra to apply it to her nose for three nights. The doctor explained that precancerous cells would react with the medication, turning the area red as the abnormal cells were selectively destroyed.
Approximately one in five Americans will develop some form of skin cancer during their lives, according to a report from the American Academy of Dermatology, so this was an important discussion. In the end, the medication treated the growth, and Soubra avoided possibly requiring a more invasive procedure. AKs can evolve into squamous cell carcinomas—the second most common form of skin cancer—which need to be surgically excised, along with healthy-looking skin as a safety margin. And excisions leave scars. “It’s kind of ironic that I was going in for this beauty treatment,” says Soubra, “and it possibly saved my nose.”
The laser treatment she received ended up being the “perfect dovetail” to her Picato treatment, Sherber says, because the laser treatment brought fresh, undamaged skin to the surface, combating sun damage and preventing precancerous lesions.
More Americans are getting cosmetic procedures these days—there were 15.6 million done in 2014 alone, an increase of 3 percent from 2013, according to the American Society of Plastic Surgeons. And as women and men of all ages in our area seek to slim down, smooth wrinkles, and brighten their smiles, they may find that these procedures also help with everything from treating precancerous spots to facilitating exercise and supporting oral health.
“The prevailing demand driving innovation in our fields is that people want more powerful results with less downtime,” says Sherber. That’s an especially important point in a power city like DC, where deals are done over lunch and a polished appearance—for better or worse—matters.
In the old days, ablative laser resurfacing treatments destroyed the outer layer of skin while heating the underlying layer, which caused collagen fibers to shrink. These treatments typically required downtime of one to two weeks to allow new skin to grow. Redness could persist for months, and the intense heat and extensive inflammation associated with older treatments could harm patients with darker skin tones.
Many of today’s fractionated non ablative lasers, like the one Sherber used on Soubra, can be employed on patients with a variety of skin tones—good news for our area’s multicultural population. Nonablative lasers treat microscopic columns of skin to smooth wrinkles and fne lines with little to no downtime, and they can help one avoid potentially cancerous damage that years of exposure to the sun’s ultraviolet (UV) rays can cause. And such damage is not uncommon: In a 2014 survey of facial plastic surgeons, 87 percent reported seeing patients for reconstructive work related to skin cancer, according to the American Academy of Facial Plastic and Reconstructive Surgery.
Exposure to UV rays may result in AKs, which typically present as red, scaly patches, explains Tina B. West, MD, a board certified dermatologist and founder of the West Institute (5530 Wisconsin Ave. #925, Chevy Chase, 301-986-9378). “In the old days, we’d freeze them with liquid nitrogen and you’d have to wait to see them.”
If untreated, up to 10 percent of AKs develop into squamous cell carcinoma, according to the Skin Cancer Foundation. So while having precancerous cells doesn’t automatically mean you’ll get skin cancer, the latest laser procedures can treat these areas before they have a chance to worsen.
But today’s lasers and light-based treatments can do even more. Light-based treatments can kill the bacteria that cause acne—a boon for those avoiding antibiotics due to concerns about antibiotic resistance or unpleasant side effects such as nausea. “Taking antibiotics over the long term can change the balance of good bacteria that live in the gastrointestinal tract and can also make a person more prone to antibiotic-resistant infections,” explains Sherber. “The latest treatments, such as those incorporating blue light, can help treat infammatory acne without antibiotics, and certain fractionated non ablative lasers also can help treat acne’s aftereffects, such as scarring and dark marks called postinfammatory hyperpigmentation.”
To address other common cosmetic concerns, Ultherapy is a new FDA-approved technology that allows nonsurgical lifting and tightening of the face, eyebrows, neck, and décolletage. “The procedure delivers ultrasound energy to the same foundational layer typically addressed by surgeons during cosmetic surgery, without cutting or disrupting the surface of the skin,” says A.N. Mesbahi, MD, a board-certified plastic surgeon at the National Center for Plastic Surgery (7601 Lewinsville Road, Ste. 400, McLean, 703-287-8277). “The energy initiates the body’s natural response to stimulate the growth of fresh, new collagen and strengthen weak collagen. Unique to Ultherapy is the use of ultrasound imaging…. There is no recovery time—only minimal bruising, at the most, that can easily be concealed—and while there is an initial effect, significant results begin around three months.”
If you have a hate-hate relationship with your love handles, you’ve got options. And these options can also make it easier to do certain exercises and offer an incentive to work out. (The American Heart Association recommends that adults get at least 150 minutes of moderate exercise per week or 75 minutes of vigorous exercise per week or a combination of both.)
Liposuction—the third most popular cosmetic surgical procedure in 2014, according to the American Society of Plastic Surgeons—breaks up fat, then removes it from your body using suction. It’s “the gold standard” for eliminating excess fat, says Christopher D. Knotts, MD, a board-certified plastic surgeon at Austin-Weston Center for Cosmetic Surgery (1825 Samuel Morse Dr., Reston, 703-893-6168). The latest techniques employ heat to help wrinkly or flabby skin shrink after the fat is removed, and the newest devices include those with ultrasound technology (such as VASERlipo) or a laser (Smartlipo). “Smartlipo seals vessels and decreases bruising,” says A. Dean Jabs, MD, PhD, a board-certifed plastic surgeon with Cosmetic Surgery Associates (6430 Rockledge Dr. #100, North Bethesda, 301-493-4334). “What we’re doing is a refnement of the technique. We’re adding modalities—things to remove the fat better.”
Body contouring procedures—such as a tummy tuck (abdominoplasty), which removes excess fat and skin and can restore weakened muscles—also have added benefits.
“When speaking with my weight-loss patients, I tell them that body contouring surgery to remove excess hanging skin after massive weight loss can help to prevent weight regain,” says Ariel N. Rad, MD, PhD, a board-certified plastic surgeon and cofounder of Sherber+Rad. “I reference an important 2013 study in the journal Plastic and Reconstructive Surgery that reported a nearly four-fold reduction in weight regain after body contouring surgery. By giving my patients a slimmer, trimmer body, not only is their confidence restored, but I also can empower them with the knowledge that they have a lower risk of relapsing into obesity, thus reducing their risk of heart and joint problems.”
Patients should discuss the benefits and risks and whether these procedures are right for them with a board-certified plastic surgeon. Surgical procedures can entail weeks of recovery and carry risks such as anesthesia reaction and infection.
“Most cosmetic body-contouring procedures can really serve as a springboard [for patients] to jump up their fitness,” says Knotts. “It’s easier to move.” Rad adds, “Having a new body and the peace of mind that their long-term health is improved add up to a win-win.”
One-third of American adults hadn’t visited a dentist in the past year, according to a 2014 Gallup poll. Don’t be like them. “Some people are 35 years old and they have mouths like they’re 70, [which can lead to] muscle pain and joint problems,” says Peter Rinaldi, DMD, of the Washington Center for Dentistry (1430 K St. NW, #800, 202-223- 6630).
Today’s veneers, which are thinner than the older types, have obvious cosmetic benefits, but they can also correct misaligned teeth in certain patients, says Rinaldi, who is accredited by the American Academy of Cosmetic Dentistry. To place them, your dentist removes a bit of the original tooth—usually less than a millimeter, according to the academy—then places a customized veneer over the tooth with a special adhesive. The procedure is irreversible.
Dental implant surgery has also advanced, particularly for front-of-mouth placement, Rinaldi says. The procedure replaces tooth roots with metal posts and replaces damaged or missing teeth with artificial teeth that look and function like the real deal. Individual implants can allow better access for cleaning between teeth (as opposed to tooth-supported bridges) and can help you eat without the pain of sliding dentures, according to WebMD.
Those who are interested should consult with an accredited cosmetic dentist who does this type of work often. “There’s a certain [mouth] architecture you have to adhere to,” Rinaldi notes. If you’re a candidate, you may no longer have to endure impression trays. “3-D x-rays have the ability to see things that could never have been seen before,” he adds. “Precise measurements can be taken in regard to where the nerves are and the thickness of bone to determine the best location for the placement of implants.”
In the end, the latest technology can help you not only look better but feel better, too. Just think of Heather Soubra, the grateful dermatology patient who sees more skin-cancer screenings in her future. “It’s not just about vanity and being beautiful,” she says of these visits. “It’s about our health.”
PHOTOGRAPHY BY SHUTTERSTOCK
November 5, 2018