Cosmetic Choices

Not ready to go under the knife? You’re not alone. Plenty of people are putting off the inevitable nip and tuck with less invasive alternatives.

This treatment uses a controlled amount of radio frequency energy emitted by a handpiece to heat collagen in the deeper layers of the skin on the face, causing it to contract and tighten. The tissues are in turn stimulated to produce additional collagen, creating further lifting and tightening. According to Dr. Lu-Jean Feng of the Lu-Jean Feng Clinic in Pepper Pike, the latest machines make Thermage “painless and more effective” than when it was first introduced. Dr. Steven Goldman of Beachwood Plastic Surgery and Medical Spa describes the feeling experienced during the 90-minute session as a “heating sensation that is not exactly comfortable, but tolerable.”

Although patients experience some minor swelling, there is no downtime. “You don’t even look red afterward,” Goldman assures. But both he and Feng stress that improvements are modest — even less impressive, Feng says, in overweight and older patients who need face-lifts. Feng says results generally last about six to 12 months, although Goldman says some patients enjoy the benefits for two to four years.


This recently introduced treatment combines Thermage-like radio frequency energy and infrared light to lift and tighten areas on the body. Although use of Thermage on the body was limited to the abdomen, the discomfort caused by VelaShape is tolerable enough for use on the delicate area under the upper arm, Feng says. She also touts it as a good way to lessen the appearance of cellulite. The best candidates are close to their ideal weight and don’t have a lot of loose skin in the area to be treated. Results, which require multiple treatments to attain, are modest and last about a year.


Fraxel is a gentler version of the carbon-dioxide laser that resurfaces the skin without denuding it of its top layers, says Feng. A filter on the laser “fractures” it into tiny dots rather than a full sweep, hitting only 20 percent of the skin in a given area. Enough skin remains intact that patients look like they’ve suffered nothing more than a sunburn that heals with minor flaking in about four days.

“Thermage makes the collagen contract; Fraxel actually destroys it,” Feng says. It improves skin texture and firmness and lessens the appearance of fine lines and discolorations.

While Goldman likes the Fraxel laser, he says it can’t match the dramatic results produced by its carbon dioxide predecessor, which is still in use. Results, which take four treatments scheduled over two to three weeks, last more than a year.

Improved general health

The importance of good health certainly isn’t anything new. But more plastic surgeons are re-emphasizing it. According to Beachwood plastic surgeon Dr. Bryan Michelow, more of his contemporaries are employing aestheticians who do everything from perform facials, peels and microdermabrasions to improve patients’ skin before surgery and to counsel them on postoperative care. Others take the idea further and partner with local nutritionists, even weight-loss and smoking-cessation specialists, to get patients in shape before going under the knife. (Michelow won’t perform major surgery on a smoker until he or she has stopped lighting up.) The effort pays off in fewer complications and improved results.

“No longer do patients just come to my office for a face-lift,” he declares. “We treat them from top to toe.”
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