I read an article on MSN’s Health and Fitness section on the internet today, which while covering relevant cosmetic topics, did a disservice and injustice to many of them. The article was intended to suggest that the nine procedures/treatments reviewed were either unsafe or were not effective. As such, you should rethink them. Having either performed them in patients or studied the evidence, I think a critical review of the article’s content is in order. I will do so based in the order they were covered in the article.
BOTOX BREAST LIFT
This one I would completely agree with everything said in the article. This is a ridiculous idea and anyone that knows anything about breast lift surgery would concur. This is simply someone trying to push the envelope of what Botox can do. Botox may be a miracle drug but it has no place or role in trying to lift a breast. Anyone that uses it as such should be ashamed of themselves for such chicanery….and subjecting patients to such a terrible waste of money.
FISH PEDICURES
Obviously a novel marketing idea from the nail industry but no small fish could do as good as job as a human with a file and scissors. Their mention of possible fish contamination is valid but I have enough trouble thinking of using instruments and baths that have been used and cleaned from other people….let enough a tank full of smelly fish.
EYEBROW WAXING
This is commonly done and highly sought after from many patients. To condemn it as unsafe or at high risk for causing burns flies against broad experience in many good facilities with well trained people. This remains a simple and highly effective cosmetic procedure for shaping the eyebrows and getting rid of that ‘unibrow’.
LATISSE
This eyelash enhancer, while new, is FDA-approved and perfectly safe. Yes, some patients will develop eyelash or eyelid sensitivity with its use and be unable to use it. This is clearly on the packaging inserts and is discussed with all patients to which we prescribe. To the few patients who develop sensitivity to the problem, they are quickly and easily treated to resolve their mild allergic reaction.
TEETH WHITENING
Teeth are whitened primarily by different concentrations of hydrogen peroxide. The higher the concentration, the quicker and whiter most teeth become. But with higher concentrations come increased risk of tooth sensitivity. UV (blue light) lights enable lower concentrations of hydrogen peroxide to be used which enhance their effectiveness while keeping down sensitivity. In my teeth whitening protocol, we use two 20 minutes light sessions (with eye protection) with a 7% hydrogen peroxide solution, followed by a final 20 minute session with 35% hydrogen peroxide without any light. This is perfectly safe and exposes the patient to less UV radiation than a single series of dental x-rays.
The placement of permanent tattoo pigments into the lashline and eyebrows has now been successfully done for nearly 20 years. I have yet to see a single case of an inflammatory reaction to the implanted pigments. Patients are fully educated beforehand as to the irreversibility of their decision and that is why we spend time reviewing pigment placement and color before actually doing it. Patients are generally thrilled with the use of permanent makeup…so much so that they always come back for touch-ups over the years when there has been some fading of the color.
CHEMICAL PEELS
Despite the advent of the laser, facial skin exfoliation and rejuvenation is still done largely by chemical peels. There are numerous chemical agents in many different concentrations that can be tailored to the amount of improvement and recovery that the patient wants. A chemical peel is…..well it is a burn plain and simple. The depth of the burn is chosen between the provider and the patient. Light chemical peels, such as fruit acids (AHA) and glycolics, are always done by an aesthetician in my practice. They are perfectly safe and produce very gratifying results with little to no downtime. Moderate depth and stronger peels, such as trichloroacetic acid (TCAS), are done by me exclusively under the guise of more improvement with an accepted longer recovery time.
BRAVA BREAST ENHANCEMENT
The issue here is not one of safety but of effectiveness. Most patients will not be happy with a 1/2 cup size improvement taking a long protracted time to get there. But for those small number of women who are ardent opponents of surgery and implants, this is their only real option.
THERMAGE
Thermage touts some mild skin tightening of the face and select body areas. In some patients, they do get visible results, in others no real long-term improvement is seen. While it is possible to create too much heat and cause an injury, the issue with Thermage is one of expectations and value in my opinion. Most patients are motivated to get some jowl improvement. Limited facelifts or jowl lifts cost a little more with proven results. When the two are compared in terms of value, Thermage falls short.
Dr. Barry Eppley
Indianapolis, Indiana