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As tightly as people are holding onto their cash and cutting back on unnecessary expenses these days, many are willing to upgrade their appearances, no matter the price.
Plastic surgeon Dr. Jose Rios and cosmetic dermatologist Dr. Matthew Kelleher say their practices continue to boom despite the economy.
"Plastic surgery is as popular as ever," Rios said. "We are seeing a slight shift to nonsurgical procedures, though, which don't have as large up-front costs. There are also more options to finance our procedures if a patient prefers credit."

During stressful times, people feel it's especially nice to feel good about themselves physically, said Rios, who is part of Rios and Lapinski Dermatology and Plastic Surgery Associates in Joliet and Frankfort.

"We're just about as busy as we ever were," said Kelleher, a cosmetic dermatologist at Advanced Cosmetic Laser and Surgery Center and Dermatology Ltd. in Joliet. "I think this is true because the procedures we do are smaller, more affordable and less invasive. Our patients are able to bounce back quickly and are back to work soon. Our procedures are simple, in-out procedures done in the office."

Both doctors were asked to give their top 10 procedures performed at their offices.
Dr. Jose Rios
1. Breast augmentation . This is Rios' specialty and is the surgery most of his patients request of him. He said the procedure he uses is unlike most others and doesn't produce as much bruising. Pain pills aren't even necessary, he said, and there are no drains or special wrappings or bindings.

Most patients who want larger breasts start out with an A cup or B cup and want a "full C cup." His clients are usually either in the 18- to 25-year-old range and have small breasts or they are older than 30 and have had children and want to regain some fullness. He doesn't perform augmentations to create extremely large breasts, he said.

2. Tummy tucks . Most of his clients who get tummy tucks are women who have had children and who have some loose skin in their lower abdominal area. Others have had an emergency Cesarean section or other surgeries and don't like the scar.

"We can eliminate that scar completely," Rios said, "by removing the vertical scar and making a horizontal scar lower down at the bikini line."

3. Liposuction . Most common are the tummy, hips and the lower back area just above the hips.

4. Breast reductions . This is one plastic surgery that is often covered by insurance, Rios said. He's performed the procedure on women of all ages, from 17-year-olds to 65-year-olds.

"These women are suffering when they come in," he said. "It can cause neck and shoulder pain and upper back pain."

Surgery to reduce the size of the breasts can cause significant scarring, Rios said, but it is also a plastic surgery that has a very high customer satisfaction rate.

5. Breast lifts . Most of Rios' clients who request this surgery have had children and breast-fed them. Breast-feeding, he said, can alter the breasts in every way you can think of. It can make them smaller, larger, droop, or they can stay the same. It's the women who say their breasts are "droopy" who request breast lifts. The nipples can be pointing down, he said, and they come in saying they want their breasts back where they used to be.

6. Brow lifts . A brow lift is something that some clients specifically request, and it's also done many times when they come in requesting eye lifts. Brow and eye lifts are frequently done together.

7. Eye lifts and face lifts . Done as a woman grows older and wants to freshen up her look a bit.

8. Botox . Rios said Botox are injections done on the face to "prevent active wrinkling." Injections are given to specific areas that a person's expressions cause to wrinkle, such as on the forehead, between the eyebrows, at the crow's feet at the corners of the eyes, and across the upper lip.

Botox is short for Botulinum toxin, which is the toxic substance produced by the bacteria that causes botulism. The toxin actually paralyzes muscles for a short period.

9. Fillers . These are substances injected into established lines on the face, such as the lines that go from the sides of the nose to the corners of the mouth, or the larger wrinkles on the brow. Essentially, fillers pump the wrinkle out. Rios said they can be used in combination with Botox.

10. Rejuvenation laser treatment . This can correct facial discoloration, fine lines, and acne scarring.
Dr. Matthew Kelleher
1. Laser facial rejuvenation . Kelleher's offices have more than 20 different types of lasers. He might use one or more lasers on one patient to correct a condition. These procedures are used to treat facial redness, spider veins, sun spots, large oil glands, enlarged pores, wrinkles and other skin problems.

2. Liposculpture . This is different from liposuction, Kelleher said, in that it is done under local anesthesia in the office, rather than in a surgical room at the hospital. It has lower risks, he said, and is significantly safer with smaller incisions and no sutures.

3. Fraxel . This is the brand name of a specialized laser that Kelleher said is unique. It is safer and more effective than other lasers, he said, because it fractionates the laser beam into thousands of microscopic lasers. It's a very exciting advancement in laser therapy, he said, in that it burrows millions of microscopic tunnels in the skin that stimulate new collagen growth. He uses it to treat aging, sun damage, and scars.

4. Botox . Kelleher uses Botox on patients of all ages to prevent wrinkles by relaxing the muscles. If tiny lines are treated with Botox injections very early, he said, the procedure is 100 percent effective in correcting the wrinkles.

5. Injectable fillers . A range of materials is used to fill in deeper wrinkles, and the procedure is reversible if necessary. Filler injections last between six and 12 months.

6. Minimally invasive scar revision . Kelleher uses combinations of lasers and injectable medicines that make scars disappear or become less noticeable. These procedures can flatten or fill in scars and can take the redness out of them. He can work on scars on any place on the body and most often uses the procedure for cheloids, acne scars, surgical scars, and traumatic scars.

7. Thermage . This is radiofrequency tissue targeting that uses electrical current to heat the lower layers of the skin, causing it to shrink and become tighter. It's a great procedure, Kelleher said. He was one of the first to use it in Illinois, and Kelleher has never had one complication from it. It's good for loose skin on the neck, face, jowls, thighs, arms and tummies.

8. Breast reduction by liposculpture . Kelleher said this procedure is perfect for younger women who still have good skin tone and don't need too much tissue removed. It is done under local anesthesia and only uses a 1/8-inch incision with no stitches.

9. Thermage liposculpture . Kelleher said this is an alternative to a face lift. Thermage is done to the face and neck, then liposculpture is performed. The tightening achieved by Thermage makes this like a "turbo-charged" liposculpture, he said. It can be done when there is a lot of loose skin on the neck and produces a very dramatic result.

10. Schlerotherapy . Kelleher injects medicine into spider and varicose veins that cause then to close and go away. It's a very safe procedure, he said.

February 25, 2009
By JEANNE MILLSAP For The Herald News
Digital Chicago, Inc