Nipping, tucking off years

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Nipping, tucking off years
September 08, 2007
By David Phelps, Star Tribune
Minneapolis Star Tribune

Aging baby boomers are leading a surge in cosmetic surgery procedures. And men are jumping in, adding liposuction and Botox to their wish lists.

Call it another legacy of the baby boomer generation. Or call it the "Dr. 90210" effect.
Whatever you call it, the numbers tell the story. Cosmetic surgery is surging.

Across the Twin Cities and across Minnesota, people are lining up for laser surgery to make their skin look younger, Botox injections to eliminate crow's feet, breast enhancements and reductions for aesthetic and health reasons and liposuction to eliminate unwanted body mass.

"Every day I'm busier and busier," said Dr. Sharon Kshettry, a gynecologist for 30 years who opened a skin care clinic this summer. "More women are working, and are working to later ages, and looking good is important to them."

But it's not only women who seek cosmetic enhancements of their appearances. Men, in small but growing numbers, also are getting liposuction and Botox treatments, as well as hair transplants.

"They want to look younger to be more competitive in the workplace," said Dr. Joseph Gryskiewicz, an Edina cosmetic surgeon who heads the emerging trends task force for the American Society of Plastic Surgeons.

The interest in looking younger apparently knows no geographical boundaries.

Even the Buffalo Clinic, in growing but largely rural Wright County 40 miles west of the Twin Cities, has a separate skin care center. The four-year-old practice has four family-practitioner physicians and two physician assistants. It now needs more space and more doctors.

"Every time Oprah does a special on a procedure, the phones start ringing," said Deb Lauer, the center's nurse manager.

Lauer said that half the center's patients receive medical treatment for conditions such as acne, while half come in for cosmetic procedures such as hair removal and dermal fills to smooth out wrinkles.

"That's for us baby boomers who lived out in the sun with no [sunscreen] protection when we were younger," Lauer said.

TV shows fuel demand

But it's more than an aging population contributing to the rise in cosmetic surgery. The country's culture plays a role as well.

The popularity of the reality TV show "Dr. 90210," featuring a cosmetic surgeon known as Dr. Rey and his patients in Beverly Hills, Calif., and the FX television drama "Nip/Tuck" have mainstreamed the notion of cosmetic surgery and fueled demand for procedures.

"Yeah, that drives interest in it, but it distorts it as well," said Dr. Scott Ross, a cosmetic surgeon with clinics in Edina, Eden Prairie, St. Cloud, Woodbury and one soon in Plymouth. "It's still surgery."

There are basically two types of cosmetic procedures. There's surgery, which includes breast and nose reshaping, liposuction for the hips and tummy tucks for the stomach area. And there's minimally invasive procedures such as chemical peels, hair removal and wrinkle fills.

Nearly 11 million served

Cosmetic treatments in the U.S. jumped 7 percent in 2006, to nearly 11 million procedures, according to the American Society of Plastic Surgeons. Surgical procedures were up 2 percent. The five most popular surgeries were breast augmentations, nose reshaping, liposuction, eyelid surgery and tummy tucks.

Minimally invasive procedures were up 8 percent. By far, the most popular was Botox, by 4-1 over the next most performed treatment, chemical peels.

The American Academy of Cosmetic Surgery also reported that males now make up 21 percent of the patient base, up 3 percent in the past four years.

The academy's statistics show that cosmetic procedures are increasing in frequency in the north-central region of the U.S., which includes Minnesota. Breast augmentations in the region increased from 11 percent of the national total in 2001 to 15 percent last year. Botox injections rose from 8 percent of the national total five years ago to 15 percent last year.

Surgeons and skin technicians say that more consumers are turning to cosmetic procedures, because newer and improved technologies, such as lasers, allow more work without cutting under the skin.

"Laser technology has significantly improved," Kshettry said. "It's minimally painless. There's no blood loss, no infection, no down [recovery] time. Every [fashion] magazine is talking about these lasers."

On a recent Wednesday morning, Ross treated Tricia Ayers for broken capillaries on her face. The photo facial laser session was over in 15 minutes, and Ayers said it was virtually painless.

What makes the growth in cosmetic surgery interesting is that this is a cash business.

Insurance covers very few procedures, most notably treatment for skin cancer. Some breast reductions are covered if back problems are an issue. Eyelid surgery can be covered if eyesight is hampered by a problem with the eyelid. Otherwise, the patient pays at the time of the procedure.

No claims hassles

But some plastic surgeons are concerned that the prospect of having patients pay on the spot is pushing more physicians into the cash cosmetic business rather than having to deal with insured patients and hassling over claims.

"I could do a droopy eyelid [for cosmetic purposes] and get $2,000. If I do it with Medicare, I get $350," said Dr. Frank Pilney of Plastic Surgery Associates in St. Paul. "Doctors are moving laterally to get something [in their practice] not paid for by a third party. You get more cash on the barrelhead if you have cosmetic services."

Pilney said that patients need to know the expertise of the providers they use. "You have to be careful where you go and what you get done," he said.

The photo facial laser to repair sun-damaged capillaries that Ross performed runs $395 per treatment with three treatments standard. Liposuction is about $5,000, while breast augmentation runs between $5,000 and $6,000.

"These are baby boomers who are getting older and have more discretionary income," Gryskiewicz said.

"Even in times of a recession, it's a priority for people to look good," Ross said.

The skin care center in the Buffalo Clinic lists procedure prices on its website and offers monthly specials. The special for September and October is $50 off for a microlaser peel, a procedure that starts at $650 per treatment.

Much of the face-tightening and wrinkle-filling is done on women in their 40s and older. Breast work tends to be sought by younger women, sometimes after they've had children. Gryskiewicz said that the average age of his augmentation patients is 32.

"Many want to go back to the way they looked before children, because everything's gone south. They want to be attractive," Gryskiewicz said. "It's the most common procedure I do, by far."

The Society of Plastic Surgeons said that so-called "mommy makeovers" are booming. That phenomenon consists of a tummy tuck, breast augmentation and breast lift. Those procedures increased by 11 percent last year, significantly greater than the growth in overall plastic surgeries.

Ross said that cosmetic surgeons sometimes have to be counselors as well as physicians.

"A patient might not be in a stable relationship and wants to look better. Sometimes people come in with pictures from magazines and say they want to look like that. You have to sit down with them and tell them, 'You need to feel good about yourself.' You have to make sure they have reasonable expectations."

David Phelps Ô 612-673-7269

David Phelps Ô dphelps@startribune.com

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