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Advice for a beautiful experience

The popularity of plastic surgery and cosmetic dentistry is soaring...

While the vast majority of cosmetic procedures are successful, choosing the right practitioner and following some important guidelines will ensure the best and safest outcome.
    “The operative word is ‘surgery,’” says Dr. Keith Brewer of Brewer Plastic Surgery in Davis. “Just because it’s ‘plastic’ doesn’t mean it’s minimally invasive. The bigger the scope of the procedure, the more the risk.” 
    How can you maximize the odds of a positive outcome and minimize the risks?
    Start by asking your family doctor and friends for referrals. “Make sure your surgeon is certified by the American Board of Plastic Surgery (ABPS),” recommends Dr. William J. McClure of Napa Valley Plastic Surgery. “There are a lot of phony boards out there.”
    Surgeons certified by the ABPS are trained to perform procedures anywhere on the body. Certain other specialists, such as otolaryngologists, are limited to performing head and neck procedures. Check the American Board of Medical Specialties to determine if a certifying board is legitimate.
    “There are people out there doing plastic surgery who aren’t qualified,” says McClure.
Consumers can also check up on doctors through these resources:
•    The  Medical Board of California (licensure and complaints)
•    County courthouse (civil or criminal records)
•    Internet search (some websites detail allegedly botched procedures)
    Be sure that outpatient clinics are accredited. “The most common accreditation body is the American Association for Accreditation of Ambulatory Surgery Facilities,” says Dr. Brian Klink of Solano Plastic Surgery in Vacaville.
    Choose an anesthesiologist certified by the American Board of Anesthesiology. Tell your surgeon about serious health conditions such as diabetes, or heart or lung problems, which should require medical clearance from your primary care physician prior to surgery. Disclose all prescription and nonprescription drugs you are taking, and tobacco use. Birth control pills, for instance, increase the risk of blood clots, while sedatives can endanger patients under anesthesia. Smoking increases the risk of complications and makes scarring more likely by impeding blood flow.
    Body procedures carry higher risks than face lifts. Major body makeovers might best be accomplished in stages. If you combine procedures, consider hospitalization.   
    Procedures featured on TV may not produce long-lasting, desirable results, Klink warns. For example, he says that string lifts (face lifts without incisions) have fallen from favor.
    Ask about materials and warranties. Some manufacturers warranty breast implants and offer replacement products at no charge.

Some things old, some things new

Breast augmentation, liposuction and facial rejuvenation are popular cosmetic surgeries for women. Common procedures for men are rejuvenation around the eyes, followed by liposuction of hips and abdomen.
    Wrinkle filler injections are also popular. Botox is generally safe and effective, though its effects are temporary. But nonmedical grades can pose risks.
    “In Florida last year, people were injecting Botox that was 10 times more powerful than they thought,” Brewer says. “It ended up putting a bunch of people in a hospital on respirators, temporarily, because it paralyzed them.”
    New, longer-lasting injectables are now available. “Radiesse breaks down after a little longer [than Botox] and ArteFill is supposed to be permanent,” says Brewer, who suggests using caution with products that produce permanent results.

Flash those pearly whites   

“A perfect smile will do more for your social confidence than any other single cosmetic or surgical procedure,” says Dr. Bruce Bosler of Bosler Cosmetic Dentistry in Vacaville. He suggests choosing a dentist accredited by the American Academy of Cosmetic Dentistry.
    Dr. Randy L. Johnson of the Center for Contemporary Dentistry in Vacaville advises picking a practitioner with training in aesthetic dentistry through a university or continuing education courses. “Any dentist can call him or herself a cosmetic dentist even if they have no formal training in aesthetic dentistry,” he says.
    Ask for before-and-after photos, be wary of below-industry rates and ask about materials and labs. “Some budget dental offices using basement fees could be using foreign laboratories,” Bosler says. “[If so] there is no assurance of safety or quality.”
    Popular cosmetic dental procedures include teeth whitening, Invisalign (a clear teeth-straightening system) and veneers to change the color or shape of teeth. New procedures include gingival (gum) recontouring using lasers, and power-bleaching lights for faster in-office whitening.
    Most cosmetic dentistry procedures are done with local or no anesthesia. In some cases, oral conscious sedation is administered with a dissolvable tablet that produces relaxation. The procedure is safer than IV sedation, Bosler says. “Patients often fall asleep and don’t have much memory of the procedure, though they are conscious.”
    The majority of cosmetic dentistry procedures are safe and successful. “If it’s not ideal,” Bosler concludes, “we can do it again and make it ideal. That’s what is exciting about dental cosmetics.”

RESOURCES
American Academy of Cosmetic Dentistry, aacd.com
American Association for Accreditation of Ambulatory Surgery Facilities, Inc., aaaasf.org
American Board of Medical Specialties, abms.org
The American Board of Plastic Surgery, Inc., abplsurg.org
The Medical Board of California, medbd.ca.gov

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