Wall Street Journal Gold, Frankincense and... Botox Katherine Rosman Rosemarie Hurley has always loved her husband's smile, but after this holiday season, she thinks she's going to love it even more. For his Christmas present, Harry Hurley will receive a gift certificate for teeth whitening, worth about $600.
Never mind that Harry Hurley, a 54-year-old insurance underwriter in Estero, Fla., never even mentioned wanting pearly whites, which made her a little anxious about the gift's implications. So she broke the news before paying the bill. "It's a sticky situation," says Rosemarie, 51, an insurance broker. The good news: he says he never would have thought of it himself - and "it seemed like a good idea."
Holidays long have been occasion for giving loved ones image-improving presents, such as expensive ties or diamond earrings. This season, a few adventurous gift-givers are addressing the issue more directly - by wrapping up certificates for Botox injections, liposuction, even breast implants. The medical and beauty professions are jumping into the fray by offering vouchers, coupons and seasonal promotions. Skinklinic, a medical spa with locations in Manhattan, Las Vegas and Greenwich, Conn., is offering gift certificates for, among other things, a new lipplumping treatment. (Its ad slogan: "Kissable for Kissmas.") In Studio City, Calif., Belle Visage Day Spa launched a gift-certificate program in October and already has sold about 60 vouchers - about $18,000 worth - mostly for Botox and other wrinklesmoothing injections. Also in time for the holidays, Advanced Aesthetics Institute, a 12-spa chain based in West Palm Beach, Fla., has introduced Spirit Lift Cards redeemable for everything from manicures to facelifts. In Las Vegas, surgeon Julio Garcia has sold about a dozen vouchers for facelifts or other treatments, which his office presents on parchment paper rolled up with a silver ribbon. "We want them to look nice under the tree," says office manager Sandie Heitmann. The idea of surprising a loved one with cosmetic procedures is gaining steam. The American Academy of Facial Plastic and Reconstructive Surgery says 35 percent of its members report they performed surgery received as gifts in 2003 - up from 31 percent in 2002, the first year it posed the question. "It's a good way to get someone into a plastic surgeon's office," says Melinda Minton, executive director of the Spa Association, whose members include medical spas, an emerging group that pairs traditional spa treatments with more invasive procedures such as Botox injections and surgery. This gift of lift is just the latest frontier for the plastic-surgery business, which increased 22 percent last year from 2002, to $9.4 billion, according to the American Society for Aesthetic Plastic Surgery, or Asaps. Cosmetic procedures have become increasingly mainstream as TV programs such as FX's "Nip/Tuck" and ABC's "Extreme Makeover" reach millions of viewers a week. Expensive procedures, meanwhile, are becoming more accessible, with banks such as Capital One recently starting to market loans to finance the work. And some nonsurgical procedures are getting cheaper: Botox injections run about $375, down 9 percent from 2002, according to Asaps.
That helps explain the new entry on David McDonald's wish list. The 50-year-old high school biology teacher from Greenwich, Conn., says he could live with the creases between his nose and mouth. But now that injections of Restylane - an acid that pumps up sunken lips and wrinkles can be had for less than $500, he has asked his wife to stuff his stocking with a certificate for the treatment. His wife, Nancy McDonald, says the request from her "macho guy" surprised her. "He wanted something for the boat," she says. "But he wanted the injections, too." Not all gift recipients are enthusiastic about a surprise tummy tuck, of course - and in some cases, the gift's implications can damage a relationship. The idea also raises ethical concerns for medical professionals. Some doctors say the practice could interfere with a patient's choice of surgeons, or keep recipients from fully weighing a procedure's pros and cons because the bill already is paid. Plastic-surgeon societies say their guidelines discourage such business promotions as gift vouchers, though they say no doctors are currently being disciplined for doing so. Some doctors are cautiously exploring the possibilities, providing gift cards only when asked, or only when the recipient already is a client of the practice. In Atlanta, plastic surgeon H. Chip Cole offers certificates for Botox only, because he says the treatments aren't permanent. In Beverly Hills, Calif., plastic surgeon Norman Leaf says he tries to make sure the recipient, not the giftgiver, is asking for the work. "Otherwise, it's a little bit Pygmalionish," he says. Stacey Noble says her "new lips" were a thoughtful and romantic gesture - not to mention a practical one. The co-owner of a Las Vegas kids' store and birthday party space was thrilled when her husband gave her a certificate for Restylane injections to mark her recent 47th birthday, and she's looking forward to getting her lips pumped up anew as a Christmas gift. "I have more jewelry that I can ever use," she says. "And how often can you wear a fur coat?" Of course, husbands have paid for wives' facelifts since plastic surgery was popularized in the 1960s. And spa gift certificates have been popular for a few years (revenue from gift certificates accounts for 25 percent of the $11 billion spa market, according to marketing company Spa Finder). But the recent proliferation of medical spas combines the two trends: Now, certificates can be redeemed not only for facials, but also for surprise sessions of Botox, or certificates for facelifts or breast augmentations. As people talk more openly about surgery as a gift, Ashley Perry is seizing the moment: This Christmas, she's asking for a full C cup. After years of wanting breast implants - and unable to afford them herself - the 19-year-old college freshman in Rosehill, Kan., says she was finally inspired to ask her family and boyfriend to chip in. At first, her boyfriend was concerned Ms. Perry was trying to please him, but she says that wasn't the case: "It's for me and no one else." Diana Stoneson of Los Angeles says that like any gift, cosmetic procedures are only right for certain people. The 35-year-old graphic and Web designer says she felt comfortable giving a friend a Botox voucher this fall - "it takes a certain kind of relationship," she says - and for Christmas, she's planning to give a certificate for a $250 photofacial to a friend who has complained to her about skin discoloration. Still, Stoneson says she'd be surprised if someone returned the favor. "I would probably think it was funny," she says. "People who know me know I'm into natural skin care."
Thankful and ready to face future Domestic-violence victim to undergo surgery, speak out against abuse JACQUIELYNN FLOYD Staff Writer 26 November 2004 The Dallas Morning News WACO - Carolyn Thomas, who lost so much when she was shot in the face last year, remains grateful for the blessings she still has. In December, police say, an ex-boyfriend shot and killed Carolyn's mother, then shot Carolyn in the right temple, destroying most of her face. She was left unable to eat, needs the help of a trachea tube to breathe and wears a mask to cover the ruined void that once was her face. But she has remained relentlessly upbeat, determined to use her experience to warn other women away from abusive men. Since Carolyn's story appeared in The Dallas Morning News in September, she has received the abundant gift of hope. Caring strangers sent cards, donations and e-mails of support. And within the next two months, a Houston medical team will begin the intricate process of rebuilding Carolyn's face, funded by a national domestic-violence foundation. The chief surgeon told Carolyn they'll graft skin from her back onto her face and will use bone from a leg to build a new nose. "I haven't heard yet where my lips are coming from," she said with her trademark wry laugh. Before the first surgery, Carolyn has volunteered to be photographed for public-service posters about domestic violence. "I want people to know that this is the reality," she said. Her hopes for the surgery? "I don't expect to come out looking like a beauty queen," she said. "But he [the surgeon] said my face will pretty much look normal." And "normal" to Carolyn sounds like paradise. PHOTO(S): (NATHAN HUNSINGER/Staff Photographer) A national domestic-violence foundation is funding a process to rebuild the face of Carolyn Thomas, who police say was shot in her right temple by an ex-boyfriend.
Surgery for abuse victims
212 words 1 December 2004 Chicago Tribune
Long after the relationship is over, victims of domestic violence often grapple with far more than the emotional repercussions of their ordeal. Frequently they bear physical scars that serve as ugly reminders of the past. Now battered women can receive free cosmetic and reconstructive surgery to remove scars and minimize injuries caused by domestic violence under a nationwide program called Face to Face: The National Domestic Violence Project. "These patients have a lot of emotional needs that need to be addressed," said Dr. Jeffrey Rawnsley, a plastic surgeon at UCLA who is part of the program. "They also have a lot of physical reminders every time they look in the mirror. We heal the outside so the inside can fully heal." Under the program, the surgery is performed by facial plastic and reconstructive physicians who work on a pro bono basis. Two Chicago-area facial plastic surgeons participate in the program. The program is sponsored by the American Academy of Facial Plastic and Reconstructive Surgery, which works with the National Coalition Against Domestic Violence to provide services to victims. Call 800-842-4546 for more information. Callers are screened to determine that their injuries are a result of domestic violence.
Nips, tucks, even liposuction, make holiday wish lists The procedures have been popularized by reality TV shows, but doctors are wary. By Sheri Hall / The Detroit News WEST BLOOMFIELD -- Christmas came early for Elyse Andrews when her husband gave her a present last week -- a gift certificate for breast implants from plastic surgeon Dr. Gregory Roche. "New breasts for Christmas -- I'm thrilled," said Andrews, 29, who said her husband was so excited about the present that he couldn't wait until Christmas morning. "I know it seems kind of weird, but it's something that I've always wanted." Andrews is among thousands who will unwrap vouchers for cosmetic surgery this holiday season. As its popularity continues to surge, adventurous gift-givers are lining up to give their loved ones everything from Botox injections to stop wrinkles, which cost up to $1,000, to face-lifts and breast implants, which start at $5,000. The American Academy of Facial Plastic and Reconstructive Surgery says 35 percent of its members report that they performed surgery received as gifts in 2003 - up from 31 percent in 2002, the first year it posed the question.
"It's another way of offering a unique present," Roche said. A handful of people come into Roche's West Bloomfield office weekly to buy presents ranging from breast implants to laser hair removal. "Cosmetic surgery has become more affordable and mainstream, and it's finally reached a level where people can afford it," he said. For the plastic surgery business, gift-giving is just the latest frontier. The specialty is gaining momentum nationwide thanks to new, more-affordable procedures and reality television shows like ABC's "Extreme Makeover," where people undergo an array of procedures to improve their looks. Doctors performed 1.2 million cosmetic procedures last year alone in 12 Midwestern states including Michigan. That's up 64 percent from 2001, according to data collected by the American Society of Plastic Surgeons. While liposuction may seem like the perfect gift for the person who has everything, some plastic surgeons insist that cosmetic surgery gift vouchers are unethical and can lead to disappointment. Plastic surgery societies say they discourage promotions like gift certificates. "It sets up an expectation for the patient that they're going to have this surgery even though they haven't been evaluated medically and surgically," said Dr. David Hing, head of plastic surgery at St. Joseph Mercy Hospital in Ann Arbor. "It's a decision made by the giver without having medical and surgical input about whether the procedure is appropriate for the patient." Hing's practice in Ann Arbor doesn't issue monetary gift certificates. Instead, he suggests giftgivers schedule a consultation with a plastic surgeon and offer to pay for the procedure the patient and doctor agree upon. Roche said his gift certificates aren't guaranteed until the patient comes in for a medical evaluation. If the procedure received as a gift is not appropriate, Roche will recommend another one or refund the money. "Once you get a coupon, you're treated like any other patient," he said. "You could be rejected based on a medical issue. We consider safety as our utmost goal." Even if the recipient is healthy, that doesn't mean they won't resent a gift designed to improve their appearance. "A husband may think his wife needs a nose job, she might think her nose looks good," said Dr. Richard Hainer, a plastic surgeon in Rochester Hills. "You can see how that might cause a problem." Hainer issues vouchers for a monetary amount that can be redeemed for anything from skin care products to surgical procedures, but only after the patient has met with him. Radio station WKQI-FM (95.5) has seized on the popularity of plastic surgery with a contest called "The Breast Christmas Ever," where the winner receives a breast augmentation. The station hasn't announced this year's winner yet. Last year's winner, Kara Cope, is thrilled with her breast implants.
"It was an awesome Christmas present," said the Livonia mother of two. "They look nice, and really natural." While popular among listeners, especially around the holidays, such contests are controversial among cosmetic surgeons. The American Society of Plastic Surgeons, the specialty group recognized by the American Board of Medical Specialties, bans contests among its members. "A contest shouldn't dictate medicine -- that's the point," said Dr. Michael Freedland, a plastic surgeon in Bloomfield Hills and a member of the group. "The person who wins a free breast augmentation might not be a candidate." For its part, the radio station actually allows a doctor to choose the contest winner, which ensures the recipient is medically-qualified. "And at the end of the day, it's up to the listener if they want to participate," said Dom Theodore, the station's promotions manager. "I don't think it's ethical for a husband to buy their wife this without them knowing about it or consenting to it. I don't think any medical procedure should be determined by another party." Robert Wedge didn't mind when his girlfriend took the liberty of buying him a gift certificate for laser hair removal this summer. "I guess you could call it Christmas in July," said the 26-year-old from Berkley. So far, he has had two treatments on his back. And he'll have several more before the voucher expires. "It was more of a comical present than anything else," he said. "We're pretty funny like that." "I know it seems kind of weird, but it's something that I've always wanted."
You can reach Sheri Hall at (313) 223-4686 or shall@detnews.com.
Greenwich Time Blast victim gets help from town surgeon By Michael Dinan December 5, 2004 Jason Pronyk can't remember exactly what happened inside Baghdad's Canal Hotel that sweltering Tuesday afternoon.
Pronyk, 34, had been in Iraq one month as a program specialist with the U.N. Develop-ment Group. He thinks he was ordering coffee for seven colleagues at 4:30 p.m. on Aug. 19, 2003. He remembers opening a door for a hotel staff member, and a truck bomb detonated outside the three-story building, killing 22 people and wounding more than 150 others. "Glass came like bullets. . . . It was a galaxy of glass and debris," Pronyk said. Injuries from the suicide bombing sent Pronyk through a series of surgeries and a nine-month recovery program, mostly in his native Canada. Neurosurgeons extracted glass from the front of his brain and drained blood that had pooled inside his head. Glass, metal and other foreign matter remain lodged in his face, shoulder and chest. Eighteen screws hold his skull together. He has lost his peripheral vision and feeling in his forehead. Pronyk, who returned in June to work at the United Nations in Manhattan, where he lives, met last month with Greenwich resident Dr. Darrick E. Antell, a plastic surgeon he was referred to by the U.N. Medical Service Department. Antell, 53, who practices mostly cosmetic surgery such as liposuction, face and neck lifts, and breast augmentation and reduction, will reattach a portion of Pronyk's ear that was severed in the bombing. Reconstructive surgery, though it makes up only 5 percent of Antell's business now, accounted for 95 percent when he started his practice more than 20 years ago. "Reconstructive aspects are really at the foundation of plastic surgery," said Antell, who ran a burn unit in California and was on call for hospitals' emergency departments. "That's where we're all trained initially. A lot of people forget that because of the media and ladies' magazines." Celebrity makeovers and television shows such as "Nip/Tuck," "The Swan," and "I Want a Famous Face" may focus attention on cosmetic procedures, another expert said, but the heart of plastic surgery lies elsewhere. Modern plastic surgery started as reconstructive surgery for soldiers injured during World War I, said Dr. Joel Rein, chief of Greenwich Hospital's plastic surgery section since 1978 and a former naval medical officer. "Cosmetic plastic surgery has become so popular that people have stopped thinking about what the underlying principles are," said Rein, a 1963 graduate of Columbia University's College of Physicians & Surgeons. "Plastic surgery actually started around 1929 following soldiers' injuries to the head and neck. In trench warfare, many soldiers looked up over the trenches and were hit in the face." Plastic surgery has evolved since then to encompass vast and often overlooked contributions to general reconstructive surgery, Rein said. The first kidney transplant and procedures to reshape skulls damaged by birth defects, implant fingers and limbs lost in violent accidents and restore breasts following mastectomies all originated with plastic surgeons, he said. "Foundations of reconstruction have always been the bedrock in plastic surgery principles," said Rein, a Greenwich resident. "What's happened since the 1980s is the principles of reconstruction have extended into the elective field." Even so, traumatic repair surgery, like that for patients whose faces are mutilated in car accidents, remains a constant source of work for plastic surgeons, Rein said.
Antell said he treats all patients carefully, but especially so when they come to him as the victims of violent events or accidents. "As a surgeon, you're always taking into consideration the emotional needs as well as the physical," he said. "With a violent accident of this type, it raises your antennae even more. Surprisingly, the patients I've met who were involved in this (bombing) are remarkably calm." Pronyk is one of three U.N. employees injured in the blast that Antell has been hired to work on. Antell helped mend the facial scars of two others. A diplomat with the American Board of Plastic Surgery, Antell has worked with several U.N. employees since befriending the head of its Medical Service Department several years ago. For Pronyk, who also has consulted Antell about removing minute glass shards from under his eye, the surgery represents another small step back to his pre-bomb life. "There's constant psychological processing," he said. "You hear lightning and you jump. There's a constant recollection. The surgery will hopefully restore the ear as close to pre-explosion as possible. . . . I have things I'm forced to live with and it doesn't seem to impair me. I live, work, and have resumed life as close to normal as possible."
Sacramento Bee Plastic surgery gets a big lift from baby boomers By M.S. Enkoji -- Bee Staff Writer
Paula Buckingham is at that age. You know, when you look in the mirror and you sometimes tug up on the sides of your face - just to see the possibilities. Thrilled with the results after an initial nip and tuck, Buckingham is contemplating a second round of cosmetic surgery. And why not? "I don't have time to put myself last anymore," said the 46-year-old state worker from Roseville. The nation's plastic surgeons, the doctors who perk up the face, sharpen the eyes and grease the joints, are looking out for people like her. And they're a busy bunch. From 1992 to 2003, the years the baby boomers moved into their 40s, the number of all people undergoing some sort of cosmetic surgery every year didn't double or triple, but jumped more than sevenfold to almost 3 million.
Despite the risks and the cost, face-lifts performed annually by members of the American Society of Plastic Surgeons doubled to 86,500, while eyelid surgeries per year zoomed 118 percent. By 2003, patients of the society's doctors were estimated to have shelled out $8.4 billion annually - 18 times the yearly budget of Sacramento County - on cosmetic surgery. Experts say the surge in plastic surgery's popularity reflects not only the desire of baby boomers to look young as they move into midlife but also tectonic shifts in society, physiology and medical technology. "It's really like the perfect storm or the perfect opportunity," said Dr. Neil Martin, a Washington, D.C., eye surgeon. Jackie Carrigan, an assistant professor of sociology at California State University, Sacramento, said baby boomers, those born between 1946 and 1964, are reaping the benefits of widespread health care and preventive medicine, which means they can expect longer, more vibrant lives than their parents. In 1900, the life expectancy of a newborn male was 48 years, 51 years for baby girls. By 1949, the life expectancy of males was 65.5 years and 73.2 years for females, according to the National Center for Health Statistics. "In some ways, there's an extended middle-age status," said Carrigan, a specialist in health and demography. "They're not feeling old." That was the disconnect 53-year-old Jennifer Cerruti experienced when she looked into the mirror. "I don't want to look older, droopier or tired," said Cerruti, who had a partial face-lift in January. The single mother of two and owner of a Sacramento midtown hair salon is built more like a willowy teenager, the result of rigorous workouts and disciplined eating habits, she said. Already a veteran of a nose job and a brow lift, she submitted to surgery on her lower face this year to please herself, rather than to attract dates. "I'm 53 and if someone is picking me for the way I look, it's downhill from here," she said. But for others, competition for romance and career advancement do become factors in weighing the pros and cons of plastic surgery. More divorces mean more midlife dating, said Nancy Irwin, a Los Angeles-area therapist and frequent public speaker on well-being. "Plus," she said, "both genders are working longer. Nobody retires at 65 anymore." That work-force competition could explain why more men are going under the knife, Carrigan and others said. In a phone survey by the American Society of Plastic Surgeons, nearly 34 percent of men said they viewed cosmetic surgery more favorably now than 10 years ago.
Dr. Thomas Stevenson, plastic surgery chief at the UC Davis Medical Center, said he performs about one male face-lift a month. One Los Angeles ophthalmologist said half his patients who seek laser surgery to correct eyesight are 43 or older, and they're clear on what they want. "They want to feel like a 30-year-old, they want to move like a 30-year-old and they want to look like a 30-year-old," said Dr. Robert Maloney, spokesman for the American Academy of Ophthalmology. Advances in medical technology help. At a recent convention of the American Society of Plastic Surgeons, the buzz was all about new methods that will hurt less, produce better results and reduce risks and recovery time: reshaping body fat without cutting into skin, using a barblike implement to tack down skin for face-lifts instead of cutting and stitching, and a new generation of laser-light treatments that smooth wrinkles and zap age spots. The trend is toward procedures with less pain and more gain. In the last year, a new machine made its debut using a radio frequency that heats deeper layers of the skin to stimulate collagen growth, said Andrew Kaufman, an assistant clinical professor at UCLA. Collagen tightens the skin, much like a face-lift. Studies show that the benefit from the new procedure is about half that of a surgical face-lift, without the downtime and risk of surgery, he said. How about eyes that can read a menu by the soft glow of candlelight sans reading glasses? The Food and Drug Administration has approved a type of lens implant that potentially could eliminate the need for reading glasses, the accouterment of advancing age. Cataracts, rather than vanity, led to the development of the lens, equipped with tiny hinges that allow the eye to adjust between near and far vision. "I've got really happy people," said Martin, the Washington eye surgeon who has already done about 50 Crystal Lens implants since they were approved a year ago. "It's not like being 18 again, but more like 40," said Martin, whose practice is in suburban Washington, D.C. The procedure is pricey - $5,000 per eye. And it works only for certain vision problems. For a generation that has grown up with one technological innovation after another to ease their lives, taking advantage of advances in cosmetic surgery is a logical progression, said Carolyn de la Peña, professor of American studies at the University of California, Davis. "People get comfortable with getting what they want with technology," said de la Peña, author of the book "The Body Electric," a historical look at the influence of technology on the body. Hair seldom grays anymore, teeth are as white as newborns' and bodies stay muscled. So people expect their faces to adjust, too, she said.
A cautionary tale unfolds when medical technology raises the bar, intensifying pressure on those who hesitate or prefer to age naturally, she said: "It could change the definition of normal." Another author who has critically examined what she calls "the perfection industries" in her book "Aged by Culture" ties the boom in plastic surgery to forces as lofty as the global economy for heightening competition in the work force, thus creating anxiety among older workers. "You should vote for more job creation; you wouldn't get a face-lift," said Margaret Gullette, a resident scholar at the Women's Studies Research Center of Brandeis University in Massachusetts. In her Roseville home, Buckingham is firmly confident about the surgery that transformed her. A year ago, after losing 80 pounds the old-fashioned way, she had a breast reduction, followed by a tummy tuck to complete her new look. She can wear clothes from trendy stores she had to bypass before: "I wish I would have done it 10 years ago." But Buckingham acknowledges that she worked hard to lose weight and had realistic expectations. "I didn't expect perfection. I didn't expect to come out looking like Barbie, but I knew it would make me feel better about myself," she said.