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Rhode Island Monthly Magazine*

The newest cosmetic procedures boast close to no downtime and natural-looking results. No wonder everyone [even your doctor] wants to do lunch.
Edited by Nicole Maranhas

You know what they say. After thirty, it’s bangs or Botox©. A growing number of people are choosing the latter:

According to the American Society for Plastic Surgery, nearly two million people in New England and the mid-Atlantic region opted for minimally invasive cosmetic procedures last year.

Once the purview of ladies who lunch, cosmetic work no longer discriminates. An increasing number of men are seeking out Botox© and wrinkle fillers. The demographics are also getting younger; many patients now opt for treatments in their thirties.

And to doctors of all specialties. Because nonsurgical cosmetic treatments are a cash-upfront cow, medical practitioners from all fields are milking the industry—which can make patient safety an issue. While many procedures are effective and safe when performed correctly, they pose risks in the wrong hands.

An obstetrician, for example, might take a weekend certification course on Botox© or Juvederm© before offering the treatments to clients. Many plastic surgeons and dermatologists question this kind of crossover, warning that even a top-notch doctor may lack the experience and knowledge for damage control if complications occur. “The injector should have a comprehensive understanding of facial muscles, their function and the effect of specific doses of Botox on muscle activity and facial expression,” says Dr. Patrick Sullivan, a plastic surgeon in Providence and associate professor at Brown.

The risks aren’t always medical. “What training do you get in facial artistry if you’re a gynecologist?” Sullivan asks. Botox© injected in the wrong places can cause eyebrows to become abnormally elevated, giving the patient a look of perpetual surprise. There may be eyelid drooping if an improper injection freezes the muscle that controls the eyelid. And with fillers that draw in water over time, it takes a couple of days to see results. “The person doing the filling has to be able to anticipate these changes to give the patient the best result,” says Sullivan.

It takes only one look at a procedure gone wrong to see why cosmetic medicine is no time for budget shopping.

“If somebody low-balls the price, there is a reason they’re doing it,” says Dr. Richard Zienowicz, a plastic surgeon in Providence who is also an associate professor at Brown. He recalls treating a patient who came to him with third-degree burns and permanent scars caused by a laser treatment from a nonspecialist who took a weekend course in the technique. On another occasion, a patient sought his help for permanent scarring that occurred after a board-certified surgeon trained in facial plastic surgery performed a tummy tuck. These stories are common. “Seek the advice of nurses and doctors who work with the individual, as well as satisfied clients,” says Zienowicz.

With a more youthful face just a lunch hour away, it’s easy to get caught up. — Denise Dowling

*Reprinted in party with permission granted by Rhode Island Monthly Communications, Inc. ©2008