Doctor Answers Questions About Growing Industry

Increasingly, older Americans are looking in the mirror and unhappy with what they see: Scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, and spider veins top the list of complaints. As skin worries grow, so have new ways to treat them (think Botox) and new places to seek help. Once mainly the purview of dermatologists and plastic surgeons, only a few hours of television will bombard you with ads for clinics, fat farms, body contouring and even vaginal rejuvenation. There is a parade of new skin care products, new businesses such as medispas and doctors changing their specialties.

Nowadays, these medical procedures — surgical and less invasive — are lumped under the term “medical aesthetics,” and an estimated 20 million procedures were performed worldwide in 2014–15.

As a physician who has now shifted her attention to
skin and medical aesthetics in recent years, Bellingham’s Dr. Tianna Tsitsis has had a close-up look at this trend and what it means for aging Americans. In her introductory column for the magazine, Dr. Tsitsis answers some fundamental questions about this emerging field:

WHAT IS MEDICAL AESTHETICS?

Medical aesthetics is a term for specialties that focus on improving the appearance of aging skin through the treatment of conditions such as scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, and spider ve ins. Recently, body contouring, platelet-rich plasma treatments and vaginal rejuvenation have been added to the plethora of procedures included under this heading.

HISTORY OF MEDICAL AESTHETICS

Medical spas, also known as medispas, started in the early 2000s and have increased dramatically in the past 10 years. The industry’s popularity has been driven by numerous factors: an aging population’s demand for appearance-enhancing procedures, an increasing number of physicians performing them, increased use of antiaging skin care products by younger generations, and the failure of over-the-counter cosmetic products producing results. Instead of surgical facelifts, less-invasive procedures to smooth wrinkles and tighten skin have come from technological improvements in laser and light procedures. Older people in the workforce want to look younger, but don’t want to take time off from their jobs.

WHO IS DOING THIS?

For some, having work done lost its shame years ago. According to the American Society for Dermatologic Surgery, in 2014 more than 52 percent of people surveyed were considering some kind of aesthetic procedure, up 30 percent from just two years prior. In the U.S. alone, more than 15.5 million cosmetic, minimally invasive procedures were done in 2016,
 a 3 percent increase from the year before, according to the American Society of Plastic Surgeons survey. Not limited to women, there was a 25 percent increase in male aesthetic procedures performed between 2014–15, according to the ASPS.

The ASPS estimates that $13.5 billion was spent on cosmetic procedures in the U.S. alone in 2015. With numerous websites like RealSelf.com, magazines like New Beauty and TV shows (Botched and Extreme Makeover), the industry has become part of the media culture.

Not long ago, only plastic surgeons and dermatologists were trained appropriately. Now, doctors in other specialties such as internal medicine and family practice have been getting certified.

WHAT ARE THE POPULAR PROCEDURES BEING DONE TODAY?

Per the American Society of Plastic Surgeons in 2016, the most popular surgical procedures remain breast augmentation, liposuction, nose reshaping, eyelid surgery, and facelifts. Among non-surgical (hence noninvasive) procedures, Botox is the number one aesthetic procedure done in the world. This is followed closely by fillers, laser hair removal, chemical peels, microdermabrasion, photo facials and skin resurfacing. As stated above, platelet rich plasma treatments are becoming popular, especially since Kim Kardashian had a video done while she was having a facial using her own platelets. Laser vaginal rejuvenation is one of the fastest growing procedures now available because it offers a non-invasive option to those many women who are unhappy with their sexual function.
In future articles, we will examine details regarding these
and other popular treatments. Stay tuned.

Dr. Tianna Tsitsis is a triple-board-certified physician with a special interest in skin aesthetics. She opened RejuvenationMD in 2014.

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"For some, having work done lost its shame years ago. According to the American Society for Dermatologic Surgery, in 2014 more than 52 percent of people surveyed were considering some kind of aesthetic procedure"