Sunday, June 24, 2001

Lisa Carley prepared Linda Yamashiro for a chemical peel last
week at Kaiser's Hawaii Pacific University clinic in downtown Honolulu.

American Beauty

Cosmetic procedures help
aging baby boomers keep
up appearances

Cosmetic surgery gains acceptance

By Lyn Danninger

Linda Yamashiro is typical of baby boomers whose use of cosmetic procedures -- surgical and otherwise -- keeps island doctors busy regardless of whether the economy is beefing up or paring down.

A busy, married mother of three with a full-time job at Kaiser Permanente, Yamashiro had never thought much about cosmetic treatments until a friend described her enjoyment having a spa facial last year.

Then Yamashiro's employer decided to open a cosmetic dermatology clinic downtown, within its Hawaii Pacific University medical clinic on Bishop Street. She signed up to be one of the first to try the services. She volunteered for a light chemical peel, one of the skin-care fix-me-ups to be offered when the clinic opens to the public next month.

Americans of both sexes are being nipped, tucked, peeled and poked in record numbers. Last year 5.7 million people in the United States underwent cosmetic procedures, according to the American Society for Aesthetic Plastic Surgery. That's a 25 percent increase over the previous year and a 173 percent jump since 1997.

Despite concerns about plunging stock prices and gloomy pronouncements about the economy, a record number of people -- many of them middle-class, aging baby boomers -- still dip into their wallets for an assortment of cosmetic surgeries and treatments. While some mainland plastic surgeons report a slowdown in big-ticket procedures, less costly treatments don't seem to take a hit. And Hawaii plastic surgeons say business continues to be strong.

Yamashiro recently underwent what will be the first of about six chemical treatments, each done a week apart.

"A little tingling at first but now it just feels like a sunburn," she said. "A lot of people in the office have said they noticed I had a glow."

The clinic, which opens officially in July, will be available both to Kaiser members and the public. It will be staffed by an aesthetician and a cosmetic dermatologist. Prices for nonsurgical treatments range between $150 and about $400. Services are not covered as a health plan benefit for members. If the clinic proves successful, Kaiser plans to rotate cosmetic services at its other clinics, said Jeanne Talbot, Kaiser's manager of new ventures, said.

The big jump in the number of people willing to undergo cosmetic procedures can in part be explained by an increase in nonsurgical options now available, said local plastic surgeon Clyde Ishii.

"People are busy and on the move. They want to recover faster and are looking for ways to look their very best with minimal down time, so it's things like light chemical peels during lunchtime and programs they can do for themselves at home," he said.

Ishii said that because those procedures are cheaper, less invasive and require minimal healing time, they are increasingly seen as just another part of maintaining or improving appearance. For example, the median national price for a botox injection procedure is about $400, while the median price for a facelift is $5,250, according to the American Society for Aesthetic Plastic Surgery. Prices, though, vary widely by procedure.

Lisa Carley prepared Linda Yamashiro for a chemical peel last
week at Kaiser's Hawaii Pacific University clinic. Less expensive
than face lifts, chemical peels are gaining popularity.

Though no statistics are available locally, it appears Hawaii residents are lining up for cosmetic services in similar proportion to their mainland counterparts, say local cosmetic practitioners.

Sun damage to skin and a warm climate allowing fewer, and more revealing, clothes also may help increase the number of people seeking cosmetic services in Hawaii, they say.

The biggest upsurge in the number of cosmetic procedures done nationally is the growing popularity of nonsurgical botox injections, a procedure to help eliminate wrinkles and frown lines.

Kaiser hopes to capitalize on these new procedures. Less invasive services such as chemical peels, microderm abrasion and the removal of spider veins by injection will be among the first offerings. By the end of the year, Talbot anticipates offering treatments from laser hair- and tattoo-removal to botox and collagen injections.

The idea of a cosmetic dermatology clinic within the Kaiser system is not new, Talbot said.

"Members had been asking for cosmetic services for some time," she said.

It also was a good business opportunity, judging by the number of members' referral requests for cosmetic services, Talbot said. Kaiser also had tried the clinic successfully in California.

While plenty of people still have traditional surgical procedures such as tummy tucks, breast augmentations and face lifts, Ishii said the non-invasive facial treatments, such as those Kaiser will offer, are the current attraction.

"It's very common to see regular people coming in. Probably in the last four to five years, there has been much more interest," said Ishii.

Patients often pay for their cosmetic surgeries, which generally are not covered by medical insurance, with a credit card, though that doesn't necessarily mean patients overextend themselves to pay for procedures.

"People tell me if they put in on a credit card, they can get airline miles," he said.

Cosmetic dentistry procedures such as teeth whitening, porcelain veneers and full mouth restorations also are popular.

Like Ishii, aesthetic dentist Dennis Nagata said he has seen an increase in recent years of people, primarily baby boomers, requesting a variety of cosmetic dental services.

And they're willing to pay for it.

"A full mouth, non-metal bonded restoration can run between $30,000 and $50,000 -- or the cost of a BMW," Nagata said.

While the procedures can be costly, Nagata said the results have made patients his best salespeople.

"Their self-confidence just soars. Not only that, they start noticing other people's teeth and start telling people, so that's how we got very busy," he said.

New materials and advances in technology help to make the procedures more comfortable and require less time. A full mouth restoration can be done in as few as two visits, Nagata said.

As for Yamashiro, she is already looking forward to her next facial treatment and is considering other cosmetic touch-ups in the future.

"Perhaps cosmetic dentistry, or I might even consider getting my eyelids done if they droop when I get older," she said.

Cosmetic surgery
gains acceptance

By Lyn Danninger

Attitudes toward cosmetic improvements for both sexes have changed in recent years, keeping demand for cosmetic surgeries high.

A recent survey by the American Society for Aesthetic Plastic Surgery said 77 percent of women polled would not be embarrassed if people outside their immediate circle found out they had plastic surgery. But in perhaps more of a revelation, the same proportion of men, 77 percent, said the same thing.

That's a big change from even 10 years ago, when people were reluctant to acknowledge they underwent cosmetic surgery, experts say.

In an AARP nationwide survey of people 18 and older, published in January, 60 percent of those polled agreed in principle that if someone is not happy about the way she or he looks, there's nothing wrong with undergoing cosmetic surgery. But 60 percent said they believed it was still more acceptable for a woman to undergo a cosmetic procedure.

More than 1 million botox injections were given in the United States last year, an increase of 120 percent over 1999 and more than 1,600 percent since 1997, according to the survey.

Other procedures scoring high in popularity included chemical peels, up 31 percent since 1997; microderm abrasion, up 113 percent since 1999; and collagen injections, up 71 percent since 1997.

Among surgical procedures, liposuction proved most popular, according to the survey.

On the Web:
>> American Society for Aesthetic Plastic Surgery:
>> American Academy of Cosmetic Surgery:
>> American Academy of Facial Plastic and Reconstructive Surgery:

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