"The next big thing" by Susan Daly

April 2, 2009 - PRLog -- The clichés of the ageing socialite with the tightly stretched face or the wealthy old dowager with the cheekbones of a Slavic supermodel are over. New advances in both surgical and non-invasive aesthetic treatments mean that Irish women -- and men -- can now embrace anti-ageing 'intervention' without spending six weeks swaddled in bandages.

Dr Patrick Treacy of the Ailesbury Clinic confirms that fractionised lasers are the new buzzword. "But another big thing that is going to happen in the market place is hair transplanting for women," he says. "We can transplant follicles individually and it can all be done in a few hours. A lot of women lose their eyebrows as they get older, and 30pc of them have thinning hair."
He sees another procedure -- laser-assisted fat removal -- becoming a popular alternative to traditional liposuction. "With traditional suction, you suck out blood vessels, fat, veins, everything and the patient takes six weeks to heal. With Vaser, you put in an ultrasonic probe and 15 minutes later you take it out. It only targets the fat and bruising is much less," he says.
This year, Macrolane -- a filler for breasts, rather than surgical implants -- has been "the big thing", says Dr Treacy. "God, that came as a bolt out of the blue, but people who would never contemplate breast implants would consider Macrolane. We are doing about five patients a day and we find that there are two ages at which the demand peaks: from 20 to 25 and from 30 to 35." And if a patient is nervous about any of these procedures, they can request a shot of midazolam, a sedative drug that causes retrograde amnesia: basically, it makes you forget what you have been through.

Dr Treacy feels that the demand for cosmetic surgery is falling off in favour of three-dimensional derma-fillers such as Sculptra (first used to reconstruct the gaunt faces of HIV sufferers), Botox and other procedures that do not require a general anaesthetic. "It could also be that surgery is falling off because people cannot afford it. And Irish women are very aware of all their options now through magazines, even."

Deadly risks

There is also the possibility that Irish women have been frightened away from more drastic procedures by high-profile cases of deaths related to cosmetic surgery. Limerick mother Kay Cregan (42) died three days after undergoing a facelift in New York in March 2005. Advanced Cosmetic Surgery -- which went into liquidation in June this year -- strongly denied liability for the death of a different woman after a gastric banding procedure was carried out by a French doctor at their Dublin clinic in 2007.

David O'Donovan is a consultant plastic surgeon who operates in both public hospitals and out of the newly founded Aesthetic Surgery Ireland clinic in Ballsbridge. He says that the clinic only employs surgeons whose specialist area is Plastic, Reconstructive and Aesthetic Surgery, a regulation he hopes will be made mandatory in Ireland in the future.

"The only speciality that you train in where you get examined on proficiency in cosmetic surgery is if you have trained as a plastic surgeon," he explains. "With a lot of other clinics, you'll see them advertised as saying that they only use specialists, but if you look them up at the Medical Council, you'll find they are specialists in other areas. People who are trained in general surgery, for example, but they're not breaking any laws."

You can go on to the Medical Council's website at www.medicalcouncil.ie/registration/specialists. asp and type in the name of a surgeon you might be considering using, to check their speciality.

"We frequently turn people away," says O'Donovan. "We'll give you a medical opinion on whether the thing bothering you needs surgery. I would say that more often, I get criticised by the patient for being negative about the surgery."

Katherine Mulrooney confirms this caution. "There have been a couple of cases where I think, 'You don't you need this'," she says. "Or their request is a little bit finicky; they are focusing on minute details. You must be aware that there are other psychological issues in the background, and you have to be honest with the patient. They don't always take it well."

On the other hand, says O'Donovan: "If you want to see the good side of cosmetic surgery, particularly in a young patient who is very self-conscious, introverted and has no social life and who gets over a hurdle that's physical, it's just a huge transformation.

"It is easy to judge from the sidelines, saying you shouldn't have got that done, sure aren't you alive, and you have your kidneys and all the rest of it, but for some people it's a major issue. I don't feel bad about providing that kind of service."

He advises against Botox being used at too young an age: "It does not feel good for me to suggest to a 20-year-old that they should have Botox in their face. You don't put a metal plate in your leg in case you break it in the future."

Beauty salon options

If the idea of a general anaesthetic is still worrying -- or you feel your face needs a boost, not an overhaul -- there is a glut of new machines entering a beauty salon near you that claim to supersede anything that has come before. Mr O'Donovan is wary of laser machines being used by unqualified practitioners. "I have at least two cases on my books at the moment where I am giving a medical opinion on burns caused by lasers used in beauty salons for hair removal," he says. But there are other alternatives.

"The Fraxel machine works by firing heated tunnels into the skin, and you can determine the aggressiveness of the treatment and the surface area that is treated," explains Katherine. "Rather than a single laser beam, the laser is broken into fractions, working on small pockets of skin which are healed quickly by joining with the healthy skin islands surrounding them. It has been FDA-approved for chloasma (pigmentation often appearing during pregnancy) and acne scars, and there are very promising trials on post-op scars and stretchmarks."

For anyone who remembers that Sex And The City scene where Samantha turns up to Carrie's book launch hiding under a heavy black veil, because a chemical peel has left her face like a peeled tomato, this is a welcome advance. "It is on a par with a medium-depth chemical peel, but much more controlled," says Katherine.Mulroney
With beauty counters groaning under the weight of so many anti-ageing creams these days, it's a wonder anyone would think of shelling out for hi-tech lasers.

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The Ailesbury Clinic opened in Dublin in 2002. It was awarded Best Medical Practice at the 2005 Irish Healthcare Pharmaceutical Awards. It was selected as runner-up in the 2008 and 2009 finals of the Best Aesthetic Medical Clinic in the UK and Ireland.