‘Cooler’ Laser Carries Off Wrinkles in Vapor Clouds : Surgery: Some doctors predict that new method of turning back the clock will catch on in image-conscious Southern California.
It looks like a high-tech method of torture--prick a face repeatedly with a two-inch long needle, then use an intense laser beam to vaporize the skin into white curls of smoke.
But people are willing to pay as much as $2,000 to have this done to them, and physicians across the nation have been scrambling in the last two months to learn how to use the lasers.
They say the procedure gets rid of wrinkles, turning the clock back on aging.
So far, Ventura County doctors have performed the procedure only about a dozen times. And at least one Ventura plastic surgeon said the laser can never do as much as a face lift does to make someone look younger.
But some physicians predict that laser treatments will catch on quickly in appearance-conscious Southern California.
“It is by far the hottest thing out there right now in plastic surgery,” said Dr. Christopher Costanzo, a Thousand Oaks plastic surgeon.
Lasers have been approved by federal regulators for use on human skin for years, but until recently they were rarely used because their intensity caused burns and scars. In the past two years, however, engineers have devised a “cooler” laser that, by pulsing or quickly scanning over the skin, vaporizes wrinkles.
“This is the most important advance in plastic surgery since liposuction in 1982,” said Dr. Thomas Roberts, a South Carolina plastic surgeon who lectured about the technique at a conference of the American Society for Aesthetic Plastic Surgery held in San Francisco in March.
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The American Society for Laser Medicine and Surgery also heard about the procedure at its annual meeting in San Diego last month. Since then, doctors have been rushing to introduce the technique around the country.
“There’s tremendous interest in this. It’s really revolutionizing skin care,” said Dr. David Apfelberg, a plastic surgeon in Atherton, Calif., who has been using one of the lasers since July, 1994, and was one of the presenters at the San Francisco meeting.
Rentals of the $150,000 lasers have “just absolutely exploded” in the past few months, said Geza Toth, owner of Image Laser Rentals in Fountain Valley, Calif.
Roberts has been using one of the new lasers for a year and has vaporized the wrinkles of about 100 patients, more than anyone else in the country, he said. He said he has already taught 250 doctors to use the laser, and that established doctors from California have been taking time off from work to travel to South Carolina to learn the technique.
Costanzo had used the procedure only three or four times before, but he was nevertheless confident enough to invite a newspaper reporter and a television crew into his operating room as he removed the crow’s-feet from the corners of the eyes of Marcia Clark, an Agoura Hills financial consultant--not the L.A. prosecutor.
Clark said she was motivated by her impending 40th birthday.
She had disobeyed the doctor’s orders to forgo makeup for the operation, conceding that she had applied pink lipstick and “a little bit of blush.”
She reclined with her eyes shut as Costanzo injected local anesthetic into her face and then blasted away with the laser, transforming her tiny wrinkles into white curls of smoke that were then sucked away by a vacuum.
She was concerned that her sore eyes would interfere with the beauty parlor appointment she had scheduled after the procedure. Costanzo told her not to go, warning that the bleach for her hair might irritate her skin or eyes.
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All of which raises the obvious question: Is this simply an exercise in vanity?
Absolutely, plastic surgeons said unapologetically.
“I think vanity is good,” Costanzo said. “People want to look good. They should look good.”
It is an open question whether people will find “looking good” worth undergoing the procedure, complete with the post-operative feeling and appearance that Costanzo described as “road burn.”
Some doctors, however, said they expected the laser to quickly gain acceptance, particularly in Southern California, where plastic surgery is already extremely popular and where the intense sunshine breeds wrinkles.
While the novelty of the technique did not faze Costanzo, it left Clark joking nervously.
“Did you bone up on these other two so you know what you’re doing before you get to me?” she asked the doctor.
Some doctors, too, warned that the technique is still risky.
“There’s a lot we don’t know about the long-term effects,” said Dr. Bruce Achauer, an Orange, Calif., plastic surgeon who has written a book about lasers. “There’s no such thing as risk-free anything.”
Doctors who make mistakes with a laser can blind a patient or discolor the person’s skin, Achauer said.
Dr. Arthur E. Flynn of Ventura cautioned that the laser can smooth lines like crow’s-feet or “old lady’s lips,” but cannot remove flaps of excess skin and thus is no substitute for a face lift.
Despite the risks, Clark took her chances Tuesday in the doctor’s office.
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So did Mary Austin, an Encino woman in her 40s who said she hoped getting rid of the wrinkles around her mouth would help her self-esteem and her career.
“It will help out there in the business world. The better you look, the longer you last,” said Austin who, like Clark, had undergone plastic surgery before.
Costanzo, for his part, could barely contain his enthusiasm after doing three of the operations in two hours.
“This is not the fountain of youth, but it is certainly a weapon against aging, and I think it holds a lot of promise,” he said.
