Acne, excessive sweating, a bulging tummy that doesn’t budge – for some, these are an inconvenience or an annoyance. For others, these conditions affect their quality of life on a daily basis. If you’ve considered seeing a doctor for a cosmetic procedure, read on. Dr. Eric Fete chats about the latest advances in his field, groundbreaking treatments to help patients feel – and look – better than ever.
Many people perceive cosmetic medical procedures as being similar to going to a spa. Could you discuss some important medical aspects of cosmetic surgery?
Some places you can go just to get Botox. It can be done by a nurse and a lot of them will do a great job, but if you’re doing anything advanced or invasive to the skin, you want to have someone who has been trained in that. Not all surgeons have experience in cosmetic medicine. They don’t teach many of these techniques in residencies. In a lot of cases, we learn the newest techniques from doctors who develop the treatments themselves. The world of medicine and technology is changing so fast, I think it’s imperative that the doctor you choose is experienced. Find someone who focuses on that 100 percent of the time.
What kinds of topics should be discussed to make sure patients are ready for a cosmetic medical procedure, especially one that may alter their appearance?
A physician should spend time with patients explaining how the procedure works and what could happen. A detailed history and physical exam assesses for anything that would preclude patients from getting the procedure. Their mental status is also assessed to make sure they have realistic expectations and that they’re not having self-esteem issues. An example of someone with unrealistic expectations would be a 70-year-old, massively overweight patient who is expecting to have a six-pack after one procedure. Doctors see some who have had a lot of procedures who are still not happy. That can be a red flag, and the doctor can, in turn, decline to do the procedure in the patient’s best interest. Doctors should make sure they’re on the same page as their patients and they fully understand the risks and benefits of any procedure.
Cosmetic surgeries such as liposuction have had a reputation for being dangerous in the past. What advances in the last 10 to 20 years have improved the safety of such procedures?
The biggest changes are new techniques and new technology. The old way of doing things – putting people under general anesthesia and using physical disruption to liquefy the fat – is kind of passé. There are new ways of doing those procedures that are less invasive. Now technologies such as ultrasounds and lasers can literally shape the body. These are more effective at breaking up the fat and also tighten the skin and the underlying collagen. Recovery is quicker and there’s less damage to the tissues. Most of these procedures can be done under local anesthesia, minimizing the risks associated with general anesthesia. Instead of four to five hours in surgery, patients are done after only a couple hours and are mobile more quickly. It decreases both pain and the risk of infection.
What treatment is available for excessive sweating (hyperhidrosis) and how do these treatments work?
One of the treatments is Botox injection. It works, but it only lasts for three or four months. A new technique is the NoSweat procedure. The armpit is anesthetized and then a very small incision is made in the skin and a laser fiber is inserted under the skin. The risk of injury is pretty much zero. The laser specifically targets sweat glands and won’t damage any other tissues. It’s usually a one-time treatment and most patients have a 75 percent improvement and they don’t have to go back every three to four months.
What is PRP Therapy?
PRP stands for platelet rich plasma. The patient’s own blood is taken and platelets and growth factors are separated out and that platelet rich plasma is injected back into the tissue. A version of this technique has been used for years by NFL athletes and pro golfers. Some physicians use it for musculoskeletal issues such as tendon or ligament injuries, knee arthritis, or rotator cuff injuries. The injections help the body to heal itself, making those structures regenerate and become stronger again. It is now being used for facial regeneration, for sexual dysfunction (the O-shot and the Priapus shot, or P-shot) and to regrow hair in men and in women. There is further research being done on other modalities – growing skin and rebuilding bone and heart tissue. This is very exciting and bodes very well for patients.
What are the latest treatments available for acne?
Treatment for acne depends on the severity of the case. An aesthetician can treat milder conditions. Treatment could be as simple as topical medical therapy. Topical microbial products – many of them proprietary – can simply take care of it right then and there. Then there are extractions and peels. Beyond that, laser or light therapy can be used, or, if it’s a severe case, patients are put on oral antibiotics. Laser or light therapy works by killing the bacteria that are causing the inflammation and clogging the pores. It also helps with cell turnover and skin turnover to reduce swelling and improves the look of scarring. After treatment, the patient is put on a regimen to prevent breakouts so he or she doesn’t get any scarring in the future. It’s a continuum of care based on how the patient presents and what type of treatment he or she has had in the past.
What is Ultherapy?
Ultherapy is an FDA-approved, non-surgical and non-invasive treatment using ultrasound to tighten loose skin. Patients like that it’s a procedure that causes no scars and no discoloration. The ultrasound stimulates the collagen to tighten and contract, which then causes secondary skin tightening. It doesn’t cause any discoloration of the skin and patients see results within a couple months or less.
Dr. Eric Fete
Eric Fete, DO, is a cosmetic surgeon in active practice at Artemis Laser and Vein Center in Dublin. Fete serves as the chief medical officer for Artemis and is an active member of the American Board of Cosmetic Surgery. He is board certified in emergency medicine and completed his residency at Doctors Hospital in Columbus. He is also a member in the American Osteopathic Association, the American College of Osteopathic Emergency Physicians, the Wilderness Medical Society and the Ohio State Medical Association. His past experience includes service on the Quality Assurance Committee and operating as the director of emergency services with Emergency Medicine Physicians.
