Nashville becoming mecca for hot, new cosmetic procedures

By CLAUDIA PINTO Staff Writer - THE TENNESSEAN

Lasers, chemical peels, injections. Rose Underwood has sampled just about everything on the non-surgical buffet to look a few years younger.

Recently, the 62-year-old Nashville woman tried something that hasn't even hit the market: Juvederm, an injection that promises to fill even deep wrinkles and plump up sunken skin.

"I've done it all," Underwood said after reeling off a list of all the procedures she's tried. "We're all vain. We love the compliments we get."

Underwood is not alone. Nashville, with its music celebrities and medical complexes, has become something of a mecca for cosmetic procedures, doctors here say.

These procedures, ranging from tummy tucks to breast enlargements to Botox injections, are not believed to rival in number those being performed in such places as Southern California, South Florida or New York City. But more of them are being performed here than in most other places, doctors say.

"It's bigger here in Nashville than in cities of comparable size because of the entertainment industry," said Dr. Brian Biesman of Nashville Centre for Laser and Facial Surgery.

Increasingly, noninvasive cosmetic procedures, which require no cutting, are becoming more popular.

Such treatments are up 726 percent in the U.S. since 1997, while cosmetic surgeries are up 119 percent during the same period.There were 9.3 million nonsurgical procedures and 2.2 million surgical procedures in 2005, accordingto the American Society for Aesthetic Plastic Surgery.

No one tracks the number of procedures conducted locally. However, Biesman said he'd definitely noticed a lean toward nonsurgical treatments.

"People don't want to sit around in bandages for weeks at a time," he said.

Dr. Joseph DeLozier, a Nashville plastic surgeon in private practice, said he, too, has had a surge in requests for noninvasive treatments. In addition to demand from the entertainment industry, DeLozier says, Nashville status as a health-care hub helps fuel the number of procedures conducted here.

"We have a much larger health-care organization," he said.

Being vain without the pain is big business. Americans spent about $12.4 billion on noninvasive cosmetic treatments last year, the plastic surgery society reports.

And doctors say people are already calling about Juvederm, the newest product, which won't be available for a few months. Juvederm comes from Allergan, the makers of Botox. Select doctors' offices will receive a small number of doses next month, and it will be available to all doctors in January. Allergan officials aren't disclosing how many or which offices will gain early access to the shots.

Biesman and DeLozier are two doctors who already have used Juvederm in clinical trials. The injections are typically used to fill lines between the eyes, on the forehead and around the mouth, as well as for plumping cheeks and the skin below the eyes.

Juvederm and other noninvasive products aren't a replacement for face lifts. Biesman says areas injected with Juvederm will get a little lift, but that severely sagging skin isn't going anywhere.

He said results were much more subtle and natural-looking than those from surgery.

"If you look at youthful people, their skin isn't tight," Biesman said. "So we don't want to pull up the skin. What we want to do is fill out the skin."

Hot shots

Though nonsurgical procedures aren't cheap, Biesman and DeLozier say most of their clients are "regular folks," mostly female. They say 20 percent to 25 percent of their patrons are men.

"We get a lot of women sending in their husbands," Biesman said. "Men tend to come in on their own when they are changing jobs. They feel like they are competing against younger guys."

One trend that DeLozier has noticed is an increase in late 20-somethings getting treatments.

"They are coming in younger and younger," he says.

Biesman says many people come in when they are facing difficult challenges in life, such as divorce or a traumatizing birthday.

"It's amazing the amount of 39- and 49-year-olds you'll see," Biesman said.

But the majority of his clients just want to look their best.

"Most 50-year-olds don't want to look 30," he said. "Most people just want to look really good for their age."

There's already a similar product to Juvederm on the market called Restylane. But Juvederm promises to last months longer and fill deeper wrinkles.

Underwood, who was able to try Juvederm by participating in a study, said she could not immediately tell a difference between the two products.

"To me the big question will be how long it lasts," she said, noting that Restylane lasts about six months for her while Juvederm may last up to 12.

Though not yet on the market, Juvederm already has created a buzz. Biesman says his office started getting calls about the shots after a recent Wall Street Journal article about its limited release.

"People always want to try the latest thing," he said, adding that he's been getting lots of requests from people who want plumper cheeks. "Full cheeks are very in right now."

Trends are fleeting, but Biesman and DeLozier both said the most popular procedures right now include:

? Fractional resurfacing, a $500-$1,000 laser treatment best foreliminating fine lines and discoloration from sun damage.

? Thermage, radio-frequency technology that tightens skin. It costs between $1,500 and $3,500, depending on the area treated.

? Botox injections, the No. 1 nonsurgical procedure in 2005, costing $500 and commonly used to smooth lines on the neck and around the mouth and eyes.

Underwood says she's spent thousands of dollars trying them all. For her, it's worth the money because she believes she looks 12 years younger.

"It helps so much. I don't think I look my age," she said. "Most people think I'm in my late 40s or early 50s."

Allergan hasn't announced how much Juvederm will cost. Biesman says he suspects it will be comparable to Restylane, about $600 per syringe. ?