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Spa, MD: The Results-oriented Revolution

By: Jeffery S. Dover, MD, and Amy Kamin
Posted: May 29, 2008, from the June 2008 issue of Skin Inc. magazine.

Until recently, the only effective procedure available to the individual wanting appearance enhancement was a face lift. Throughout the past few years, treatments featuring Botox and fillers, as well as laser and light procedures—in conjunction with good skin care—have revolutionized the ability to rejuvenate an aging face.


According to a consumer survey by the American Society for Aesthetic Plastic Surgery (ASAPS) of 1,000 American households in 2007, 83% of women and 78% of men would not be embarrassed to undergo cosmetic surgery. This has been a major shift in society’s views toward cosmetic procedures. It has become trendy to openly contemplate procedures with peers, discuss a physician’s techniques and compare results. This trend, however, is occurring in regard to noninvasive, nonsurgical procedures. Recent statistics from the ASAPS reveal that, of 11.4 million procedures performed, 17%—or 1.9 million—were surgical, such as face lifts, eyelid lifts and liposuction, while 83%—or 9.5 million—were nonsurgical, such as the injection of Botox and fillers, and laser and light-based treatments.

Fillers and injectables

While face lifts are surgical procedures associated with anxiety, high cost,and significant recovery periods, filler and Botox treatments are relatively simple, safe, quick, relatively inexpensive and, in many instances, without downtime. Many individuals who would never consider a cosmetic surgical procedure are happy to have a noninvasive procedure. Because of this, the potential pool of candidates has increased dramatically.

At the same time, there have been incredible technological developments related to these noninvasive options. Product and equipment manufacturers have initiated more aggressive marketing approaches, using increasingly sophisticated and expensive direct-to-consumer television and print campaigns.


Since the early 1900s, there has been an interest in finding filler substances to enhance the face. The goal was safe and effective tissue augmentation. The early history, however, is full of examples of poor results and terrible reactions.