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| ASSEMBLY EDITION • ORLANDO, FLA |
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With the enormous popularity of cosmetic surgery and TV shows like Extreme Makeover, the multibillion-dollar industry surrounding aesthetic medical procedures is growing exponentially, and some family physicians are adding aesthetic procedures to their practice.
In an extra-fee CME course yesterday, family physician Greta McLaren, M.D., shared her expertise on the most common cosmetic procedures FPs are performing. McLaren is an assistant professor of family practice at the University of Colorado, Boulder, and medical director of Park Meadows Center for Cosmetic Procedures in Lonetree, Colo.
Among the top procedures done by family physicians, said McLaren, are Botox injections, chemical peels, microdermabrasion, collagen injections, laser and light-source photofacials, and photodynamic therapy.
McLaren characterized photodynamic therapy as "the newest and most exciting" cosmetic procedure for family practice. It offers acne patients a nontoxic alternative to Accutane.
"Why should family physicians do cosmetic procedures?" McLaren asked. "Why not? We have training in dermatology. We perform multiple dermatologic procedures daily. We already have our patients' confidence because we are their primary care providers. And patients like one-stop shopping."
Botox causes a temporary block in facial nerve signals, preventing muscle contractions, she said. The injections decrease the appearance of facial wrinkles for about three months.
Chemical peels involve the application of a caustic chemical, such as glycolic or salicylic acid, to produce a controlled-partial thickness burn of the top layers of facial skin, McLaren explained. Peels destroy the skin and peel away sun-damaged skin, providing a younger look. Superficial peels can be performed by a nurse or aesthetician in a family practice, freeing the physician for other patient care, she said.
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Microdermabrasion can be performed along with chemical peels to remove fine lines and refine large pores. The procedure shoots micronized crystals of aluminum oxide or sodium at the skin to sandblast it and improve its texture, she said.
So-called filler agents, including collagen, hyaluronic acid and autologous fat, are used to fill in static facial lines not caused by muscle contractions and to add volume, McLaren said. Commercial agents are formulated with an anesthetic to minimize patient discomfort.
Lasers and intense pulsed light devices are valuable in treating age spots, telangiectasias, rosacea, port-wine stains, acne and benign brown spots, McLaren said. Pulsed light devices are popular for photofacials to lighten age spots, improve the appearance of rosacea and melasma, and stimulate collagen formation, she said.
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published by the AAFP News Department.
Copyright © 2003 by American Academy of Family Physicians.