COSMETIC SURGERY
Dr. Fank Venzara
Taking the ‘Sting’ Out of Beauty
PLUCKING, tweezing, binding, and sucking it in are all things that women complain of on a daily basis. Compound that with squeezing into tight shoes, tight jeans, and uncomfortable bras and there is no wonder that most contemporary women trying to doll themselves up will tell you that “beauty is painful.” If it’s not painful it’s certainly uncomfortable. Take it one more step into the medical arena and you magnify that old cliché.
PROCEDURES such as botox, laser hair removal, and injectable fillers can be painful but now they don’t have to be torture. There has been some significant advances in pain control for the cosmetic surgical patient and it is disheartening that some men and women who are interested in these and similar procedures may be too afraid of the pain to try them.
Procedures such as botox, laser hair removal, and injectable fillers can be painful but now they don’t have to be torture. We as a surgical community have had some significant advances in pain control regarding the cosmetic surgical patient and find it disheartening that some men and women have desired these and similar procedures but were just too afraid of the pain to try them.
So what is out there to help take the sting out of cosmetic surgery? Often, it is nothing new but an old standby intervention like using cold or ice which can significantly take the edge off certain procedures. The problem with cold interventions is the time it takes for them to work and their short duration of action.
Time is valuable and waiting for ice packs to work simply isn’t feasible at times. Laser manufacturers know this and have actually incorporated sapphire cooled laser tips into their arsenal of laser machines to apply direct skin cooling before each pulse of laser. This has helped ease the sting of laser hair removal as well as photorejuvenative procedures.
Local or Regional Anesthesia
A more effective but more invasive approach to combat cosmetic procedure discomfort is to use some type of local or regional anesthesia. When used effectively, local anesthesia minimizes and sometimes eliminates all of the pain associated with in-office cosmetic procedures.
We typically use local anesthesia when we are working in highly sensitive areas like the lips, nose, and hands. The downside of the local or regional block has always been the discomfort associated with the administration of the block. The upside is the effectiveness when compared to other types of anesthesia. A good numbing block lasts long enough for procedure relief without leaving you numb for the rest of the day.
The options for different local anesthetics include the following:
- Novocain is the most recognized one by the public, but not used much anymore due to its high incidence of allergies.
- Lidocaine (Xylocaine) is the most commonly used local anesthetic in surgical and dental offices but it can take hours to wear off and typically local cosmetic procedures take 15-30 minutes or less so there is no need for the prolonged numbing.
- Septocaine, a shorter acting numbing medicine which decreases the time spent with that weird feeling, is also used in cases requiring shorter periods of anesthesia.
THE FDA recently approved Pliaglis, a combination of two common topical anesthetics – ones that are applied to the skin. Pliaglis forms a gel-like mask that releases them.
Topical Anesthesia
The most popular option for reducing the pain of cosmetic procedures is topical anesthesia. The most well known product is called EMLA. This is a substance that is simply placed on the area to be treated and after a period of time the area becomes numb.
So what’s the catch? These topical formulations are somewhat limited by the depth of penetration into the skin. Therefore, if your procedure, such as laser or injectable filler, goes below that level you will have significant discomfort. So how do we combat that phenomenon? Fortunately, there is a new product by Galderma Inc. called Pliaglis that has an answer to that problem.
The Pliaglis dries to form a mask over the patient’s own skin that allows the medicine to penetrate deeper into the skin. It is a newer product that we have introduced into our practice with great results. Our feeling is that this numbing medicine will become a household name. We have been really impressed with it. We feel like it has added a nice tool to our fight against cosmetic surgical pain. Maybe beauty does not have to be so painful after all.
Dr. Frank Venzara was born in Chicago and has resided for the majority of his life in South and Central Florida. He is a graduate of both University of Miami’s Undergraduate Program and Medical School. He trained as a surgical resident at Jackson Memorial Hospital in Miami and as a plastic surgery fellow at the University of Missouri’s Truman Medical Center in Kansas City, Missouri. He has practiced in the Central Brevard County, Florida area for 25 years as a Board Certified Plastic and Reconstructive Surgeon. When not attending to his surgery schedule, Frank enjoys surfing and fishing. Dr. Venzara can be reached at 321-452-3882, or CLICK HERE for more information.
