conley6.gif (2529 bytes)


More than a Pretty face
Surprising medical uses for cosmetic procedures


May 2014

The field of plastic surgery is like a tree with two main branches. Cosmetic surgery, an elective procedure, aims to improve aesthetic appearance. Reconstructive surgery is focused on improving function, often after trauma or disease. Sometimes those branches intertwine to improve both form and function. Here we explore three common cosmetic procedures that also have medical benefits.

Botulinum Toxin (Botox)

Botulinum toxin is an injectable neuromodulator, which interrupts the transmission of nerve signals and weakens a muscle so that it canít contract. This substance is the most popular way to cosmetically smooth fine lines and wrinkles. It also is FDA-approved as a "dramatic" treatment for excessive sweating in the underarms, hands and feet, and to "break the cycle" of chronic migraines. Additionally, "Botox can be used to relieve spasticity (involuntary muscle spasms) in patients with cerebral palsy," says Dr. Philip Sonderman of Greater Milwaukee Plastic Surgeons. Botulinum toxin treatments are temporary.

Scar Revision

Scar revision treatments minimize a scar so that it is more consistent with the surrounding skin tone and texture. There are several varieties of scars. Some cause subtle discoloration or surface irregularities. Hypertropic scars develop directly at a wound site, while keloids grow and extend beyond the bounds of an original wound or incision. Scars that pull together skin and underlying tissue during healing are called contractures, and can restrict movement, especially where a wound crosses a joint. Scars mature over a year so it is best to wait before starting treatment. Although scar revision can improve the appearance of a scar, it cannot be completely erased.

"Every scar is treated differently to make it less thick and unsightly, or improve function in an area with restricted range of motion," says Dr. Andrew Dodd, a plastic surgeon at Aurora Wilkinson Medical Clinic. Procedures can be steroid injections to help reduce pain or itching, laser resurfacing to smooth the skin, or surgery to remove or reorient a scar that crosses a joint in an abnormal fashion.

Nasal Surgery

Septoplasty is surgery to correct breathing issues by straightening the septum, or the supporting wall between the nostrils that directs airflow. Rhinoplasty is a cosmetic procedure to improve the appearance and proportion of the nose. When cosmetic techniques overlap with reconstructive surgery, it is "the epitome of our goal to improve form and function," says Dr. Sachin Pawar, a facial plastics and reconstructive surgeon at Froedtert & the Medical College of Wisconsin. "Plastic surgeons walk a fine line to open the nasal passage while maintaining appearance of the nose."

Although the results of nasal surgery are usually permanent, cartilage might continue to noticeably change and reshape as you age. Candidates for septoplasty and/or rhinoplasty should be adolescents (girls age 14-16, boys age 16-18) or older.

Reconstructive surgery is generally covered by most health insurance policies, although coverage for specific procedures and levels of coverage might vary. Because it is a choice, cosmetic surgery is usually not covered by health insurance.

When selecting a plastic surgeon, he or she should have the experience, training and credibility you desire in a doctor. The surgeon should have current certification by the American Board of Plastic Surgery and be a member of the American Society of Plastic Surgeons. Before committing to a procedure, discuss its possible limitations, and potential risks and complications. Be sure you feel completely comfortable with the surgeon, clinic and/or organization you select.


This story ran in the May 2014 issue of: