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Extreme makeover: Coming to a beach near you

Summer is around the corner and your local plastic surgeon has a few tricks to get you through the season.
/ Source: WebMD

With just a few weeks left until Memorial Day, men and women are scurrying to do whatever they can to look their very best on the beach. From low-carb diets and round-the-clock pilates classes to butt and bicep implants, there are no limits to the lengths that people will go to, to create the makeover to look like Arnold, Britney, or Beyonce this summer.

So when you notice the growing numbers of bodacious bods on the beach, there may be more to it than you realize, say leading plastic surgeons, aestheticians, podiatrists, and dermatologists.

Makeover magic
Implants are creating muscle definition in both men and women and here's what is available to create the body you may have dreamed about.

Next time a handsome man or pretty woman struts by you on the beach, makes a muscle and winks, think twice: That round, ripped bicep could be a fake! Beverly Hills, Calif., plastic surgeon Nikolas Chugay, DO, and others are doing more bicep implants as beach season 2004 approaches.

"It takes an hour and once it's performed, you've got the biceps of Schwarzenegger," he says. The implants are made of soft silicone that "does not leak, pop, or disintegrate," he says. They provide "a nice enhancement and you can continue doing your workout and building your biceps without any impingement," he says.

Most people have been ecstatic with the results of the procedure, he says, but he notes that there are inherent risks with any and all surgeries including infection or bleeding.

When asked if bicep implants are the next big thing, Chugay says: "I think so [but] remember that the buttock implant was developed over 12 years ago and it took this long to become way in demand due to J-Lo's [generous buttocks], so it may not happen over night."

To perform the surgery, a surgeon makes an incision in the upper arm and a solid soft implant is inserted into the pocket. Results are visible immediately.

While breast implants have been popular for a while, new implants with the consistency of gummy bears called cohesive gel implants are available in clinical trials and are said to have the look and feel of silicone with the safety of saline. While the FDA may never allow silicone implants back on the market, a new survey released at the annual meeting of the American Society for Aesthetic Plastic Surgery (ASAPS) in Vancouver, British Columbia, showed that women are just as happy -- if not happier -- with the saline implants anyway.

Think breast implants are for women only? Think again. Pectoral implants are commonly referred to as breast implants for men. This procedure increases the appearance of the size and shape of a man's pectoral muscles. Here the incision for the implant is hidden in the armpit and the solid implant is inserted in the chest. According to ASAPS figures, 1,734 such male breast implants were done in 2003.

Et tu calf?
Calf implants, too, can help men fill out their chicken legs and help women shape and increase the size of their lower legs. In 2003, 1,170 people had their legs surgically enhanced with calf implants, according to ASAPS stats.

Thanks to J-Lo, gluteal or butt implant surgeries appear to be on the rise and statistics from ASAPS show that 3,885 of the procedures were performed in the U.S. in 2003 -- that's up 533 percent since 2002.

Surgery not your cup of tea? Kristine Panariello of Spa Secret in Bay Ridge, N.Y., suggests taking a nonsurgical route to beautifying the buttocks.

The "butt lift" involves microdermabrasion (or a steady stream tiny crystals sandblasted across the buttocks to remove the dead, outer layer of skin) and then a lifting treatment using collagen, vitamin E, C, and ginseng extract to firm, tone the bring back elasticity to the buttocks, followed by a tightening gel. The procedure costs about $250 for a one-hour session and after it, voila!

Sandal season strategies

The latest statistics show that cosmetic foot surgery is on the rise, even though organizations -- including the American Academy of Orthopedic Surgeons -- strongly caution against such cosmetic procedures. "I do tend to do a lot more surgeries before summer because it's sandal season and a lot of women want to get their feet looking nice for summer and they may be in bad shape from winter," says New York City podiatrist Oliver Zong, DPM.

"The most common is little pinky toe surgery called toe tuck," he says.

It involves a pinky toe that is painful from being cramped in a shoe and as a result, has become crooked, fat, pudgy, red, and really painful and we make it straight and slimmer, and you are able to wear heels and look better without shoes," he says.

Also, "a lot of women get toe shortening of the second toe which may be very long and either they don't like the way it looks or it jams in their shoe and becomes crooked," Zong says. Other foot procedures include collagen injections that add temporary padding to the soles of the feet.

Sayonara cellulite?
There are new treatments -- targeting the lumpy skin that on legs and buttocks - that may be a viable way to get rid of cellulite once and for all, experts tell WebMD.

They include mesotherapy, lasers, and combinations thereof.

"Mesotherapy is a technique where we inject medication, plant extracts, and vitamins into the mesoderm layer of the skin to break-up the amount of cellulite that's visible," explains Marion Shapiro, DO, president of Mesotherapy Associates in New York City and West Orange, N.J. The mesoderm is the middle layer of the skin. "We break the band in skin that causes the lumpy appearance and melt the fat to give a smoother appearance," she says. Shapiro regularly performs mesotherapy on legs, arms, backs, and abdomens.

"You typically see results in four weeks depending on how severe the cellulite is and it costs roughly $500 a session," she says. "It is the only method of permanently getting rid of 50 percent of cellulite," she says. And it only takes 20 minutes.

"With mesotherapy, you can finally take your sarong off and reveal your new you," she says. When it comes to cellulite, 80 percent of women have cellulite and the other 20 percent think they do, quips Dr. Tina Alster, director of the Washington Institute of Dermatologic Laser Surgery in Washington. The next big thing in cellulite removal may very well be a new technique called Velasmooth that combines radiofrequency waves, a laser, and a mechanical massage to break up the fat and mobilize the water from tissues to improve the appearance of cellulite. Alster is currently conducting clinical trials using Velasmooth twice a week for a month.

"I think that as soon as we show our results in the Fall, this is going to be a big deal," she predicts. "It is the closest thing I have seen to a viable treatment option for cellulite." Stay tuned.

Dr. Bruce E. Katz, medical director of the Juva Skin and Laser Center in New York City likes the triActive laser for treating cellulite.

"In 10-12 treatments, the cellulite is gone," he says. The laser action breaks up cellulite and helps to increase drainage of lymph and blood cells, so fat cells aren't backed up with the fluid that leads to a cottage cheese appearance, he explains. In addition, the treatment also involves a mechanical massage that may result in a tighter appearance in the treated areas. Then, the system's localized cooling aids in smoothing the appearance of cellulite.

Tummy be gone
"Liposuction increases big time in Spring -- especially in the hips, inner and outer thighs, chin, and neck area," Chugay says.

"Any contouring surgery [gives] as a tremendous boost in morale and helps people feel better about themselves," Chugay says. But alone, it's not enough. "It will take more than liposuction, you also need to start exercising and change diet to maintain a new slimmer figure. According to ASAPS, liposuction was the No. 1 surgical cosmetic procedure performed in 2003.

Fake and bake
We all know that sun bathing can increase risk of skin cancer and tanning salons are major culprits. The beauty of airbrush tanning is advocates say it's all the tan and none of the risk.

"It's the same idea as airbrushing a photo," Panariello says.

"It can make you look leaner and create cleavage," she says. The system that she uses, Arubatan, is time-released, involves no ultraviolet radiation and lasts for seven days, she tells WebMD.

Airbrushed tanning is incredibly popular, agrees Sasha Kaminik, co-owner of Le Boe European Day Spa in Coral Springs, Fla. She uses a system called Fantasy tan.

"A technician controls the intensity and color," she says. "It costs $35 a session and most people do it once a week to keep it up," she says. "The tan shows up within two hours and lasts about seven to 10 days -- if you don't scrub -- and it fades naturally." The active ingredient in Fantasy tan is dihydroxyacetone (DHA), which is commonly used in some self-tanning creams, and reacts with amino acids on the outermost top layer of the skin to produce a tan color.

As surgery increases, so too does scarring, [and] "we do scrubs and microdermabrasion of all body parts to hide scars and the airbrush tanning also camouflages scars," Kaminik says.

Male bikini wax?
While women have been suffering through the Brazilian bikini wax for years, media reports suggest that in several major metropolitan areas including New York, Los Angeles, Atlanta, and Washington, men are paying up to $100 for bikini waxes that take it all off.

For women, the Brazilian wax chiefly involves the buttocks, pubic area, and everything else save for about an inch long just above the vaginal area. "We have several technicians who do it so men can wear Speedos," says Kaminik.

Back-ne be gone
As more and more men wax their backs to look smooth on the beach, they may be more prone to back acne -- or at least it may become more visible.

Women too may be prone to these unsightly blemishes which are only a real problem in summer when they trade in their sweater set for a bikini. To the rescue: the Smoothbeam laser.

"People tend to work out a lot, they perspire and acne gets worse on their back area and it's hard to access the back with topical treatments," Alster says.

"A topical cream or solution also runs off very easily and some of these treatments stain or bleach out clothes." Not Smoothbeam.

Besides destroying acne-causing bacteria like other acne treatments, heat from the Smoothbeam shrinks sebaceous glands, so they produce less oil. Most everybody shows improvement in acne with two to three treatments, she says.

A word of caution ...
"There are unrealistic expectations tied into timing a makeover for a social event or a season," says Dr. Laurie A. Casas, a plastic surgeon in suburban Chicago and chair of ASAPS Communications Commission.

Her advice: "Diet, exercise, and then explore realistic options for changing certain body parts and remember to choose a board certified licensed cosmetic surgeon for best results. Check credentials," she stresses. To find a licensed plastic surgeon near you, visit the ASAPS web site at