Looking Good: The latest in medical and cosmetic technologies
(top l-r): Lo, Kuenker and Jeffries (middle l-r): Leithauser and Madion (bottom): Andriese
Hot lasers. Cold lasers. Microwaves. Micro-needling. Platelet-rich plasma therapy.
They are among the newer cosmetic and medical treatments people in the Grand Traverse region are increasingly seeking, according to providers of these health and aesthetic procedures.
Noninvasive and minimally invasive procedures are in, they say. Major surgical procedures that require long recoveries are out for busy executives and others wanting to look and feel good.
Beauty Inside and Out
Cosmetic procedures today aren’t just about looking better. Today they’re also about giving people an edge in the workplace, said Courtney Lo, clinical director of Cosmetic Skin & Laser Center in Traverse City and Petoskey.
Busy executives “want to maintain a refreshed look that says, ‘Yeah, I’ve still got it,’” she said. “It’s frustrating when someone thinks or says, ‘You look tired,’ during a work interaction. We focus on treatments to prevent that.”
If you don’t want to let others see you sweat while delivering a crucial PowerPoint, Lo said an under-the-radar treatment called Miradry might be just the ticket.
Miradry is a noninvasive procedure that uses microwaves to reduce the number of underarm sweat glands. The procedure costs $1,500 or $2,500 for two treatments when paid up front. Two treatments are recommended.
“I wish everyone who has bad underarm sweating and odor knew about Miradry, which reduces that problem by about 80 percent, and it’s permanent,” Lo said. “It’s life-changing for people who sweat through their shirts at work, during presentations, or on dates.”
Lo said her clients are increasingly turning to a variety of minimally or non-invasive procedures, such as Botox and various laser sculpting treatments to prevent imperfections and correct them as they age. “That’s our niche – treatments that give natural yet dramatic changes with minimal downtime and minimal hassle,” she said. “It’s not all about turning back the clock.”
Lo said in the past 15 years her practice has grown tenfold in revenue and number of clients. It built a new office on Front Street last year and was chosen by SkinCeuticals as one of only 100 advanced medical spas in the nation. “Traverse City is a great town seeing lots of growth, and aesthetics is growing too, so we’re in a good spot,” she said.
A New Vision
Cataract surgery was once just that. Most people who wore glasses or contact lenses to correct their vision still needed them after surgery. But a new laser procedure, combined with advanced lenses, can restore vision in many patients.
“Cataract surgery becomes a refractive procedure,” said Dr. Matthew Madion, an ophthalmologist who specializes in cataract and refractive surgery at Grand Traverse Ophthalmology Clinic in Traverse City. “Patients now have the potential to see without glasses.”
In traditional cataract surgery, the clouded natural eye lens is replaced with an artificial “intraocular” lens. Surgeons make an incision in the eye, either manually or aided by a laser, and use ultrasound to break up and remove the old lens.
But Madion can now correct vision in many cataract patients in a procedure similar to LASIK surgery that involves the use of new “femtosecond” lasers and advanced lenses. The procedure is known as refractive cataract surgery.
“The femtosecond laser allows us to cut the corneal tissue with extreme accuracy,” he said. “For us, the advancements in technology have been huge. Even in the past five years, the technology continues to change and get better for us.”
Intraocular lenses for cataract surgery have been available for 50 years, but they are much improved and there are many options for people wanting to improve their vision, Madion said.
Presbyopia lenses correct for distance and near vision. They can be a good option for restoring vision in patients without much astigmatism, an irregular shape of the cornea that causes blurred vision. Toric lenses can be used in patients with astigmatism and eliminate the need for glasses or contact lenses for distance vision.
Using the femtosecond laser and advanced lenses adds about $1,400 to $2,500 to the cost of traditional cataract surgery, amounts not covered by insurance, Madion said. About 40 percent of his patients are choosing the new procedures.
The new technology also is attracting younger patients who have developed cataracts, but don’t yet have significant vision impairment and want to get rid of their glasses or contact lenses, Madion said. In the past, many people put off having cataract surgery until they couldn’t pass a vision test to renew their drivers’ licenses.
While the new procedures are producing more revenue for his practice, Madion said that in “adopting the technology to the needs of the patient, the revenue ends up wherever it ends up. We’ve not using the technology unless it’s the right thing for the patient and provides the result we want.”
People looking for treatments to remove acne scars, unwanted lines and other complexion problems are increasingly turning to a relatively new process called microneedling, said Dr. Laura Leithauser of the Skin Cancer and Dermatology Center in Traverse City.
Microneedling uses a device known as a dermaroller to insert small needles into the skin. The treatment generates new collagen and skin tissue to produce smoother, firmer and more toned skin. The treatment can also be combined with something called platelet-rich plasma therapy to improve complexion or treat hair loss.
Blood is drawn from the patient and a centrifuge is used to separate the platelet-rich plasma from whole blood. The plasma is then inserted into the skin in conjunction with microneedling. “A lot of patients are asking for it,” Leithauser said. But most of Leithauser’s time is devoted to treating patients with skin cancer using Mohs surgery, a procedure that’s been in use for decades. Leithauser is a fellowship-trained Mohs surgeon. “It’s considered the gold standard for treating areas where there isn’t a lot of skin or in sensitive areas” such as feet, hands, neck and genitals, she said.
Mohs surgery preserves the maximum amount of healthy tissue and has the highest cancer cure rate of any type of skin cancer treatment, Leithauser said. But it cannot be used to treat melanoma, the most serious type of skin cancer.
Leithauser, who started the Skin Cancer and Dermatology Center last July, said her practice has grown “exponentially,” because of the increased prevalence of skin cancer and people seeking cosmetic treatments. She recently added a second dermatologist to her practice, Dr. Anthony Van Vreede.
Eight Weeks to Slim
Lasers are replacing more invasive procedures in a variety of medical and aesthetic applications. Dr. Ann Kuenker, a Traverse City physician who specializes in weight loss and skin treatments, is offering a laser treatment designed to dissolve fat and tighten skin.
The UltraSlim laser, which was approved for fat reduction by the Food and Drug Administration in 2010, can be an alternative to surgical procedures such a liposuction for some patients. “It’s something I always wanted to try,” said Kuenker, who also is affiliated with the Elk Rapids Skin & Laser Clinic. “I’m always looking for things that aren’t terribly expensive.”
The Ultraslim laser uses a patented type of light to stimulate fat cells, “causing immediate fat loss with no pain, downtime or side effects,” she said.
It tends to work best with soft, loose fat, Kuenker said. Some men, in particular, have large bellies with hard fat that the laser light can’t penetrate.
Kuenker cautioned that the laser treatment is not by itself a weight-loss treatment. It’s used to reduce inches and tone areas of the body. “If you eat and drink a lot and expect to get a 30-year-old body again, it’s a waste of time,” she said.
Fat-reduction treatments last from 30 to 45 minutes. It takes one treatment a week for six to eight weeks to get the desired results, Kuenker said. For skin tightening, two treatments a week for about two weeks are recommended. One treatment a month is required for skin-tightening maintenance.
Cost of the procedure is $1,500-to-$2,000 for six to eight treatments, Kuenker said. The treatments are not covered by insurance. She began offering the UltraSlim treatments in May of 2018 and has seen business from the laser procedures rise 30 percent since then. They’ve become so popular that Kuenker recently purchased a second UltraSlim machine.
Treating musculoskeletal and neuromuscular pain typically involves injections, surgery and physical therapy.
But physicians at Neuromuscular & Rehabilitation Associates of Northern Michigan are finding encouraging results in treating various types of pain with a patented cold laser, known as Multiwave Locked System Laser therapy. The relatively new procedure combines two light wavelengths to reduce pain and inflammation long-term.
Neuromuscular & Rehabilitation Associates in Traverse City purchased a $70,000 MLS laser last year. “We’re quite enthusiastic about this device,” said Dr. Stephen Andriese, one of three physicians in the practice. The laser therapy reduces inflammation and promotes circulation and blood flow to an affected area, giving pain relief, he said.
Andriese said he’s getting particularly good results in treating lower back pain with the laser. Of the first 10 patients treated, seven have had ongoing relief three months after the surgery. He’s also had success in using the therapy to treat patients with tendonitis, osteoarthritis and TMJ, a disorder of the jaw joint.
In one “profound” example, Andriese said he treated a patient who had chronic swelling and pain long after having a knee replacement. He was told by one doctor that he had an “angry knee” and would likely have to live with the pain.
“It was affecting his life in every way,” Andriese said.
But after 12 treatments, the patient’s range of motion grew by 25 degrees and his pain was virtually eliminated.
“It can be fantastic, but I can’t say that it works every time,” Andriese said.
The therapy, which costs $60 per treatment, is not covered by insurance. Acute pain conditions typically require six visits, while 12 visits are usually required to treat chronic pain.
There is controversy in the medical field over the low-level “cold” laser’s effectiveness.
That’s primarily because there’s little standardization in how the lasers are used, making it difficult to study their large-scale effectiveness, Andriese said. A medical license is not required to purchase and use an MLS Laser. Andriese said he follows a set of protocols recommended by the manufacturer and his own experience that he believes is important in obtaining good results for his patients.
“We plan to continue to collect data so we can be able to inform patients of the likelihood of success from the treatment,” he said.
Andriese said he’d also like to see more primary care physicians use the MLS Laser as an alternative to addictive pain medication and some “invasive procedures that don’t work.”
Body-toning treatments often promise to melt or burn fat away. Dr. Christopher Jeffries at the Center for Plastic Surgery and Skin Care in Traverse City freezes it off.
The procedure, known as CoolSculpting, uses an applicator to freeze fat cells, which die off over several months. The procedure is designed for those who are “reasonably fit with localized pockets of fat. It is perfect for addressing those stubborn areas where exercise and diet alone cannot fix. CoolSculpting is not a massive weight loss solution,” according to the center’s website.
CoolSculpting was developed about 10 years ago after researchers discovered that children who habitually sucked on ice pops developed dimples. The exposure to constant cold caused the loss of fat tissue in their cheeks. The procedure takes between 30 to 45 minutes and can be done during a person’s lunch hour.
“People go home the same day and start seeing results in a month to six weeks,” Dr. Jeffries said. “We’ve had really good success with it.”
Nationally, the price per application runs between $500 and $700, Jeffries said. CoolSculpting is not covered by insurance. The demand for cosmetic procedures in the Grand Traverse region “mimics demand in bigger cities,” he said. Patients are looking for more minimally invasive procedures that take less time to perform and result in faster healing.
“The trend is to more in-office procedures, such as minilifts and combined modalities instead of one big procedure in the hospital,” Jeffries said. “People want to compromise with smaller procedures that have less downtime for the sake of convenience.”
Jeffries purchased a CoolSculpting device three years ago and has seen demand increase so much that he recently bought a second machine.
Business for all types of cosmetic procedures at The Center for Plastic Surgery and Skin Care is booming, Jeffries said. The practice has hired six staffers over the past several years and is looking to add more. “We’re booking well into the summer and are about as busy as week can be,” he said.