The Four Levels of Cosmedic Care

hile these general levels are based on the outcomes and relative risks of certain treatments, there are important relationships among the levels, which explain why we should consider them as a continuum. Here is some general information to consider about each level, including what the procedures can and cannot do, who’s best able to provide each type of treatment, the realistic outcomes of the most common treatments and procedures, and their similarities and differences.

Surgical or invasive procedures reposition our tissue and restore lost volume to rejuvenate our faces. Body contouring can reduce fat deposits, lift sagging skin, and shape our arms, hips, and thighs. The most common surgical procedures can be grouped in three categories:

Face — surgical repositioning and volume restoration
Breast — breast lifts, augmentations, and reductions
Facial rejuvenation — eyelid surgery, forehead lift, facelift, and neck lift
Facial implants
Ear surgery
Body Contouring — liposuction, tummy tucks, and arm, thigh, and body lifts

Moderately invasive procedures, while nonsurgical, are neither risk-free nor a substitute for plastic surgery. This level includes injection therapy with Botox®, soft tissue fillers, laser skin resurfacing, deep chemical peels, nonsurgical skin tightening, and cellulite treatments.

The longevity of these treatments varies—from a few months to a few years. For a time, they reduce the appearance of lines and creases, plump thin lips, enhance shallow contours, and soften wrinkles. But we don’t achieve the same results as we would with surgery or surgery combined with moderately invasive procedures, which produce more noticeable and longer lasting results.

Minimally invasive treatments even out our skin tone, increase cell turnover, promote cell growth, remove unsightly veins or abnormal hair growth, and stimulate collagen production to help the skin retain its softness and reduce the appearance of lines and wrinkles.

Common procedures include light-based treatments to remove sunspots (e.g., Intense Pulsed Light, or IPL®), microdermabrasion, light skin peels, spider vein treatment, hair removal, and treatment of leg veins. These treatments—usually undertaken in a series—are not without risk and should be performed by a trained provider overseen by a plastic surgeon.

Medical skin care can produce pleasing outcomes for patients by reducing the effects of sun damage and discolorations and improving skin texture.

Noninvasive cosmetic procedures—or spa treatments—are therapeutic and relaxing, designed primarily to reduce blemishes and revitalize and protect the skin. The results are temporary.

These techniques and treatments—such as cellulite wraps, facials, and deep tissue massages—are used by people of all ages, from younger people who want to improve skin tone to older adults looking to relieve muscle tension or back pain.

Plastic surgeons work with patients at all stages of life, evaluating health, medical, psychological history, and body type to provide comprehensive advice according to their personal cosmetic medicine goals. They help explain the specific results a procedure can and cannot deliver and its associated risks; how to choose the right course of action depending on our age, needs, and wishes; and what we can expect to look like after the procedure.

Unlike others who may be trained in only a few cosmetic procedures, plastic surgeons are educated in the full spectrum of cosmetic surgical and nonsurgical care. They hone their skills and techniques through one of the lengthiest and most comprehensive training programs in all of medicine.

Besides delivering great results for patients through comprehensive cosmetic procedures, our focus as plastic surgeons is on patient safety. We believe that patients deserve the highest quality of care and safety, which is delivered in our accredited facilities.

Plastic surgeons are actively involved in research to develop new techniques and improve existing procedures that will deliver scientifically proven outcomes for patients undergoing cosmetic or reconstructive procedures. Plastic surgeons are directing cutting-edge advances in the field, based on research using stem cells, biomaterials, and biomechanical engineering.