What  do Dragons’ Den millionaire Duncan Bannatyne, hearthrob George Clooney and U2 frontman Bono have in common?

All three having gone under the knife in recent years to remove tired-looking eye bags.

Cosmetic surgery clinics report a massive increase in demand for the procedure – known as blepharoplasty – among men.

And some are putting its popularity down to the fact that men are increasingly desperate to look young and energetic to protect themselves in the workplace. It’s important to project a positive, can-do attitude at all times. Eye bag removal reshapes the upper and lower eyelids. But it’s not cheap.

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Injectables, dermal fillers, laser surgery, plastic surgery, photorejuvenation, laser skin treatments… In the face of nose-diving portfolios and little disposable income to go around, should ridding the face of wrinkles really be a priority?

Dr. Philip Prioleau, dermatologist, and Dr. Cap Lesesne, plastic surgeon, both in private practice on Manhattan’s Upper East Side debate the issue of priorities in cosmetic procedures.

There is an excellent article/slide show on MSN today. You will enjoy reading and watching it. It deals with:

• Botox breast lift
• “Doctor fish” manicures and pedicures
• Waxing
• Eyelash-thickening drops
• UV-activated teeth whitening
• Permanent makeup
• Chemical peels
• Brava breast enhancement, and
• Thermage

We find the “Doctor fish” manicure and pedicures especially entertaining. Well, we, however, should stay focused on the subject of our blog and comment on three treatments, that are near and dear to us.

LaserOffers.com comment

Waxing. Add up what you have and will spend on waxing and think about laser hair removal again.

Chemical peels. They work great in skilled hands. In most cases you will have oddly colored, patchy skin, redness, scaling and blisters; and the possibility of triggering previously dormant cold sores. Low concentration products you can buy OTC or online do not work and can cause unwanted side effects. High concentration in unskilled hand may cause scarring. Laser resurfacing is a very comparable, but much safer alternative.

Thermage. Remember the buzz initiated in 2002 by Oprah about this ”non-surgical facelift” by radio waves? Expensive glossy marketing has put this machine in thousands of aesthetic practices. Few doctors are still very happy with their investment. The number of unhappy patients with burnt the skin, scars, dents and grooves on the face, is much greater. Neither complication is very common, but both happen often enough that doctors say potential patients need to be more aware of the risks.

Many consumers bombard laser manufacturers looking to buy a hair removal laser for home use. “The price for a full body hair removal at a medical aesthetic clinic is over $3,000. Why can’t buy a laser and do it myself and share the laser with the family?” Most people are surprised that even for a used light-based device for hair removal medical professionals have to pay upwards of $50,000.

Why laser manufacturers do not make devices for consumers?

The simple answer is: laser hair removal devices are not a consumer technology. It’s not a matter of cost. Some consumers might consider footing a $50K bill for personal use. It’s not a matter of making the laser technology cheap and affordable to general public. Due to safety considerations lasers should never be used without medical supervision.

The home-based market for aesthetic devices is a potential source of significant growth for the aesthetic industry.  While this seems to represent a considerably larger market opportunity than the professional aesthetic equipment market, we believe that even cheap low power home-based hair removal devices will be competing against conventional razors, electronic razors, waxing products, light-based epilation, electrolysis, bleaching, and hair growth inhibitors. For skin rejuvenation, some of the leading alternatives include conventional facials, chemical peels, and microdermabrasion, which are competitively offered by day spa kind of outfits.

What consumer laser devices are avaialble now?

Palomar Medical Technologies has made the most advanced attempt into the field. Years ago they forged a what seemed a guaranteed success partnership with Gillette to develop and commercialize a home-based hair removal device. It was very long in the making and recently Gillette waived the exclusive distribution rights to the device, which seems like a clear indication that the device did not meet internal expectations during the 12-month consumer assessment trial. The future of the project is unclear.

Privately held Radiancy introduced its homebased hair removal device, no!no!, in October 2007 in the U.S., which is exclusively offered through cosmetics retailer Sephora at $250 per unit. The company’s approach to market was unique in that it contracted directly with a single retailer that has a national presence as opposed to consumer products distributor capable of reaching multiple retail outlets (the approach currently being pursued by Syneron and Palomar). We believe that Radiancy is expanding its home-use line to include solutions for acne and facial skin rejuvenation.

All patients who used Silk’n, a low-energy pulsed-light device intended for home-use hair removal, showed a positive clinical response to treatment in a controlled study by the Washington Institute of Dermatologic Laser Surgery, which was published in mid-March 2009. Hair counts were reduced 37.8% to 53.6% 6 months after three treatments. Skin region influenced clinical response, with lower legs exhibiting greater hair reduction than arms and inguinal and axillary areas. Mild erythema was experienced in 25% of patients, but no other side effects or complications were encountered. Patient satisfaction scores were high, with all patients stating that they would purchase the device for future home use.

It appears that this low-energy pulsed light device can be applied safely and effectively for at-home hair removal in a variety of nonfacial locations and skin phototypes I-IV. These devices are available via a limited number of physicians in the U.S.

Other devices, such as nuFace and Zeno, are not using laser technologies.

LaserOffers.com. It is highly unlikely that consumers will see an affordable but effective light-based device for permanent hair reduction or photorejuvenation in a store near you in the many years to come. The long-term efficacy of the experimental devices listed above is incomparable to any hair reduction treatments offered by professional IPLs and lasers.

There is a good article at empowerher.com, which deals with the subject LaserOffers.com staff has been covering in the last couple of months – the trend towards less expensive surgery and more affordable non-invasive treatments. ”Women who would really benefit most from a facelift would do well to consider the long-term cost of a series of non-invasive treatments versus surgery. One surgeon noted that while facelifts aren’t cheap, the beneficial effects typically last up to 10 years. You can pay as much or more for 10 years of injections with less dramatic results”.

Facial plastic surgeons are experiencing a slowdown in demand for high-ticket plastic surgery. Some of them are trying to adapt and offer new services with the use of non-invasive tools like injectables, chemical peels, lasers and other treatments.

We believe that given the current economic situation, rapid development of the anti-aging medicine and the downtime associated with major plastic surgeries, we will see many more traditional plastic surgeons expand their practices by offering non-invasive and routine maintenance services such as photorejuvenation and dermal injectables.

This is a common question and we hear a lot of discussions among practitioners about what laser is best for large areas, like legs or a man’s back. We have reviewed several studies published in the last few years, and here is the consensus among our medical panel members.

Alex or YAG?

For individuals with fair skin types I-III each laser will provide good long term results, i.e. 75-80% permanent hair reduction.  The 755-nm alexandrite laser is significantly more painful and it is not unlikely that some individuals, especially men, will quit after the 5th treatment, thus potentially reducing the overall efficacy of the treatment.

Alexandrite (755 nm) is not recommended for skin types IV-VI due to the high level of the absorption of this wavelength by the malanin of the skin. Overheating typically results in dispigmentation or scarring of the dark skin. This laser should not be used on tanned skin for the same reason. Nd:YAG 1064 nm laser is the golden standard for hair reduction on dark and tanned skin.

Can I combine Alex with Nd:YAG?

We have reviewed a sizable body of research to answer this question. Yes, these lasers can be  used in combination.

Several randomized, single-center, within-participant, investigator-blinded, active-controlled clinical trials have been cmpleted with individuals aged 16 to 50 years with skin phototypes III and IV. These are the only two skin types, which could benefit from a combination treatment. Typical results are: the mean hair reduction 18 months after the last treatment, as measured by the assessors from digital photographs, are 75-82% for alexandrite laser, 74-80% for the Nd:YAG laser, and 77-80% for the combination therapy. The incidence of adverse effects (hyperpigmentation) and pain severity were significantly greater in areas that received combination therapy.

The conclusion is what the majority of practitioners already know: do not use alexandrite lasers for skin types darker than III; Nd:YAG lasers are good for all skin types and tanned skin; combination therapy does not have any additional benefit and may cause more adverse effects.

A very good study by doctors Kono T, Frederick Groff W, Chan HH, Sakurai H, Yamaki T of the Department of Plastic and Reconstructive Surgery in Tokyo Women’s Medical University, Tokyo, Japan (tkono@prs.twmu.ac.jp)  just came out.

Pulsed dye laser (PDL) treatment of hypertrophic port-wine stains (PWSs) on the lips has demonstrated poor efficacy and a potential risk of dyspigmentation. PDL-resistant hypertrophic PWS can be safely treated with much greater efficacy with deeper penetrating lasers such as a 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. 80% of the treated patients showed good to excellent improvement without complications.