STORY BY

Jacqueline Preston

Whether it's a face lift, tummy tuck or nose-reshaping, cosmetic surgery is still the rage for many women – and men – who want to redefine their appearances. But should persons of color be concerned about potential side effects of plastic surgery on their distinctive skin?

The answer is "yes" and "no."

Sound confusing? Not so, says a plastic surgeon at The University of Texas Medical School at Houston. New-generation lasers - standard cosmetic surgery tools - are taking the fear out of cosmetic surgery on dark skin. Lasers work by targeting different substances within the skin, such as water, hemoglobin, and melanin. They selectively remove the superficial layers of skin in different thicknesses, causing the new-formed skin to be tighter, healthier and more youthful in appearance.

The key is knowing what's right for you.

The new and improved laser

"There are new laser treatments that can be safely used in African-Americans and other people with dark skin," says Dr. Christopher Livingston, assistant professor of plastic surgery at UT Medical School. "However, lasers may cause skin discoloration, keloid scarring, and possible infections in darker-skinned people and you can't reverse it. Patients of darker color are at a greater risk and need to be aware of all the potential complications."

The first lasers used by plastic surgeons were not recommended for people with dark skin because of loss of skin color and the formation of keloids - thick, raised scars that form as an exaggerated response to wound healing. These scars typically surface on the earlobe, shoulders, sternum and scalp. Recent advances, however, have made laser treatment for cosmetic and even medical purposes safe and effective.

"The new lasers target a specific wavelength that can be used selectively to treat a variety of conditions like removing fine lines, wrinkles, age spots, and some tattoos and superficial veins," Livingston says. "The older generation lasers potentially caused blotchiness and keloid formation."

Fortunately, the skin in African-Americans and certain Hispanic complexions don't show photo-aging as quickly as in Caucasian women. This is due to the natural melanin production, which adds color to their skin and hair.

Unfortunately, black women do have to worry about their facial aging due to a progressive decrease in collagen and elasticity, Livingston says. "When their skin begins to droop, the procedure they choose is a face lift to tighten up their skin and achieve a younger, more youthful appearance."

For Caucasian women, Livingston says cosmetic procedures such as chemical peels, laser resurfacing, dermabrasion, and medicinal treatments using Retin-A are common and can improve the look of chronically sun-damaged skin. "Lighter skin burns easily and tans infrequently," he adds. "The need for anti-aging procedures occurs more often in light-skinned women."

Choosing cosmetic surgery

Since the melanin in dark skin slows down the aging process, why should dark-skinned women in search of the proverbial fountain of youth have cosmetic surgery?

"For people of African descent with dark skin who want to get rid of unsightly hair, age spots, or visible veins, cosmetic surgery is an option worth considering," Livingston says. "The new lasers can do this with fewer of the complications such as hyperpigmentation or hypopigmentation."

If you are a woman of color and you're ready to enhance your appearance, read these tips before you make a decision:

• It's a family affair. Does your mother or grandmother have a history of keloid scarring? Are you in generally good health? These are just two questions you should ask yourself. If you answered 'no' and 'yes' in that order, you're probably a good candidate for cosmetic surgery. Talk with your physician.
• Don't compromise. Livingston says cosmetic surgery should be reserved for enhancing your appearance, not totally changing your natural looks. For example, the African nose, the Asian nose and the Caucasian nose are unique to each face. A drastic alteration can completely change your look.
• Don't expect a miracle. A face lift may slow down the aging process, but it will not stop it. Physical perfection is impossible to achieve. Have realistic expectations. Consult with your plastic surgeon on what you want to achieve. Beware of guarantees. Between you and your doctor, you can ensure that your goals will be realistically met and that you are satisfied with the results.
• "But I Play One on TV." Television shows like "Extreme Makeover" and "The Swan" are unrealistic and don't represent the average cosmetic surgery patient, Livingston cautions. "The people on these shows go away for three months after having a chin implant, rhinoplasty and liposuction, and using a personal fitness trainer and a stylist, and it all costs thousands of dollars. They don't bounce back immediately," he adds. "Plastic surgery can be uncomfortable, time consuming and expensive. Plus, most people don't want to take such drastic measures to change their looks."
• Seek a reputable physician. A good plastic surgeon knows the risks and benefits of cosmetic surgery and will share them with you. Listen to him or her and get as much information as you can. To find a board-certified surgeon, log on at www.plasticsurgery.com, the official Web site of the American Board of Plastic Surgery.

UPDATED: 6-21-2004

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