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A new you
What it would cost to be redone from head to toe
01:00 AM EST on Sunday, January 4, 2004

BY LAURA MEADE KIRK
Journal Staff Writer

Every year you decide to lose weight, tone your body and generally fix yourself up so you look better. And every year, the steps in this process turn out to be harder than they seemed on Jan. 1.

There's an easier way: LIFEStyles has queried some of the top doctors in the area to find out how much it would cost to simply buy a new you for the new year. Here's a look at what's available, from head to toe.

GET BACK YOUR HAIR: Prescriptions to hair transplants, $20 to $20,000

You don't have to be bald to need hair loss treatments: About half of all men will suffer hair loss, while one quarter of women will as well, said Dr. Robert Leonard, medical director of Leonard Hair Transplant Associates and its sister company, the Aesthetic Rejuvenation Center in Cranston.

Heidi West, a disc jockey with LITE Rock 105, has been having the new LUCE LDS 100 light treatments for about a year because her hair was starting to thin -- just as her mother's hair did. "I'm 27 years old and I haven't had long hair since I was 12 or 13," she said. Now, she said, "It's really gotten a lot longer, it really is healthier and it's stronger. . . . It's great. I love it."

There are basically two steps to treating hair loss, Leonard said. First, he said, is to stop hair loss from getting worse. Male and female pattern baldness is "a progressive condition," he said. "If they do nothing, they will be balder next year."

Medications including Propecia and Rogaine have proven effective in stopping the progression of hair loss 70 to 83 percent of the time, while also contributing to regrowth in 50 to 66 percent of all cases. (Rogaine, which is a non-prescription medication, costs $20 to $30 a month, while Propecia, a prescription, costs $55 to $65 a month.)

Leonard said Luce treatments, which stimulate the blood flow near the hair follicles, stop progressive hair loss in 85 percent of cases and contributes to regrowth in about 50 percent of the cases. (This treatment costs $1,750 to $3,500 for the year.)

The second stage of treatment, he said, is hair transplants for people with thinning or balding hair. In this, he said, he harvests "donor" hair and plants it in the area to regrow. It's not guaranteed to restore hair to someone who's entirely bald, but people will see more hair than they had. (Transplants can cost $3,500 to $20,000).

GIVE UP THE GLASSES: Laser eye surgery, $1,800 to $4,000 per eye:

Advances in laser eye surgery mean that just about anyone can put away their eyeglasses forever, according to Dr. Paul Koch, of Koch Eye Associates.

LASIK, or laser in-situ keratomileusis, remains "the most popular vision correction procedure in the world," Koch said. And it's now effective for virtually anyone who requires glasses to see things far away -- even those who previously weren't good candidates for the procedure. "We are now able to measure the cornea at 200 different spots and customize the treatment to those patients much more specifically than ever before." LASIK usually costs about $1,800 per eye, he said.

Dr. Elliot Perlman, who performs Lasik surgery at the Rhode Island Eye Institute in Providence, said it's still not for everyone. But the techniques have certainly improved over the years. In the past, he said, they'd use lasers to mold the cornea to match the prescription in a patient's glasses. Now, they take a wave scan of the patient's cornea that enables the doctor to customize the surgery to that patient, often resulting in better than 20-20 vision, he said. That surgery costs $2,000 to $2,500 per eye.

Two new treatments are available for farsightedness as well, Koch said. One procedure, called "blended vision," involves using LASIK to enhance the reading vision in one eye while improving distance vision in the other. Another procedure, approved within the past few months, involves replacing the natural lens in your eye -- which loses its ability to focus over time, contributing to reading problems caused by aging -- with a new flexible lens called an "accommodating intraocular lens." This costs about $4,000 per eye. "It's like an internal contact lens," he said, and it provides a permanent solution for people who struggle with reading vision.

Another treatment, due to be federally approved for widespread use early this year, involves the implantation of an "intraocular contact lens," Koch said. "This is literally a tiny contact lens we place inside your eye instead of having you wear it on the outside of your eye." It will cost about $3,600 per eye, he said.

BANISH THE BAGS AND WRINKLES: Botox, collagen and blepharoplasty (eyelid surgery): $290 to $2,500.

Botox injections (about $375), can selectively paralyze or weaken facial muscles to help reduce wrinkles such as laugh lines, crows feet and lines on the forehead, said Dr. Marla Angermeier, a dermatologist in Providence who specializes in sclerotheraphy (removal of varicose and spider veins), botox and collagen treatments. Meanwhile, injections of collagen ($290 to $350) can help fill in small defects, like wrinkles around the mouth, and they can be used to augment the size of your lips. Both of these treatments are temporary and need to be repeated every three to four months.

Last month, the FDA approved two new filler materials -- restylene and perlane -- which can provide longer-lasting relief than collagen, Angermeier said.

Another filler known as radiance that is targeted for use for deep wrinkles, such as the furrows of the forehead and the folds by lips and cheeks, has also been approved, said Dr. Curtis Perry of the Artistic Surgical Center in East Greenwich. This costs about $1,500 per application, but lasts two years or more.

Dr. R. Jeffrey Hoffman of the Rhode Island Eye Institute, does blepharoplasty, brow lifts and cheek lifts to help get rid of puffiness, bags and circles around the eyes -- which become especially noticeable after people have eye surgery and no longer wear glasses that hide the wrinkles.

Belpharoplasty, which addresses drooping upper eyelids and puffy or baggy lower eyelids, costs $1,950 to $2,150. He also does eyebrow and forehead elevations, to eliminate drooping eyebrows and sagging foreheads, for about $2,500. These treatments not only get rid of the bags, but also help improve skin tone.

LIFT AND FLUFF THAT FACE: Face lifts and fat injections: $1,500 to $15,000.

Time takes its toll on the face in two ways, Perry said. "The skin and their muscles lose their elasticity, giving a sagging effect, and you also lose volume in your face -- your face will thin out at the upper cheek, below the jowls and above the chin. That's what gives you an older face."

If there's a lot of sagging tissues and muscles in the brow, jowls and chin, a face lift ($5,000 to $15,000) may be in order, Perry said: Lifting the sagging tissue gives people a more energetic look and may make them look younger.

Not everyone needs a face lift, though, he said."If you really want to look younger, you want to add a little more volume in localized areas," Perry explained. He said people can see how their face has lost volume by looking at a high school or wedding photo, as compared with how they look today. He uses fat injections ($1,500 to $10,000) to add volume to the lip, along the chin and along the side of the face "just to get a nice curve and soften the look."

And some people need a combination of the face lift and fat injections to get the look they want.

FREE YOURSELF OF FRECKLES AND SPIDER VEINS: Pulse light treatment, $275

An intense pulse light device, similar to a laser, can remove lentigos, or freckles, as well as spider veins on the face, Angermeier said. A one-time treatment ($275) is effective for most people, though some may need repeat treatments.

SMOOTH FINE LINES AND BLOTCHY SKIN: Chemical peels and photo facials, $75 to $3,000.

Very light chemical peels of clycolic acid ($75) gently exfoliate and even out the pigment of the skin, when used with similar at-home treatments, Angermeier said. It also helps stimulate collagen formation, which helps smooth fine lines without injections or surgery.

Deeper chemical peels, with trichloracetic acid, can help even out blotchy looking skin and coarser wrinkles. Those cost about $500 and also require at-home treatment, she said.

The Aesthetic Rejuvenation Center also uses a "Smooth Beam" laser and radio frequency to help reduce acne scarring, discoloration and wrinkles, while combining this treatment with a chemical peel to treat current cases of acne ($2,400 for four or five treatments).

Fotofacial RF is a new skin rejuvenation program using energy applied to the surface of the skin to eliminate age spots, spider veins and fine lines and wrinkles, Leonard said. It smooths and firms skin and helps stimulate collagen. The 15-week program costs $1,500 to $3,000.

A NEW NOSE: Rhinoplasty, $3,000 to $10,000

Whether your nose is too big, too small or just the wrong shape for your face, you can get a one that fits your face better. Perry said the price tag ranges from $3,000 to $10,000.

BRIGHTEN YOUR SMILE: Teeth whitening, $325 to $525

Many dentists can now help you have whiter teeth through a high-powered peroxide treatment designed to bleach out the discolored tubulars in your teeth. The Hodosh Cosmetic and Implant Dentistry practice in Cranston, for example, charges $525 for a one-hour treatment, plus two at-home treatments, or $325 for a seven-day at-home treatment program.

That's more expensive than the over-the-counter whitening treatments, but the store-bought whiteners take longer because they have a lower concentration of peroxide than that available in the dental office, a spokesman explained. The treatment might need to be refreshed each year, or more often for severely discolored teeth.

BODY SCULPTING: Liposuction and fat injections: $2,000 to $8,000.

Liposuction, or the surgical removal of fat, is the most commonly performed cosmetic procedure in the U.S. But it isn't just about taking the fat out, Perry said. "You're really trying to emphasize shaping and structures. . . As you're removing the fat, occasionally I do fat injection in the body area as well . . . to shape the sculpture."

Liposuction ($3,000 to $8,000 per area) can be used just about anywhere on the body that "you have an unwanted bulge," Perry said. For women, that's generally the thigh, hips, abdomen, upper arms and neck area, while men target love handles, the stomach and neck.

But this isn't a weight loss tool, Perry said, stressing that it can be risky to use liposuction to remove "large volumes (of fat cells) at one time." Instead, he sees it as "a good adjunct" to weight loss by helping people lose some of the bulge after they've lost a lot of weight.

He also sees it as a tool for "spot contouring" to help get rid of specific bulges of the body, as opposed to using it to get rid of all body fat.

When it comes to liposuction, he said, "I'm not going to make you smaller. I'm got make you better shaped."

That sometimes involves using liposuction to remove fat from one area of the body, then use fat injections ($2,000 to $5,000) to flesh out another area, to smooth a body's curves and lines, he said. For example, he may use liposuction to remove a person's love handles then use fat injections to round out the hips and thighs.

BIGGER BREASTS: saline breast implants, $3,000 to $12,000

Despite the controversy over the years, breast implants are popular, Perry said; breast augmentation is the second most common cosmetic procedure in the U.S. But he, like many doctors, uses saline instead of silicone breast implants ($3,000 to $12,000).

VANQUISH VARICOSE VEINS: starting at $275.

Sclerotherapy ($275), is a nonsurgical way to get rid of some varicose and spider veins on the legs, Angermeier said. It involves injecting a solution into the vein, which then disappears. But larger veins may require surgery or the use of laser catheters, as opposed to laser light treatments. Although it gets rid of a spider vein permanently, it doesn't prevent new ones from appearing.

SHAVE NO MORE: Laser hair removal for $150 to $700 per treatment.

The Aesthetic Rejuvenation Center uses a new Aurora system, that combines the use of intense pulse lights and radio frequencies, to remove hair from virtually anywhere on the body. Charges range from $150 to $700 a treatment, and some areas may require more than one treatment for total removal.

SUPPORT YOUR FEET: Custom orthotic devices $350 to $500

Flat feet and high arches can contribute to foot, knee and back problems but custom orthotic devices, or orthoses, may be able to provide relief, said Dr. Robert W. Gibbons, of Rhode Island Foot Care in North Providence, who's also president of the Rhode Island Podiatric Medical Association.

"The foot is technically a shock absorber," Gibbons said, explaining that one-and-a-half times your body weight is transmitted through your skeletal structure with each step a person takes. So flat feet or high arches can affect other areas of your body.

Gibbons said he designs custom orthotic devices or inserts after conducting a thorough biomechanical exam and making a model of the foot, to craft a device that will help the foot sit properly. "It technically makes your foot a better shock absorber," he explained.

The custom orthotic devices range from $350 to $500, including the exam and casting, Gibbons said. Not everyone needs or can afford a custom orthotic device, he noted, and lots of over the counter remedies are available. But he likened them to buying reading glasses off the rack, as opposed to having eyeglasses customized to your individual needs.

There also are two types of custom orthotic devices, for everyday and for dress wear. The everyday devices tend to be bigger and offer more support than the dress ones, he noted.

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