Looking Art in the Face

by Andrea Frampton
Five years ago it may have been slightly unusual for a husband and wife of middle-class backgrounds to schedule simultaneous visits with Dr. Harrison Putman, III. But now, Putman, a third generation physician in Peoria and a board-certified facial plastic and reconstructive surgeon, said it’s a fairly common meeting.

“The wife will usually get a facelift and eyelid blepharoplasty (a procedure where fat and excess bags are removed from the eye area),” Putman said. “The husband will have a rhinoplasty and a hair transplant. We see a steady stream of middle America.”

Because most insurance policies don’t cover plastic surgery procedures, many consumers pay out-of-pocket for pre-existing conditions including cleft palates, burn scars and congenital facial deformities. And the same goes for cosmetic surgery, considered medically unnecessary by insurance companies. However, both kinds of procedures have become more affordable than ever, Putman said, and now many people save up for plastic and cosmetic surgery procedures like they would for a must-have jewelry piece. Prior to surgery, Putman and his staff try to work out a payment plan, if necessary, to help make a life-changing procedure possible.

About 80 percent of the procedures that run through Putman’s office are cosmetic and the remaining are skin-care related. In such a youth-obsessed culture, many people view plastic surgery as a business advantage which could, ultimately, increase their net worth. According to a study in the American Economic Review, attractive people earn, on average, 10 to 15 percent more than their notso- pretty co-workers. Many of Putman’s clients who are often confident social butterflies and business gurus, are the first ones to seek out cosmetic surgery, he said. Since recently co-authoring two books on plastic surgery procedures, Your Complete Guide to Nose Reshaping and Your Complete Guide to Facial Rejuvenation, Putman said consumers are flocking to receive information on procedures.

Although many procedures center on reconstructing or minimizing a facial structure or area of the body, he still highly stresses the importance of a pro-active approach to skin care. “We try to get everyone on a skin protection program,” Putman said.

The programs focus on including exfoliants, moisturizers and antioxidants into a skin-care regimen. Since diet also heavily influences skin’s overall appearance, foods high in sugar and carbohydrates, which break down collagen, are discouraged. Vegetables, fruits, lean proteins as well as flax and fish oil, are encouraged and will show a clear benefit for skin, Putman said.

Usually the 1980 Tulane University Medical Center graduate can describe procedures in about 30 minutes, but he doesn’t hesitate to schedule a second consultation if necessary. “We also review the plan before surgery,” Putman said. “An informed patient is a happy patient.”

For the last 15 years and still today, about 80 percent of his clients remain women, but the age of female clients has dropped.

While women in their 20s now visit Putman for procedures varying from nose reshaping to chin liposuction, the majority of his patients are in their 40s and 50s. Overall, plastic surgery has surged in popularity just as the quality of care is improving. Shows like ABC’s Extreme Makeover, FX’s Nip/Tuck and E!’s Dr. 90210 have sent scores of people—seeking to put a new face forward—streaming into plastic surgeons’ offices.

However, it’s the unrealistic standards that television characters often portray that, Putman said, can disappoint clients. Hollywood’s goal of producing shock value entertainment—as with the show Extreme Makeover which patients often take on multiple major surgeries at once—often generates false expectations.

Based on the age and health of a patient, many can elect more than one procedure at a time, Putman said, but, generally not more than one major surgery at a time. While a facial procedure such as a collagen injection is not traumatic, more invasive procedures like liposuction can put a strain on a patient’s healing process. “My goal is to educate the patient, to give an in-depth facial analysis,” Putman said. “What the patient wants and where they are, many times, are not the same.” He stresses that surgery is not for everyone.

In types of cases when a patient is unsure of a procedure, he will answer questions and offer several choices and ultimately leave the decision to the individual. In an effort to further educate the knowledge-hungry public, Putman recently co-authored Your Complete Guide to Facial Rejuvenation, which reached local bookstores in January.

The book contains 75 color illustrations and photos, including dozens of before and after pictures of those who had facelifts, eyelid lifts, brow lifts and skin rejuvenation procedures. It gives information on how to determine if someone is a candidate for a facelift and narrows down what type of facelift would be the most beneficial. Other concerns, like how soon to go out in public after a facelift, post-surgical pain after an eye lift and the general length of time of the results, are addressed.

In addition, Putman co-authored Your Complete Guide to Nose Reshaping with other plastic surgeons who have collectively performed thousands of rhinoplasties. The book answers questions about what kind of anesthesia is used during surgery and how soon you could to return to work. About 300,000 people have nose reshaping procedures in the U.S. each year. Both books are available for purchase at www.addicusbooks.com or can be found at Barnes and Noble bookstores.

Because of the traumatic cases seen on television, many times patients think they will experience massive swelling after most procedures and many times, Putman said, that is not the case.

“New technology can even help reduce bruising and swelling,” Putman said.

Patients are now lining up for minimally-invasive procedures to treat wrinkles and other skin imperfections. Lasers are now available that can quickly remove the outer layer of the skin, including blemishes and other damaged areas. The laser also tightens the skin, which in turn can smooth the texture of the skin and reduce large pores. Wrinkles, fine lines, forehead creasing and crow’s feet can also be reduced with today’s lasers. For many of the laser procedures, ice packs are the only numbing agents needed. A procedure called the weekend laser peel treats a variety of skin problems including sun or age spots, spider veins and wrinkles. There is no bleeding and the skin is left smooth and pink. Since the laser doesn’t reach the deeper part of the epidermis, patients generally have a rapid recovery. Prior to all procedures, skincare consultations must be scheduled.

With our fast-paced lifestyles, procedures that take under 30 minutes are also popular. Appointments for BOTOX, which smoothes out skin tissue and makes wrinkles less visible for anywhere from three to six months, usually run around 20 minutes. BOTOX is actually the brand name of a toxin produced by the bacterium Clostridium botulinum which can cause paralysis and is associated with food poisoning. But small, diluted amounts can be directed injected into specific muscles causing controlled weakening of the muscles. Putman cautions to get most procedures well ahead of any special event because the effects often take several weeks to appear.

Staying in the forefront of technology, Putman was chosen to participate in a study for a very promising new radiofrequency technology. The treatment is directed at improving the appearance of cellulite as well as tightening skin. This radiofrequency device is also used to treat glabellar furrowing or frown lines. Known as Zenage, it is an alternative to BOTOX for the area between the brows. Zenage involves a simple needle stick procedure: a needle is introduced within the brow line so there will be no visible mark. When the needle tip is in the proper location, radiofrequency energy is then applied to the nerve area. Total procedure time is approximately 20 minutes, and results are instantaneous. The results, less visible fine lines, are expected to last up to 18 months. PCA Skin Peptide Lip Therapy is also available and is a new scientifically- formulated procedure to increase lip volume, reduce lip lines and aid in the retention and accumulation of the natural oils in the lips. Studies have shown that BMX Complex reduces water loss by 17 percent and increases skin hydration by 40 percent after two weeks. The formula, Palmitoyl Oligopeptide, stimulates collagen synthesis to strengthen lips and diminish fine lines. After 30 days, results showed a 29 percent reduction in lip lines and over a 40 percent increase in lip hydration, softness and fullness. In addition, powerful antioxidants in the peptide shield lips from harmful free radicals and environmental damage.

A new FDA-approved biocompatible implant material, Radiesse, is the answer to a facial enhancement with more commitment. The minimally-invasive procedure fills in nasolabial folds, the creases that runs from the nose to the corner of the mouth, and corrects scars and wrinkles. The effects usually last between three and five years.

Through participation in community projects such as the Central Illinois Orofacial Anomalies Team, Putman is able to provide treatment for infants and individuals up to age 21. The team, which works through Easter Seals, takes a multi-disciplinary approach to the diagnosis, evaluation, and management of individuals with cleft lip or palate, speech problems, ear deformities or other conditions. The team partners with the Division of Specialized Care for Children (DSCC) and other agencies within the central Illinois area. Although the major focus is children, appropriate adult referrals are also accepted.

Putman is also part of the FACE TO FACE program and may travel to Vietnam, Cuba or China this year as part of FACE TO FACE International. Providing his own expenses and working pro-bono, Putman will aid war injury victims and the medically underserved.

FACE TO FACE was started in 1994 by the Educational and Research Foundation for the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). The program offers facial plastic and reconstructive surgery to domestic violence survivors to repair injuries on the face, head and neck caused by an intimate partner or spouse.

No matter what procedure he may be performing, Putman said patients find comfort in knowing that his is board-certified with the American Academy of Facial Plastic and Reconstructive Surgery. “Board-certified” simply means a doctor is recognized by the American Board of Medical Specialties (ABMS). A facial plastic surgeon, like Putman, is usually board-certified in otolaryngology, the surgery of the head and neck. To become board-certified, a physician must pass a series of rigorous oral and written tests over medical procedures and practices.

To determine if a physician is board-certified to provide facial plastic surgery call 1-800-332-FACE. a&s