surgery tweaks.

SURGERY TWEAKS

Minimal recovery time. Maximum results. Can the latest "minor" plastic-surgery procedures really deliver on their promises? By Judith Newman

not every woman yearns for the fireworks of plastic surgery -- face-lift! Nose job! Breast implants! Sometimes, just a sparkler will do, in the form of fewer lines here or less flab there. More and more, women are turning to what some surgeons call "minors": procedures that require minimal invasiveness and downtime, but still yield significant physical and emotional payoffs. A combination of better and lighter anesthesia plus smaller and more precise surgical instruments has made "tweaks" (such as liposuction of double chins, ear pinning, and eye-bag removal) not just possible, but also increasingly popular. Although no one keeps exact records on how many people are getting these surgeries, the number of overall procedures for patients ages 19 to 34 increased 101 percent from 1997 to 2003, in part because the number of young women having minor surgeries is increasing, according to the American Society for Aesthetic Plastic Surgery (ASAPS). Patients in their 20s, 30s, and 40s "work; they have busy lives," says Sherrell J. Aston, chairman of the plastic surgery department at Manhattan Eye, Ear, and Throat Hospital. "They simply don't have the time to take two weeks out of their lives to recover from a surgery." One key feature that defines all these procedures as tweaks is the level of anesthesia involved: Every operation in this category can be performed under either local anesthetic or intravenous (a.k.a. twilight) sedation -- which, unlike general anesthesia, requires no breathing tube and uses fast-acting drugs that leave the system in two to six hours. Still, while a patient may be in and out of the doctor's office in an hour -- and the very word "tweak" may sound kiss-kiss and carefree -- rearranging flesh is not the same as rearranging furniture. "There is always risk, even in the most minor procedure," notes Robert W. Bernard, a plastic surgeon in White Plains, New York, and past president of the ASAPS. Those risks include excessive bleeding, infection, and permanent numbness (particularly after liposuction), and occur in 1 to 5 percent of the cases, depending on the type of surgery. There is also the matter of expectations and personal tolerance: One person's tweak may very well be another's major surgery. Some ...