NYT article by Paul Sullivan
Philip Fear, a radiologist, has helped build a physicians’ group in Saratoga Springs, N.Y., to over 20 doctors. And his successful practice means that he is often asked to give lectures to medical groups.
“I’m a happy person,” Dr. Fear, 49, said.
But until last year, he was reluctant to smile because his teeth were badly stained from a combination of genetic factors and tetracycline, an antibiotic he took as a child. Worse, in 2005, he let a dentist talk him into a gold crown on a tooth, on the basis that it would last forever while a porcelain one would have to be replaced in 20 years.
“He said you wouldn’t notice it, but I noticed it,” Dr. Fear said. “There would be this North Star in pictures.”
So last fall, he spent $60,000 to have porcelain veneers put on his teeth. “I feel more confident,” he said. “I feel a lot better about my teeth.”
Dr. Fear is among a growing number of people who are spending tens of thousands of dollars to look a little bit better. These aren’t the people going under the knife to stretch their face taut, suck out the effects of overeating or inflate, deflate or reinflate parts of their bodies. Instead, these are people who believe that a little work will make a difference in their careers and their perceptions of themselves and can afford to pay for it.
“Patients are looking for, ‘How do I look better, but I have no time to recuperate in my bed for a week,’ ” said Michael Gold, a dermatologist whose practice in Nashville is about 30 percent cosmetic work. “The trend in all of cosmetic surgery since Botox came out is totally noninvasive procedures. Their numbers are going up.”
Mr. Gold performs skin-tightening procedures using a thermal treatment. It breaks down the fat cells and makes the skin look tighter without much pain or redness.
He said a popular thermal treatment, from EndyMed, costs $300 to $400 a treatment in Nashville, and most people need a half-dozen treatments to improve an area. The same procedure in a city like New York could cost $1,000 a treatment, he said.
While any cosmetic treatment may seem vain, many people say these less-invasive treatments have improved their lives. Allie Wu, 31, said she ground her teeth while she slept for years. As a result, her jaw clicked when she opened and shut her mouth.
In 2009, she had surgery to correct her jaw alignment, but it made the problem worse. Closing her mouth became more painful. She had a second procedure to fix the first one in 2010, but that led to further complications, including nerve damage and seven lost teeth.
“I could only chew on one side,” she said. “I also had problems breathing. I had a lisp.”
When she moved to New York three years ago to take a job as an actuary at a life insurance company, she went to a third oral surgeon to fix her lower jaw. This time it worked, but her teeth were misaligned and discolored from the two previous operations.
“Emotionally, I was really down,” Ms. Wu said. “I felt like I shouldn’t have gotten any surgery. I would have rather lived with the joint pain than gone through all the pain and bills. It changed my look.”
The oral surgeon referred her to a cosmetic dentist who recommended she have her top teeth lengthened to reduce the appearance of her overbite. She said it has helped her professionally.
“My smile looks natural,” she said. “My speech is better. I don’t have a lisp anymore. I can eat. The veneers corrected the color and the functionality.”
There is academic research on the business benefits of appearance. In “Beauty Is Wealth: C.E.O. Appearance and Shareholder Value,” presented at the American Finance Association meeting in January, Joseph T. Halford and Scott H. C. Hsu of the University of Wisconsin at Milwaukee studied how a chief executive’s appearance affected a company’s stock price.
The professors assessed 667 chief executives of companies in the Standard & Poor’s 500-stock index using a facial attractiveness index. (It measured the correlation of geometry and beauty.) They found that appearance mattered — perhaps not the most shocking finding. Their research, though, built on other studies that linked personal achievement to attractiveness.
Because these procedures are less invasive, they do not fix everything. And they can be abused the same way more invasive plastic surgery can.
“Patients have to be realistic,” Dr. Gold said. “If someone has skin overhanging their stomach, akin to ‘The Biggest Loser,’ they’re not going to benefit from what I do. They need a tummy tuck procedure.”
He said any ethical dermatologist would try to dissuade a person who has become hooked on cosmetic procedures.
It’s no different in cosmetic dentistry. The elephants in the room are those unnaturally white teeth, known as Chiclets in the trade.
“There is no such thing as a white tooth,” said Dr. Michael Apa, who worked on Dr. Fear’s and Ms. Wu’s teeth. “Teeth are yellow-white when you’re young and gray-white when you’re older.”
In his practice in Manhattan, he said, he makes temporary teeth the color patients choose so they can try them. If they want to change colors after the veneers are in place, he said, he has to cut them off and start over.
“The best advice I can give people is to really utilize the consultation as much as possible and get a real understanding of what they’re in for,” he said. “It’s hard to say what the teeth are going to look like. The best way is to see countless before-and-after photos. You should ask for cases similar to yours.”
Whether facial or dental, these procedures do not freeze time the way some aggressive face-lifts seem to do. A thermal treatment is going to have to be redone every couple of years. But how long it lasts depends on someone’s lifestyle, with exercise and healthful eating extending the time between treatments.
“We’re not stopping the clock,” Dr. Gold said. “We’re turning it back. If you have this done when you’re 40, you’ll need something done at 45.”
The same goes for teeth. Dr. Apa said most people could expect to get 15 to 20 years out of veneers. But people who don’t take care of them the way they would natural teeth — you still have to brush, floss and go light on the cotton candy — will accelerate the natural decay.
“If you’re cavity-prone and not brushing your teeth, you’re going to have rampant decay and you’re going to be cutting them off every 10 years,” he said. “You have to keep them clean and take care of them, or over time, bacteria breaks down that margin between the restoration and the tooth.”
If the decay is severe, the teeth will have to be pulled and the patient will need surgery to do a root canal and attach posts for implants.
Of course, in businesses founded on beauty and vanity, a great smile is everything. Julien Farel, a French-born hairstylist who owns several beauty businesses in the United States, said that at age 45 he felt that he had to have something done to continue to look young.
“It was important for me not to age, but I’m not someone who wants to go under the needle,” he said. “As a European, we always look at the Americans having the perfect smile.”
For him, the price of 18 veneers was a business expense. “I sell beauty, and I want to look great,” he said. “This is a very important part of who I am.”
When you charge $1,000 for a haircut, as he does, paying $3,000 a tooth may not seem such a stretch. His haircuts last six months; his new teeth could last 20 years.
But for others, these procedures are about gaining a quiet confidence to go about their regular lives. “I work in the insurance industry, and appearance is not as important for me as it is for someone in modeling,” Ms. Wu said. “But I feel it gave me self-confidence. I feel more confident going into work.”
Source: nytimes.com
Posted by: Steven Maimes, The Wealthy Doctor
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