Treatment of Photoaging
http://www.100md.com
《新英格兰医药杂志》
To the Editor: In a section entitled "Procedures for Facial Rejuvenation" in his article on the treatment of photoaging, Stern (April 8 issue)1 briefly mentions blepharoplasty and face-lifts, and he characterizes them as expensive, highly profitable, and poorly studied in a scientific manner. The rest of the discussion focuses on nonsurgical procedures that are temporary, as he notes in his concluding paragraph.
We believe that this characterization is both incomplete and biased. Surgical procedures are the gold standard for facial rejuvenation and are significantly more permanent than dermatological procedures. Done well, they are safe and effective and can be life-altering.
Rodney J. Rohrich, M.D.
Michael E. Decherd, M.D.
University of Texas Southwestern Medical Center
Dallas, TX 75390-9132
rod.rohrich@utsouthwestern.edu
References
Stern RS. Treatment of photoaging. N Engl J Med 2004;350:1526-1534.
Dr. Stern replies: In my article, I emphasize the treatments that have been most rigorously evaluated and that are relatively affordable. Surgical procedures such as blepharoplasty and face-lifts can alter a person's appearance substantially, often, but not always, for the better. Having been unable to uncover such information, I regret that Drs. Rohrich and Decherd do not provide robust outcome data on the procedures they advocate. I consider an average fee of more than $5,000 for an operation lasting several hours to be expensive and profitable.1
The experience of a mystery shopper who consulted five established plastic surgeons with the same requests illustrates the lack of consensus among cosmetic surgeons about optimal therapy.2 Both the recommended treatments and their costs ($2,900 to $14,150) varied greatly among the surgeons. Given the lack of good studies quantifying the benefits and risks of many of the cosmetic procedures and products that leading plastic surgeons now advocate and sell, and given the even scantier information on individual surgeons' outcomes, I hope the American Society of Plastic Surgeons will take a leading role in filling this void in the data.
Robert S. Stern, M.D.
Beth Israel Deaconess Medical Center
Boston, MA 02215
rstern@bidmc.harvard.edu
References
American Society of Plastic Surgeons. (Accessed July 15, 2004, at http://www.plasticsurgery.org/public-education/procedures/index.cfm.)
Besonen J. Does this woman need a facelift? Boston Magazine. February 2000.
We believe that this characterization is both incomplete and biased. Surgical procedures are the gold standard for facial rejuvenation and are significantly more permanent than dermatological procedures. Done well, they are safe and effective and can be life-altering.
Rodney J. Rohrich, M.D.
Michael E. Decherd, M.D.
University of Texas Southwestern Medical Center
Dallas, TX 75390-9132
rod.rohrich@utsouthwestern.edu
References
Stern RS. Treatment of photoaging. N Engl J Med 2004;350:1526-1534.
Dr. Stern replies: In my article, I emphasize the treatments that have been most rigorously evaluated and that are relatively affordable. Surgical procedures such as blepharoplasty and face-lifts can alter a person's appearance substantially, often, but not always, for the better. Having been unable to uncover such information, I regret that Drs. Rohrich and Decherd do not provide robust outcome data on the procedures they advocate. I consider an average fee of more than $5,000 for an operation lasting several hours to be expensive and profitable.1
The experience of a mystery shopper who consulted five established plastic surgeons with the same requests illustrates the lack of consensus among cosmetic surgeons about optimal therapy.2 Both the recommended treatments and their costs ($2,900 to $14,150) varied greatly among the surgeons. Given the lack of good studies quantifying the benefits and risks of many of the cosmetic procedures and products that leading plastic surgeons now advocate and sell, and given the even scantier information on individual surgeons' outcomes, I hope the American Society of Plastic Surgeons will take a leading role in filling this void in the data.
Robert S. Stern, M.D.
Beth Israel Deaconess Medical Center
Boston, MA 02215
rstern@bidmc.harvard.edu
References
American Society of Plastic Surgeons. (Accessed July 15, 2004, at http://www.plasticsurgery.org/public-education/procedures/index.cfm.)
Besonen J. Does this woman need a facelift? Boston Magazine. February 2000.