Cutting Edge Techniques Take Cutting Out of Plastic Surgery

PHOTO: Dr. Doris Day gives Cheri Bollman Ulthera treatments, which use focused ultrasound to achieve results similar to traditional surgical face lifts.
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According to a recent study cited by the American Society for Aesthetic Plastic Surgery, over 50 percent of Americans would like to have their appearance enhanced through cosmetic medicine. It is a $10 billion a year business.

In record numbers -- 14 million cosmetic procedures were done in 2011 alone, according to the American Society for Plastic Surgeons -- Americans are being cut, stretched, tucked, smoothed, tapered, injected and filled.

But how these changes are made is changing, thanks to new techniques and tools that are making plastic surgery involve less, well, surgery.

Watch the full story on "The Cutting Edge," a "20/20" special, Friday at 10 p.m. ET/9 CT.

"The catch phrase in the old days was, 'Heal of steel' -- the knife can do everything," said New York plastic surgeon Dr. Doug Steinbrech, in an interview with ABC News' Barbara Walters.

"What we are trying to do with facelifts now is to limit the amount of surgery we are actually doing," Steinbrech said. "The cutting and the incisions, the length of the incisions."

Less cutting means shorter recoveries and fewer scars. To complete a face lift, for example, Steinbrech uses a new skin-tightening device, not a scalpel. The face lift takes a little less than three hours under anesthesia. A patient's stitches can be removed after five days. The overall cost? Up to $35,000.

Some doctors go even further than Steinbrech, getting many of the same results without going under the knife at all.

How?

"We have different tools and we also have different approaches," said dermatologist Dr. Doris Day, who has explained these tools and approaches in a book called "Forget the Facelift."

"I don't believe in aging gracefully," Day said in an interview with Walters. "I think you have to fight it every step of the way."

Day said the new tools she champions, such as fillers and lasers, offer patients an option that can replace or be combined with more traditional surgery.

"I don't think one excludes the other," Day said. "However, my experience has been that you can get rid of lines and wrinkles, but that doesn't always make someone look younger; they just look smoother. What we lose over time is volume. And what we do is we -- very carefully, naturally and discreetly -- add back volume."

Before coming to Day, Cheri Bollman, 48, had never had cosmetic procedures, not even a facial. The lines on her face showed the stress of raising a large family.

"Unlike Lady Gaga, I was not born this way," Bollman said with a laugh while sitting in Day's office.

Bollman and her husband have four natural children and have adopted seven more. Their outsized, multiracial, musical family was featured on the TV show "My Life is a Sitcom."

Day gave Bollman a non-surgical face lift using a new device that uses heat to shrink tissue under the skin.

"It's not a laser," Day said. "It uses ultrasound. But not the kind of ultrasound you had maybe during pregnancy and for other things. This is high-density focused ultrasound that delivers heat very deep, that helps give a lift."

Day then applied her eye and artistry, observing how Bollman's face moved as Bollman spoke, to determine what to do next.

Day decided to inject a combination of fillers made out of a sugary gel that adds volume to cheeks and temples.

"Before, we just had a few different types of animal-based collagen, and now we have a whole palette of tools available," Day said. "We are putting some elements deep, and some elements more superficial, to get a very natural approach."

Liposonix Uses Ultrasound to Melt Fat From Outside

Next, Day used new forms of Botox to even out Bollman's eyebrows and soften her crow's feet. Finally, Day applied finishing touches with a laser tool that evens out skin tone and texture.

A series of procedures like this typically costs about $11,000, Day said.

"It looks so natural!" Bollman said of her new face. Three weeks later, after the procedures had had time to take full effect, she reported, "I noticed I don't have to pick up my eyelid to put on makeup anymore."

Less invasive cosmetic surgery isn't limited to the face. As she was treating Bollman, Day was treating another patient, Ellen Cribbin, using Liposonix, a more powerful ultrasound tool to melt fat without surgery.

"Liposonix is the newest kid on the block for helping to re-sculpt and melt fat," Day said. "It's like liposuction, but it's a non-surgical approach. ... It uses that high-density focus ultrasound to actually heat up and melt fat."

After just one treatment Cribbin is expected to drop one dress size. Her cousin Lauren Vincelli has had even better results. Now one month after her treatment, she has dropped two dress sizes.

So have Day and Steinbrech found the fountain of youth in these new cosmetic techniques?

"Well, it may not be that you never look old, but you can put it a long way off," said Day. "We can slow that process down in a very natural way, with these procedures."

Watch the full story on "The Cutting Edge," a "20/20" special, online here.

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