comscore A new you: No surgery required | Honolulu Star-Advertiser

A new you: No surgery required

    Dr. Todd Mirzai of Hawaii Plastic Surgery Associates demonstrates how a nonsurgical face lift would be carried out using an ultrasound technique called Ultherapy. Serving as his model is Kelly Tojami.
    Nicole Bradford, right, medical esthetician and laser technologist for Dr. Choon Kia Yeo, offers Josalynn Shook a glass of water as Shook undergoes Coolsculpting of her abdomen. The horseshoe-shaped pillow is to keep her comfortable during the hourlong treatment.
    A roll of abdominal fat, left, is drawn into the pocket of a Coolsculpting vacuum applicator, between two cooling pads. The pads cool the area to just above freezing and turn fat from a liquid into a solid. Afterward the abdomen is massaged to break up and flatten the fat.
    Photographs taken before, left, and 90 days after treatment show toning and lifting of the skin around the eyes.
    A woman’s neck before, left, and four months after Ultherapy.

Two trendy, noninvasive cosmetic surgery treatments now available in Hawaii promise no cutting, no scarring, no side effects and no downtime.

One — Ultherapy — relies on the same ultrasound imaging technology used to examine pregnant women or treat kidney stones to reduce the appearance of saggy cheeks, jowls, jawlines and necks. The other — Coolsculpting — is touted as a less traumatic option to liposuction to remove unwanted bulges.

“The baby boomers are driving this market. They don’t want to let aging come without a fight,” said Dr. Todd Mirzai of Hawaii Plastic Surgery Associates, who began offering Ultherapy early this year.

Both treatments have been approved by the Food and Drug Administration.


Mirzai said Ultherapy is the first nonsurgical treatment that treats sagging tissue at two levels: the deep part of the skin and the skin’s underlying support structure.

“We are using age-old technology to see below the surface of the skin,” he said.

The Ultherapy device takes radiation-free images of the inner layers of skin and heats the areas to be treated, causing the skin to respond and create collagen, a protein that gives the skin the appearance of fullness and smoothness. The treatment precisely targets tissue beneath the skin’s surface, leaving the top layers unharmed.

The ultrasound pulses might feel hot, prickly or tingly, and patients might experience some discomfort during a session, which takes about 45 to 60 minutes.

“Just like exercise builds a muscle, it is this heat energy that builds collagen and provides an overall lifting effect to the face and neck,” Mirzai said.

“It is a first-of-its-kind technology — it’s a game changer. We are able to see below the skin and visualize the tissues without making any incisions.”

The procedure, which costs about $4,500 for a face and neck treatment, is said to work best for patients just starting to show signs of aging, not those with a lot of excess skin and muscle. Mirzai said most of his patients who have undergone Ultherapy are in the 35-to-65 age range.

“It’s not a replacement for the face lift,” Mirzai said. “There’s no magic bullet, but doing things earlier could eliminate the need for surgery. It could at least push the process back.”

In a study conducted by Northwestern University, about 89 percent of people who had the procedure saw significant improvement, with an average brow lift of 2 to 3 millimeters. Mirzai said the visible effects from one treatment include toning and lifting of loose skin. Full results are apparent about three or four months after the procedure is done, he said.

Tracy Wade said she noticed big differences after her procedure in February. Wade, a 48-year-old Hawaii Kai resident, had uneven eyebrows, so Mirzai used Ultherapy to lift the drooping brow.

“One brow was naturally higher than the other, but now they are even,” she said. “I’m so happy about that.”

She said the appearance of dark circles under her eyes was lessened.

Wade said the procedure was a little uncomfortable yet tolerable. “It lifted everything,” she added. “My face looks less droopy.”

The procedure has been available in the United States for the past year.

“It’s just the tip of the iceberg,” Mirzai said. Eventually it will be used for arms, breasts, tummy tightening and butt lifts, he said.


This body-contouring procedure that “freezes” fat can be done during your lunch hour or while working on a laptop or reading a book. An added bonus: The results are gradual, so there’s no sudden change in appearance.

The Coolsculpting process, developed by Zeltiq, uses a device to vacuum up the fat bulge between cooling panels. Pressure and intense cold are applied, but any initial discomfort subsides in about seven to 10 minutes, according to Nicole Bradford, medical esthetician and laser technician at Honolulu MedSpa, which has offered the treatment since March.

“It never reaches a freezing point where it would harm the skin. And, it does not affect the organs in any way,” she said.

The cooled, damaged fat cells begin to shrink and are eventually flushed from the body through natural means. Results can be seen about three weeks and will be most dramatic after two months, Bradford said. The body will continue to flush fat cells for up to six months.

Eileen Sugimoto, a 35-year-old Manoa resident, decided to try Coolsculpting to get rid of her post-pregnancy belly a couple of months ago. “I wanted to get rid of that hard-to-lose area,” she said, noting she is happy with her results since she went down a pants size.

Sugimoto described the procedure as uncomfortable at first. “It was really cold, and I wasn’t sure what to expect,” she said.

After about 10 to 15 minutes, the discomfort subsided. “I actually took a nap during the procedure,” Sugimoto said.

The procedure, which starts at $850, is noninvasive, so patients can return to normal activity immediately. Temporary redness, minor bruising, tingling or numbness might occur in the treated area.

Coolsculpting is not meant to be used as a weight-loss method, explained Dr. Choon Kia Yeo, medical director of Honolulu MedSpa.

“It’s ideal for anyone with a bulge. It’s meant to reshape and removes about 20 percent of the fat in the treated area,” he said.

“This technology is very cool; it doesn’t hurt. All you do is sit down or lie down. We suck up the fat in the

Zeltiq, and it cools it down for an hour.”

Coolsculpting has been on the market since 2009. The procedure is not recommended for people with Lupus or cold sensitivities or individuals who had a lap band or gastric bypass surgery. If you’ve had a tummy tuck or C-section, you would need to wait about four months after either of those procedures.

The procedure is approved by the FDA for use on the abdomen, sides and back. Results are permanent as long as weight is maintained.


>> Hawaii Plastic Surgery Associates, 1907 S. Beretania St., Suite 120; 952-9779

>> Honolulu MedSpa, 1650 Liliha St., Suite 102; 528-0888;

Comments have been disabled for this story...

Click here to see our full coverage of the coronavirus outbreak. Submit your coronavirus news tip.

Be the first to know
Get web push notifications from Star-Advertiser when the next breaking story happens — it's FREE! You just need a supported web browser.
Subscribe for this feature

Scroll Up