Demand - and differing methods - are growing in plastic surgery

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When Daniel C. Baker, one of the country's most renowned plastic surgeons, graduated from Columbia University College of Physicians and Surgeons in 1968, he never could have dreamed that 43 years later he would be cochairing, with plastic surgeons Sherrell J. Aston and Thomas D. Rees, a symposium that included sessions on vaginal rejuvenation and reshaping the buttocks Italian, Brazilian, French, or Swedish style. "It's a new world," says Baker, "where it's difficult to separate the hype from the science. Every patient must be a savvy consumer."

It is not easy. The world of cosmetic enhancement is seductive. The pages of slick magazines are crammed with pictures of gorgeous models whose ads and testimonials promise a new look and a new life. Jane Davis of Cherry Hill insists that the combination of a face-lift, a new hair style, and the use of facial fillers has given her fresh energy and the thrill of incredulous stares from people who can't believe she's a grandmother. The smorgasbord of options - even procedures that are edgy and marginally excessive - has become irresistible, not only to baby boomers who are defining aging their own way, but also to their twentysomething daughters, increasing numbers of men, and those over 75. Almost no person and no body part is off limits.

Looking younger

"My patients in their 60s and 70s are often energetic women who like wearing the same stylish clothes as their daughters," says cosmetic surgeon Kevin Cross, whose practice is located at Demé, a medical/dental collaborative with offices in Center City Philadelphia and on the Main Line. "They want to go to the beach and look good in a bikini."

Cross is able to give them flatter tummies, and even treat their "batwing" arms, the loose underarm flesh on the upper limbs, with "invisible" tightening. The incision is hidden in the armpit, replacing the telltale scar that used to stretch to the elbow.