In the last 10 years, there has been a 444 percent increase in the number of cosmetic procedures performed in the United States. By cosmetic procedures, we re talking about both surgical think facelifts, breast augmentation and nose jobs and non-surgical chemical peels, Botox injections, and laser hair removal, to name just a few. In 2005 alone, nearly 11.5 million procedures were performed.

The names of the procedures can be confusing. Lipoplasty? Blepharoplasty? Thermage? What does it all mean? The Blade presents a glossary of terms that, it is hoped, will shed a little light on the many procedures available.

This is a major surgical procedure known most often as a tummy tuck. Excess skin and fat in the lower abdomen are removed, and the muscles of the abdominal wall are tightened. It is sometimes performed in conjunction with liposuction in order to more fully sculpt the body.

James Hunyadi, M.D, F.A.C.S., is a board certified plastic surgeon. He says, We do quite a few abdominoplasties, yes. Usually for women who have had a significant amount of weight loss, or those who have had children and don t plan to have any more, who have loose skin in the lower abdomen after pregnancy."

He notes that patients who are at risk for breast cancer are not the best candidates for abdominoplasty, since it can remove an option for breast reconstruction after cancer using abdominal tissue.

Also known as eyelid surgery, it is a procedure to remove fat, excess skin and muscle from the upper and lower eyelids. It can correct drooping upper lids and puffy bags below the eyes, which can make you look older and more tired than you feel, and may even interfere with your vision.

Dr. Hunyadi says that some patients want to change the shape of their eyes with a procedure called a canthal plasty, in which the eye is elevated at the corners.

Men and women who request blepharoplasty, he says, often have a lot of extra skin around the eyes and want to appear more youthful.

Some have good skin tone but have bulging in the lower lid an inherited trait.

The brow lift, also called a forehead lift, corrects drooping brows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired. It also results in a more youthful appearance. The surgeon makes an incision above the hairline and lifts the skin of the forehead, removing underlying tissue and releasing or altering the muscle. The excess skin is then trimmed off at the incision point, and the incision is closed. Dr. Hunyadi says that this procedure is often combined with an upper or lower lid blepharoplasty.

Our goal is to make them look more refreshed and not always look surprised, Dr. Hunyadi says. Most plastic surgeons would agree that the surprised look is not the best aesthetic. We raise the brow just a few millimeters above the bony rim of the eye.

Botulinum Toxin

Better known as Botox , this is an injection of a protein derived from botulism. It paralyzes certain facial muscles which cause frown lines, crows feet and other wrinkles. The effects last three to four months. Botox is often used in conjunction with dermal fillers.

Chemical Peels

Used to treat wrinkles around the eyes and mouth, age spots, skin discolorations, and mild acne scars, this involves an application of an acid to the face to remove outer layers of aged, discolored or irregular skin.

The mildest form of this involves alphahydroxy acids; trichloroacetic acids are used for a deeper peel, and phenol produces the deepest peel. Chemical peels are usually performed in a plastic surgeon s office.

They sound scary, says Manesh Gupta, a plastic surgeon who is certified by the Board of Surgeons and the Board of Plastic Surgery. And it does involve applying a controlled amount of burn to the face. A laser will do the same thing and so will dermabrasion. All three involve methods of resurfacing the skin.

He says that skin, the body s largest organ by weight, is constantly replacing dead skin cells the epidermis from the dermis. The chemical peel removes the dead layers and turns over the living layers.

Collagen is useless to apply to the top of the skin, but your own cells produce it, he says. And with irritated skin, collagen will produce more and fill in.

Used to treat scarring, remove tattoos, and minimize age spots, wrinkles and some skin growths, this procedure is performed by a surgeon using a rough wire brush or a burr containing diamond particles attached to a motorized

handle. The surgeon scrapes the skin until the scar or wrinkle

is less visible.

Dermal Filler

A substance injected into the skin to restore volume to the skin and smooth out facial wrinkles, dermal filler is also known as collagen, Restylane, Hylaform, Sculptra and Radiesse. These may also be used to plump lips and add volume to cheeks and other facial areas. The least expensive of these, collagen, is made from cow hide and lasts three to six months. The most expensive, Radiesse, is a synthetic material that can last two years or more.

This is a very common part of our practice, Dr. Hunyadi says. He prefers to use Restylane, which lasts six to nine months or longer.

The nice thing is, if you don t like it, you don t have to worry about it, he says.

Dermaplaning

Similar to dermabrasion, except that the surgeon uses an instrument called a dermatome, which moves back and forth to skim off the surface layers of skin.

Facial implants are used to improve a problem area, such as a chin, or to provide a more youthful look, as in the cheeks. Some of the implants are made of a solid silicone. Facial implants are often inserted as a part of another surgery, such as a facelift.

With age, there is some volume loss, Dr. Gupta says. This volume loss and the dark circles under the eyes and sunken cheeks can make you look older than you really feel. Implants fill up that volume.

A chin implant to correct a receding chin is often done in conjunction with rhinoplasty, or nose surgery. It s not that they don t like their mouth or lips, they don t like the way the nose looks with the chin.

I ve put two or three of those into patients under the age of 25, he says.

Facial Vein Treatment

Facial veins can be treated with electrosurgery, in which veins are zapped with a quick current of electricity from a handheld needle, or with lasers that destroy the blood vessel but leave surrounding tissue unharmed. Similar to vascular lasers is intense pulsed light therapy, which can take longer but have fewer side effects.

Dr. Gupta says that facial veins are often caused by rosacea, or from hormones or allergies. He finds that when facial veins are caused by rosacea, he often has better results with creams that are niacin-based.

Laser Hair Removal

Long wavelength lasers and pulsed light sources disable the hair follicle. This treatment can be used to remove unwanted hair from the face, underarms, back, legs, chest, and bikini area. Results vary, and repeated treatments may be necessary.

Laser Skin Resurfacing

Similar to dermabrasion and dermaplaning, this procedure removes wrinkled and damaged skin, layer by layer. With the use of a laser, there is less chance of bruising or bleeding, but there is a greater risk of burning or activating a herpes virus, resulting in cold sores.

First Published January 26, 2007, 7:12 p.m.