By Elaine Yamasaki

Youth pays a premium for living in these beautiful hills. With the Santa Ana winds sweeping in and the clear midday sun beating down incessantly as summer gives way to fall, you have probably felt the effects of dry, parched skin that doesn't look or feel the way it used to. Add to that the effects of time and gravity and we could all probably use a tune-up.

Though we work out and get facials, or apply make-up with the skill of Matisse, many of us have longed for a day when we could wake up and simply enhance our looks - not camouflage or hide. That day has come.  

Thanks to recent advances in cosmetic surgery, the risk and stigma attached to procedures done in years past have given way to a more relaxed confidence with the advent of laser technology, ultrasound and new methods that minimize scarring. Today's plastic surgery can be performed as an outpatient procedure that often allows patients to return to their usual activities in as little as a week. According to internationally renowned plastic surgeon Renato Calabria, who has just expanded his Santa Monica practice to Westlake Village, "these new procedures allow us to accomplish our goals in a safer manner, with less discomfort, less swelling perhaps, and certainly, with more precision and better results than the traditional knife." Among his high profile clientele are the celebrities, movie stars and producers who have entrusted their livelihoods into his skilled hands. "Here, success is based on self confidence and esteem, something that can only come from within," explains Dr. Calabria,

"What cosmetic surgery does is bring out that confidence and positive feeling, because a person's self-perception is paramount to his or her achievement in life." As a frequent goodwill missionary to less advanced nations, Dr. Calabria has seen many times the transforming power of corrective surgery.  

Among the more popular and "minimally invasive" new procedures are the vertical Facelift with no visible scars; endoscopic brow and facelift (using a microscopic camera to guide the surgeon); new anatomical breast enhancement; laser breast lift and reduction; laser skin resurfacing (which uses a laser beam to vaporize damaged skin to reveal healthy new skin beneath) and ultrasonic liposuction. This last procedure - in which excess fat is melted before suction, making the process more precise and easier to perform - is quite the rage in Europe and has been mastered by only a few surgeons here in the states. This brings us to the importance of selecting the right doctor.

1. Remaining State-of-the-Art. It is critical that a surgeon be aware of changing technologies and techniques evolving constantly in this highly specialized area of medicine. "A surgeon cannot offer something he can't perform." Meticulous training and remaining current are vitally necessary to maintaining a state-of-the-art practice.  

2. Communication and Relationship. Another point to consider in searching for the right surgeon is your ability to communicate and establish a rapport with one another. "A lot of my patients are happy with their outcomes because I am honest with them.

Dissatisfaction comes when the patient is not realistic about his or her expectations, or the doctor is not clear about all aspects of the surgery," says Dr. Calabria. "I always make a point to fully disclose the advantages and drawbacks of all the methods available and I suggest solutions based.on medical feasibility

 Sometimes the latest hype about a new procedure does not offer the best solution. "Though occasionally a person may desire a dramatic alteration all at once, most patients start conservatively. Your surgeon should be someone with whom you feel comfortable discussing your goals and insecurities. "A good surgeon will listen and make an objective assessment of a patient's desires, recognizing that each person is unique and must be treated accordingly:"

3. Aesthetic Sensitivity. Contact several references and review extensive samples of the surgeon's work to lend insight into his or her ability to consistently achieve good results. "A knowledge of classic proportions is essential ... I have always enjoyed painting and sculpting  as an Italian, it is part of my heritage," says Dr. Calabria. "A surgeon must have an innate sense of aesthetics ...and this cannot be taught."

The mythical fountain of youth may yet elude us, but plastic surgery today can provide a viable alternative. When you're ready to take the first step, it will be a comfort to know that you have left your future in the hands of an honest, conservative and artistically sensitive surgeon.