First it was the bridemaids luncheon, then came spa days as a way brides-to-be thanked their circle of attendants.
Now a growing trend in cosmopolitan cities is for the bride-to-be to spring for Botox injections for all her girls at a bridal party, held in a location of her choosing.
Drs. Carey Nease and Chad Deal at Southern Surgical Arts say Botox parties, in general, are held in Chattanooga, but they don't endorse them.
"Our personal preference is not to go out of the office to work Botox parties," says Nease. "Both for the safety of the procedure, as well as making sure people are of sound mind at the time (not inebriated), we prefer to do it in the office under controlled circumstances."
Here are facts and figures on the most popular pre-wedding procedures. Prices given are national averages according to the American Society of Plastic Surgeons or the American Academy of Cosmetic Surgery; however, most local fees for the surgeries begin at $1,000 or more higher.
Procedure: An injection into the muscle between the brows and/or the eyes to block nerve impulses that cause forehead wrinkles, crow's feet. When injected under the arms, it can stop sweating.
Plan ahead: Three months.
Cost (national average): $400 and up, depending on amount needed.
Procedure: Application of a liquid chemical solution that removes the upper layers of skin, revealing younger-looking layers underneath. Peels may be light, medium or deep.
Plan ahead: Three months minimum.
Cost: $140-$1,200, depending on depth of peel.
Procedure: Micro-needling procedure that stimulates collagen production. Can reduce fine lines, wrinkles and minimize acne scars.
Plan ahead: Two weeks ahead; or once a month over 4 to 6 months.
Cost: $300 for one treatment.
Procedure: Light "sanding" of upper layer of skin to smooth skin and reduce blemishes and wrinkles.
Plan ahead: Six months; often more than one treatment required.
Cost: $150 per treatment.
RESTYLANE & SCULPTRA
Procedure: Injections to fill out wrinkles, plump lips, reduce laugh lines.
Plan ahead: One month minimum. Treatment takes less than one hour, but allow time for redness and swelling to disappear.
Procedure: Surgery to change the size or shape of the nose.
Plan ahead: Six months minimum.
Cost: $4,400 surgical fees only.
Procedure: Insertion of saline or silicone implants to increase breast size.
Plan ahead: Three to six months; minimum six weeks. Have it done before purchasing the bridal gown.
Cost: From $4,000 for surgeon's fees only.
Procedure: Fat removal from beneath the skin of arm, thighs, midriff, hips.
Plan ahead: Six months.
Cost: $2,800 for surgical fees only, prices rise depending on amount of work done.
Source: American Society of Plastic Surgeons, American Academy of Cosmetic Surgery
Like every bride-to-be, Jennifer White wanted to look flawless on the day she tied the knot with Marco Kuysten.
"A bride thinks everything has to be perfect -- perfect dress, perfect hair, perfect flowers -- but there was one thing that wasn't perfect: my eyes. It's a family trait that the skin is baggy below the eyes," says the former Ringgold, Ga., resident, now living in Atlanta.
So five months before her wedding she had it corrected with surgery.
"They took out some muscle and all the fatty tissue. Did a stitch right under the lash line and some kind of a lift above the eye. I got a much smoother undereye. Had there not been a wedding, I probably would have continued to put it off, but the wedding prompted me to do it.
"It was a confidence boost," she says.
As many as one in three brides consider some type of cosmetic or plastic surgery before their wedding, and about 10 percent actually say "I do," according to bridal and plastic surgery websites.
After they've spent months -- and money -- ensuring the rest of their wedding is perfect, why take the chance on being unhappy with the way the wedding photos look? Not when a little Botox or microdermabrasion could ensure the bride's face is glowing, or a breast augmentation can boost her confidence as she comes down the aisle in her strapless gown.
It's a trend that has coined the Internet nickname "bridalplasty" -- a term that many plastic surgeons dislike, saying it implies going under the knife, and cosmetic procedures don't always go that far.
However, brides are booking surgeon's consultations right alongside hair, makeup and nail appointments as part of their wedding planning. Dr. Jeanne Scanland at Chattanooga's Center for Plastic and Reconstructive Surgery says the number of brides coming through her practice has been steadily increasing over the last 10 years.
"Younger brides are most interested in breast augmentation, liposuction and minor office facial procedures," she lists. The latter include injectable fillers such as Radiesse, Juvederm, Restylane, Perlane and Sculptra, or even having her inject their own fat to increase volume in their lips or cheeks.
"Older brides often request surgical procedures such as breast augmentation, breast uplifts or reductions, tummy tucks, liposuction and facial rejuvenation. The most common facial surgeries are brow lifts, eyelid lifts, fat injections, neck lifts and face lifts," says Scanland, who is the only female board-certified plastic surgeon between Nashville and Atlanta.
She recommends these surgical procedures begin no later than three months before a wedding, but preferably as early as six months.
The problem, say local surgeons, is that brides-to-be frequently don't start planning these procedures early enough. For example, June brides should already be booking -- or at least in consultations -- for procedures before their weddings.
"A lot of people think they can walk in and have their surgery tomorrow," says Dr. Christopher Chase of Associates in Plastic & Reconstructive Surgery. "Most of the time it's going to be several weeks before the schedule opens up in order to fit people in."
Chase finds a large number of brides coming to his practice want minimally invasive procedures to freshen up their skin. But even minor procedures require planning.
"There is always the potential for swelling or bruising, so you can't do it the week before the wedding," especially at this time of year, when it's heading into the peak wedding season, he advises.
As many as 30 percent of his clients are women planning for summer weddings, he says, and he sees just as many mothers of the brides and grooms as younger women. Moms are more prone to want facial surgeries such as brow and eyelid lifts, he says.
Scanland says she likes to start moderate chemical peels and medical-grade skin-care products as soon as possible before the wedding, sometimes as early as one year in advance.
"The longer time I have to get the skin in excellent condition, the better the results will be. I recommend trying fillers and neuromodulators (such as Botox) as early as one year before the wedding to see if patients like the results," she says. "If they are happy with the results, we can repeat these procedures one to two months before the wedding. I usually do a light chemical peel two to three weeks before the wedding to give a beautiful glow to the skin."
Dr. Chad Deal at Southern Surgical Arts says the new Dermapen -- a form of micro-needling the skin to deliver hyaluronic acid serum to brighten the skin -- has "taken this market by storm." He describes the procedure as somewhat comparable to tattooing "only more comfortable" because the needle doesn't go as deeply into the skin.
"The down time is only a day, maybe two, and the skin has a very glowing look," Deal says.
He advises doing this procedure a minimum of five days before the wedding because there is always the potential for bruising anytime a needle is injected into the skin.
Deal adds that the number of men getting these aesthetic procedures is growing by leaps and bounds.
"Men tend to do Botox and skin care," he says.
Neuromodulators such as Botox are primarily used to eliminate lines between the eyebrows and crow's feet at the corners of the eyes. But a rapidly growing Botox procedure is to inject it under the arms to stop sweating.
Nervous groom? No sweat. Want to pass that bridal gown down to your daughter? You can do so without underarm stains.
Dr. Carey Nease, partner with Deal in Southern Surgical Arts, says he is seeing a growing number of brides who have had massive weight losses -- 100 pounds plus -- and want help shedding the resulting loose skin.
"This is more common now with Lap-Band procedures, gastric bands and diet and exercise. They are coming in excited about their achievement but unhappy with all the loose extra skin. It (having it surgically removed) is a reward, somewhat, for their accomplishment," Nease says.
Procedures most commonly used for this, he says, are tummy tucks, breast lifts and implants, thigh lifts and brachioplasty, which is reshaping sagging skin on the underside of the upper arm). For brides, it's essential that such surgical resculpting is done well before the wedding.
"These patients really have to plan ahead of time to get rid of excess skin on thighs, abdomen or breasts. It may take one or two procedures. For multiple areas, you could have a patient for a year before they become excited about how they look and scars have faded," he explains.
Nease says breast procedures are most common on younger women -- 20- and 30-year-olds -- as well as women with asymmetric breasts, one result of big weight losses. Any breast procedure should be done a minimum of six weeks before the wedding to make sure all wounds have time to heal, says Deal, preferably eight weeks prior.
"The bottom line is we don't want patients coming in and saying, 'I'm getting married next week. What can you do?' You want to be excited for them, but if they come in a week ahead, there's not much we can do."
Contact Susan Pierce at firstname.lastname@example.org or 423-757-6284.