In their heroic effort to keep Angelenos attractive, a growing number of L.A. physicians are setting down their scalpels and picking up lasers.

From zapping unwanted hair to erasing wrinkles, birthmarks and tattoos, the use of lasers in cosmetic surgery has exploded over the last two years, according to Irving Arons, president of the laser market research firm Spectrum Consulting.

The number of procedures being performed is growing in the United States by about 25 percent a year, Arons said, and by the year 2000, likely will generate $5 billion in annual physician billings.

Nowhere is that growth more evident than in Los Angeles, where a combination of leathery sun-worshipers and vainglorious entertainment folk has made the region the cosmetic surgery capital of the world.

Already well-versed in the art of tucks, lifts and peels, Southern Californians and their physicians have embraced the new technology.

"People are educated here; they know all about it," said Dr. Richard Fleming, a partner in the Beverly Hills Institute of Aesthetic and Reconstructive Surgery. Fleming regularly uses the laser to remove patients' wrinkles in a process known as skin resurfacing.

But with the growing acceptance of lasers in cosmetic procedures, some warn that physicians and patients alike may be placing too much faith in a single gee-whiz technology.

"There's a saying that if the only tool you have is a hammer, the whole world starts to look like a nail," said Dr. Gary Broder, president of the American Society of Plastic & Reconstructive Surgeons and a professor of surgery at USC's School of Medicine.

Several factors are driving the laser's newfound popularity. In the last two years, lower-cost lasers have hit the market, making the technology more affordable to private practice physicians. Machines that once sold for upwards of $100,000 can now be had for between $60,000 and $70,000. Also, the Food and Drug Administration has approved these new devices, as well as older ones, for a wider range of treatments.

"The laser's been around for a long time, but in terms of the sophistication of the equipment and techniques, it has in the last two years gone from true infancy to much more sophisticated procedures," Fleming said.

During the same period, baby boomers have begun to reach middle age.

"It was the latest thing for what I needed done," explained Kim, a 44-year-old South Bay realtor who spent $7,500 to have her face resurfaced. "My generation is a lot more career-oriented. We do what we can to advance in our careers. When my parents were my age, they didn't have this type of technology, so why not take advantage of it?"

Another factor contributing to the surge in laser surgery are the growing numbers of people from gangbangers to businessmen who have grown disenchanted with their tattoos and want them removed.

Dr. Steven Popkow, a physician at the TLC Skin Laser Center in Los Angeles, performs about 20 tattoo removals a week with a laser he began leasing last fall.

"I had to do something to make up for my dropping income from managed care," Popkow said. "It was either this or open a restaurant."

Popkow charges between $100 and $300 for the service, which usually requires four to six sessions to complete. He said he plans to expand into removal of sun spots and treatment of other pigmentation disorders to help offset the $2,000 a month he pays for the machine.

At the heart of cosmetic laser surgery is the laser, a device that dates back to the 1950s and is now used in everything from computer printers to CD players. Essentially a very focused beam of light, the laser is used by physicians to pulverize skin cells, or in the case of tattoos, ink, to achieve any number of desired results.

In skin resurfacing, the laser zaps away the top several layers of skin on a person's face, ideally removing the fine lines and wrinkles in the process. In tattoo removal, the laser beam knocks the ink below the skin, where it is eventually absorbed by the body.

Neither process is painless. Each zap is likened to having a rubber band snapped against your skin, and each can cause a small amount of bleeding. But compared to the chemical or surgical methods used before, the laser procedures are mild, physicians say.

Industry analysts say that, as the technology continues to advance and baby boomers continue to age, lasers will play a still greater role in cosmetic surgery, which is already growing at an annual rate of about 20 percent. Hair removal and treatment of spider veins are seen as areas for particularly rapid growth.

"Hair removal is a very hot topic right now," said Ken Whitty, a marketing director for Coherent Corp. in San Francisco, which makes several of the most popular cosmetic lasers. Electrolysis and sales of hair removal creams now generate about $2 billion a year in the United States, and lasers could assume a big chunk of that, Whitty and others said.

"We're very optimistic about our growth," Whitty said.

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