New surgical techniques, devices and medications abound for those who wantto correct those pesky imperfections

You know that thingamajig? That flaw - your flabby arms, loud snore, bald head, poor eyesight, frown lines, unmentionable whatever - that always has bothered you, but you thought you were stuck with? You may not be. You've heard tidbits on the latest medical advances - the new lasers and ultrasonic devices, new medications and procedures. But they often sound mysterious, experimental, radical. How safe are they? How expensive? What's available? Here's a quick guide to what can be done today - and what's right around the bend. Get ready to kiss your thingamajig goodbye: EYE CARE: Imagine a world in which glasses, if not eliminated, are a rarity. n The Cutting Edge: Laser eye, or refractive, surgery was first performed in 1987 and approved by the Food and Drug Administration 21/2 years ago. Dr. John Shepherd and his colleagues at the Shepherd Eye Center in Las Vegas perform the surgery approximately 1,000 times a year. The procedure, called LASIK, clears up moderate nearsightedness by reshaping the cornea using a new excimer laser (cost: $2,000 per eye, usually not covered by insurance). "Over a lifetime, it would probably be cheaper than contact lenses," Shepherd says. To qualify, vision must be stable and eyes must be otherwise healthy. The outpatient surgery, he says, has a "minimal risk" involving little more than a few anesthetized eyedrops and about 60 seconds of cornea carving. "It heals within a few hours, so there's no pain, and by the next day, it's hard to tell they've had surgery," he says. As for the future: "I think (this will) be like orthodontia, when people get to be in their early 20s, a large number will simply have their eyes corrected." n Around the Bend: The Shepherd Eye Center is one of four sites in the country testing a new procedure for high extremes of nearsightedness and farsightedness (over minus 10 - say, if you wear extremely thick glasses) called implantable contact lens, developed four years ago by STAAR Surgical. These are basically contact lenses that are implanted behind the iris and left in as long as they are needed. After testing is completed, Shepherd expects them to be on the market within two years. HAIR CARE: Imagine a world in which we can easily zap away the hair we don't want, and pop a pill for the hair we do want. n The Cutting Edge: Propecia, released this year in the footsteps of Rogaine, stimulates hair growth internally, rather than topically. "Sixty-six percent of male patients who took the medication had visible hair re-growth," Dr. Margaret Sommerville, a Summerlin dermatologist, says. "It's a huge advancement, it's the first oral medication we have in our repertoire." There's only one hitch: "You have to take it indefinitely," she says. "You will reverse benefits if you stop." Covered by some insurance companies, Propecia retails for approximately $45 a month. And for those who want to shed hair, not sprout it, laser hair removal is slowly moving to the forefront. "As a whole, this procedure is safe, not very painful, and quicker than electrolysis," Sommerville says. Prices range from $200-$700 per treatment, with an average of three treatments necessary. n Around the Bend: As laser hair removal drops in price, it may someday put all other methods of hair removal out of business. "I do see it becoming cheaper," Sommerville says, "and eventually, I think this may even replace shaving and waxing." SKIN CARE: Imagine a world in which a zap of a laser can eradicate spider veins, stretchmarks and wrinkles. n The Cutting Edge: Those looking for an alternative to the two-week hibernation required after traditional CO2 (carbon dioxide) laser resurfacing might look into the newer Erbium: YAG laser, which allows for shorter treatment recovery time. The cost of both is still high, though, at least several thousand dollars. Another new laser, the Versapulse, is being touted by some doctors as highly effective on spider veins. And for those looking for a quick fix for wrinkles, Botox is hot. Dermatologists have found that injecting the neurotoxin into a wrinkle in effect paralyzes the muscle, clearing up lines for a few months (cost: $250). n Around the Bend: Research is ongoing. EAR, NOSE AND THROAT: Imagine a world in which petty annoyances such as snoring and serious afflictions such as deafness are eliminated. n The Cutting Edge: Tired of lying awake nights, listening to your partner's snoring? Somnoplasty, a new procedure just barely out on the market, zaps the tissue that causes snoring (the uvula and soft palate at the back of the throat) with two minutes of radio frequency energy, shrinking the tissue without the soreness associated with traditional laser and surgical treatments. The $1,000-$2,500 procedure is considered cosmetic and generally not insured, but offers a 90 percent success rate. Dr. Walter Schroeder, an otolaryngologist with Ear, Nose & Throat Consultants of Nevada, already performs about five laser treatments a week. He expects customers to flock to the new painless method. "Their spouses are basically towing them in, saying, 'It's time to have something done.'" n Around the Bend: Cochlear implants, an established surgical proceedure that plants an electronic device into the inner ear, can correct deafness by converting sounds into electrical impulses sent and interpreted by the brain. The procedure (cost: tens of thousands of dollars, covered by insurance) has a 90 percent success rate, and has been made available locally only in the past year by the Ear, Nose & Throat Consultants of Nevada. But as this becomes standard procedure for deaf children, it may eliminate profound deafness in future generations. INFERTILITY: Imagine a world in which babies can be mixed, stirred, frozen, thawed and provided exactly as ordered. n The Cutting Edge: In vitro fertilization (IVF), once considered a chancy and expensive procedure, now has a much higher success rate and a more affordable price tag, according to reproductive endocrinologist Dr. Bruce Shapiro, founder of the 10-year-old Fertility Center of Las Vegas. The center has fostered more than 700 births since it began offering treatment in 1988, when only 15 percent of embryos implanted in a woman's uterus resulted in a live birth - today, nearly half do. The cost of IVF (which is sometimes covered by insurance) is approximately $7,500 per attempt, and most couples succeed within two times. The Fertility Center can also screen at-risk embryos for genetic faults before implantation. With even more stunning ramifications, parents can opt for a still-experimental procedure called "enriched fraction," which, for an extra $1,400, separates sperm by weight, and thus by gender. This allows them to influence - if not choose - the sex of their baby with a higher rate of probability. n Around the Bend: Scientists are experimenting on ways to give those women reluctant to use a surrogate egg the chance to reproduce, using their own genetic material. One method injects the older egg with cytoplasm from a younger woman's egg, which seems to give the egg the vitality it needs to develop. Another transfers the nucleus of the fertilized egg into a younger egg's cell, the nucleus of which has been removed. The freezing (cyropreservation) of sperm and embryos has been successful, but the more difficult task - thawing and fertilizing a frozen egg cell - has finally been achieved, although it is not reliable enough to be offered commercially. Still, Shapiro agrees that it's possible to envision a future in which we can all deposit our reproductive cells while they're young and healthy, and simply thaw them out later, if needed. PLASTIC SURGERY: Imagine a world in which bodies are sculpted by ultrasonic waves and body parts are grown in the lab and transplanted to the body. n The Cutting Edge: Silicon breasts are back. Since the FDA's 1992 moratorium on their use in response to safety concerns and class-action lawsuits, saline has been mandatory for women undergoing first-time enhancement. However, in the past year, two companies have gained approval to offer silicon gel implants for women undergoing replacement or reconstuction, as long as they agree to participate in a study aimed at proving their safety. Dr. William Zamboni, chief of the Medical School's Division of Plastic Surgery at UNLV, is one of a handful of Las Vegas doctors authorized to offer the implants, which arrived this month. Ultrasonic Assisted Lipoplasty (UAL), introduced into Nevada by Dr. Zamboni in 1994, has supplemented, if not replaced, traditional liposuction for certain body sites, especially in fat removal from backs, hips and abdomen, and harder male fat. The 1-2 hour procedure (cost: $2,000-$6,000), considered an "off-label use by the FDA," consists of making an incision and inserting a probe, the sound waves of which liquify the fat, making it easier to suction it out - and easier for the patient to recover. n Around the Bend: Need some new cartilage for arthritic joints? Or a new body part entirely? Scientists are using animals to study tissue engineering - using a petri dish to generate skin, bone or nerve cells that can be transferred to the body. Now available is Integra, a manufactured skin substitute that can take the place of real skin for grafts. Up next: For someone who has lost or been born without an ear, for example, doctors hope to generate skin cells, place them in an ear-shaped mold and attach them to the head. "I think we'll see human applications within the next two years," Zamboni says. "The potential is endless."

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