New Cosmetic Procedures to Look Younger
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With more cosmetic procedures to choose from -- including nonsurgical options such as Botox injections as
well as new, less-invasive surgical methods -- reversing the effects of aging has never been safer or quicker.
How old you look depends largely upon the quality and texture of your facial skin -- including wrinkles, lines
and brown spots.
It also depends upon the quantity of your facial skin. As you age, your skin stretches and loses elasticity,
leading to jowls, hanging neck and other areas of loose skin.
For the best results, I now recommend an integrated approach to achieving a more youthful appearance --
one that combines the use of the prescription lotion Renova to reduce fine wrinkles... Botox to eliminate frown
lines ... filler materials to fill in deep wrinkles and creases in the skin... laser treatments to resurface the
skin... and minimally invasive surgery, to tighten loose skin.
Important: Get evaluated and treated by a board-certified dermatologist or plastic surgeon who can provide all
of these capabilities -- rather than someone who just offers Botox injections or laser treatments, for example.
RENOVA
Daily treatment with prescription-strength Renova (tretinoin) can reduce fine wrinkles, keep the skin surface
healthy and smooth and reduce discoloration, such as brown spots. Apply a pea-sized amount of cream to
the face each night at bedtime, after removing all cosmetics, washing your face with mild soap and drying
thoroughly. Typical prescription cost: $10 to $20.
Everyone should keep sun exposure to a minimum and apply a sunscreen of SPF 15 or higher when out in
the sun. Caution: If you use Renova, this advice is especially important, in order to prevent skin irritation --
since Renova makes skin more sun sensitive.
BOTOX AND MYOBLOC
Getting injections of Botox or its chemical cousin, Myobloc, is now the most common cosmetic procedure in
the US.
Botox works by temporarily paralyzing the facial muscles that cause frown lines. The Food and Drug
Administration (FDA) officially approved Botox for this purpose (for frown lines only) in April 2002 -- but it was
already in wide use before then. Botox injections are almost painless and can be administered in just
minutes. No recovery time is needed.
During each treatment, a number of injections are made in a specific site where excess muscle activity
causes wrinkles. Cost: Several hundred dollars per site.
Common sites: Vertical lines between the eyebrows, lines across the forehead, smile lines around the eyes
and bands on the neck.
Botox injections are also sometimes used for wrinkles around the mouth and for deep creases in the cheeks
or the cords ("turkey gobbler") of the neck.
Botox injections generally need to be repeated every three to four months to maintain their effect. Because
unwanted reactions occasionally occur, injections should be given only by an experienced doctor in his/her
office -- never at a health club or in someone's home.
FILLER MATERIALS
More than 40 types of dermal filler material are now available. These are injected under the skin to plump up
the outer skin where lines and creases have formed, causing them to diminish temporarily. Dermal fillers are
used to fill out smile lines and other creases and folds in the face and neck, and can also be injected into the
lips to make them look fuller.
The most popular filler, bovine collagen, has been in use for decades. Bovine collagen injections last about
three months and cost about $300 to $500 per syringe. Normally, one to two syringes are needed.
Collagen may become less popular once the FDA approves the use of a new class of filler materials called
hyaluronic acid derivatives. Bovine collagen is derived from cows and requires allergy testing, since it causes
a reaction in about 3% of patients. Hyaluronic acid occurs naturally in humans, and is virtually nonallergenic.
It is excellent at retaining water and fills out the skin very well. Best of all, hyaluronic acid lasts about twice as
long as bovine collagen -- up to six months for a single treatment.
The procedure, in which the filler is applied in gel form through an ultrathin needle, takes about 30 minutes.
Typical cost: $350 to $450 per syringe (up to two syringes are typically needed to treat one site).
Two hyaluronic acid products, Perlane and Restylane, have been approved for use in Europe, Canada and
the US.
LASER RESURFACING
Laser resurfacing with a carbon dioxide laser has replaced dermabrasion and chemical peels as the
treatment of choice for "sanding down" facial wrinkles.
The two most common treatment sites are under the eyes, where the skin often gets loose and crepe-like,
and on the fine vertical lines around the lips. Typical cost: $1,000 per site.
MINIMALLY INVASIVE SURGERY
For people who want to eliminate areas of sagging skin that don't respond to nonsurgical approaches,
several new, minimally invasive surgical techniques are now coming into wide use. These involve shorter
recovery times, significantly less scarring and lower costs. They include...
A scarless procedure to remove the bags of the lower eyelid area, using an incision inside the eyelid. Typical
cost: $3,000.
A short-scar face-lift (mini-lift or a limited-incision face-lift). A four-inch incision is made on the side of the
head, through which the doctor works to tighten the cheek, jowl and neck areas. The stitches are removed
after about five days. Typical cost: $8,000 to $9,000.
Removal of fat in the cheeks. This simple procedure involves removal of a small piece of fat from inside the
mouth on either side, to give the face a more angular appearance (the so-called "waif look"). Typical cost:
$2,500 to $3,000.
