Beat The Clock

By R.J. Ignelzi

December 7, 2007 8 min read


Treatments offer quick solutions to skin rejuvenation

By R.J. Ignelzi

Copley News Service

When people told Kay Corden how great she looked after her first couple of Botox injections, she quickly dismissed their compliments.

"I was just divorced and feeling insecure. Botox was my little rebellion, and I thought people were just being kind," says the 51-year-old mother of three.

That was more than five years and a dozen cosmetic procedures ago. Since then, Corden has had regular Botox injections to minimize the lines between her brows and at the corners of her eyes. She has had wrinkle fillers injected into her lower face to soften laugh lines and the tiny creases along her lips. And she has undergone a light laser treatment to help tighten her skin.

"Now when people tell me my skin looks beautiful, I believe them," says the licensed aesthetician, who looks 10 to 15 years younger than her age. "I hear compliments so often that I guess these (noninvasive treatments) must be working."

While plenty of Corden's friends and clients have had face-lifts and other cosmetic surgery, invasive procedures aren't for her.

"I don't want to go under the knife," she says. "I think I've found the perfect combination of noninvasive treatments for me. I'm happy with the injectables and lasers."

Corden's not alone.

The number of cosmetic surgical procedures fell over the last six years by 3 percent to 1.9 million, according to the American Society of Plastic Surgeons. Over that same period, minimally invasive procedures including injections and some laser treatments were performed on 9.1 million

Americans. That's an increase of a whopping 66 percent.

Not that long ago, ridding the face of wrinkles required a full surgical face-lift or deep laser resurfacing, which meant lots of money, significant discomfort and weeks of recovery time. But five years ago, when the Food and Drug Administration approved the botulinum derivative Botox for cosmetic purposes, a revolution was launched that made facial rejuvenation almost as easy as getting a pedicure.

"People are really busy and don't want to take time off to recover from surgery," says dermatologist Dr. E. Victor Ross, director of the Laser and Cosmetic Center at Scripps Clinic in San Diego. "Today there are a lot of things that people who are 30 to 60 or older can do that are far less invasive and lets them get back into action quickly."

Even some people who have gone the cosmetic surgery route are determined not to go that way again.

Busy real estate broker Bette Curtis had a surgical face-lift and loved it. But, after five years and losing 80 pounds, the drooping skin around her mouth needed help.

"I didn't want another invasive procedure," says the 60-year-old. "It's very expensive, there are risk factors, and in my job, I just can't afford the down time."

She and her surgeon, Dr. Michael Roark at La Jolla Cosmetic Surgery Centre, decided on a noninvasive option called ArteFill. Developed by San Diego's Artes Medical, the wrinkle filler is the first one to be called permanent. Although some skin experts are skeptical about the product and its unknown long-term effects, Curtis is thrilled with the results.

"It was the perfect quick solution," Curtis says. "It plumped it up and filled it out, and now people tell me I look really good."

Different products and treatments do different things and are used in different areas of the face. Botox works by paralyzing the forehead facial muscles that help form wrinkles. Some skin fillers plump up wrinkles and folds, while others add more pout to your pucker. Volumizers can add fullness to hollow cheeks. Updated gentle lasers help tighten loose skin. Still other treatments trigger the production of collagen, the natural scaffolding that supports skin structure that diminishes as we age.

Doctors don't expect injectables, lasers and thermal treatments to replace face-lifts. For older patients with loose, sagging skin, surgery is still the best alternative. But minimally invasive procedures might be just the ticket for anyone willing to accept more of a refreshening and rejuvenation rather than a transformation.

"You don't want to have people ask you if you've had 'something done,'" says Dr. Susan Stuart, a dermatologist with Scripps Memorial Hospital. "You just want to look more rested. People might ask you if you just had a vacation or did something new to your hair. The noninvasive procedures give you results that look natural."

Vicki Jones was sold after just one Botox injection.

"It took 10 to 15 years off my face almost immediately, so why would I want to go under the knife when I can do this twice a year?" says the 58-year-old, who's one of Stuart's patients. "I'm not ready to be 58. Botox (and other injectables) are the easy way out."

Combining different products and procedures often yields the best results. That's why dermatologists like Dr. Mitchel Goldman have 35 different lasers in his practice and uses nearly every wrinkle filler and volumizer on the market.

"People come in for some Botox with Affirm (laser) and then some Sculptra (a volumizer) or Restylane (a filler)," says the medical director of La Jolla Spa MD. "By using different combinations, you can hit a home run every time."

Even patients who choose more aggressive surgical procedures may benefit from noninvasive treatments that can enhance the cosmetic surgery.

After a face-lift, plastic surgeon Jeffry Schafer often uses wrinkle fillers to plump up the crease that runs from the nose to the corner of the mouth, called the nasolabial fold or "marionette lines."

"That's a very difficult area to treat surgically, and it's not really helped by a face-lift. By using injectable fillers, though, we can soften that crease," Schafer says. "Many of the noninvasive techniques can really augment the results of plastic surgery."

Although the benefits are immediate with few risks or side effects, most of the less-invasive treatments are only a temporary fix and must be repeated every few months to maintain the look.

"If you don't want down time, and want to look good tomorrow or next week, that's fine," Goldman says. "But you must know it will require multiple treatments. Nothing on this planet can be injected into the face and make all of your wrinkles go away permanently."

The longer an injectable lasts, the more it costs. Patients are charged by the syringe or vial and most facial treatments require one to two syringes. Botox starts at about $300 per syringe, while long-lasting filler ArteFill is approximately $1,500 per injection. Some doctors offer a discount or package rate for multiple syringes or treatments.

Like surgical cosmetic procedures, noninvasive ones aren't covered by insurance. Fans of noninvasive treatments reason that a shot of Botox or a wrinkle filler a couple times a year, while not cheap, is more affordable than a $15,000 face-lift, at least initially.

"I used to feel guilty about spending the money (for the procedures), but then I hit 50 and thought, 'It's time for Mom,'" Corden says. "I treat myself. Instead of buying a new pair of shoes, I spend it on Botox."

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