Not long ago, men and women who wanted a more youthful appearance assumed that they would have to have a face-lift. A face-lift smooths sagging skin by pulling it up and tightening it, but the surgery doesn't give the skin itself a younger look.

Cosmetic dermatologists, on the other hand, have a number of options to create younger looking skin by getting rid of many lines and age spots. Some of these techniques make it possible to "plump" the face to reverse the sunken look that age can cause. These techniques are all non surgical and safe.


Fillers are materials that create volume to make up for the tablespoons of facial fat people lose as they age. The filler is injected directly into deep wrinkles to plump them. The materials are effective for many people older than age 60, assuming that their skin is reasonably taut. Fillers can decrease facial lines and wrinkles, treat frown lines between the eyes and also plump hollow cheeks and thinning lips.

Although there are a number of fillers, Re-stylane is one of the most popular, along with Perlane (a thicker form of Restylane), which is used for deeper wrinkles.

Procedures take approximately one hour. The results are immediate and can last from three to six months, after which the body absorbs the material. The procedure can be a bit uncomfortable, but the only side effects are a few hours of slight puffiness in the area and sometimes small, barely visible lumps that disappear within a few days to a few weeks. Approved by the US Food and Drug Administration (FDA), Restylane is a bioengineered, nonanimal, stabilized hyaluronic acid. It is almost identical to a sub_ stance found naturally in the body, making it safe to have repeat procedures.

I like to combine Restylane treatments with Botox. Although many people associate Botox skin injections with the "frozen" look sometimes seen on the faces of film stars, I prefer to use it more judiciously to relax muscles and give the face a destressed look.

Note: I do not recommend silicone injections to smooth the skin. Unlike other fillers, silicone is permanent, meaning that yon are stuck with the result and your face may not age well around it.

Cost: Restylane and Perlane cost approximately $750 for the first syringe. There may be a discount for additional syringes used during the same treatment. Most people need more than one syringe. Botox costs $400 to $600 for a single area of the face treated, also with some discount for each additional area treated.

A patient's own fat is a good filler, as well, because it gives the face an especially soft, natural look. For such fat transfer, the person's own fat is taken from another area of the body, usually the thighs or buttocks. Because this requires a micro liposuction procedure, exceptionally thin people are not candidates. Once the fat is harvested, it is frozen and remains usable for three years.

Fat transfer requires several treatments during a few months. Although this procedure hasn't been in use long enough for us to definitively say how long the results last, we are finding it to be semi permanent. And unlike synthetic fillers, natural fat tends to build up and stay-eventually eliminating the need for more injections.

You may experience some bruising and swelling for a week or so after the procedure, and there is a slight risk of infection. While this is a more expensive treatment (the total cost is approximately $5,000), it is cost-effective because it lasts so long.


Peels are available in gentle, medium and strong intensities. All peels chemically remove skin on the face and/or hands, which exposes the under layer-new skin that has been sheltered from the sun and other elements, and therefore, looks better. The difference among peels is how deeply they penetrate.

Gentle peels affect only the top layer and diminish fine lines and fade age spots. Ideally, you would get gentle peels approximately once a month. Many spas offer these, but technicians there may not have adequate training and use weaker chemicals than dermatologist. you can resume normal activities immediately after gentle peels.

Medium peels go deeper and more effectively remove age spots and fine lines as well as improve skin color and texture. They require two or three sessions for three to five weeks. You can resume normal activities immediately afterward. Results last approximately one year.

Deep (or strong) peels. The strongest peel-either a phenol or a trichloroacetic acid (TCA) peel-penetrates deep into the skin. It dramatically rids the face of moderately deep lines and age spots in just one treatment. Often, just specific wrinkled or discolored areas of the face arc deep-peeled.

This peel is relatively painful because it destroys the upper layer of skin and results in temporary blisters and scabbing. There is some risk of infection, so meticulous post-procedure care is necessary. People who have darker skin are not candidates because these peels lighten the skin and therefore, would create too much contrast with the neck. Also, anyone who has taken the drug Accutane within the last year is not a candidate because during this period, the skin is too sensitive for a deep peel. The recovery process takes at least three weeks.

Cost: Gentle peels run from $200 to $400 each...medium peels, from $200 to $1,200, depending on how much of the face is peeled... phenol or TCA peels, up to $4,000, also depending on the amount of skin treated.

Laser And Photo Rejuvenation

Laser treatment tones the skin and improves skin texture Photo rejuvenation uses pulsed light to eliminate age spots and undesirable pigmentation.

Laser therapy also stimulates the production of collagen, the natural substance in the skin that helps keep it plump and unlined. This stimulation continues for several months after the treatment, giving ever-improving results' These treatments are painless, and one to three treatments can achieve desirable results.

For skin that appears leathery and discolored by sun exposure, a topical photosensitizing solution called Levulan is applied one hour before the light-based therapy session begins. Levulan allows the light to go deeper into the skin, there by enhancing the effect of the treatment. 'We have not found any risks or side effects for laser or photo rejuvenation treatments.

Cost: Laser and photo rejuvenation treatments run from $200 to $1,200 depending on how much skin is treated. Adding Levulan brings the cost to $500 to $1,500.

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