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In-Office Procedures

 

The most effective ways to stay looking young.

If you have: WRINKLES ON YOUR FOREHEAD

Try Botox Cosmetic, which costs between $400 and $600. With this treatment, a diluted form of botulinum toxin is injected into a muscle to temporarily relax it, smoothing expression lines. Since wrinkles are partially formed by repetitive contractions, some dermatologists are now also using Botox in areas that are still smooth but prone to deep lines (e.g., next to the eyes and between the brows) to prevent creases from forming in the first place. The downside is that treatments must be repeated every three to four months, and you may have slight bruising wherever the needle entered the skin. Be sure to choose your doctor carefully; you don't want to take away all movement and it takes experience not to make a patient look expressionless. To find a board certified dermatologist or plastic surgeon in your area, visit botoxcosmetic.com.

Botox is slowly overtaking the brow lift (which costs about $3,400), a surgical procedure that smooths lines by pulling up the forehead through incisions made in the scalp. Complications may include too taut skin and a higher-than natural hairline.

If your: LIPS ARE THINNING OUT

Try hyaluronic acid injections, like Juvéderm, which typically cost between $500 and $1,000 for both top and bottom lips (one treatment should last from six to 12 months). Collagen injections are also popular; these injectables, which go by the names CosmoDerm or CosmoPlast, are fillers made from purified human collagen and cost between $400 and $800 per treatment (each one lasts up to four months). Both types of injections take only about 10 minutes, but they are painful. Many patients opt for a nerve block (similar to the Novocaine shot you get at a dentist's office) in addition to a topical anesthetic to make the procedure tolerable. Your lips will be swollen for about 24 hours and may look bruised for up to a week.

Lip injections are slowly making the V-Y lip augmentation, or lip lift, obsolete. This surgical procedure (which costs about $1,600) is designed to permanently increase the size of your lips. It involves making V-shaped cuts inside the lips, then stitching the cuts closed to create a more puckered-up shape. There is a six to eight-week recovery period, and risks include infection and possible permanent loss of feeling in parts of your lips.

If your: EYELIDS ARE CREPEY

Try Thermage, a device that uses radio frequency energy to heat the skin, causing collagen to contract (and stimulating new production of this firming fiber) and saggy skin to tighten. Prices run from $1,200 to $2,000 per session; you'll need just one. But you won't get full results instantly—the firming becomes more apparent over six months. The most common complaint is pain; most patients opt for a prescription painkiller like Vicodin or a topical anesthetic.

Thermage is gaining on the popular eyelid procedure blepharoplasty. In this process, plastic surgeons reposition fat and tighten skin through incisions in the eyelids (cost: about $3,000). The top complication includes removing too much skin, resulting in an overly wide-eyed look.

If your: SKIN IS GROWING SLACK

Thermage can also be used for the whole face. Just one treatment should do the trick and costs about $3,000. Or opt for a combination machine like the ReFirme ST (about $1,500 per treatment; you'll need three to four), which uses a blend of radio frequency energy and infrared light to stimulate collagen (results last up to two years). You may need a topical numbing cream to dull the pain of ReFirme ST; side effects include mild swelling and redness that last for just a few hours post-treatment.

Thermage and combination machines are making the face-lift passe;. The surgery, which repositions the skin and underlying muscle (average cost: $7,000) requires at least two weeks of downtime, and risks include infection and nerve damage.

If you have: SMILE LINES AROUND YOUR MOUTH

Try hyaluronic acid injections like Juvéderm and Restylane, which cost between $500 and $1,000 per treatment and should last for six to 12 months. Sculptra, a synthetic poly-Llactic acid injection that runs about $1,300 per session (you'll need about four at monthly intervals, with results lasting up to two years) is a second, less common option.

Both types of injectable are used to restore fullness, but they do it in different ways. Hyaluronic acid is injected directly into the nasolabial folds to fill them instantly, while Sculptra is injected into the deeper layers of the skin to stimulate collagen production, a gradual process that takes about six months. It's a good option for people who have lost substantial fat in the cheeks and around the mouth.

A recent University of Michigan study showed that Restylane triggers collagen production as well, though only a tiny amount when compared to Sculptra. The hope is that you'll need less correction over time since the skin appears to grow smoother in areas injected with fillers. General complaints include pain (a topical anesthetic is typical) and temporary bumps and bruising, which are more common with Sculptra because it's placed deeper in the skin and uses a larger needle.

Hyaluronic and poly-Llactic acid injectables are more popular now than the lower face-lift ($5,000 and up), which requires incisions in front of the ears to tighten the skin in the lower half of the face. Aside from a week or more of recovery, possible side effects include scarring, infection, and asymmetry (when one side of the face is pulled tighter than the other).

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