Fight Age, Without Surgery

Looking to rid yourself of crow's feet or laugh lines? A non-surgical cosmetic procedure could be the answer.

WebMD Feature

Reviewed By Brunilda Nazario

When the crow's feet creep in around your eyes, and the lines around your mouth linger long after you've stopped laughing, a cosmetic procedure may be the answer. But before you opt for surgery such as a facelift, know that there are quite a few non-surgical cosmetic procedures out there that help you turn back the clock -- or at least stop the hands of time for a few months. 

"The trend in cosmetic surgery is getting away from aggressive reconstructing and going for a more subtle, progressive change to a person's appearance," says surgeon Steve Margolis, MD. Subtle enough, explains Margolis, that instead of noticing a dramatic change, "Non-surgical cosmetic procedures allow a person to look great for his or her age." 

From Botox injections and cosmetic fillers, to chemical peels, to laser resurfacing, non-surgical cosmetic procedures provide a more youthful looking appearance, with quicker recovery times, lower costs, and a more natural result.  What do these procedures involve? And how do you know you're ready to take the next step and go for that facelift?

Botox Finds a Partner  

A natural protein that relaxes the active muscles in the face that cause wrinkles, Botox injections are all the rage: More than 1 million people worldwide were treated with this non-surgical cosmetic procedure in 2002, according to the American Society of Plastic Surgeons.  

"Botox is most effective around the eyes and on frown lines between the brow, and around the lips," says Rod Rohrich, MD, president-elect of the American Society of Plastic Surgeons. "But it is temporary." 

Botox costs about $400-$650 per session. The results of Botox last about 3-4 months, but since it only relaxes facial muscles to tighten the skin, it leaves behind surface wrinkles -- especially if the wrinkle is deep. Now, there is an answer to this problem: By partnering Botox with a cosmetic filler, the skin is tightened, the wrinkle is filled in, and the results last longer. 

Cosmetic fillers, which once included only animal-based collagen and human fat, but now include synthetic fillers such as Restylane, Artecoll, and Radiance -- all of which are awaiting FDA approval -- smooth facial lines and the creases that result from age, sun exposure, and years of facial movements, creating a younger-looking appearance.  

"Collagen is an animal-based product, so there is a risk of an allergic reaction," says Rohrich, who is also professor and chairman of the department of plastic surgery at the University of Texas Southwestern Medical Center at Dallas. "And its results only last about two to three months. These new synthetic fillers will last at least six months -- even longer if partnered with Botox."  

For Botox, which rang in about $175 million in sales in 2002, according to the Wall Street Journal, and for the new cosmetic fillers, this could be a marriage made in heaven. Research presented at the 2003 American Academy of Dermatology annual meeting showed that Botox partnered with Restylane almost doubles the longevity of their individual results: Alone, Restylane lasted 18 weeks, but used in conjunction with Botox, it lasted 32 weeks.  

As with any non-surgical cosmetic procedure, keep in mind that there are risks: Cosmetic fillers can cause the skin to look bumpy if too much is administered, or if it is used incorrectly. 

Other Non-surgical Cosmetic Procedures 

For the needle-shy or for those looking to spend a little less, there are other options that also provide a subtle, more natural-looking result. 

"People will make comments like how healthy or rested the person appears," says Margolis, who is the founder of the New England Vein and Laser Center. 

A chemical peel is a good choice for people looking to restore wrinkled, blemished, unevenly pigmented, or sun-damaged skin, according to the American Society of Plastic Surgeons. Using a chemical solution to peel away the skin's top layers, this procedure works best on those with fair, thin skin with superficial wrinkles

"Peels are good for fine wrinkles around the mouth and on the face, and downtime is about five days because it causes the skin to peel like you've had a sunburn," Rohrich tells WebMD. "But the longevity of this procedure is only about 6-12 months before you would need to have it done again." 

Microdermabrasion uses a sanding device to scrap off the top layers of the skin. This procedure softens the sharp edges of surface irregularities, including acne and other scars and fine wrinkles, especially around the mouth, according to the American Society of Plastic Surgeons. The results of this procedure are permanent, until new wrinkles appear, but it can be up to two weeks before the redness in the skin as a result of the treatment fades. 

Laser facial resurfacing smoothes the face as well as fine wrinkles by using a carbon dioxide laser device, according to the American Society of Plastic Surgeons. It softens lines around the eyes and mouth and minimizes facial scars and unevenly pigmented areas. But the results are only temporary as new wrinkles form.  

With any of these non-surgical cosmetic procedures, remember that it is essential to find a qualified and experienced professional who has a good reputation.  

"You get what you pay for," says Rohrich. So when it comes to your face, "You don't want to go bargain-basement shopping." 

Taking the Next Step 

When Botox and chemical peels have run their course, it may be time to take the next step. 

"Non-surgical cosmetic procedures are useful in younger patients, but as people get older, these have less of a role," says Rohrich. 

If you are looking for long-term results, or a dramatic change, cosmetic surgery is the answer. A facelift, for instance, can last up to 10 years, according to the American Society of Plastic Surgeons, and a nose job can last forever and change the look of your face.

But surgery also costs more, has a higher risk for complications, and a longer recovery time: at least two weeks for a facelift and several weeks for eyelid surgery

Subtle, Yet Effective 

Cosmetic surgery is a last resort, and in the meantime, non-surgical cosmetic procedures are a safer, subtle solution to fight the effects of time on your skin. 

"If you are young to middle-age, then non-surgical cosmetic procedures should work well for you," says Rohrich.  

Well enough, that you can say "see you later" to those crow's feet and frown lines, and look great for your age.

Published April 22, 2003.

SOURCES: Wall Street Journal, March 6, 2003. Steve Margolis, MD, FACS, founder and CEO, New England Vein and Laser Center, Concord, Mass. Rod J. Rohrich, MD, FACS, president-elect, American Society of Plastic Surgery; professor and chairman, department of plastic surgery, University of Texas Southwestern Medical Center, Dallas. American Society of Plastic Surgery  web site. American Academy of Dermatology Annual Meeting, San Francisco, March 21-26, 2003.

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