Your Face, Refreshed

Look 5 to 10 years younger with today’s skin techniques

If you’ve wished you could get a little medical help to look younger, but without anyone being able to tell you did it, join the club. “Our patients always say they don’t want to look ‘done,’” says Rebecca Baxt, M.D., a dermatologist at Baxt CosMedical in Paramus. “They want to look like themselves, but refreshed, as though they’d just come back from vacation.”

To meet this demand, dermatologists and plastic surgeons have developed a growing arsenal of treatments and procedures. One major caveat to any of these: They are only as good as the practitioner who performs them. While medical professionals of many kinds are trying to tap this lucrative market, you should choose one with extensive experience in the service you’re considering.

Peels and resurfacing: “Sun damage ages the skin, but that can be improved by chemical peels, sometimes more than one,” says Dr. Baxt. “A medium- strength peel will take off the top layer and all that brown garbage from the sun.” The peel is often followed by use of a cream that contains tretinoin (brand name Retin-A), which boosts collagen production, increasing skin elasticity and decreasing fine lines.

Sun damage and aging can also be addressed with Fraxel laser resurfacing. In this process, the dermatologist passes a laser over the surface of the skin. Microscopic laser beams penetrate the skin, stimulating the production of collagen. Minor swelling and redness— something like a sunburn—may lead to a couple of days’ downtime. Three to five sessions are typically needed, spaced two to four weeks apart, leading to a subtle and gradual transformation.

If you have a bit of time and want a more dramatic change, consider the TCA (trichloroacetic acid) peel, advises Sherwood Baxt, M.D., a board-certified plastic surgeon at Baxt CosMedical (and Dr. Rebecca Baxt’s father). “This is a very deep peel that is guaranteed to make you look years younger. It’s an option for my 50-something patients who have sun damage and perhaps damage from smoking.

“It takes about 15 minutes to do,” he continues. “The problem is, there’s a week of downtime. For almost all the face-lifts I do, I will do this peel at the same time because the patient is already out of commission with the face-lift. The peel gives a huge extra bang for the buck. It wipes away brown spots, blotchiness, fine lines and sun damage.”

Injectables: For deep lines and wrinkles between the eyebrows or on the forehead, Dr. Rebecca Baxt relies on Botox, the widely used injectable toxin. “Botox basically weakens the muscle that’s causing the line. As long as it’s used appropriately by someone very well trained, Botox is very safe and very effective, and can easily take five years off your face,” she says. “I often use it in combination with fillers like Juvéderm and Restylane to deal with nasolabial folds, or ‘smile lines,’ and to restore volume that’s lost in the lips and cheeks as people age.”

A new filler called Voluma, which is already in use in Europe and Canada, recently received FDA approval. Developed specifically to restore lost volume in the cheeks, this product uses hyaluronic acid, a sugar that occurs naturally in the skin, and is placed in the deeper layers of the facial skin and above the bone to restore facial volume. Its makers claim the effects last up to 18 months.

Skin tightening: Often used in conjunction with fillers, skin tightening is a gradual process, says H. William Song, M.D., an aesthetic medicine specialist at Omni Aesthetics in Oakland. “It’s very effective, but it does take several months to see the full result because it depends on your body rebuilding its own collagen, and that happens over time,” he explains.

Dr. Song’s two favorite skin-tightening treatments are ThermiRF (formerly known as Thermigen), which delivers radio frequency energy directly under the skin; and Ultherapy, which uses ultrasound. Both stimulate collagen and are effective for sagging skin on the face and neck.

Fat transfers: “We can now take fat from one area of your body, such as your stomach or hips, process it, and use it like a filler for areas of the face that have lost volume due to aging,” Dr. Song points out. “Because it’s a procedure, it takes longer than using a filler—about 90 minutes to two hours as opposed to 20 to 40 minutes for fillers.”

Because a fat transplant uses the patient’s own tissue, it has a natural appearance, the chance of an allergic reaction is eliminated, and the effects should last for years. As with any procedure, achieving a natural look with fat transplants relies on the skill of the practitioner.

Eyelifts: “The biggest bang for your buck is almost always standard eyelid surgery,” explains Dr. Sherwood Baxt. “It removes loose skin that is forming a second layer on the eyelid. It’s normally done from the inside so that there’s no scar. While I’m there, I take out bulges in fat pockets in the lower eyelids and remove any bags under the eyes.”

Beware, he says, of the eyelift/browlift combo, which leads to a definitely “done” look. “It’s the kind of thing that can make a person look as though he or she had walked into a wind tunnel. Doing just the eyelids—upper or lower, or both—is much more subtle.”

Given the myriad options available today for facial rejuvenation, Dr. Sherwood Baxt predicts that face-lift operations will become increasingly rare. “We will look back at the days when we used to cut people and pull up their skin as a time of barbaric ritual,” he says. “Women in their 40s and 50s who are just starting to get loose skin have all kinds of treatment options. There is a whole army of people who will look miraculous without ever having had surgery.”

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