Lately I've noticed a stubborn little crease on my forehead. I lift the skin just a bit, mimicking a facelift - and the crease disappears. During a facelift, the surgeon makes an incision, usually around the hairline, and then pulls the facial skin upward to smooth loose skin and wrinkles, and provide a more youthful appearance.
While a facelift can provide dramatic results, I'm not quite ready for all that. I'd just like something to freshen my face a bit. And yet I'm smart enough to know that some products and procedures billed as facelift alternatives are likely to have more of an effect on my wallet than on my face. But how to separate the facts from the fictions? I turned to an expert for help - and here's what I learned.
Topical Treatments
Dr. Joel Schlessinger, MD, FAAD, FAACS, president of the American Society of Cosmetic Dermatology and Aesthetic Surgery, assured me that creams can be very effective when targeting specific problems. No single cream can do it all, however, and sadly he could not tell me of a cream that is truly "better than Botox." He recommends the Obagi line for pigmentation and age spots, and he has found creams that accomplish such things as increasing eyelash growth and enhancing pouty lips.
Peels are another option, and their level of invasiveness depends on what you'd like. Prices range from low strength AHA peels at $30 - $100 per treatment to very strong phenol peels at $4000 or more. Chemical peels burn off the outer, damaged layers of skin, revealing the younger skin underneath. Babies have such soft skin because their cells are constantly regenerating, but this slows as we age. Chemical peels speed the process up.
There are some nasty stories about what happens if a chemical peel goes too deep, so be careful in your choice of practitioner. Some of the newer options, like blue peels, claim to be safer. At $200 - $1000, these peels may be adjusted to the desired strength. Milder peels can be repeated at regular intervals to achieve a desired result and minimize side effects and healing time. According to the blue peel website, a measured application of blue glycerine is mixed into the traditional peel chemical, trichloracetic acid (TCA), to "improve patient safety by visually indicating the TCA solution strength and facial skin coverage." Anything that helps keep the peel from going too far sounds good to me.
High Tech Salon Treatments
Laser treatments are increasingly popular these days, whether you're trying to remove unwanted hair or get rid of wrinkles. Laser "facelifts" use a carbon dioxide laser to remove outer layers of old skin and tighten muscles.
Dr. Schlessinger tells me that the first laser treatments had "a long recovery time and fabulous results. Today's technology produces only about 20-30% of the those early results, but with almost no side effects." The new buzz word, Schlessinger tells me, is "fraxellation." In today's treatments, you can "strafe" an area so that the laser only disrupts pinpoints of skin, leaving enough surface untreated to speed healing time. This one sounded good to me.
What's more, laser treatments are only one kind of skin resurfacing. Dermabrasion and microdermabrasion, which can be thought of as extreme exfoliation, are old standbys that are still quite popular.
In dermabrasion [], the surgeon removes the outer layers of skin with an electronically operated wire brush or diamond-impregnated burr. It can leave you pretty raw and is moderately painful, with a 2 to 12 week recovery. Microdermabrasion is a bit easier on the patient. It involves spraying fine crystals onto the skin, then removing them along with the top layer of skin cells. It is not as painful as dermabrasion, and is safe to repeat every couple months.
Microcurrent "facelifts" go deeper, using mild electrical stimulation to activate chemicals in the skin. Dr. Schlessinger warns that some microcurrent treatments are nothing more than quackery. In general, he says, be careful of spa-type clinics that recommend the same treatment for everyone-chances are they might own only one piece of equipment!
Every woman trying to decide which procedure to have should have a consultation with a certified surgeon, Dr. Schlessinger tells me: "This is one area in which you get what you pay for."
It used to be unheard of to visit a plastic surgeon before you really needed it-at which point your skin and facial muscles are almost beyond repair. "Today," Dr. Schlessinger assured me, "we have better alternatives to keep people looking good for much longer." The trick is to do your research and take care of your face by starting early. And while an effective Botox cream is still five years off, new treatments are developed every day. With so many good options, short of a full facelift, I am very happy to know that I will never be trapped in a prematurely aging face.