New Wrinkles in Cosmetics

Looking to improve your looks without the expensive and invasive procedures performed by a plastic surgeon? If so, a recent trend of less painful and more temporary treatments may be the best avenue for you.

Doctors and plastic surgeons increasingly have been injecting patients with products like hyaluronic acid or botulinum toxin to erase wrinkles or reduce expression lines in the face. The treatments can leave a patient with a tighter, younger-looking face for less money and less recovery time than surgery.

And the patients are flocking in droves.

In 2006, some 9.1 million people participated in minimally invasive cosmetic procedures in the United States — a rise of 66 percent since 2000, according to the American Society of Plastic Surgeons.

So which brand of injectables works best? According to area plastic surgeons and doctors, different products achieve different results.

Perhaps the most recognizable is Botox, or botulinum toxin, a watery substance that is especially good for reducing wrinkles in the forehead or near eyebrows, said Dr. Stephen Davis of Davis Cosmetic Plastic Surgery, in Cherry Hill, N.J.

"Being injected in a muscle, it stops muscles in a particular area from working," said Davis, who noted that such an effect creates a more taut look.

In 2006, Botox topped the list of minimally invasive procedures, with 4.1 million treatments, making it far and away the most popular, according to the ASPS study.

Typically, one treatment will last up to four months, according to the Botox Cosmetic Web site (

Other injectable products — more commonly known as "fillers" — deliver hyaluronic acid, a fluid abundant in the joints. When a small dose is injected into the face, it can increase the volume of facial tissue, according to Davis. Products like Restylane or Juvederm can be particularly useful in reducing the appearance of expression lines or stiffening the nasolabial fold, edges that appear from the root of the nose to the angles of the mouth.

Both treatments last around six months, state their respective Web sites.

Another minimally invasive injectable, called Radiesse, is made of calcium hydroxylapatite, which does not just "fill" an area of the face, but actually promotes the collagen growth and tissue production. It is set to last a year or more, according to its Web site.

Perhaps the longest-lasting of the injectables is Sculptra, a poly-L-lactic acid that can last for two years, according to its product information.

Chiefly used to counter the effects of lipoatrophy — or a wasting away of facial tissue — Sculptra adds volume to reduce sunken cheeks, or rejuvenate the jaw line, according to Dr. Mark P. Solomon, a plastic surgeon in Bala Cynwyd.

Since Sculptra and Radiesse last so long, patients need to be sure that the look they get from an injectable treatment is what they really want.

Weigh the Options
"I can't give you an antidote; you're stuck like that for a while," said Dr. David Francis, a medical doctor who plans to start administering injectables this month at Bernard's Salon & Day Spa in Cherry Hill.

He urges that people weigh their options before starting any treatment.

The temporary nature of the other products is a good place to start, since those methods can provide a conservative trial period where the effects last only a few months.

"As a general rule, it's better to do too little than do too much," advised Solomon.

On the flip side, however, starting this way could also be the catalyst for getting a more permanent procedure.

"It helps me figure out who is a good candidate for surgery and who is not," continued Solomon, who explained that after years and years of receiving injections with temporary effects, many patients opt for a more permanent solution, like a face or brow lift.

While women dominate the industry — having sought 8.3 million minimally invasive procedures in 2006 (according to the ASPS study) — men received 851,000 procedures that same year. The number of men choosing hyaluronic-acid injectables has risen 85 percent since 2005.

"More and more guys are doing this," said Davis. "They don't have to have surgery; there's no recovery, and no one knows something was done."

Davis said that he believes that the No. 1 spot for men to treat is the "frown lines" around the mouth. Solomon added that many of the men he treats choose to work on the forehead.

Said the doctor: "They don't want to look tired and angry." 



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