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About Face - Less-invasive cosmetic procedures gaining popularity

Don't you love it when someone says, "You really look tired," but you've just had 10 hours of sleep and feel great? Are you surprised to see an older woman reflected in a mirror and realize it's you?

While most people say they just want to age gracefully, no one really wants to look like the oldest mom in their Mommy and Me class. Yet since many women are delaying motherhood, they are likely to be attending PTA meetings with women half their age. Is it vain to want to do something beyond buying a face cream that promises to make you look younger? But who has the time or money for elaborate cosmetic procedures? Apparently, lots of people.

According to the American Society of Plastic Surgery, there has been a 465-percent increase in the total number of cosmetic procedures performed since 1997. While surgical procedures grew by 118 percent, non-surgical procedures increased by 764 percent during the same time period. These newer techniques may provide the desired results, while being less invasive and costly than surgical procedures.

We are bombarded with advertisements and articles touting new procedures, devices and products that promise to make us look younger. It's difficult to know what really works, what's safe and where you should go to get information.

Stella Desyatnikova, M.D., who practices at Edmonds Facial Plastic Surgery on the Stevens Hospital campus, has noticed an increase in patients who come to see her for non-invasive treatments. Many of her patients are moms in their 30s and 40s with young children. "Most patients are realistic -- they don't expect to look 10 or 20 years younger, they just want to look better and refreshed."

Desyatnikova says people who look tired but aren't are often candidates for an eyelid or eyebrow lift. Patients with greater needs may consider a mini face-lift, which costs about half the price of a full face-lift (approximately $3,500 instead of $7,000). These procedures are performed in a plastic surgeon's office but still require one to two weeks of recovery.

Desyatnikova also performs smaller, less-invasive and less-expensive procedures. "If you look tired because you have young children, you probably don't need anything drastic," she says. Desyatnikova says both Botox and Restylane (a filler for deep wrinkles) are effective. Too much Botox, however, will give someone a frozen face, or what she calls the "Desperate Housewife" look. You get what you pay for: Beware of inexpensive Botox treatments or "Botox parties" because although you'll pay less, it won't last as long.

These are some of the most popular, less-invasive facial treatments:

Botox: Primarily used to relax frown lines, forehead lines, crow's feet and nasal scrunch lines, this procedure involves injecting purified botulinum toxin in very tiny amounts into a targeted facial muscle. The resulting nerve blockade of that muscle causes a local immobilization of muscle movement, which prevents "crinkling" and wrinkle lines from forming when the patient frowns or squints. Results last three to four months; a treatment takes about 30 minutes and averages $400.

Filler agents: This procedure can create a smoother, more youthful look by replacing volume in deep wrinkles and facial creases including the nose to mouth line. The filler, either collagen or the more popular non-animal gel Restylane, is injected into the skin with a very fine needle. Results last from three to six months, with treatments ranging from $300-$1,000 depending of the amount of filler required.

Laser photorejuvenation: Used to reduce visible signs of sun damage, such as redness, broken blood vessels and brown spots, this gentle laser technique involves intensive light pulses. Each treatment takes 30-60 minutes; a series of about five treatments is usually required and will cost about $2,500.

Chemical peels: For this procedure, a chemical solution is applied to facial skin, causing the skin to blister and peel off over a period of days. As the treated skin blisters and peels, new, smoother and less-wrinkled skin forms. Different types of chemical peels impact the level of discomfort and the recovery time (ranging from three to 14 days). Peels start at $400 but can cost up to $2,000.

Microdermabrasion: This is a light peel involving a jet of fine crystals vacuumed across the skin. While this procedure will make the texture of the skin feel smoother, it does not last long and requires a regular maintenance schedule. It costs about $75-$200 per treatment.

Thermage: Based on radio frequency, this skin-tightening procedure is non-invasive but, according to Desyatnikova, isn't very effective, especially considering the cost: $1,000-$1,500 for a single treatment. Desyatnikova's advice is to contact a reputable plastic surgeon or dermatologist to discuss your concerns and to find out which procedure would be most appropriate for you. She says to be cautious about having treatments done at salons. Her recommendation: "Be an educated consumer and understand that these procedures are safe but should be administered by a physician who is trained in facial procedures."

Deborah Ashin, a writer and marketing consultant, became the mother of twins when she was 40 and hopes that no one thinks she's their grandmother.


Your Best Face: Looking Your Best without Plastic Surgery, by Brandith Irwin, M.D. and Mark McPherson, Ph.D. www.yourbestface.net. A comprehensive book discussing new treatments, products and skin care. Irwin practices medical and cosmetic dermatology at her own clinic in Seattle.

(www.smartskincare.com) is an independent skin care information portal for consumers that doesn't sell skin care products or cosmetics.

The American Academy of Dermatology's Web site (www.aad.org) offers general information about different cosmetic treatments and procedures.

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