When patients ask me, “How can I look youthful without surgery?” I make the following five recommendations:
How to Look Youthful Without Surgery
1. Sculptra Aesthetic®
My favorite anti-aging treatment is Sculptra, which is poly-l-lactic acid(also an alpha hydroxy acid) that stimulates your own skin cells to produce collagen. This procedure involves injecting Sculptra under the skin and works best to restore fullness to the temples and cheeks. While that may sound uncomfortable, most patients feel that it is one of the least painful treatments available and there is little to no downtime. Some may experience bruising, but it can be covered with makeup.
Because the product actually stimulates your own skin cells, the improvement that you see from Sculptra is actually due to the formation of your own collagen. While growing your own collagen is slow (improvement peaks about 9 months after treatment), the benefits last at least two years.
Dysport®/Botox®/Xeomin® are the most well-known and give the best and quickest “pick me up” of all the treatments. When used properly, these products can open up the eyes, minimize forehead, eye and lip wrinkles, and help patients look youthful without surgery almost immediately. Neuromodulators can also improve the appearance of jowls and the neck. While they work the fastest, be aware that the effects do not last as long as the other treatments, so they need to be repeated more often to maintain the effect.
Neuromodulators inhibit the muscle action that is responsible for the wrinkle. Technically, that ‘paralysis’ of muscle lasts about three months, but the wrinkle may stay away longer. Over time, some patients will “learn” not to contract the muscle responsible for a wrinkle and then may not need the neuromodulator as frequently.
Fillers such as Restylane® and Juvederm® contain hyaluronic acid, which is injected into a wrinkle to “fill” in the wrinkle. I like these products best for the wrinkles around the mouth, lip and chin area. While these fillers are injected into the skin, the pain can be decreased by chilling the area with ice first. Fillers are manufactured with and without anesthetic, so make sure that your injector is using one of the fillers with anesthetic. Fillers containing anesthetic are much less painful and make a world of difference in improving the comfort of injection.
Results are immediate, but there is more swelling and bruising associated with these treatments. Try to avoid ibuprofen, aspirin, and naproxen prior to injection, as these pain relievers can increase the risk of bruising. Acetaminophen (Tylenol) is ok. Fillers last about six months up to a year, but several treatments over time have a long lasting effect and continue to help you look youthful without surgery.
4. Intense Pulsed Light (IPL)
IPL treatments, also known as photo-facials, are like laser treatments but use a broad band of light that targets blood vessels and brown spots. IPL helps remove spider veins and age spots from the skin, which gives it a more youthful appearance. The treatments hurt a little but are very tolerable and using cooling devices prior to the pulses minimizes the discomfort. After treatment there is some swelling and redness that usually resolves after a few days. Makeup can be worn to hide the redness.
Some “peppering” of the face occurs in areas where the brown spots are lifting off the skin. The number of treatments needed depends on how much damage there is to begin with. Repeat treatments are performed no sooner than one month apart. The results of IPL can be long lasting, depending on how well a person protects their skin from the sun after treatments.
5. A Skilled Dermatologist
Lastly, the success of all of these non-surgical procedures, particularly the injectable treatments like Sculptra, neuromodulators and fillers, depends largely on the person doing the injections. As a Dermatologist who performs these injections on a daily basis, I know the little things that can make a big difference, such as:
- A reclining chair that can position the patient properly
- Good overhead lighting
- Cleaning the skin thoroughly prior to injection to prevent infection
- Taking “before” pictures
- Studying the patients face at rest and while animating
- Reviewing with the patient what is realistic, what will look best for her, and what is safe with the fewest risks
- Taking time to inject the product conservatively
- The joy is the follow-up and maintenance
This is a quick overview of my favorite ways to look youthful without surgery; however, each procedure has benefits and risks not reviewed in this article. A good doctor will make recommendations that take in consideration your concerns, your budget and the risks of the procedure.