Maybe it’s the laugh lines that don’t go away when you stop laughing, or the furrows in the brow even when you aren’t frowning. Or perhaps it’s the brown spots and rough patches on your cheeks, from years of too much sun worship. For aging faces, there comes a time when skin creams and a good night’s sleep aren’t enough to keep you looking as young as you would like. People have various reasons for turning back the clock on their appearance, from feeling better about themselves to staying more competitive in a youth-oriented workplace. But face-lifts and other plastic surgery can be a turn-off for many people, either because of their high cost, lengthy recovery times or risks of complications. Now, a widening array of minimally invasive treatments are making facial work more accessible to many people, and becoming part of their regular upkeep.
Injections of botulinum toxin type A
Better known by the brand name Botox®—are still the most popular procedure for smoothing wrinkles, especially in the forehead and brow. Newer dermal fillers like Juvederm and Restylane can plump up lips and smile lines.
FROM BOTOX TO LID LIFTS: Treatments for real life, when air brushing a photo just won’t work.
Surgeons can inject fat into the face from other parts of the body, which some patients prefer because it uses their own natural material. Laser treatments are designed to vaporize age spots and scars. And chemical peels can melt away damaged layers of outer skin, improving its tone and texture. Such treatments may last only a few months, but they cost as little as a few hundred dollars per session and can be done during a lunch hour.
Facial fillers and injections “…Can postpone the threshold for having a face-lift or major surgery for 10 to 20 years,” says Dr. F. Victor Rueckl.
Last year, the number of U.S. face-lifts, which can cost $6,000 to $15,000, fell 29% to 94,247 from a year earlier, and eyelid surgeries declined 23% to 149,943, according to the American Society for Aesthetic Plastic Surgery. By contrast, injections with Botox and Dysport rose 3.8% to 2.6 million last year. And Dr. Rueckl can attest that the less invasive approach is so much more natural looking.
WRINKLES IN TIME
Facial wrinkles and skin spots develop over time, with each decade leaving its mark.
Here is a typical progression as people age.
20s and 30s People have minimal wrinkles, often caused by sun damage. Treatments can include sunscreens and skin-care products containing retinol.
Late 30s and 40s An age for ‘wrinkles in motion,’ or lines that appear when people smile or use other expressions. These can be treated with injectables, like Botox, or dermal fillers, such as Juvederm and Restylane.
50s People often have ‘wrinkles at rest,’ or lines etched into an otherwise expressionless face. A combination of treatments can be used, including laser resurfacing or chemical peels along with injectable fillers.
60s and older A time of ‘only wrinkles,’ when people’s faces no longer have smooth skin. Treatments can include laser resurfacing or plastic surgery
The latest treatments, intended to stimulate the natural renewal process of skin, replace sagging, spotted or wrinkled skin with smoother, tighter skin with improved tone and texture.
Fillers like Restylane and Juvederm are based on hyaluronic acid, a sugar found naturally in human skin that absorbs water and acts like a cushion to restore volume and structure to
the face or fill lip lines. Injectable treatments carry risks such as bruising, lumps, local infection and scarring. And botulinum toxin may also affect nearby muscles. Dr. Rueckl warns that patients can be matched with the wrong procedure, such as laser resurfacing to make the skin look better, when the real problem is loss of volume in the face. He suggests patients discuss options with him, as he is a board-certified 
specialist and can advise about risks and follow-up care.
Too many Botox injections, for instance, can give patients a paralyzed, expressionless look, while overuse of fillers can make the face and lips look overblown and artificial. But Dr. Rueckl can ensure that you’ll look refreshed and look well-rested. After all, we can never return to our 20’s but we can look comfortable in our own skin.
