<
In the Media

Beauty by Botox
Treatment of aging uses needles instead of scalpels

By Stacy Smith Segovia - The Leaf-Chronicle

Talk TV-Botox Cosmetic
Click the link to view the video
CH News
Long-term Safety Data on Botox Cosmetic Use. Dr. Jean Carruthers, Opthalmologist and Dr. Alastair Carruthers, Carruthers Dermatology Centre.
Talk TV
Interview with Dr. Daniel Schachter about BOTOX Cosmetic®, the fastest growing medical procedure on the market.
The right age for BOTOX Cosmetic®
Discussion on self-esteem and question from Anna on is there a minimum age to receive Botox.
BOTOX Cosmetic® for facial scaring
Ellen has scaring on her face from a car accident and wanted to know if Botox would help.
Who should administer BOTOX Cosmetic® treatments?
Irene wanted to know if only a physician can administer Botox and does Botox work on the lines that extend from the nostrils down to the corner of the mouth and down to the chin.
The history and uses for BOTOX Cosmetic®
Host asks, what came first with Botox, something designed for cosmetic use of was it something designed to relax muscles?
BOTOX Cosmetic® for a 32 year old male
Dion is a 32 year old male with deep lines in the forehead and is concerned about the effect in lifting around his eyes. He doesn't want to be seen as an older guy trying to look younger.
BOTOX Cosmetic® for people in their 70?s
Host and doctor discuss age groups and sex, then going on to discuss a person 70 or 80 and what it will do for them.
BOTOX Cosmetic® in combination with other treatments
Robha looked into a facelift 10 or 15 years ago, how she went to see a surgeon and how he felt it wasn't right. She then discussed deep wrinkles on her forehead and around her eyes and wanted to know if a lift around the eyes would now help.
More and more men are having cosmetic procedures
Host and doctor discuss that a lot of the calls are from men and the host wonders if this is a surprise.
How BOTOX Cosmetic® works
Edward is 48 and is using Botox to treat deep age lines on his chin. He wanted to ask if Botox is filling in the wrinkle or relaxing the muscles?
What will happen when you stop BOTOX Cosmetic® treatments
Host asks doctor what happens if you suddenly stop Botox injections after a couple of years?

Ultimate Makeover
Click the link to view the video
Dr. M. Weinberg - BOTOX Cosmetic®, Restylane® and final makeover
Dr. M. Weinberg - BOTOX Cosmetic®, Perlane® and final makeover
Dr. R. Patterson (Part 1) - Breast augmentation
Dr. O’Neill (Part 2) - Collagen, BOTOX Cosmetic® and final makeover
Dr. L. Kellett - Mole removal, BOTOX Cosmetic® and Perlane®
Dr. O. Weiglein (Part 1) - Breast augmentation
Dr. O. Weiglein (Part 2) - BOTOX Cosmetic®, Cosmoderm/Cosmoplast, final makeover
Dr. F. Beninger - BOTOX Cosmetic®, Juviderm and final makeover
Dr. O. Weiglein - BOTOX Cosmetic®, Cosmoderm/Cosmoplast and final makeover


Preserved Saline and injection pain... ( PDF)



Baby Boomers 'terrified' of looking like dad: More men seek non-surgical facial treatments

National Post
Tue 10 May 2005
Celia Milne
AL10

Men by the thousands are turning to chemical peels and other non-surgical cosmetic procedures to keep their faces young and fresh — and to give their careers a boost.

"I definitely think it gives me a competitive edge," says Paul Devereaux, 39, who estimates he spends about $1,500 to $2,000 a year on Botox to fill in wrinkles and $780 on microdermabrasion, a gentle version of sand-blasting away sun damage.

Mr. Devereaux works in the financial services industry in Toronto, where appearance is critical in landing big clients. Looking after his face is an extension of other things he does for himself: working out and eating well. "People respect you more if you don't look dishevelled and tired," he says. He books his cosmetic appointments for either early in the morning or at lunch, and doesn't miss one iota of work time. "No one notices," he says. "My face looks redder after a workout than after microdermabrasion."

Most men favour the quick-in-quick-out-and-no-one's-the-wiser approach to cosmetic surgery. "They want less down time, more treatments," says Dr. Paul Cohen, a dermatologist in Toronto who offers a special "man's peel." Men's skin is thicker and more oily than women's, so it reacts less dramatically to these procedures, he says. "They usually have less redness than the women do and can easily go to work."

Although no one keeps track of how many Canadians are having non-surgical cosmetic procedures, the American Society for Aesthetic Plastic Surgery (ASAPS) has U.S. statistics, which are dramatic. Americans spent just under US$12.5-billion on cosmetic procedures in 2004. The knife, it seems, is passe. Surgical procedures represented only 18% of the total, while 82% were nonsurgical. Since 1997, nonsurgical cosmetic procedures have increased by a whopping 764%.

"The U.S. statistics mirror the Canadian situation closely," says Claudio De Lorenzi, a plastic surgeon in Kitchener, Ont.

What are men thinking? Dr. Alistair Carruthers, a dermatologist in Vancouver, who is known as the father of cosmetic Botox, says Baby Boomer men tell him they are terrified of looking like their dad. He estimates 10% to 20% of his cosmetic patients are male. Their favourite procedures are Botox, IPL (intense pulsed light that heats the layer below the surface of the skin to eliminate brown spots) and fillers. "Gosh, it's been so exciting the last decade. IPL is nothing short of magic. It's revolutionary."

One of the hottest new treatments on the market is called Levulan, a chemical that gets painted on before IPL. It's a photo sensitizer, so it boosts the effect of IPL. "The golfers, the sailors, the runners have tons of sun damage," Dr. Cohen says. "I tell them that the IPL with Levulan is their 'second chance'. It really can erase sun damage when they were careless in the past."

"It's a new, interesting, sexy way of treating sun damage and leaving healthy, clean skin to replace it," Dr. De Lorenzi says.

Alan Douglas, a 53-year-old real estate agent in Waterloo, has tried Levulan with IPL four times.

"I would spare no expense to have better-looking, smooth, perfect skin," he says. But he warns there can be too much of a good thing. The last time he tried it, he and his doctor decided to wait for four hours between applying the Levulan and using the IPL, to get a more pronounced effect. (Before, they had waited 20 minutes). The plan backfired. "My face was fire-truck red," he says. "I peeled for five days. I looked like a burn victim. That was frightening," he admits. Douglas had to take a week off. "I can''t afford to be away from work for that length of time."

Here's a brief summary of the most popular skin treatments:

IPL Light permeates the skin where it is discoloured. Can remove brown spots, red spots and sun damage. Takes 15 minutes. Five treatments recommended, three weeks apart. Can probably go to work one or two days later; $400 to $500 per treatment. Maintenance once a year.

IPL with Levulan $100 to $150 extra

Microdermabrasion Sprays fine crystals on to the skin, creating an abrasive action that removes the outer layer of skin. Minimizes pores and helps with sun damage. Can be used with lasers or peels. Takes 15 to 20 minutes. No healing time. Twenty-five per cent of people who received it last year were men, according to the American Society of Plastic Surgeons. Once every two weeks for five weeks. $150 per treatment.

Chemical peels Peels can be used to improve fine lines and age spots. For deep spots, you need a deep peel. The mildest peel is a glycolic peel; $100 to $150. Kojic acid peel is more aggressive; $200 to $250. TCA peel is even more dramatic, causing your own skin to peel afterward; $350 to $400.

Botox now is used for wrinkles on the forehead and around the mouth and neck. Treatment every four months.; $300 to $600 per area; $1,000 for the entire face.

In the past, these cosmetic treatments were offered a la carte, and people decided what they wanted. In the future, the procedures will be combined in a customized package deal.

Dr. Frank Lista, a plastic surgeon and medical director at The Plastic Surgery Clinic in Mississauga, Ont., has designed a program he calls The Miracle Ten. It costs $4,000 flat, and includes an at-home regimen as well as 10 visits to the clinic. "This is the latest and greatest. I cannot believe the difference."



Do creams beat Botox?

If beauty counters are to be believed, there's no need for injections. Hazel Curry investigatesFT.com site; Jan 09, 2004

Nobody likes needles. Many of us don't like wrinkles. Wouldn't it be great if, instead of injecting Botulinum in our faces, we could zap facial lifelines by smearing cream into them? Well, according to the latest lotions and potions on shop-shelves, we can.

Meet the Botox-alternative creams: there's Givenchy's No Surgetics, boasting an ingredient called DCompress that makes facial lines gradually relax, or L'Oréal's Wrinkle De-Crease with Boswelox that "visibly corrects expression lines".

Among the many great Lancôme skin creams is one called Résolution that contains D-Contraxol. Natura Bissé will sell you a product called Inhibit Expression Line Complex to "relax facial contractions".

Or you could choose from Roc's Retin-Ox Correxion cream that "reduces expression lines", Ultima II's Lifting Supreme with Botolift Extract, Nora Bode BEAUtyTOX ("the powerful alternative to Botulinum Toxin Injection"), Helena Rubinstein Expressionist and its B-Neutrox, Crème de Boto or, the most famous of the lot, DDF's Wrinkle Relax.

Although most don't spell out that they're claiming to be alternatives to Botox, the play on words is out in force. Many shoppers are bound to presume that these pots, two of which cost more than £100, will do to their wrinkles what a shot of Botox would.

Any businessman worth his briefcase will understand why cosmetic companies have taken the Botox-route. Globally, sales grew from £16m in 1993 to £200m in 2002. If a needle-free alternative existed, it would make its creator rather rich. Question is: do these creams really replace a shot of Botox?

The initial reaction from dermatologists, biochemists and Botox experts goes something like this: no.

"Our skin is not, contrary to what people may think, a free gateway," says Dr Marc Armangue, a Botox specialist at Medical Aesthetics, London. "Botox works by freezing the muscles around wrinkles.

The muscle is very deep (under the dermis and epidermis). The only way to pass these barriers is by disruption, which is why one injects Botox; another reason is that we want to place the solution in a specific area - the muscle next to the wrinkle. I don't see how you can reach a muscle and, more importantly, a specific muscle, by simply spreading a cream over the skin."

The Botox-alternative creams we examined don't contain Botox - that would be illegal. Rather, most contain one of two ingredients: palmitoyl pentapeptide and acetyl hexapeptide. Some, such as Wrinkle Relax and BEAUtyTOX, contain both.

The first ingredient is a modified chain of five amino acids that also pops up on ingredients lists as Matrixyl (a trade name). Clinical studies show that topical application reduces wrinkle appearance faster and with less irritation than retinol, a brilliant line-zapping ingredient. "It stimulates collagen, which decreases obvious lines," says Dr Diana Howard, head of research & development at the International Dermal Institute.

"Really, none of the creams containing it do the same thing as Botox (stop muscle contraction) though. But when you think about why people use Botox (to soften wrinkles and lines), you could make the case that anything that softens lines is doing a similar thing that Botox does."

So is any good anti-wrinkle cream (one with an ingredient that has been proven to soften wrinkles by upping collagen production, such as palmitoyl pentapeptide) as effective as the new Botox-alternative creams? Yes, if the Botox-alternative cream just contains palmitoyl pentapeptide.

However, those with the second ingredient, acetyl hexapeptide or argireline (its trade name), may do more. Unlike the pentapeptide, this is said to do the same as Botox - reduce muscle contraction.

It's a synthetic peptide that competes with the proteins that normally relay muscle contraction signals from the neurotransmitter acetylcholine, when we express ourselves. Unlike Botox, argireline doesn't break this communication completely, but interferes with it. This is what Lipotec, the Spanish company that patented argireline, claims.

However, there doesn't seem to be much evidence to back this up. The company has proof that the ingredient reduces muscle contraction in a petri dish, but has done little research on human beings (just a non-detailed look at its effects on 10 women).

"A lot of the (Lipotec) tests are rubbish," says Dr Nick Lowe, consultant dermatologist at London's Cranley Clinic and Middlesex Hospital, who has headed wrinkle studies in the USA and Europe. "To start with, the in vitro tests don't test against acetylcholine, rather they test a mechanism similar to it and say they can "transport the results", which they can't.

"Secondly, the tests were done in culture - well, you can stick anything in culture and get profound results. I'd have no confidence in something tested in culture - it may not work in humans. The study on 10 women involved no control (essential in scientific testing) and no expression, that is, they didn't make the women laugh, frown and so on.

"They say the study revealed that argireline reduces wrinkle depth by an average of 30 per cent, which is incredibly vague - that could be due to hydration.

"Finally, a study of 10 people is scientifically meaningless."

None of the companies selling the Botox-esque creams mentioned above could produce independent clinical trials on the efficacy of their products. Some have done in-house studies, which dermatologists say aren't reliable (simply because we have no way of knowing who is telling the truth). If something works why not commission a proper independent clinical trial, they demand. Cosmetic companies say it's cheaper and easier to do trials themselves.

So in a nutshell, we don't know if argireline does what Botox does because the independent research on its effect in human skin hasn't been done. Consumers will have to decide for themselves whether or not they want to fork out fifty-odd quid to find out.

And anyone determined to reduce wrinkles but terrified of needles, could take the advice of one Harley Street "alternative skin expert" who told the FT: "As a Botox-alternative, readers can try not smiling or frowning."

Some beauty is not worth it.

FACTFILE

  • DDF Wrinkle Relax 44 20 7235 5000

  • Nora Bode BEAUtyTOX 44 1775 722 243

  • Helena Rubinstein Expressionist 44 8701 109 705

  • Ultima II Lifting Supreme 0800 085 2716

  • Dermalogica Power Rich makes no Botox-alternative claims but is Matrixyl-rich 0800 591 818

More and more people giving it a shot: 'New injectables' a popular fix in the war on wrinkles

The Gazette (Montreal)

Tue 21 Oct 2003
Page: D7 / BREAK
Byline: Susan Kelly

Paradox: The number of North Americans seeking some form of plastic surgery has almost quadrupled over the past decade, according to the American Society of Plastic Surgeons. Yet, the majority want to avoid a scalpel if they can.

Enter the "new injectables." These new products are injected under the skin to act as fillers, plumping up sagging areas and unwanted lines. In the war on wrinkles, women (and, increasingly, men) are giving them a shot.

Arthur Swift marvels at the change in attitude. He has been a plastic surgeon for close to two decades. In 1996, he would reserve an afternoon each month for patients seeking injectables in his Montreal clinic. "The popularity of these quick fixes has skyrocketed. I now devote two full days to injectables and Botox a week. And I will see 50 patients in those two days," he said.

In fewer than 15 minutes, the right needle in the right hands can be employed to erase 10 years or more from the face. There is virtually no downtime and relatively few risks, save some minor redness or bruising.

Botox is the name most patients are familiar with, but it's not a filler, Swift said. Based on a powerful neurotoxin, it is injected in minute amounts by surgeons or dermatologists to convince wrinkle-causing muscles to ease up temporarily. It also prevents them from wreaking further havoc for up to four months.

"People actually come in asking for Botox," he said. "And they know what they're talking about. But some are off the point, because for deep wrinkles or those further down the face or around the mouth, it's often not appropriate."

"I sometimes administer Botox prior to other injectables or in combination with them," said Wayne Carey. He is director of dermatologic surgery at the Royal Victoria Hospital and an associate professor at McGill University.

In general, Botox takes care of more superficial lines or wrinkles, while fillers go to work on more deeply ingrained ones.

For injectable fillers, patients previously had two alternatives, collagen and fat. Collagen effectively plumped up lips and other areas of the face. But many people had allergic reactions, and the effects only lasted a few months. Then there's the technique of extracting fat from areas where it's plentiful, such as the thighs, and injecting it where it is fading, like the cheeks. But that is a long, tedious procedure and often painful.

Among the new injectables, some are temporary like collagen. But others claim to be permanent wrinkle fillers. Many cosmetic surgeons and dermatologists now prefer temporary fillers based on hyaluronic acid, a natural sugar-based substance found in the body and many cosmetics formulas. A key structural component of skin, it tends to decline with age. The best known hyaluronic acid-based injectable is Restylane, developed in Sweden, and a similar product from France, Juvederm.

A shot of one of these clear gels will fill you up nicely and last six months to one year. Although FDA approval for Restylane is still pending, Health Canada gave it the nod in the fall of 1998. "The only risk, which occurs very rarely, is allergic reaction," said Carey.

And then there's CosmoDerm and CosmoPlast, products lab-manufactured from human tissue. "There are more alternatives out there than ever," noted Carey. "But I find very good results with hyaluronic acid based products. And you tend to stay with what you know."

Many people want long-lasting results. Of the "permanent" injectables, Artecoll has been around longest, said Carey. The product, approved by Health Canada, was developed by Montreal-based Canderm Pharma.

Microscopic beads of a Plexiglass-like substance are encapsulated in collagen, all of which is injected to plump up unwanted creases. "You can imagine it's like a grain of sand that's put into an oyster around which a pearl is formed. In the same way the body puts a capsule around each bead. And that lifts up the skin or wrinkle," said Carey.

The entire process takes three to four months to complete.

In rare instances, people are allergic to the collagen in Artecoll. This is usually screened out in a pretest. And if administered improperly, there is a very slight - 0.125 per cent - chance of clumping or graulomas, a skin reaction to a foreign body. "But even then, most negative effects are correctable," Carey said.

As of last August, Dermalive was approved for use in Canada. It works on a principle similar to Artecoll, but the beads are made of particles of acrylic hydrogel, the same substance used in ocular implants. And it's suspended in hyaluronic acid rather than collagen. "It looks very promising," said Swift.

Another permanent product is based on a similar principle. Radiance is used widely in Europe and South America, though approval is still pending in North America. It is formulated using a natural substance, calcium hydroxylapatite, also found in bones and teeth.

But are these new injectables really permanent? Very long-term studies are impossible, since most of the products are relatively new. The first on Artecoll, for example, began in 1989. But of the 150,000 patients queried, 90 per cent are still satisfied with how they look. "I have patients who were injected in 1992 who still look great," said Carey.

What's next? Carey is keeping an eye on Silikon 1000. This injectable has yet to receive approval in the U.S. or Canada. "It gives some of the best results I've seen. But we saw catastrophic things when inexperienced people were injecting this stuff." Studies are now under way to determine if this permanent solution based on liquid, medical-grade silicon will be safe.

Swift is involved in a study for a product called Nasha, made by the same company as Restylane. "It uses larger molecules of Restylane to do larger areas or re-contouring. We may be able to give someone a stronger chin or cheeks with it, rather than an implant," he said.


Look Younger
Without Surgery

BY DIANE PETERS

Save Your Skin

The experts agree: One of the best ways to prevent further skin damage is to wear sunscreen. Even if you’ve been a sun worshipper in the past, it’s never too late to start protecting yourself. “At the very least, you’re preventing more damage and giving your body a chance to rejuvenate itself,” says Wang.

Sunscreen won’t reverse wrinkles or spots caused by the sun, but when used consistently, it helps reduce further cellular damage that, if left unchecked, can lead to more sun-induced symptoms, including skin cancer. Here is some need-to-know info:

Read the label: Seek out sunscreens that contain micronized zinc oxide or titanium dioxide. Both of these physical blockers coat the skin and create a barrier against harmful UVA and UVB rays, both of which are now known to play a role in sunburn, aging of the skin and the risk of skin cancer.

Most sunscreens use microfine particles of zinc oxide and titanium dioxide, which rub easily into the skin. Parsol 1789, a chemical blocker that protects skin by absorbing UV light, is also a powerful protector, but it may cause skin irritation or allergic reactions in some people. Make sure it’s combined with Mexoryl SX, a compound that keeps it from breaking down in the sun.

Wear it well: Apply sunscreen to exposed skin (SPF 15 or higher) year-round. “People equate sun exposure with heat, and they’re not the same at all,” says Wang. “There’s only a slight bit less UV out there in winter.” If you use a face moisturizer with blockers, one teaspoon will do the job. When you’re outside in summer wearing shorts, a T-shirt or swimwear, try to use about one teaspoon for each arm, and two for each leg.

We all want to do it: defy aging, look younger, find the fountain of youth. In fact, it’s estimated that every year in Canada, hundreds of thousands take the plunge and get age-defying surgeries such as facelifts. Cosmetic procedures are soaring in popularity, a trend that’s no doubt going to continue—especially if television has anything to do with it. Thanks to the real-life patients on shows like Extreme Makeover and The Swan, we’re getting an up-close peek at the plastic surgery process (and some of it is anything but pretty).

But looking younger is starting to get a whole lot easier than going under the knife. Ongoing breakthroughs in the antiaging industry have made turning back the hands of time easier, less expensive and relatively painless. “Noninvasive products are better than they used to be,” says Dr. Nowell Solish, a cosmetic dermatologist in Toronto. “People realize they can get good results without the risk of surgery or taking time off work.” And for many people, two weeks off work is more costly than the procedure they’re paying for.

These cosmetic innovations also help fend off the years without scary scalpels and anesthetic. “People by and large don’t want to go under the knife,” says Dr. Kevin Smith, a cosmetic dermatologist in Niagara Falls, Ont. His clients are so keen to try the minimally invasive approach that he now spends four days a week doing these procedures and only one performing surgery.

But if you’re thinking of trying out one of these age-defying innovations, be prepared for a lifetime of use, whether it’s applying a topical cream every day or undergoing injections every three to six months. “These things roll the clock back a bit,” says Smith, “but they gradually wear off and the clock starts up again if treatment is not continued.”

Though there’s still no magic pill, potion or lotion that will completely atone for all past skin sins and erase signs of aging, we’re getting nearer. Here are five surgery-free techniques that can deliver a more youthful appearance:

Problem: Age spots, fine lines
Retinoids
Natural compounds derived from vitamin A, retinoids treat brown spots and superficial wrinkles. Studies have shown that topical creams containing the retinoids tretinoin and tazarotene are highly effective. When used regularly, prescription-strength retinoids can reduce fine wrinkles and clear up mottled pigmentation and rough skin. “While you might see results in six to eight weeks, most clinical studies have stretched it to six months before there are noticeable benefits,” says Dr. Beatrice Wang, assistant professor of dermatology at Royal Victoria Hospital and McGill University in Montreal.

How they work: Retinoids penetrate deep into skin where they stimulate cell division. This has two effects: repairing the top layer of skin and enhancing the production of collagen, a protein that makes skin supple and provides structure.

Before you begin:
• You’ll need a prescription to get Retisol-A and Renova, which contain tretinoin, or Avage, which is made from tazarotene. (Unlike other prescriptions, your insurance company likely won’t cover the cost.)
• Over-the-counter (OTC) vitamin A products are called retinols, which are chemical precursors to tretinoin. “These products take longer to work and you may not see exactly the same results as with prescription retinoic acid,” says Wang. Get the most impact by wearing them at night when the sun won’t break them down and render them less effective.

Risks:
• If you use too high a concentration of a vitamin A product, your skin could react, especially at first, with redness, scaling and general irritation. Opt for the lowest concentration prescription cream—studies show they have the same impact as stronger products—or buy a nonirritating retinol.
• Retinoids increase the penetration of ultraviolet (UV) radiation, so unless you use one that contains SPF 15 or higher, wearing a daily sunscreen with UV blockers is more important than ever.

Price: OTC prices vary: Jamieson Vitamin A Retinol Vital Day Moisturizer is $11.99 for 120 ml; Vichy Reti-C Intensive Care is $37.50 for 30 ml; and RoC Retinol Triple Action is $39 for 30 ml. Prescriptions cost $20 to $40 for a tube, which should last at least two months, depending on how much you use.
Problem: Deep wrinkles (crow’s feet, fine lines)

Botox Injections
Botulinum Toxin Type A (Botox) injections are considered to be the most common minimally invasive cosmetic procedure done in Canada and their popularity is still growing. “Physicians around the world have been using Botox for about 25 years to safely treat a wide variety of medical and cosmetic conditions,” says Smith. “People who were holding back are learning about the safety and efficacy of Botox and are coming in for treatment.” Just two years ago, Smith performed about 20 Botox treatments a week; now he’s up to as many as 50. Men in particular like Botox to smooth out their foreheads. “They will often start to come in about a year after their wife comes in,” he says.

For both men and women, Botox can melt about ten years away. “Softening deep vertical frown lines is a powerful signal of rejuvenation,” says Dr. Jean Carruthers, a Vancouver ophthalmologist turned cosmetic surgeon, who 18 years ago recognized the cosmetic benefits of Botox, which was originally used to treat misaligned eyes and eyelid twitching.

How it works: Made from the bacteria Clostridium botulinum, Botox interrupts the connection between nerve and muscle, causing the surface area—frown and forehead lines, crow’s feet and neck creases—to relax.

Before you begin:
• Although some family doctors are doing Botox nowadays, Solish suggests going to an experienced dermatologist or plastic surgeon. (For help, see “Where to Start,” on page 178.)
• The first treatment lasts three to four months. After several sessions, results may last up to six months.

Risks: “The most common side effect is bruising or pain caused by the injection,” says Carruthers. And too much in your forehead could cause your eyebrows to droop, adds Smith. But in a 2004 study, Carruthers found that of 853 treatments, 99 percent were side-effect-free.

Price: On average, from $300 to $500 for each area of the face and neck treated.

Problem: Deep folds, wrinkles
Skin Fillers
As we age, our skin thins. Fillers plump it up. Of the handful of injectible fillers approved for cosmetic use in Canada, the most popular include Restylane and Perlane, which are both made from hyaluronic acid, a substance found naturally in the skin. (Collagen fillers are also available, but they’ve become less popular as their effects don’t last long.)

“These products are safe and have good results,” says Solish. “People come in and get it done in 15 to 20 minutes and look better instantly. It’s like going to get your hair done.” There are also the permanent fillers Artecoll and Dermalive. These place microscopic particles into a wrinkle so that they will remain there and stimulate the production of your own natural collagen. “The secret to success with products like Artecoll and Dermalive is to do the treatment in several stages, putting in a moderate amount and then being patient as the body responds to it,” says Smith.

How they work: Fillers are injected into the skin to increase volume in tissue. The added plumpness gives the face structure and smoothes deep wrinkles, fine lines and crow’s feet.

Before you begin:
• Results from one treatment of a nonpermanent filler can last anywhere from six months to a year.
• If you go with a permanent filler, make sure you do your homework and choose a surgeon who has lots of experience with this procedure. “If you have a problem, you have a permanent problem,” warns Solish.

Risks: A skilled dermatologist or plastic surgeon will consider potential allergies, risk of side effects (redness and swelling or pain are possible) and expense to determine the right filler for you.

Price: About $400 for most nonpermanent fillers, $700 for permanent.

Problem: Sagging skin
Nonablative Rejuvenation
Going by the brand name Thermage, this procedure tightens the skin without incisions. “It’s perfect for people who don’t want to have a surgical facelift,” says Solish. Results are seen in about four months, but some lucky patients see immediate improvement.
How it works: Radio frequencies heat and damage collagen. In turn, collagen contracts and then rebuilds and strengthens, tightening and lifting skin.

Before you begin:
• The 40-minute procedure can be uncomfortable and you might require some pain medication.
• This is not a sure thing; about 20 percent of patients don’t get noticeable results. “If you get smoother skin, it should last about two years,” says Solish.

Risks: This procedure is so new that the long-term results are unknown.

Price: Anywhere from $1,200 to $2,500 for the entire face.

Problem: Dull, yellow teeth
Teeth Whitening

Where to Start

For more information on antiaging products or to find a dermatologist, cosmetic surgeon or dentist in your area, check out:

  • The Canadian Society of Plastic Surgeons
  • The Canadian Society for Aesthetic (Cosmetic) Plastic Surgery
  • Canadian Dermatology Association
  • Canadian Dental Association
  • Dental office bleaching, laser-light treatments, do-it-yourself whitening strips or gels—even toothpaste can help transform aged teeth into more youthful pearly whites. “I don’t mind if people use drugstore products, as long as they’re monitored by their dentist,” says Dr. Guy Girtel, an Edmonton dentist. OTC strips can whiten teeth in about seven to 14 days, and they may be all that’s needed for some people. The products that deliver faster and more lasting results are available through a dentist.

    How they work: Carbamide peroxide or hydrogen peroxide penetrates enamel to lighten discoloration caused by aging and habits like smoking and drinking coffee, tea and red wine. Laser whitening applies a laser light to teeth immediately after bleaching to speed up and enhance the process.

    Before you begin:
    • Be patient with OTC products: Some can be difficult to use (those thin strips can slip off) and may take a few tries to master.
    • Peroxide doesn’t lighten fillings, crowns, veneers, bonding or bridges, so bleaching can lead to uneven colour.
    • How long any treatment lasts varies, depending on your daily oral habits, but OTC products can be effective for up to a year, while laser treatments can last from six months to two years.

    Risks: Bleaching may cause temporary tooth sensitivity and gum irritation. But don’t worry about the enamel on your teeth; studies show bleach doesn’t harm it.

    Price: A 56-pack of Crest Whitestrips costs $39; a 10 ml tube of Colgate Simply White gel is $16.99. Bleaching trays cost about $200, and laser treatments can set you back
    $600.

    Related Links

    The following links offer general information. They are for informational puposes only, and Reader's Digest does not endorse or guarantee their content. For expert opinion and counselling, always seek the services of a health-care professional.

    1-For descriptions of a number of non-surgical procedures, see the Canadian Society for Aesthetic (Cosmetic) Plastic Surgery
    2-For a list of the financial cost of some non-surgical procedures, see the Canadian Society for Aesthetic (Cosmetic) Plastic Surgery
    3-For information on Artecoll
    4-For questions and answers on Botox
    5-For information on Restylane
    6-For questions and answers on Thermage
    7-For useful facts on sun exposure, see the Canadian Dermatology Association website
    8-For a photo guide to help recognize various types of skin cancer and other skin ailments, see the Canadian Dermatology Association website
    9-For information on teeth whitening, bonding and veneers, see the Canadian Dental Association website
    10-For information on caring for your teeth, see the Canadian Dental Association website


     
      BOTOX Cosmetic® and Tarzorac® are registered trademarks of Allergen Inc. Juvéderm® is a registered trademark of laboratories D’esthetique Appliquee Corporation, a member of the Corneal Group. IPL® is a registered trademark of the Luminus group of companies.