Some people see them as laugh lines or stripes of wisdom earned with age. Others see them as problem areas. In today’s cosmetic practices, there are procedures and products that can treat just about anything, whether you want to fix “angry 11s” on your forehead, to eliminate sad looking “marionette lines” around your smile or to create an overall rejuvenation.
So we did the digging to break down some of the industry’s top procedures and promises. You may think you know what you want, but understanding the longevity of the outcome—as well as the costs, downtime and pain factor (no pain no gain is no longer true)—can help decide which options may be best for you.
“Lancaster is very conservative. We’re not any less vain than people in LA and New York. We’re just more private about it,” explains Adrienne Hughes, medical aesthetician, LG Health Physicians Plastic and Cosmetic Surgery in Lancaster. So downtime needs to be minimal, she adds. “We’ve become a very narcissistic society; [partially] because of selfies, people are very concerned about their wrinkles, [and] Botox and dermal fillers have become more popular. They’re hitting a younger and younger demographic.”
“Botox has allowed lifts to be postponed to a later date in life, but there's nothing yet to replace a facelift,” says Dr. Wendell Funk, Dr. Wendell L. Funk Cosmetic Sugery of Lancaster, York and Camp Hill.
There are also many options in between—from costs and downtime to effectiveness—plus new options you may not be aware of. And some preventative steps like regular skin care and keeping a stable weight throughout life can help keep skin from sagging later.
TRUE REFLECTION
Things start to show up in your 30s. A leg vein here, a chin hair there (so I’ve been told). As if it’s not bad enough getting gray hair, these fine lines start to appear…on the forehead, around the eyes and around the smile.
I have seen friends getting fillers to plump up “parentheses” or lines around the mouth. I know tons of people who get Botox, no big deal. But just before my 34th birthday, I noticed these sad lines around the corners of my mouth.
So I called up the trusted resource who had helped get my skin glowing for our wedding eight years ago, Adrienne Hughes, the medical aesthetician at LG Health Physicians Plastic and Cosmetic Surgery. She surprised me with a solution for the “marionette lines.” LG Health Physicians Plastic and Cosmetic Surgery doesn’t just fill the lines; the doctor injects filler into the cheek area to lift the sagging skin that is the cause of the problem. (This can be helpful in achieving those cheekbones not all of us were born with.) The filler is hyaluronic acid, naturally present in the body; and while I generally don’t trust pharmaceuticals and try not to ingest ingredients I can’t pronounce, decided I’m okay with the filler for its promise.
It sounded a little intense, but Dr. Warsaw was so gentle that, in fact, it was just a tiny pinch as the needle went in, no biggie, and I’m a wimp. The lines instantly filled. Gone with just one syringe of Juvederm. And the results of a refreshed pout (so subtle my family didn’t even notice) will last for six months to a year.
The other cosmetic procedure I decided to try this year was laser hair removal. I knew someone who had it done and loved it. I was tired of the irritation caused by frequent shaving, especially in the summer. The pain as the laser passed back and forth over the areas was even less than Alyssa Licatese owner/medical aesthetician of Blossom Med Spa in Lancaster described (like a rubber band snap). The laser she uses has a cooling tip which helps with the slight tingle. After just one treatment, the armpit and bikini line hair came back thinner and slower; I could go every other day without shaving. Six treatments total will eliminate this nuisance.
As a busy working mom who was never a 10 to begin with, watching what youthful beauty is left folding, literally, into wrinkles, treating myself to a little filler and anything to save wasted time is well worth it.
Short or light-colored eyelashes (Any Age):
PRODUCT/PROCEDURE: Eyelash extensions
PROMISE/OUTCOME: "Individual mink lashes are adhered to one of your own lashes. We do a subtle enhancement to give a natural look, or you can get more of a dramatic look, which is longer and fuller lashes," explains Alyssa Licatesse, owner/medical aesthetician of Blossom Med Spa in Lancaster.
DOWNTIME/PAIN FACTOR: No downtime and no pain
DURATION/UPKEEP: "The lashes shed with your natural lashes, which happens about every 6 weeks. At 6 weeks you will just need a little maintenance, which ranges from $50-$75," says Licatesse.
COST: Pricing ranges from $150-$220
Inability to get rid of stubborn areas of fat (Any Age):
PRODUCT/PROCEDURE: SmartLipo, laser liposuction done in office
PROMISE/OUTCOME: "Patients love it because the fat is removed in the area, and the skin gets a lot of tightening in just one treatment," says Hilary Lebouitz-Schaefer of Lébo Skin Care Center.
DOWNTIME/PAIN FACTOR: 48 hours of downtime
DURATION/UPKEEP: Only one treatment
COST: Starts at $2,500
Stubborn body fat (Any Age):
PRODUCT/PROCEDURE: Liposuction
PROMISE/OUTCOME: Liposuction surgery sculpts the body, eliminating unwanted pockets of exercise- and diet-resistant fat from the buttocks, hips, love handles, saddlebags, thighs, calves, ankles, breasts (including male breasts), back, arms and neck.
DOWNTIME/PAIN FACTOR: Achy. "Feels like a hard workout at the gym when you haven’t worked out in forever," describes Hughes. You wear compression garments for 4 weeks and, depending on what you do, can return to work in a few days.
DURATION/UPKEEP: One treatment. Does not remove cellulite and cannot tighten loose skin.
COST: $3,000+
Acne, brown spots, fine lines, sun damage (Teens-70s):
PRODUCT/PROCEDURE: Aesthetic peels
PROMISE/OUTCOME: Fades acne scarring, brown spots and sun damage and minimizes fine lines to help counteract aging
DOWNTIME/PAIN FACTOR: Minimal downtime with some peeling or flaking of skin
DURATION/UPKEEP: Every 4-6 weeks
COST: $70-$400
Aging skin (20s-70s):
PRODUCT/PROCEDURE: Microdermabrasion
PROMISE/OUTCOME: Healthier, smoother and more evenly toned skin. "Very effective to help prevent aging," says Kim Hackett, Dermatology Associates of York.
DOWNTIME/PAIN FACTOR: No downtime and no pain
DURATION/UPKEEP: "For the best results, we recommend a series of treatments administered every 4 to 6 weeks," says Hackett.
COST: About $100 per treatment
Double chin and muffin top (20s-50s):
PRODUCT/PROCEDURE: CoolSculpting. What it is: cryolypolosis—fat cells die when exposed to cold, your body processes the dead cells and you urinate them out over weeks and months. "CoolSculpting has been around for about 5 years but has gained popularity the past 3-4 years," says Dr. Wendell Funk. "A big new change is that it can address neck fat."
PROMISE/OUTCOME: “This is not weight loss. It is not a substitution for weight loss and proper diet and exercise.” Ideal candidates have a normal BMI. “This is about removing the muffin top,” states Hughes. Or for someone who has heavy thighs no matter how much weight is lost.
DOWNTIME/PAIN FACTOR: "There’s no recovery time. No one knows you’ve had it done. It looks like natural weight loss," says Hughes.
DURATION/UPKEEP: Permanent. "The fat cells don’t replicate. When you gain weight they expand. They do not migrate. You inherit [a] body type, with fat cells where they are," explains Hughes.
COST: Someone with a tiny belly can be as low as $750. Average belly is about $2,400. Chin: $1,000 single treatment.
Fine lines/wrinkles, scarring, broken capillaries, enlarged pores, and uneven tone/texture (20s-60s):
PRODUCT/PROCEDURE: Intensif RF Microneedling "creates micro-channels into the skin while emitting pulsed radio-frequency to the dermal layer of the skin. By doing this you are remodeling and creating new collagen," says Licatesse.
PROMISE/OUTCOME: Creates dramatic results for those with fine lines/wrinkles, scarring, laxity, thinning skin, broken capillaries, enlarged pores, and uneven tone and texture
DOWNTIME/PAIN FACTOR: No downtime
DURATION/UPKEEP: 3-5 sessions, 4 weeks apart. "To continue collagen stimulation it is recommended to get 1 session a year for maintenance."
COST: $350 per session
Sagging skin on face and body (20s-60s):
PRODUCT/PROCEDURE: Skin tightening and body contouring
PROMISE/OUTCOME: "We use multi-source radiofrequency for skin tightening and body contouring. The controlled heat penetrates to the dermis, which tightens the elastin fibers in the skin, stimulates collagen and assists in metabolizing unwanted fat cells. This can be used anywhere on the face or body to tighten sagging skin and will decrease the circumference of the area being treated," says Licatesse.
DOWNTIME/PAIN FACTOR: No downtime
DURATION/UPKEEP: Takes an average of 6 sessions, 1 per week
COST: $350 for 6 sessions
Unwanted hair (20s-60s):
PRODUCT/PROCEDURE: Laser hair removal
PROMISE/OUTCOME: Removes unwanted hair. Only works on black or brown hair, not white or gray.
DOWNTIME/PAIN FACTOR: No downtime. "Lasering feels like a warm rubber band snap, but our machine has a sapphire cooling tip, which makes laser hair removal a breeze," says Licatesse.
DURATION/UPKEEP: Requires 6 treatments which are spread out every 4-8 weeks. "Maintenance is as needed. Some people need it once a year or even every other year for a few hairs—others need it more often," explains Lebouitz-Schaefer.
COST: $25-50 and up per treatment, depending on body part. Packages can start as low as $350 for 6 sessions.
Anti-aging concerns (fine lines and sun/age spots) no longer being addressed by over-the-counter products (30s-40s):
PRODUCT/PROCEDURE: Prescription topical skin care
PROMISE/OUTCOME: Prevention, better skin quality. Very effective prescription-based products with Retin A (improves skin tone, texture and clarity; reduces fine lines and wrinkles and helps repair sun damage). Products with hydroquinone bleach sun spots and age spots.
DOWNTIME/PAIN FACTOR: No downtime and no pain
DURATION/UPKEEP: "You can use these products indefinitely and increase strengths; they're meant to be used long-term and consistently—the better the skin quality," affirms Hughes.
COST: You can get a full set from cleanser to sunblock for about $350 and replace items as they run out at a lower cost.
Sagging eyelids, neck, cheeks and jowls (Late 30s-Early 40s):
PRODUCT/PROCEDURE: Pelleve
PROMISE/OUTCOME: Gentle skin tightening
DOWNTIME/PAIN FACTOR: Zero downtime, no pain. But this is not designed for the loose skin of a 70- to 80-year-old woman.
DURATION/UPKEEP: 2 times per year
COST: Face $500; face plus neck $800
Sun damage/brown spots from low hormone levels (Late 40s):
PRODUCT/PROCEDURE: IPL (Intense Pulse Lasers)
PROMISE/OUTCOME: Corrects pigment issues, redness and broken capillaries; tightens skin
DOWNTIME/PAIN FACTOR: "At the time, it feels like a rubber band snap," says Hughes.
DURATION/UPKEEP: No downtime. "Skin will look red/flushed. Spots darken initially, then fade out. You can put makeup on initially," explains Hughes.
COST: $250 to get rid of a few brown spots, up to $450 for capillaries and $650 for skin tightening
Fine lines around/between eyes and on forehead (30s-60s):
PRODUCT/PROCEDURE: Botox
PROMISE/OUTCOME: Used only from the eyes up for dynamic wrinkles (around eyes and on forehead). "You can still make your angry face, but you have to concentrate to do it. You still have control of the muscles. People are terrified it will give them an expressionless face. That is never done by accident. That’s the biggest misconception," clarifies Hughes.
DOWNTIME/PAIN FACTOR: Tiny prick, very tiny needle—same as a diabetic insulin needle. No downtime. "Botox is a protein that takes several days to block the habitual facial expressions when it’s injected," explains Huges.
DURATION/UPKEEP: Lasts 3-4 months. "If you liked it, have it again," says Hughes. "It won’t be any worse or better. People often get it done for special occasions like weddings."
COST: Some practices will advertise as low as $7.50 per unit but beware of and ask about hidden costs like admin and numbing fees. Can range up to $15/unit. "Average cost for a forehead can be around $300, but that really does vary depending on how deep the lines are," says Lebouitz-Schaefer.
Décolleatge (neck/chest), brown spots, fine lines, pores, wrinkles, tattoo removel (30s-60s):
PRODUCT/PROCEDURE: PicoSure. "It's impossible to comprehend this," says Dr. Funk. Laser "energy [light] is delivered at a trillionth of a second."
PROMISE/OUTCOME: This is the newest, best thing on the market for skin rejuvenation," says Dr. Funk. "It's revolutionary."
DOWNTIME/PAIN FACTOR: No pain, no downtime. "You could go to a wedding the next day," Dr. Funk adds.
DURATION/UPKEEP: Requires 2-3 treatments for brown spots, 4-7 for fine lines and wrinkles, and 1 treatment per year to maintain because "nothing is permanent," Dr. Funk explains.
COST: $900 per treatment; starting at $350 for small tattoos requring 4-6 treatments
Sagging, tired skin (30s-60s):
PRODUCT/PROCEDURE: Ultherapy, a non-invasive procedure growing in popularity that lifts skin on the face, neck and décolletage. Hackett explains, "The focused delivery of ultrasound energy initiates the body’s natural response to stimulate the growth of fresh, new collagen."
PROMISE/OUTCOME: Non-invasive lift
DOWNTIME/PAIN FACTOR: Redness, soreness and swelling, but minimal downtime. "All this resolves within a very short period and is typically not noticeable," adds Hackett.
DURATION/UPKEEP: Results generally appear over a 3-6 month period and last up to 2 years.
COST: $500-$4,500 depending on area
Hoodes eyelids, puffiness under eyes, sagging face/skin (50s-70s):
PRODUCT/PROCEDURE: Facelifts, eyelid lifts and brow lifts
PROMISE/OUTCOME: "Botox has allowed lifts to be postponed to a later date in life, but there's nothing yet to replace a facelift," affirms Dr. Funk. "If you don't want to have a dramatic facelift, don't wait too long to do your surgery," he adds, recommending one at age 55 and another at 70.
DOWNTIME/PAIN FACTOR: Major surgery. Hospital stay overnight. Month-long recovery before stitches come out and bruising goes away.
DURATION/UPKEEP: Lasts 8-10 years
COST: $20,000 for total rejuvenation for face, eyes and forehead
