April 25, 2003, New York, NY - If you're like most women, when you look in the mirror you immediately focus on those telltale signs of aging - the fine lines creeping around your mouth, those puffy, tired-looking eyes. You take good care of your body, so shouldn't your skin be pampered as well? Whether you're looking for a low- or high-tech solution, or if you're holding out for the next big thing, the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) - the world's largest association of facial plastic and reconstructive surgeons - offers a variety of ways to tackle the most common skin problems.

Fine Lines and Wrinkles
Low-Tech: Botox injections, at $497 per session, have become a popular way to reduce the appearance of crow's-feet and furrowed brows. "Botox is perfect for softening wrinkles around the eyes and between the brows," says Dean M. Toriumi, MD, AAFPRS president, "and it is a great way for patients to preview what a more permanent surgical procedure can achieve."

High-Tech: The latest injectable filler is Radiance, whose effects last two years. Although only FDA-approved for treating incontinence, the synthetic Radiance can be legally used to treat deep wrinkles. Will Radiance replace Botox? "Not likely," says Dr. Toriumi, "however, Radiance works well in conjunction with Botox, because it fills in the deep facial lines and wrinkles."

What's Next? An FDA panel has recently recommended approval for Artecoll, another potential competitor to Botox. This permanent treatment, already available overseas, erases facial wrinkles by injecting tiny bovine-collagen-containing plastic spheres into the wrinkles. The spheres trigger the body's own collagen to plump out the wrinkle. However, the AAFPRS cautions that there have been problems reported in Europe with this product, which has been used for over seven years, and Switzerland has recently banned its use.

Puffy, Tired-Looking Eyes
Low-Tech: If your eyes have more bags than Coach® due to long hours at work and late nights partying, topical under-eye treatments should do the trick for a temporary solution. Products containing antioxidants will tighten and brighten stressed-out skin, while those containing hydroquinone and retinoids (Vitamin A derivatives) will lighten dark spots and maintain the skin's suppleness.

High-Tech: Premature aging can be accelerated due to excessive ultraviolet exposure, which makes the eyes swell and lose elasticity. A long-term fix can be achieved with blepharoplasty (eyelid surgery), during which excess fat and skin are trimmed away. This procedure, which ranges from $2,216 -$3,816, can instantly subtract years from your face.

What's Next? The latest approach to correcting droopy eyelids is raising eyebrows - literally. "Surgical rejuvenation of the upper face may require elevation of the brows to provide the best outcome," explains Toriumi. The reason many people develop sagging upper lids is due to the settling of their eyebrows, which occurs over time as part of the aging process. "When performed with an upper lid blepharoplasty, a brow-lift can dramatically rejuvenate the upper face."

Sagging, Loose Skin
Low-Tech: Firming creams can temporarily tighten the top layer of the skin. Research shows that skincare treatments containing Vitamin C (L-ascorbic acid) give your skin a more youthful appearance. "When used over time, L-ascorbic acid can improve skin tone, clarity and texture," agrees Dr. Toriumi. "An added benefit is that these products also protect skin from further environmental damage."

High-Tech: There are less invasive surgical techniques, such as the S-lift, that are replacing more aggressive face lifting procedures. These lifts are more appropriate for younger patients that have more subtle aging changes. They use smaller incisions, which result in less bruising and swelling post-op, and are less likely to create the tight, pulled back look often associated with an extensive face-lift. Also growing in popularity are mini-cheek lifts or Suspension for the sagging middle face and deep folds between the nose and lips.

What's Next? Many are trying to achieve subtle achievements in their skin contour with non-ablative laser treatment with or without Botox injections. New lasers such as VBeam and Cooltouch II, work deep within the dermis to diminish fine lines and reactivate skin-firming collagen. While results are not as dramatic as those attained with laser resurfacing, this procedure is preferred by patients due to the lack of side effects and minimal downtime.

Thinning Lips
Low-Tech: Daily exposure to harsh environmental elements contributes to thinning lips and cause lines around the mouth. Products with antioxidants like alpha lipoic acid prevent premature aging, reduce fine lines and deliver a temporarily puffier pout. A short-term bee-stung kisser can also be achieved by using lip products containing cinnamon, which stimulate circulation.

High-Tech: Lips start thinning in your late 20s and collagen injections are a popular way to not only enhance them but to smooth lines around the mouth. One to three syringes are needed per treatment, and the effects last about three to four months. Popular in Europe but not yet approved in the U.S. by the FDA, Hylaform gel and Restylane are skin fillers that like collagen occur naturally in the skin. Hylaform and Restylane injections do not require a pre-treatment skin test and are ideal for the almost five percent of Americans who are allergic to collagen.

What's Next? Advanta and UltraSoft lip implants are some of the newest alternatives in lip augmentation, and are perfect for those seeking fuller lips without quarterly touch-ups. The implants look and feel natural, and can be removed. Lip implants such as Advanta and UltraSoft offer a more defined border and less poofiness than an injectable.

Before you make an appointment
Though many of the popular nonsurgical facial cosmetic procedures today are affordable, can be performed during your lunch hour and require minimal downtime, it is still advisable to take a cautious approach. "Anyone considering facial cosmetic surgery should look for a board-certified facial plastic surgeon and consult with him or her prior to surgery," says Toriumi. It is also wise to have a complete understanding of the surgery including the risks and benefits, and above all to have realistic expectations - facial plastic surgery is about enhancing the features you already have in order to feel better about yourself.

About the AAFPRS:
The AAFPRS is the world's largest association of facial plastic and reconstructive surgeons - with more than 2,600 members - whose cosmetic and reconstructive surgery focuses on the face, head and neck. Academy fellows are board-certified and subscribe to a code of ethics. In addition, the AAFPRS provides consumers with free information and brochures and a list of qualified facial plastic surgeons in their area by calling 1-800-332-FACE or by visiting the AAFPRS Web site, www.FACEMD.org.