I rarely share my personal experiences as a way to educate or relate information about skin care or any issue related to beauty because I always prefer facts and research to anecdotes. However, in this section I would like to share my thinking and course of action about my face in regard to medical cosmetic corrective procedures. I do so because my process and decision making may possibly provide insights for you about what options you might want to consider. Again, everyone is different, yet many of our concerns about an older-looking face are similar and the long list of options is the same for everyone. The selection process is where the choices come into play.
For me, I felt my forehead wrinkles, the folds between my brows, the folds that run from the nose to my mouth (the nasal labial folds), the lines around my mouth, and the wrinkles under my eyes were the most bothersome. I was 49 years old when I thought it was time to start considering medical cosmetic corrective procedures.
To start, I felt Botox was my best option. My reasoning was that it was fast, relatively inexpensive, had no real downtime, minimal to no risk, required only one treatment to see results (as opposed to lasers or IPL treatments that need multiple treatments before you realize a noticeable benefit), and my wrinkles were supposed to be gone in 48 hours to a week. Botox lived up to my expectations and I have continued getting Botox injections every six to seven months.
A year later I decided that the lines from my nose to the corners of my mouth were becoming more noticeable and it was getting trickier to keep my makeup from sliding into those lines. I decided to have a dermal filler injected. I considered many options (there are over 30 fillers doctors can use) and opted for Artecoll, a synthetic filler that is considered semi-permanent; it can last anywhere from two to seven years.
There are risks with Artecoll, and there is disagreement between doctors about those risks. Mostly the concern is that because Artecoll is semi-permanent, various factors come into play. All dermal fillers pose a risk of moving into areas you don’t want them to go, or there can be overcorrection (think of celebrities with overblown lips), and there’s the possibility of granulomas (small, hard bumps under the skin). With a semi-permanent filler, these problems would not go away. Understanding that risk, I decided to have this procedure anyway. Artecoll had a historical safety profile that showed only a small percentage of unwanted results, it’s results were relatively long-term (over five years for me), and the idea of having to go back every six months to a year for more injections did not suit me in the least. I’m high maintenance, but I lead a busy life, and given what I wanted to accomplish the less time I needed to be in a doctor’s office the better.
Artecoll worked beautifully for me. My lip line (which was starting to recede), the laugh lines, and the lines between my brows were injected and the results did last for five years. I did have some complications with slightly tender lumps along my lips that I could feel but that weren’t visible. They did stay and have been slightly bothersome, but for me that has been a minor complication in comparison to going through the pain of injections every six months or once a year (dermal injections are painful and you can look swollen for several days!). I actually could have waited another two to three years before having more Artecoll but decided to have a touch-up after five years. (Permanent fillers do last a long time, but the face continues to age, requiring more if you desire to keep the same appearance.) The results have been impressive.
Treatments to smooth the surface of skin, build collagen, and reduce the appearance of surfaced capillaries fall in the realm of treatment with lasers and IPLs (intense pulsed light), and all those issues were among my concerns and things I wanted to fix or reduce. I chose to do a combination of both. IPLs work best for skin discolorations and surfaced capillaries, while lasers smooth the surface of skin and build collagen. (IPLs do build collagen but far less dramatically.)
I began with IPLs, and after five treatments I did see a reduction in brown discolorations and surfaced capillaries. After 18 months they started to show up again (despite the fact that I don’t tan and I’m diligent about wearing sunscreen with titanium dioxide and zinc oxide). That’s disappointing, but I am going to do another series.
I decided ablative lasers were not an option for me even though they have the most dramatic results. They impressively smooth and tighten skin and build collagen, but they also have over a 4% risk of causing damage or color loss. However, I did try a new form of laser that reduces the risks associated with traditional laser resurfacing, called fractional resurfacing. This type of laser pixilates, or breaks up, the laser emission to greatly reduce any risk yet still garners similar results. It wasn’t a pleasant treatment, it does require four to six treatments a year and then maintenance treatments, and there was downtime, but the results were noticeable, especially around my eyes, after two treatments. Of course, now I have to schedule time for this procedure, but the results are worth it.
At one point I did have liposuction to remove the fat from under my chin to prevent my neck from looking like a turkey wattle. It worked very well but that procedure was a bit of a gamble because I chose not to have surgery to tighten the jaw and neck area, which had been recommended. I was taking the chance that my neck would have enough elasticity so the skin would bounce back and not just hang (minus the fat). It was a good gamble because my skin did bounce back.
I have tried Thermage but was unimpressed with that. I have also considered a face-lift, but right now the noninvasive procedures I’ve had seem to have postponed that decision for awhile.
So for me, a combination of dermal injections, Botox, IPL, fractional resurfacing, and liposuction of my chin has made quite a difference and I’m happy with my choices. I know things could have gone wrong along the way, but I went into all of these having done my research and weighing the pros and cons and assessing my risk potential along the way. As you make decisions about your face and possible options for rejuvenation your thought process needs to follow the same pattern. What you absolutely never want to do is believe the marketing claims that make any particular procedure sound like a risk-free miracle. No such procedure exists.
Before I get to the details about the various corrective medical procedures that are available, I want to address the most important consumer challenge of all: Who should do your procedure, regardless of what you decide to have done. Given the growing number of doctors with cosmetic or plastic surgery practices and dermatologists who are performing cosmetic corrective procedures (and the advertisements are about as prevalent and some of them as insufferable as those for car dealerships), it is very difficult to know where to go and how to get started.
Most women use one of four methods to select a physician: articles in fashion magazines; finding out where celebrities went (everybody loves knowing where the stars are going for anything and everything, regardless of how they look); getting a referral from a friend or a friend of a friend; and, last but not least, checking out the doctors who advertise their services.
Though I wouldn’t call these the worst plans of action, they should just be the beginning of the process. The most important thing to know is whether your physician is board certified. That doesn’t guarantee you might not encounter complications or have less than optimal results, but at least you have a better chance of avoiding problems. Doctors of any background can perform cosmetic corrective procedures; you want one who has been specifically trained to work in that field. The Internet makes it easier than ever before to find out the qualifications of the physician you want to see. Here are the steps to follow.
If you are considering plastic or cosmetic surgery, at the very least be sure that your doctor is certified by the American Board of Plastic Surgery (www. abps. org). If you want to see a dermatologist in the United States, be sure they are certified by the American Board of Dermatology (www. abderm. org). To verify that your doctor is legitimately board certified, go to the American Board of Medical Specialties at www. abms. org. Certification lets you know the physician has had the training required to earn the title of specialist.
Each country will have its own resources for board-certified physicians, surgeons, and dermatologists who work in these areas of expertise. What gets confusing is that there are lots of boards that claim to be able to accredit physicians, but not all of them are legit. Don’t be fooled by other similar, professional-sounding boards.
When it comes to surgery, you will also want to find out if your doctor has hospital privileges. Even if the procedure will not be performed at the hospital (and 53% of cosmetic surgeries are not), some feel it is important to know that your doctor is qualified and has the necessary training to be accepted. The American Society of Aesthetic Plastic Surgery states that “it is important to find out if the doctor has operating privileges in an accredited hospital for the same procedure you would like to have performed. Before granting operating privileges, hospital review committees evaluate a surgeon’s training and competency for specific procedures. If the doctor does not have hospital privileges to perform your procedure, look for another surgeon.” (Source: www. surgery. org)
Of course, there are great dermatologists and plastic surgeons who are not board certified, but the odds of getting someone who is inexperienced are greatly reduced when you take the time to find out if that person is board certified. To be certified by the ABPS, a physician must have at least five to six years of approved surgical training, including a two – to three-year residency in plastic surgery. He or she must also have been in practice for at least two years and pass comprehensive written and oral exams in plastic surgery.