BROCKTON COSMETIC SURGERY CENTER
Sorin Eremia, M.D.
4440 Brockton Ave., Ste. 200
Riverside, CA 92501
(909) 275-0988
| A little touch-up: Wrinkle relaxers and volume fillers give people non-surgical options to face lifts
Published: June 29, 2004 Witten by: LAURIE LUCAS THE PRESS-ENTERPRISE Charlene Ellen Smith of Bloomington has given up on growing old gracefully. Her lipstick runs uphill above her top lip into tiny tributaries. Crevices known as nasolabial folds stretch from nose to mouth, bracketing her smile. Two vertical lines carve themselves into a scowl between her brows. Smith wanted a facsimile of her former self without spending big bucks on an overhaul. So she turned to the fastest-growing segment of the booming cosmetic-surgery business - a combination of wrinkle relaxers and soft-tissue fillers. Known as minimally invasive procedures, they accounted for nearly half of the 7 million non-surgical treatments performed last year, according to the American Society of Plastic Surgeons. Dr. Keith LaFerriere, president of the American Academy of Facial Plastic and Reconstructive Surgery, says more patients are women younger than 40 who are influenced by the popularity of cosmetic transformations glorified on prime-time TV shows. "Most people need a little touch-up, not the extreme makeovers they see on TV," maintains Dr. Abel Torres, chief of the division of dermatology at Loma Linda University Medical Center. He says today's facial tune-ups tend to be safer and more natural looking than ever before - and less costly than nips and tucks. But doctors point out that for some patients, soft-tissue augmentation and wrinkle reductions are steppingstones to cosmetic surgery. "I've thought about a face lift," says Smith, 37, an animal-cruelty investigator for Riverside County. "I'm not afraid to have one. It's the money." For now, however, she's delighted that the stopgaps work their magic. More than Botox Like millions of other women seeking "facial rejuvenation" without a scalpel's touch, Smith looked hard at the bottom line. A face lift typically costs $5,000 to $10,000 and lasts five to 10 years. Injectable volume fillers and muscle relaxants run from $300 to more than $1,000 per syringe, and they usually last three months to several years, depending on the treatment. Smith consulted a dermatologist in Riverside that she had found online: Sorin Eremia, director of cosmetic surgery in the division of dermatology at UCLA Medical Center. "The big news is that now we have more choices," he says. Several months ago, Smith opted for two of the most popular injectable fountain-of-youth phials: Botox - a muscle relaxant for her forehead wrinkles - and Restylane, a new filler that knocked out her laugh lines and puffed up her lips. Smith is delighted with the results: Her smackers are fuller without looking like inflated inner tubes, her expression is softer and her smile indentations are shadows of themselves. What's more, Restylane will keep her pucker plumped up and her wrinkles at bay for six months to a year, twice as long as the original bovine collagen shots first popularized more than 20 years ago. Eremia says he's almost completely stopped using bovine collagen, so-called because it's made from purified cows' skin. Restylane, the new darling of dermatologists and cosmetic surgeons since its recent FDA approval, is genetically engineered. It's identical to hyaluronic acid, a natural component of the body's connective tissue. Eremia hails Restylane as "a far better product than collagen at the same cost with long-lasting results. And (Restylane) does absolute wonders for the lips." Although you can't prevent the hourglass from running out, you can sure slow it down. Here's a guide to some anti-aging treatments: Wrinkle relaxer. Botox is the brand name for purified botulinum toxin type A. It has become the gold standard for achieving a kinder, gentler expression: In 2003, board-certified doctors administered 2,891,390 injections of Botox. It's injected in minute quantities to relax frown lines between brows, worry lines on foreheads, crow's feet around the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. Studies have also suggested that Botox is effective in relieving migraine headaches, excessive sweating and muscle spasms in the neck and eyes. Results take a few days to appear fully and last three to six months. Average cost for an entire forehead and around the eyes is $400 to $600. Rare, temporary side effects include small bruising at injection sites, dry or watery eyes, headache, and droopy eyelids. Volume fillers Bovine collagen, sold under various brand names, is made from purified from cows' skin. Zyderm I is thin and used for fine lines, hollows under the eyes and shallow scars. Zyderm II is thicker and effective for deeper lines and scars. Zyplast, the thickest, is the choice for deep furrows, scars and lip enhancement. Last year, the FDA approved two types of human-based collagen, CosmoDerm and CosmoPlast. Results are immediate and last three to six months. Average cost: $400 to $500 per injection. The biggest risk of bovine collagen is allergic reaction. Two skin tests spaced at least two weeks apart could determine this condition. No allergy test is required for human collagen. Other rare but reported risks include infection, abscesses, open sores, skin peeling, scarring and lumpiness, which may persist throughout the treated area. Autologous fat transplantation or microlipoinjection extracts fat cells from the patient's abdomen, thighs, buttocks or elsewhere and re-injects them beneath the facial skin. Fat is most often used to fill in "sunken" cheeks or laugh lines, to correct skin depressions or indentations, to minimize forehead wrinkles and to enhance the lips. Surgeons can freeze fat up to two years and re-inject it. There's no chance of an allergic reaction, but with most patients, about a third to of the original injection disappears within three to six months, requiring two to three more injections. The initial fat extraction and facial injection costs $800 to $1,200; each subsequent injection runs $200 to $300. Restylane is a clear gel based on a non-animal, synthetic hyaluronic acid. It's injected to erase wrinkles and plump up lips. No pre-test is necessary because hyaluronic acid occurs naturally in the body, providing moisture and elasticity in the skin. A syringe costs about $400 and lasts six to 12 months. Prior mini-injections of a local anesthetic or a regional "nerve block" will ease pain caused by the procedure. Hylaform gel is hyaluronic acid extracted from rooster combs. Its uses, longevity and cost are similar to Restylane's. However, because it's an animal byproduct, there's the potential for an allergic reaction. Radiance is made from ground calcium hydroxylapatite, an element found in bone and teeth. Currently FDA-approved to treat human vocal-cord paralysis and some types of incontinence, it's being used "off label" by some doctors as injectable wrinkle filler around the lips and in deep laugh lines and acne scars. A syringe costs $1,000 or more and some doctors report results lasting two to three years. One major drawback is that Radiance can lump easily and form granulomas - small, sometimes itchy bumps under the skin.Studies show the problem can last months or years. The lumps can also migrate to other parts of the body with a potential for complications, according to the American Society of Plastic Surgeons. |