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New wrinkle in cosmetic surgery Image-conscious adults are turning to less time-consuming and less invasive procedures for a fresh look

In case you have not noticed, plastic surgery has recently gotten its own face-lift. Now women (and men) can pluck, plug and primp with relative ease as more non-invasive and time-saving procedures are added to the beauty menu.

"These days, people want minimally invasive procedures and low detectability," said Dr. Kulwant S. Bhangoo, a South Buffalo cosmetic surgeon. "They always don't want people to know they're having a cosmetic procedure. They want very little down time. They do not want any scars.

"Also, the more sophisticated patients do not want a drastic change; they want subtle improvement. They want to look fresh and less tired."

Many factors contribute to the loss of a youthful appearance in the face, including heredity, gravity, environmental conditions and stress. More people are turning to cosmetic surgery for a fresh look.

Changing appearance may not be the right call for everyone, but according to statistics just released by the American Society of Plastic Surgeons, 240,000 more minimally invasive procedures -- Botox, chemical peels, soft-tissue fillers -- were performed in 2005 than in 2004. That's a 12 percent increase. Botox, meanwhile, was the most popular treatment in 2005, with 1,276,232 procedures performed.

We've highlighted a few of the more popular treatments below, along with what to expect and how much they cost.

You'll see that they all have one element in common: minimal down time. You can have the work done and be back on track faster than you can say Dr. 90210.

>Fill it

At age 48, Sandie Ben is blessed with good skin and very few wrinkles, yet fine lines around her lips bothered her. Even though no one else probably noticed, Ben did -- every time she pulled down her car visor mirror to apply lipstick.

"They would drive me crazy," said the registered nurse and volunteer firefighter. "I was going through a rough time, working full time with a family. I thought I would do something for myself."

Fillers act to plump up the skin. They are injectable, temporary -- usually lasting for six months to one year -- and can be the perfect remedy for Ben's fine lines, according to Dr. Andrew Giacobbe, who suggested Restylane as the go-to hyaluronic acid filler.

"Hyaluronic acid is normally present in the body, and as we age, we lose some of it," said Giacobbe, who practices in Amherst. "Collagen used to be the gold standard, but it would end up lumpy. Restylane lasts longer, goes in smoother and is far superior.

"A common application is to plump up lips, or the crease that forms in the cheek area between the nostril and the upper corner of the lip," Giacobbe added. "As we age, those folds become more pronounced."

During the typical 30-minute in-office treatment, Giacobbe first applies a numbing agent followed by the Restlyane injection. The cost depends on the amount of filler used, with many patients paying from $300 to $500.

"About the only thing you feel is the pinch from the numbing agent," said Ben. "And then he gives you the injections. You don't even know it's being done. The worst part is that your face is numb, but that only lasts for an hour. I did it and went shopping after."

>Contour thread lift

Just one month ago, registered nurse Marcia Trawinski did not like what greeted her in the mirror. Today, after having a thread lift, she can distinguish her cheekbones. Friends have even said her face looks tighter.

"I feel better and look younger," said Trawinski, 59. "I think we are all interested in improving our appearance, no matter how old we are."

The contour thread lift involves the placement of from two to six barbed threads under the facial skin starting from the temple to the jawline. When the strings are pulled up, the tiny barbs catch the underlying tissue and actually lift your face, preserving its natural contours.

"It is ideal for patients who show early signs of aging, who do not have too much skin or a lot of fullness," explained Bhangoo, adding that the polypropylene thread used does not dissolve.

The procedure is performed under local anesthetic with the actual time depending on the number of threads used. A typical procedure usually takes 60 minutes to perform, uses three strings and will leave slight swelling for the first 24 to 48 hours. After six weeks, a band of scar tissue forms around the thread and will act as a protective "scaffolding."

The number of threads is determined by the elasticity of the face and whether correction is needed in the neck area. Cost -- per string -- ranges from $300 to $500. The effects endure for five to seven years.

"The whole crux of this procedure lies in placing the thread at the right depth," said Bhangoo. "If it is placed too close to the skin, it will result in dimpling, and the patient may be able to feel it. If it is placed too deep, it goes into the muscle and will not result in an effective pull."

The thread lift is not a replacement for a standard face lift, Bhangoo cautioned. Still, it gives the patient 50 to 60 percent of the improvement offered by the conventional face lift at a 70 percent reduction in cost. In addition, more threads can be added if needed, while the threads already in place can be tightened.

Trawinski recalled feeling only a slight tug as the threads were pulled upward. The incision, she added, was closed with staples.

"It seemed like a relatively simple procedure," she said. "I'm hoping it lasts for several years."

>Skin resurfacing

People with sun-damaged skin often opt for laser treatments to de-wrinkle their faces, chests and necks. Not only that, lasers can fade age spots and eliminate that muddled pigmentation that marks a sun-lover's skin.

"People don't realize this, but when they go out in the sun, their chest and neck get more damage than the face itself," said Dr. Zvi Sharf of the Center for Plastic Surgey in Orchard Park and Williamsville.

Fractional resurfacing lasers can eliminate old pigmented skin cells. It penetrates deep into the skin, targeting designated areas while leaving other areas unaffected. This "fractional" treatment allows skin to heal much faster than if the entire area were treated.

"After the procedure, for the first hour, it looks like you have a sunburn, but you can put makeup on right away," said Sharf. "What sets it apart from other lasers is it creates a collagen secretion in your skin, which gives it a good texture."

On average, patients receive a series of three to five 90-minute treatments, spaced from from four to seven days apart. Much of the 90 minutes is spent preparing the skin, first exfoliating the dirt and then applying dye that will serve as target for the laser. A numbing ointment is then applied followed by the 30-minute laser treatment.

"It's a conservative treatment for people with a lot of skin damage from the sun," said Sharf. "It truly cleans the skin."

The cost ranges from $2,500 to $3,200.


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