| |
May 10, 2004
Alisa
Kauffman has been practicing dentistry for nearly two decades,
but some new patients still
mistake the petite, 44-year-old
New Yorker for a dental-school student. "I tell them it's just
the Botox." But the popular treatment, which paralyzes the
muscles that form wrinkles, is actually just one weapon in
Kauffman's anti-aging arsenal. She began applying Retin-A (trans-retinoic
acid) daily to wrinkle-prone areas of her face at 28, well
before the vitamin-A derivative became widely accepted as a
topical treatment for fine lines.
At 40, she added more potent
products. Besides periodic Botox shots for her forehead and
eyes, every few months she gets injections of Restylane to
smooth the skin by her mouth (the transparent hyaluronic acid
gel, used to fill wrinkles, was approved by the Food and Drug
Administration in December). Kauffman also regularly undergoes
intense pulse-light (IPL) treatments — laserlike pulses of
high-intensity light that penetrate the skin — to get rid of
a sprinkle of sun spots on her face. "I am very vigilant," says
Kauffman, an attractive redhead. "I try to take care of things
before they happen."
That's much easier to do these days. The
quest for youth — or, at least, the appearance of it — is ages
old. But the range of nonsurgical, anti-aging options has soared
in recent
years. Most women are wary of going under the knife in their
30s and 40s, but they'll undergo a temporary treatment that
can smooth their skin in one lunch break. Less costly and more
convenient than surgery, cosmetic injectables, IPL therapy
and other wrinkle remedies are booming as more and more women
incorporate them into their beauty-maintenance routines. The
American Society of Plastic Surgeons says 6.9 million such
procedures were performed last year — up 41 percent from the
year before. Women made up 86 percent of the patients.
A few
years ago doctors relied on collagen that came from cows and
required a skin test. Now there's a range of fillers, from
Restylane to CosmoDerm and CosmoPlast — both made from human
collagen that require no test — and, of course, Botox, which
gained FDA approval just two years ago for the treatment of
frown lines. "They're extraordinarily quick to perform and
have an extraordinarily rapid recovery — if there is a recovery
period at all," says New York surgeon Philip Miller, who performed
Kauffman's procedures. He and other practitioners say the uncomplicated
nature of the treatments keeps women coming back for more. "I
have several female patients who feel that because they are
in the workplace and around so many young people, they need
to do whatever they can to keep up a more youthful appearance — without
using surgery," says Boston dermatologist Lynn Baden.
"It makes
you look good, so why not do it?" says Robin Rothkopf, 46,
a real-estate investor in Newton, Mass., who has had Botox,
Restylane and human collagen injections. "Every single person
I know does it. Young and old — everybody." While the side
effects of such treatments appear minimal, no U.S. studies
have tracked
long-term use. The psychological impact on women is also a
concern. Clinical psychologist Rita Freedman, author of "Bodylove:
Learning to Like Our Looks and Ourselves, A Practical Guide
for Women," calls it the "creeping disease."
"One woman gets
Botox and then her neighbor and relatives look at her and feel
relatively unattractive and feel they need to do something,
too," she says. Women in the work force seem particular susceptible
to such pressure. "Working women are judged in a different
way than men; they have to be equally productive but also keep
their appearance up," says Elliot Jacobs, a Manhattan plastic
surgeon who treats several high-powered executives.
"A man
can have lines on his face and look 'distinguished,' whereas
a woman looks 'old.' They're judged by different standards.
It's sad, but it's true." Younger women are not immune. While
nearly half of those who underwent minimally invasive procedures
last year were between 35 and 50 years old, almost 20 percent
were between 19 and 34. That has critics of cosmetic procedures
particularly concerned. "When people in their 20s and early
30s are running off to have Botox, there's a real problem.
We place far, far too much emphasis on youth and beauty," says
Lia Macko, coauthor of "Midlife Crisis at 30: How the Stakes
Have Changed for a New Generation — And What to Do About It."
But
research shows that more attractive people get better jobs
and salaries, and more respect from peers. "We have evidence
showing that, whether we like it or not, appearance does matter," says
David B. Sarwer, assistant professor of psychology at the University
of Pennsylvania School of Medicine and director of education
for the school's weight and eating disorders program.
"They
get preferential treatment in a variety of situations across
a life span. And we know that especially with women, we equate
beauty with youthfulness. So trying to present yourself as
looking as young as possible might actually make practical
sense." Though maybe not financial. At $500 or more per session,
noninvasive treatments can add up. But patients say it's worth
it.
" The cost does bother me, and it's a pain to go back every
few months," admits Rothkopf. "But what's the alternative? " Women
like Rothkopf and Kauffman might be able to decrease their
visits, and maybe their bills, in the near future. Several
longer-lasting treatments are pending FDA approval.
One is
Radiance, which contains calcium hydroxylapatite (a component
of teeth and bones) and has been shown to keep wrinkles filled
for more than three years when injected. Another, polylactic
acid (marketed as Sculptra), stimulates collagen production
to fill wrinkles and is already widely used in Europe. It has
been shown to last up to 18 months. (Restylane's effects, on
the other hand, wear off after four to nine months.) Such long-term
temporary treatments, however, can only postpone the need for
permanent procedures so long, say some experts.
"
You reach
a point where you might as well do the face-lift. In the end,
the only thing that is really going to tighten your skin is
to lift it up — and that requires surgery," says Boston plastic
surgeon Ramsey Alsarraf, coauthor of "The Aging Face: A Systematic
Approach."
More than 8.7 million cosmetic plastic-surgery procedures
were performed last year, according to the American Society
of Plastic Surgeons — an increase of nearly one third. Eyebrow
lifts and face-lifts were among the most popular procedures.
Even Kauffman admits that at some point in the not-so-distant
future, her temporary treatments might not be enough. Her 65-year-old
mother, Theda Kauffman, who still gets Botox, had a face-lift
when she was 55. Kauffman doesn't plan to wait even that long. "You
don't want to do it right away," she says. "But get it before
you need it. Then you keep looking good." For now, anyway.
© 2004
Newsweek, Inc.
|
