With the obvious exception of certain Hollywood stars — Nicole Kidman, we’re looking at you — in most cases, today’s name in the cosmetic-enhancement game is “undertreat.”
Top cosmetic dermatologists and surgeons are taking a judicious approach to injectibles such as Botox and Juvederm (a filler) and incorporating chemical peels and laser treatments such as IPL (intense pulsed light) and fraxel to help patients look naturally youthful rather than plastic.
“In L.A. the objective tends to be to erase all expression,” confirms cosmetic surgeon Dr. Jean Carruthers, clinical professor in the Department of Ophthalmology at the University of British Columbia and one of the pioneers of Botox use in facial rejuvenation.
“Stars know their faces are on display at least 10 times the size of reality and in high definition. But in other cities, we’re seeing more sensitivity to needing movement and character in faces.”
A proponent of combining Botox treatments with fillers to lessen time’s bootprint on the face, Carruthers says facelift numbers are actually down from previous years.
“We lose volume in certain areas as we age,” she points out. “Fillers were about filling in a line or wrinkle, but they’ve become more important when it comes to replacing volume. They give a softer effect than, say, cheek fillers, and work better with each patient’s unique features.” Fillers also mean no down time and relatively little discomfort.
Dr. Diane Wong, owner of Glow Medi Spa in Toronto’s Yorkville area, says most women still don’t want anyone to know they’re having anything done.
“My patients don’t want the skating-rink forehead; they’d rather keep a few fine lines or small wrinkles. So I take a baby-steps approach.” Her objective is not to change the face, but simply to rewind a few years. Wong’s undertreat philosophy sometimes has the occasional patient thinking she can’t see a difference, but Wong says it’s because over time patients adjust to the changes. “Going through all the ‘before’ photos we took together always reassures them.”
Glycolic-acid peels and IPL, fraxel and profractional laser treatments smooth skin, reduce wrinkles, stimulate collagen production and even out the complexion, all of which contribute to a younger looking face without going over the top, says Dr. Lisa Kellett, owner of DLK on Avenue, also in Toronto’s Yorkville area. “Non-surgical skin tightening technology such as thermage also continues to get better and better,” she adds.
There’s a line in the cosmetic-procedure sand, says Carruthers. “Cross it and you look done. Most people don’t want that anymore.”