Face Facts
The New Injectable Fast Fixes
June 20, 2007
By Hope Keller
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Marjorie Liss has a love affair with needles. “I view every stick as a gift,” she avows. She got hooked after only one time. After that, she says, “I didn’t care if I had to take a second mortgage.”
Heroin? Cocaine?
No — Botox and Restylane, the new face fixes that smooth and firm creased, sagging skin in the time it takes to have lunch.
The injectables, as they’re known, have taken the country by storm. Botox, which temporarily paralyzes muscles so skin can’t wrinkle, is the No. 1 injectable cosmetic procedure in America, the number of treatments increasing by more than 2,000 percent since 1997. More than 3 million treatments were performed last year, mainly on women. Restylane and the other fillers, used to plump wrinkles and grooves, are in second place, with nearly 1.6 million treatments.
Liss got turned on by Dr. Frederic Brandt, the celebrity skin guru known as the Baron of Botox who helped pioneer the injectables’ use to reverse the signs of aging. While Botox and the fillers are not cheap — the cost of treatment can range from $500 to more than $5,000 depending on the number of vials used and the doctor — they are less expensive than traditional plastic surgery. Results last from three months to a year or longer.
“I didn’t want to be cut,” says Liss, 64, a Baltimore pianist and teacher. “I wanted to be freshened up.”
She continues: “I had these marionette lines around my mouth and thought, ‘Wouldn’t it be nice if I didn’t have them?’ So I picked up the phone.”
A few months later she went up to New York — Dr. Brandt practices there and in Florida — and had a Restylane treatment. Sayonara, marionette mouth. Next time she had Restylane and Botox, including a Botox neck lift, a Brandt specialty. Next she had her cheekbones enhanced and her chin contoured with Restylane.
“Having these procedures doesn’t shockingly change the way I look,” she says. “It doesn’t change my face structure. It doesn’t make me look like somebody has hacked me up and put me back together again like a Picasso.”
“I love my appointments,” says Liss, who drives a 1984 Buick LeSabre Limited and saves her money for visits with Dr. Brandt. “Your face is just so terribly important.”
Dermatologist Diane Orlinsky has seen injectable cosmetic procedures go from making up about 10 percent of her business four years ago to 50 percent today. “They become addicts,” she says of her patients, who are mostly in their 40s, 50s and 60s. “They love it.”
The old-style fillers, which used bovine collagen and frequently caused allergic reactions, have been nearly completely ousted by Restylane and the other hyaluronic acid injectables, which do not require an allergy test. “Anybody who knows what they’re doing isn’t using that,” Dr. Orlinsky says of bovine collagen. She calls the new fillers her favorite products — after Botox, that is. “Botox is a given. Botox is almost like going to the dentist.”
Dr. Orlinsky uses Restylane to fill mild to moderate lines and Radiesse to plump deeper creases. Juvederm is used to enhance the size of lips. Dr. Orlinsky also uses Juvederm to recreate the philtrum, the parallel lines running from mouth to nose that tend to flatten with age. “The goal is to look like yourself but a little better,” she says. “You don’t want people to say, ‘Oh my god, what did that person do to herself?’”
Fat injections are another kind of injectable. Dr. Patrick Byrne, director of facial plastic surgery at the Johns Hopkins Cosmetic Center, harvests fat from a patient’s abdomen or inner thigh and uses it to replace volume around the eyes and in the cheeks. “It really looks spectacular,” he says.
A sign of the injectables’ ubiquity is the spa-ification of cosmetic medicine. Dr. Randolph Capone, director of the Baltimore Center for Facial Plastic Surgery, is also the medical director at Studio 921 in Federal Hill. “People find it a little less intimidating to go into a spa setting to make first contact with a physician instead of an austere and sterile physician’s office,” he says.
More than vanity is behind the injectable craze. Looking old can be a bad career move. A study of hiring bias by economists Daniel Hamermesh and Jeff Biddle revealed that a person with below-average looks makes 9 percent less an hour than an average-looking person. A really good-looking woman can make about 5 percent more than an average-looking colleague. (This equates looking good with looking young, but that’s another story.)
Elizabeth Lunt, a magazine editor and the mother of two elementary school children, is on the fence about Botox and the rest of the skin doctors’ armamentarium. But she knows that women are judged harshly as they age — and that those judgments can hold women back when they are far from ready to pack it in.
“You want your appearance to reflect the way you feel,” says Lunt, 43, of Baltimore. “Women don’t feel old in their 40s and they don’t want other people making judgments about what they can still do.”
Yet, she says, “contemplating these procedures causes you to contemplate your identity. The sand is running through the hourglass.”
