Need a lift?

Old and aging? No problem. The latest fixes for saggy, lumpy skin are just a derma visit away.

After decades of too much pride in feminine achievement and vaguely veiled distaste for appearance, women all over the world are once more besieged with the minutiae of how to look good, beautiful, and young. Celluloid celebs are back to making up more and dressing less, the better to show off unlined faces and gorgeous bods.

Women now talk about cosmetic procedures almost as often as they open their Facebook pages. Need a pick-me-up? We talk with an expert about your nonsurgical options to the nip-and-tuck.

Hyaluronic acid (HA) fillers

What are they? Fillers are substances that replace lost skin volume due to disease or aging. Among these, hyaluronic acid (HA) fillers are most popular today because they are similar to one of the components that make up skin, says Malaysia-based consultant dermatologist Dr. Melinda Tong. Collagen was once widely used, but its popularity has declined since its bovine origins first presented an increased risk of allergic reactions.

How do they work? Baby fat, commonly located in the cheeks, is a normal feature of youthfulness. As we age, this baby fat starts to disappear. "When a person is young, the cheeks are plump and they serve as scaffolding to keep the skin taut and lifted. Many patients come to see me for fillers becausetheir face has ‘dropped,’ resulting in saggy jowls, hollowing of the lower eyelids, and deepening of the lines running from the sides of their nose to the corners of their mouth [nasolabial folds]," Dr. Tong explains.

Fillers can be used just about anywhere in the face and body where volume is lacking, including depressed scars.

How long does it last? The lifespan of a filler depends on the type used. Fillers generally last from several months to several years.

Are there side effects? The majority of Dr. Tong’s patients who get HA fillers do not experience side effects, except the occasional patient who gets mild temporary bruising at the needle site. "The ideal filler is one that feels natural and does not cause any reactions ... [although] fillers that last longer are at higher risk of causing side effects," Dr. Tong said. Possible sideeffects include lumping, infection, and allergic reactions, which appear like angry red patches on the skin.

Botulinum toxin injection

What is it? The botulinum toxin is produced by the bacteria Clostridium botulinum. In large amounts, this toxin causes botulism, an acute paralytic disease, of which there are three types: food-borne, infant, and wound botulism. All are deadly if untreated. In its medical application,botulinum toxin type A is injected to treat a multiplicity of involuntary muscle contractions or disorders, from dystonia (abnormal body movements) to strabismus (cross-eye or lazy eye). However, in its cosmetic incarnation, small injected amounts of botulinum toxin type A can smooth facial lines and improve skin tone.

How does it work? Botulinum toxin (BTA) works on the receptors in the muscles to make them relax. Many wrinkles in the upper half of the face are due to movement of the facial muscles of expression. "Over the years, due to repeated contractions of the muscles, the overlying skin gets pulled into a permanent crease and a wrinkle results," says Dr Tong. Examples of these include crow’s feet or smile lines beside the eyes, frown lines between the eyebrows, and surprise lines on the forehead.

"BTA can also be used to create a more oval-shaped face. Some people have square jaws due to prominent masseter muscles (large muscles that move the jaws). By injecting BTA, the muscles can be reduced in size."

How long does it last? The effects of BTA last three to six months.

Are there side effects? Side effects are rare. Mild bruising may occur, which is normal with any procedure that involves needles. In extremely rare circumstances, eyelid droop or asymmetry of the face may result if the injections are not administered correctly. However, these side effects will disappear within a few months as the BTA wears off. Botox is contraindicated in some individuals, e.g., pregnant or breastfeeding women and those who suffer from a neurological condition. Consult your doctor first before signing up for injections.

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