What she's considering for later: "I'd like to try IPL [intense pulsed light] laser treatments to help even out my skin tone. I've seen patients get amazing results. You usually have to do several treatments, but there's no downtime. I think eventually I might do a brow lift, too. I've noticed my brow dropping already, and since I'm Asian and don't have creases in my eyelids, it's more noticeable. We can do brow lifts endoscopically now, so we just make three to five small incisions rather than cutting from ear to ear like they used to. The results are quite conservative, not that surprised-deer-in-headlights look. Whether I'll ever have a facelift…I don't know. Asian women do tend to age a little slower, so I probably wouldn't even need to consider it until I'm in my 60s."
What she'd never do: "A permanent filler, like silicone. I'd also never do anything more than a superficial chemical peel and wouldn't try ablative laser resurfacing, like the CO2 laser. When you have darker skin, you have to be really careful with procedures that exfoliate too deeply because they can cause permanent pigmentary changes."
Her most aging mistake: "Not wearing sunscreen until about five years ago. If I'd always worn it, I wouldn't have brown spots and broken blood vessels now."
The one thing she wishes her patients would realize: "That no cream, no matter how expensive, can lift your eyelids or tighten your jowls or completely remove the puffiness under your eyes. The only thing that will do that is surgery."
The biggest breakthrough she's seen in the past five years: "Definitely Botox. When we first started using it cosmetically a decade ago, everyone was getting that frozen look; now doctors are very selective about where they make their injections, and results look more natural. And Botox has a great safety profile."
The most overhyped product: "Any cream that claims to be a wrinkle eraser."
The most overhyped procedure: "I'm wary of any noninvasive procedure that promises significant skin tightening or facelift-like results. Thermage is pretty high on that list. When a sales rep came to our office once, he said about 30 percent of people don't respond at all. For such an expensive treatment [around $2,500], I think that number is way too high."