Hydroquinone: A topical ingredient that inhibits the pigment-forming enzyme tyrosinase, to lighten discoloration. A 2 percent concentration is available over-the-counter; doctors can prescribe 4 percent, for more dramatic lightening.
Chemical peels: An acid solution is painted on the face to lift away the upper layers of skin, improving texture and discoloration. A basic, light peel most commonly uses glycolic or salicylic acid and causes mild, temporary redness. Four to six monthly treatments are generally recommended.
Microdermabrasion: Tiny aluminum oxide crystals are sprayed against the skin to buff away dead cells, improving texture and removing surface pigmentation. Skin may be pink for a few hours afterward. A series of four to six treatments is usually suggested.
Botox: A purified injectable form of botulinum toxin that blocks the nerve impulses that cause muscle activity — and the resulting expression lines. After it's injected (you feel a pinch), lines disappear in about a week; results last three to four months. (Many dermatologists now also use Dysport, a newer FDA-approved botulinum toxin comparable to Botox in effectiveness and longevity.)
Hyaluronic acid fillers (Restylane, Perlane, Juvéderm): Synthetic sugars injected into the skin to plump lines and restore lost volume in the face. Restylane and Juvéderm are now mixed with anesthetic lidocaine, so injections cause minimal discomfort. Results are noticeable immediately and last about six months. You may have slight swelling for a day or two; bruising is also possible.
Radiesse: A filler made up of calcium-based beads that can recontour the cheeks and jawline. You see results right away, and they last up to a year. You may have slight swelling for a day or two; bruising is possible.
Fat transfer: Fat harvested from one part of the body (usually the butt or thighs) is used to recontour the face. Results generally last about six months to two years. You may experience a couple of days of swelling and bruising.
Next: Browlifts, thermage, blepharoplasty, and more...
Fractional nonablative laser (brand names include Fraxel Dual or Palomar Lux 1540 Fractional): A laser's pixilated beam targets collagen and pigment beneath the surface of the skin. It can soften fine lines and treat diffuse freckling. Three to five treatments (at 30- to 60-day intervals) are usually recommended; a topical numbing cream and ibuprofen prevent discomfort. Skin is red and peeling for a couple of days afterward.
Intense pulsed light (IPL): Pulses of light are delivered to the skin to reduce hyperpigmentation and redness. Three to five sessions are usually suggested. The treatment is virtually painless (you may feel some warmth); skin could be red for a few hours afterward.
Q-switched laser: Emits beams of red light that are absorbed by melanin to fade brown pigmentation. The treatment feels like rubber-band snaps; each spot darkens and falls away after about two weeks.
Thermage: Radiofrequency energy heats lower layers of skin, tightening collagen. Requires some over-the-counter pain medication; only one treatment is necessary, and there is no downtime. Results peak after six months and last one to two years.
Titan: An infrared laser heats lower layers of skin to tighten collagen. Treatments are painless, and most effective in a series of three. There is no downtime; results peak after six months and last one to two years.
Blepharoplasty: Surgery in which excess skin is removed from the upper and/or lower eyelids. The procedure is performed under general anesthesia or intravenous sedation. Downtime is about four or five days; some bruising and swelling could last for several weeks.
Browlift: Plastic surgeons usually use one of three techniques: An endoscopic browlift repositions tissue beneath the skin through three to five small (less than an inch) incisions along the hairline. A coronal browlift raises the brow, and removes extra skin, through an incision made from ear to ear, several centimeters behind the hairline. A lateral temporal browlift cuts away excess skin through two incisions (of about an inch and a half), made just behind the hairline. General anesthesia or intravenous sedation is required for all procedures. Downtime is about five days; swelling may not completely subside for several weeks.
Facelift: Through incisions made along the hairline and around the ears, a surgeon cuts away excess skin and lifts underlying tissue. General anesthesia is recommended; downtime is at least one week (often two), and bruising and swelling may not subside for a month or more.
Adventures in Beauty