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April 20, 2007

Cosmetic Surgery Lowdown

Cosmetic Surgery Low Down

Photo Credit: Edwin Ho

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TREATMENT: Hyaluronic acid (HA) injections.
DESIGNED FOR: Subtle changes.
HOW IT WORKS: Doctors inject a small amount of synthetic HA (Restylane, Hylaform, and Captique are the most common) into the hollowed area. Hyaluronic acid, which exists naturally in your body, has a hydrating, plumping effect that makes it an ideal filler. Plus, it helps diminish dark circles by putting a buffer between your skin and the blood vessels that cause the shadows, says Dr. Hirmand.
DOWNTIME: A week of bruising and swelling. Bruising is more likely with injections around the eyes than in the lips, since this fragile skin is so rich in blood vessels.
PROS: HA is more free-flowing than fat (the old filler used in this area) and can provide a smoother, more natural look.
CONS: Since HA attracts water, injecting too much of it can create bumps or unevenness. And there is a small but real risk of vision loss or blindness with any injection near the eye.
COST: About $600 to $750. Results last up to a year — HA stays put longer here than in other parts of the face.
STAVE OFF SURGERY WITH: A light-reflecting under-eye product, such as Neutrogena Skin Soothing Under Eye Corrector, Natural Light, $8.99.

TREATMENT: Sclerotherapy.
DESIGNED FOR: Anyone with dark circles but taut skin — and a willingness to try a controversial new procedure.
HOW IT WORKS: Steven Victor, M.D., a New York City dermatologist, maintains that superficial veins create dark shadows. He injects the veins with a solution (often salt water) that irritates capillary walls. They then collapse and are absorbed by your body.
DOWNTIME: One to two weeks for bruising; you need two to three treatments.
PROS: No more shadows.
CONS: Sclerotherapy was developed to treat spider veins in the legs. Using it near the eyes is experimental and potentially dangerous.
COST: About $375 per treatment. Results can last up to five years.
STAVE OFF SURGERY WITH: Hylexin, $95, designed to reduce the blood-vessel leaks believed to lead to circles, or high-tech creams such as Philosophy Dark Shadows, $30, and Clinique All About Eyes, $46.

There's a fine line between great-looking and you've-got-to-be-kidding lips. The new fillers only get you so far — the rest is about finding a reliable doctor to inject them.
Injections are no longer just about plumping up the lips (good-bye, platypus); the current trend is to use them to restore the border of the lips that you lose as you age, and to lift sagging corners as well. But for natural results, you've got to put yourself in the hands of a doctor whose work you like. New injectables are rampant: Juvéderm, with the highest concentration of HA yet, is the latest. Yet some docs cling to collagen (human or bovine), since it causes less bruising.

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