The California Cure Saving Face

by Carol Wolper

Saving one’s face—also known as anti-aging—is right at the intersection of vanity and judgment. Twenty years ago, I had too much of the former and not enough of the latter. Had I not been a struggling writer, and had I more ready cash, I might have gone for lip augmentation or been convinced that a forehead lift was the answer to a few wrinkles. I might have ended up altering my face to the point where I was no longer me—and it would have been my fault.

I know that for some women, altering is exactly the point. I have a friend Belinda, who is on her third face, and as lovely a face as it is, it bears no resemblance to the girl in her 21st-birthday-party video.

I guess you can call me one of those people who makes a case for aging gracefully, if you keep in mind that for me, “gracefully” means doing everything I can to look good without distorting my natural features. Do most women want to look a decade younger? Of course. Do I think it’s possible? Sure. Possible without surgery? Why not? There’s a world of products and procedures out there designed to keep us looking like the best version of our natural selves. Here’s the hitch: You’ve got to do your research. It seems every day there’s talk of some new technique, some new laser, some new skin-care line.

But saving face is a personal challenge. It’s not about what works for somebody else—it’s about what works for you. So as part of my ongoing personal research, I recently checked out a couple of places I’ve been hearing about in Beverly Hills—the mother lode of anti-aging solutions: Beverly Hills Plastic Surgery, run by Dr. Gabriel Chiu; and the Institute of Aesthetic Medicine in Thibiant Beverly Hills, formerly the Aida Thibiant European Day Spa, which has been reconceived as a skin clinic that combines spa services with noninvasive cosmetic procedures by Dr. Harry Glassman.

For women like myself, who have taken their face care up a notch in order to delay surgical nips and tucks, Glassman’s low-key skin clinic is one-stop maintenance. All the usual spa services are available, as are the typical noninvasive cosmetic procedures (Botox, fillers, laser treatments, facial peels) and what is known as “the noninvasive face-lift.” This procedure consists of six weekly treatments using an electromagnetic field to tighten and tone muscles of the face and two sessions of the Titan skin treatment, which uses an FDA-approved infrared light source to stimulate collagen production. Whether you opt for a facial or a so-called face-lift, chances are you’ll end up feeling you’ve scored a point or two in the fight to maintain.

Chiu, at Beverly Hills Plastic Surgery, was relaxed and convivial when we met—but more important, he was helpful. He handed me what he called a flow chart—not just a list but a detailed explanation of each procedure written in a language I understood, not medical tech talk. I’ll never understand what hyaluronic acid is other than it’s the key ingredient in Restylane and Juvéderm and other popular injectable fillers. But what I do want to know is why one might suit me better than another.

Chiu’s flow chart covered all areas, from Botox to fillers to retinoids (topicals like the standard Retin-A) to antioxidants (a must in skin care, especially if it contains vitamin C) to skin resurfacing to lasers to photo rejuvenation. Perhaps it’s because computers and cell phones have made us all a little ADD, but the chart was like—pardon my lame analogy—a laser, cleanly cutting through the morass of data and precisely zeroing in on the bottom line.

You’ve got to be smart about what you choose. That fact inspired me to come up with a list of five areas a patient needs to consider.

Risk: Beware of any doctor who says, “I’ve done this treatment on more than a thousand women, and I’ve never had a problem.” Even though that may be true, it implies an assurance that can’t really be given. Everyone is different.

Expectations: It’s possible that a few laser treatments will change your life, but settling for improvement instead of transformation is probably a better objective.

Aesthetics: Keep it in mind that your face should match your personality. I was once friends with a woman who has high cheekbones and the kind of refined look that matched well with her bookish intelligence. As she got older, she opted to have fat injections, which made her look like a chubby-cheeked Cabbage Patch doll. Listening to that face discuss the projected national deficit took some getting used to.

Gravity: Make peace with the enemy. No matter how many cosmetic procedures you have, gravity will win eventually. Accept the challenge of seeing how long you can credibly preserve your youthfulness, and enjoy the good fight. If this sounds too spiritual, I’m sorry. But hey, I live in L.A.—this stuff rubs off on you after a while.

Significant Others: Who are you trying to please—yourself or your mate? When I mentioned this to Glassman, he reminded me of an old adage: “A man marries a woman hoping she’ll never change. A woman marries a man hoping she can change him.” I love that observation, because it hits on the very thing that sends so many women off the rails when it comes to their facial choices—fear of change. Women interpret not changing as having to look as young as they possibly can—as young as they looked when their guy fell in love with them. But in trying to do too much to stay the same, they do the opposite. This is the conundrum. I asked both Chiu and Glassman if they’d seen a change in aesthetics here in L.A. over the past few years. They agreed there has been a shift toward a more natural look. It’s a look that is helped along by skin care and skin treatments.

All of this brings me back to vanity. Though I have less now than I did 20 years ago, I have plenty, and that’s a good thing. Vanity keeps us vigilant about taking care of ourselves inside and out. Besides, it is timeless and an integral part of a woman’s inner wiring. I was recently reminded that long before Nostradamus became a famous seer, he was an alchemist, turning herbs and flowers into topical concoctions for the face and body. He compiled his “recipes” into a book that became the equivalent of a 16th-century bestseller.

Without question, aging more naturally is getting easier all the time. Products and services are only going to get better. Healthy vanity, good judgment and the best use of the latest products and treatments are making me brave. Bring on the next birthday. I’m ready.

Tools of the Trade

BOTOX: Injectible mostly used on the forehead. Can temporarily smooth lines and wrinkles—like crow’s feet and frown lines—by reducing the activity of the muscles.

RESTYLANE & JUVÉDERM: The two most popular fillers. Made of hyaluronic-acid gel and used most often to fill in the folds that run from the nose to the mouth.

PREVELLE & HYDRELLE: Newer members of the hyaluronic-acid family. Contain a numbing agent (lidocaine) to make injections more comfortable.

RADIESSE: Filler made of calcium microspheres in a gel suspension. Provides firmness in places like the cheeks, where it can give a higher-cheekbone appearance.

DERMABRASION: Mechanical skin-resurfacing technique. Less popular due to an increase in the use of laser energy–based treatments.

CHEMICAL PEELS: Vary from superficial to deep, depending on the patient’s skin and goals. Lighter peels include salicylic and alpha-hydroxy acids, which provide brighter skin without a lot of recovery time.

TRICHLOROACETIC ACID: Medium-depth peel. Alleviates fine surface wrinkles, superficial blemishes and pigment problems.

IPL: Intense pulsed light—also known as a photo facial—used to treat vascular and pigmentation lesions, rosacea and acne. Delivers energy into the deep part of the skin, leaving the epidermis untouched. More easily tolerated than lasers, and no downtime required after what is usually four to six treatments.

LUMENIS PHOTODERM: Procedure for skin discoloration and dullness from sun damage or hormone changes. Requires multiple treatments (usually four to six).

FRAXEL RE:STORE & LUMENIS ACTIVEFX: Treatments using fractionated CO2 and erbium lasers, which can offer better results and faster recovery time than standard lasers to treat fine lines and wrinkles.

—Information courtesy of Dr. Gabriel Chiu of Beverly Hills Plastic Surgery