Ways to fight the aging process of the face

Pick up any magazine, or look at most professional photography, and there's been a fair amount of photoshopping. It's a great tool for perfecting imperfections in prints, but in real life, it can leave us women feeling a bit less than perfect.

We teamed up with a dermatologist, Dr. Mark McCune, and a handful of women to learn what, exactly, can and is being done about aging.

For women in their 20s...

There aren't many concerns cosmetically. Women are usually at the peak of natural youthfulness during this decade. While photoaging is occurring, it hasn't yet produced visible signs of damage or aging.

Women in this category most often request Botox Cosmetic to relax vertical "11 lines" which start to show up between the brows - also called frown lines - and horizontal creases which start to show up on their foreheads. Some also get fillers to fill any lining in those areas that does not go away when the face is relaxed.

"Most girls in this age group are not interested in facial skin care," said McCune.

Dr. McCune's recommended treatments are:
1. Sun protection - at least SPF 30
3. Good skin care regimen (consult a dermatologist)
4. Do not smoke! Smoking greatly accelerates aging of the skin, especially around the mouth.
5. Some procedures which can help:
    a. Botox Cosmetic (wrinkles which disappear when face is at rest will fade) - $15 for first unit, $13.50 for each additional unit. An example: Botox for the "11 lines" (or frown lines) my cost upwards of $360.
    b. Fillers like Juvederm (fills in wrinkles which don't fade on their own) - Cost is $320 to $570 a treatment depending on how much you need.
    c. Chemical peels

For women in their 30s...

Most women will start to notice signs of aging in their 30s. Fine lines and wrinkles start to develop - frown lines, forehead lines, crow's feet, smile lines, and lines around the mouth. The skin can also start to develop brown spots that look like large freckles.

Subsurface collagen starts to break down, making the face appear dull and flat. Any changes noticed in the 20s will intensify and worsen in this decade of aging. The face starts to lose volume, typically starting under the eyes. Lips can become thinner and more wrinkled and pore sizes keep getting bigger. A lot of the time, this is the age when precancerous lesions and skin cancers are discovered.

Dr. McCune's recommended treatments are:
1. Everything listed in the 20s category
2. Laser treatments for brown spots, red blood vessels, fine lines, pore size, lost glow of skin, poor texture
    a. Alexandrite Q-switched laser (Alex laser) removes brown spots on any body site (face, hands, etc.) - Half session for 7 minutes runs $300. A full, 15 minute session runs $470. Patients describe a heat sensation similar to a sunburn following the procedure. Cool air is used to lessen the amount of heat a patient feels during the procedure.
    b. Gemini 532 vascular laser (Gemini) removes facial redness, developed blood vessels, and undereye dark circles. This procedure costs the same as the Alex laser.
    c. Fraxel Restore laser ( Fraxel) helps with brown spots, red blood vessels, fine lines, poor size, facial glow, etc. Of the treatments highlighted for this story this is the most all-encompassing, crème of the crop procedures... it will cost you upwards of $4,000 for the treatment.
3. Volume replacement
    a. Sculptra Aesthetic is a poly-L-lactic acid  which stimulates your own collagen formation and causes areas of facial volume loss to re-expand. Correction lasts 18 to 24 months and costs from $1,000 to $2,000 a session.
    b. Hyaluronic Acid Injections (also known as liquid facelift), can work well but you have to keep going back every 6 to 12 months.

Women in this age group also start to deal with unwanted body fat in places that used to stay thin. Diet and exercise don't work! Some problem areas are upper and lower abdomen, waistline (muffin tops) and inner thighs.

Dr. McCune uses a product called CoolSculpting which freezes fat in those problem areas and reduces their volume. Not as effective as liposuction, but "very safe, and most often very satisfying to patients who do it," said Dr. McCune. CoolSculpting costs $1,500 per area (Upper abdomen, lower abdomen, or muffin tops).

For women in their 40s, 50s, and beyond...

Unfortunately, everything you started to see in your 30s will intensify and worsen and women will start to

pursue more information and start to explore options.

While most women will start to look into plastic surgery for eyelid, face and neck lifts...and lifted breasts, abdomens and legs, others are still afraid to make the leap to surgery.

Even if a woman has worked hard to keep her face in shape over the years, she often forgets to care for her hands and those can often give away a person's true age.

Dr. McCune's recommended treatments are:
1. Everything done for younger patients
2. Alex laser (mentioned above) for brownspots anywhere on the body, especially good for hands. Cost is $300 to $470 depending on area treated.
3. Hand volume restoration- fat injections using fat from another part of the body.
4. Medium Depth Chemical Peeling can improve photoaging of the face a great deal. It is invasive, with a two week downtime. Dr. McCune said this one is much safer than a phenol peel which can produce irritability of the heart and result in cardiac arrhythmias.

For men...

Very few men pursue cosmetic treatments. For this story, however, we sat in on a Gemini Laser treatment on a male patient. He had a significant number of veins visible over his cheek and nose area. We watched as the laser essentially erased the lines. Lee, the patient, said he was shocked by the results. He wished he would have come in sooner and would be telling his friends.

As with any medical procedure, make sure to research the person to which you plan to entrust your face, body or hands. Make sure they are qualified and safe. All of these procedures have the potential to help you have a more youthful appearance, but only if they're done right.

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