Concern about facial aging, wrinkles, loose skin, sagging cheeks, jowls, and ?turkey neck?, and other signs of advancing age is very common among the 40 to 50 year olds in the United States, both men and women. A startling 12.4 million cosmetic plastic surgery operations were performed in this country last year and estimates are that nearly half of them were to correct facial aging. Most of the questions I receive at my website http://saveyourface.com/whatsnew/index.php and http://saveyourface.com/askdoc/index.php are from patients who want to stop the facial aging process.

As the baby boomers reach their 50's everyone wants to look younger but no one wants to have surgery. Most people do not want to have surgery especially if it is not for serious medical reasons.

However revolutionary advances in technology have made it possible for many people to reverse facial aging changes using new non-surgical facial rejuvenation techniques without having to undergo surgery.

This past Wednesday September 28, 2005, I spoke on a panel entitled Non-surgical Facial Rejuvenation at the meeting of the American Society of Plastic Surgeons in Chicago, Illinois. My topic was Botox?, the soft tissue fillers including Restylane? and Radiesse?, and the many exfoliative chemical peels using Glycolic, Lactic, and Salicylic acid. I came away from that meeting very excited and enthused about all the wonderful new non-surgical facial rejuvenation therapies that are safe and effective for patients today.

There are so many new non-surgical facial rejuvntion options available that the patient must understand exactly what facial aging change it is that they want to correct. Usually the patient just feels that their face looks older but cannot pinpoint exactly which facial aging change is causing concern. It is important to seek consultation with an experienced board certified plastic surgeon who understands all the options so that the correct option is chosen for your very unique face. I advise you to avoid doctors who only do one or two facial rejuvenation procedures and tend to push patients to have the procedure that he/she performs rather than customizing the procedure to the patient's needs.

The various non surgical facial rejuvination opions available today include:

? Topical cremes, microdermabrasion?, and superficial skin peels with glycolic, lactic, and salicylic acid to produce exfoliation to freshen the skin and give it a youthful glow. These treatments also stimulate the skin to form new collagen to replace the old damaged aged collagen, and help rejuvenate the facial skin.

? Topical cremes, microdermabrasion?, lasers, IPL or Photofacial, and Fraxel? can be used to remove brown spots, pignent, blood vessels called telangiectasias, and rosacea from the facial skin. Pigment and blood vessels are a classic sign of facial aging and the non-surgical removal of these skin discolorations provides noticeable facial rejuvenation.

? Botox? can be used to relax the muscles of facial expression and remove crow's feet, worry lines, frown lines, and bunny lines all of which are very early signs of facial aging. Botox? effectively removes these lines in most people for 6 to 9 months after a simple nearly painless injection.

? Deep facial lines called the nasolabial fold lines and marionette lines make the face look tired and old and coupled with the frown lines often make people look angry. New soft tissue fillers can soften the nasal-labial fold lines and marionette lines when they are injected into the skin beneath the aging lines. Commonly used soft tissue fillers are Zyplast?and Zyderm? - both made of collagen, Restylane?, Restylane Finelines?, Hylaform?, Perlane?, Radiesse?, Artecoll?, Artefill?, CosmoDerm?, CosmoPlast?, Sculptra?, Fascian?, Cymetra?, and Isolagen?. Each of these fillers has different characteristics and are better for some facial aging changes than others. For a thorough discusion of fillers consult Chapter 7 ?No Down Time Facial Anti-aging Procedures‿ in Save Your Face, available on line at http://saveyourface.com/BuyTheBook.html

? The final facial aging change to treat is loose sagging skin. While a plastic surgical face lift is still the ?gold standard‿ for facial rejuvenation, several new technologies are evolving which can tighten aged facial skin. Titan? and Palomar Starlux LuxIR Fractional use infrared waves, and Thermage? and Aluma? with FACES? use radiofrequency waves, are all being used to heat the collagen in the deep layers of the skin called the dermis causing the collagen to shorten and tighten the skin. While these technologies are new and only about 30% effective and require multiple treatments, they will most certainly be improved in the future and effective skin tightening of aging facial skin will be possible.

Non-surgical facial rejuvenation is here and is getting more effective as new products come out every month. One of my common expressions whenever I speak about the new non-surgical options for facial rejuvenation is ?plastic surgery is becoming non-surgical‿ and try to encourage my fellow plastic surgeons to embrace the new technology. I still believe that plastic surgeons are the best doctors to provide the non-surgical facial rejuvenation procedures for patients because they are the facial aging experts and they have the ability to do what is necessary for the patient whether it is Botox? or a face lift. Each face is unique and a ?one size fits all‿ approach just does not work in facial rejuvenation. In my practice at the Adams Center on Newbury Street in Boston , my partner Dr. Bill Adams and I have 50 years of experience in Plastic Surgery between us and provide our patients with an honest opinion on the best options to rejuvenate their unique face.

Brooke R. Seckel, M.D., FACS