Facing Facts About My Face

Hey, what’s with all these new cosmetic procedures? Botox, Restylane, Laser Surgery – there are so many new products being aggressively marketed to women my age that it’s overwhelming. I’m not ready to go under the knife, but I do have a few issues and it seems to me I should at least know what’s out there. So I decided to attend a group consultation hosted by noted cosmetic dermatologist Dr. Andrew Scheman.

Dr. Scheman’s suburban Chicago practice is booming. It can take over a month to schedule a private appointment with him. To meet consumer demand, he holds regular group consultations, where he presents the latest and greatest products and techniques for achieving a younger looking appearance.

There were two other women at my group consult, held in the elegant waiting area of Dr. Scheman’s offices. I eyed them both furtively, trying to guess their ages and figure out what their skin problems were. Me, I wanted to know what I could do about the blotchy spots on my face as well as the lines on either side of my mouth.

Dr. Scheman started out our session very matter-of-factly. There was no discussion of the ethics of cosmetic enhancements or any salesmanship about the benefits of looking younger. He simply asked us what areas we were interested in learning about. Turns out I was in luck. One of the women, Debbie, was also concerned about deepening smile lines. The other, Maureen, had pigmentation issues like me. Dr. Scheman addressed the smile lines first.

The lines around the mouth, or nasolabial folds, are more than just wrinkles and can’t be treated with topical creams. As you age, your face begins to lose fat. Lacking the underlying support, the skin on your face begins to sag, making expression lines around the mouth look more pronounced. (Here’s a case where losing fat is a bad thing!)

The way to diminish these lines is by injecting “fillers” under the site to plump up the area. Dr. Scheman uses a variety of hyaluronic acid based products. After a quick examination of my lines, Dr. Scheman recommended Juvederm for me and estimated the cost of a single treatment at $400. The treatment would take less than 30 minutes, have minimal side effects (maybe a little swelling) and last about nine months.

“But what about Botox?” I asked. Dr. Scheman explained that Botox is used to treat “dynamic” lines caused by muscle movement. Botox relaxes the muscles that create frown lines on the forehead. Since the lines around my mouth are considered “static” – visible even when the muscles are at rest – they are best treated with fillers. Got it, now what do I do about these dark patches on my face?

When I was first pregnant 15 years ago I developed the “mask of pregnancy” and it never really went away. Dr. Scheman examined my face and said that I indeed had melasma. Melasma is mainly caused by hormones and is light sensitive, which explains why my patches become darker in the summer. I’d seen these amazing transformations on “Extreme Makeover” where years of sun damage and age spots were erased by lasers or deep peels. I was hoping there would be some quick fix for me too. Unfortunately there isn’t.

Because my condition is sensitive to light, laser therapy would just make the spots worse. The only treatment, said Dr. Scheman, is a combination of a fading cream and a killer sunscreen. Did you know that most sunscreens on the market don’t protect against the rays that cause aging? I didn’t! Most sunscreens block UVB rays, which cause cancer, but do not protect against the UVA rays that cause wrinkles and age spots. But Dr. Scheman knew of one sunscreen that blocks both types of rays.

“Uh-oh” I thought to myself, “Here comes the sales pitch for the $100 sunscreen.” Nope. Dr. Scheman recommends Neutrogena’s Healthy Defense 45 SPF Moisturizer with Helioplex, and you can buy it for about twelve bucks at the drugstore. He did recommend a prescription fading cream called Tri-Luma, but cautioned that it would only be effective if I were diligent about using the Neutrogena sunscreen. I bought a tube of Tri-Luma for $90 on the spot.

I left the doctor’s office feeling comforted. I realized that I’d been blaming myself for not taking care of my skin properly. But how could I fight losing facial fat and my own hormones? Now I had a fairly straightforward cure for my blotchy face and a not-too-scary option to deal with my most pronounced wrinkles.

Have I booked my appointment for Juvederm injections yet? I’m not saying. But if you see me with a smile playing around my unblemished, unlined cheeks, you’ll know I’ve been re-juvedermated.