A combination of earlier magazine work and new blog posts

Getting the Look Without the Pain

Increasing numbers of nonsurgical procedures now offer the fountain of youth in the bat of an eye.

0ur obsession with youth is nothing new. In the 1980s, archaeologists discovered ancient Egyptian medical tablets dating back 3,000 years. The heading was “For Transforming an Old Man into a Youth,” and a recipe for an acid facial peel to erase wrinkles was included. Of course, the Egyptians did not have the advantage of today’s breakthrough medical procedures, which, in the hands of a skilled artisan, can radically reverse the aging clock. Lucky us.

The latest trend is how to stay looking eternally young without resorting to real surgery. So recently I decided to ask seven of South Florida’s best-known cosmetic surgeons and dermatologists what their favorite, noninvasive procedure of the moment is. And I wanted procedures that are used on both men and women. The doctors are listed in alphabetical order, just so you don’t think I have any favorites—I would trust my face to any of them.

LESLIE BAUMANN, an internationally recognized dermatologist, is the bestselling author of The Skin Type Solution: A Revolutionary Guide to Your Best Skin Ever. Her pick of the moment is Intermittent Pulse Light (IPL). IPL is a no-downtime procedure for photo-damaged skin, and it can also zap age spots, broken veins or any blotchiness or redness on the skin.

“I love it,” says Baumann, whose skin is flawless and gives no indication that she is an avid tennis player. “IPL is just about painless. It feels like a little rubber band hitting you for a second—no bruising—and someone can come in on their lunch hour and most of the time be back at work without anyone knowing they did anything. It even temporarily improves fine wrinkles. It’s so cool.”

Baumann is proud that her University of Miami Cosmetic Center has the latest IPL equipment. In fact, she helps companies test their devices to see if they work. And Baumann is not on her own, working with other IPL specialists such as Dr. Wendy Lee. They have two different IPL machines and must determine your skin tone and problems before deciding which is best to use, as well as the intensity of the treatment. They can even use Levulan, a photosensitizing agent, which turbocharger the treatments. (The only downside is that you will look like you have sunburn for a few days).

FREDRIC BRANDT, dubbed the Baron of Botox, is one of the country’s premier dermatologists and boasts a wildly successful skin-care line that is carried everywhere from Sephora to Bloomingdale’s. He is the world’s largest user of Botox, buying more than $1 million worth a year to fill in the faces of his extensive celebrity clientele. And Botox is still his fav choice.

“Botox has changed so much since I began using it in the mid 1990s,” Brandt says. “We did not know the power of Botox in its infancy.”

He has discovered new ways to use Botox in addition to the traditional freezing of facial wrinkles, employing it for nonsurgical neck and forehead lifts, and “if you relax certain muscles the right way, it’s almost like having a temporary face-lift.”

For Brandt, technique is everything. “I love Botox,” he says. “It is so innovative, just like an artist’s brush, and it’s not just the Botox, it’s the way it is used. We can stave off surgery for years.”

No wonder he has a five-month waiting list—unless you know Madonna….

JULIO GALLO is the moving force behind the incredibly popular and pampering cosmetic spa The Miami Institute for Age Management and Intervention in the Four Seasons Hotel, Miami. He loves Aluma, a fairly new radio-frequency machine that is predictable and virtually pain-free.

“It treats fine lines and really improves the skin,” he says. “It gets deep enough to stimulate collagen and has a tightening effect.”

The treatment is simple: After applying numbing cream, Gallo passes the Aluma machine over your face. It looks like a little vacuum and makes a small suctioning noise. A small amount of heat is all you feel.

“Some people tell me that it’s like getting a facial massage,” he says.

“It doesn’t hurt in the least.”

Gallo has used Aluma on the neck, face, abdomen and even the dreaded bat wings under the arms, all with great results.

“It’s perfect for any place you need a little extra skin tightening,” he says. Results can last two years, and there is no bruising or recovery time. No wonder he has a waiting list for Aluma.

STEVE MANDY’s arrival here has proven to be Aspen’s loss and Miami’s gain. Mandy, who has carved out one of South Beach’s best specialty practices, is a derm who is proud of staying on the cutting edge. His current pick for a noninvasive trick is Sculptra, an injectable synthetic filler that can fill in sunken areas on the face.

“An aging face loses collagen and elasticity,” Mandy says. “I consider Sculptra to be the concrete and steel of facial reconstruction.”

For Mandy, Sculptra is one of many tools he uses, often combining it with other fillers for fine-tuning.

“Sometimes I get a super athlete who is young and has almost no body fat,” he says. “Their body looks great, but their face can seem gaunt. By generating collagen growth, Sculptra can really make their face look much healthier.”

Mandy finds that both men and women, across a broad age spectrum, have benefited from Sculptra. “If you start at the right time, you can delay, or postpone forever, surgery. Tools like Sculptra are just one of many state-of-the-art tools that a good derm must have.”

Mandy says one of the side benefits of plumping the collagen is that it improves skin’s color and texture, and that can never be a bad side effect.

MARK NESTOR, director of Adventura’s Skin and Cancer Associates Center for Cosmetic Enhancement, is on the front lines of battling the sun damage inflicted on most of us who live in South Florida. He says he has a tough time picking just one favorite noninvasive procedure, but says that if pressed, it would have to be Fraxel, a laser treatment that is the choice du jour for many cosmetic-surgery fans because it zaps brown spots, closes large pores and eliminates fine lines.

“Fraxel can really improve your appearance,” Nestor says. “You’ll feel the difference in your skin after the first treatment. It’s like resurfacing the face.”

Fraxel might be a lunch-hour procedure in terms of time, but a day or two of redness is not unusual. And most fans, who love how healthy their skin looks after a treatment, usually go six to nine times, each a month apart. But at 1,000 a session, start saving your money now.

THOMAS TZIKAS is a Delray Beach cosmetic surgeon referred to in Palm Beach society circles as “the Rejuvenator.” So when you look at “Shot on Site Palm Beach” pages in this issue, don’t be surprised if some of the smiling, perfect faces are the result of his handiwork. Tzikas’ current favorite is Radiance, another injectable synthetic filler.

“The real sign of age that I notice right away in someone’s face is a loss of volume,” he says. “People lose fat over time. Restoring volume is the key to turning back the clock.”

Tzikas calls Radiance, which can last from 12 to 18 months, one “of the most versatile fillers” made, though he says he also believes its success depends equally on the ability of the doctor applying it. Tzikas has a waiting list for Radiance treatments because he is good with it. He is also the largest user in the United States.

“What I do is not just fill lines,” he says. “I’m like an artist. I sculpt and mold the face. This is not the same procedure for every person but has to be very individualized to be done right. I can take years off of someone with just an hour of their time.”

Tzikas typically uses Radiance between the eyebrows, for cheek augmentation, to fill marionette lines and even for sculpting the jaw line.

MARTY ZAIAC is a leading Miami Beach dermatologist and co-founder of the Greater Miami Skin and Laser Center. He does not have a single favorite right now, but instead has a favorite combo approach.

“All the procedures are good,” Zaiac says. “But they are better if used together.”

First, Zaiac likes Botox, as does Brandt. “I use Botox to relax the muscles, to eliminate the expressions we don’t want to have,” he says. “It’s a balance of leaving some muscle movement, but not actually paralysis.”

Then he likes to use a filler. “Sculptra is good, but I prefer the hyaluronic acids, like Restylane. Everyone loses volume over time, and it’s great to use fillers to restore some of that. You get immediate results.”

The third part of Zaiac’s youth cocktail is a laser procedure to “tighten the skin and improve the texture and color.” Fraxel is his first choice, with IPL right behind.

And finally, he likes to use photodynamic therapy, which was originally developed along with light to kill cancer cells. “But we discovered about 10 years ago that it had a cosmetic effect and improves the overall quality of the skin.”

But all this poses a real dilemma: Where, and with whom, do you start first? With these doctors, it is hard to go wrong, and the great news about these techniques is that not only are they noninvasive, but none are permanent. So if you don’t like the results, you don’t have to live with them forever, and if you do like them, just add these doctors and their procedures to your BlackBerry calendar.