A combination of earlier magazine work and new blog posts

Airplane Remedies for Your Body and Soul

Make sure you land at your destination ready to hit the ground running when flying between Miami and New York.

Lost bags? Hours in the security line? Long delays? Air travel after 9/11 is no day at the beach, but for those of us who fly frequently between New York and the sixth borough, South Beach, this is the price we pay for having fun in two of the country’s most exciting cities.

But the hassle of flying is one thing. What you do not want is for your flight to make you sick. Follow these tips so that when you arrive in either city, you are fresh to drink, dine and party.

Most of you probably think the only thing you have to avoid is sitting in front of someone with a hacking cough. Don’t you hate that? Why did they pick my flight and my section of the plane? Can’t they put their hands over their mouth? The best thing you can do – I learned this from a cool South Beach doc – is to take a tiny swab of an antibiotic cream such as Neosporin, put it on a Q-tip and place it gently around the edge of your nostril. It will catch and destroy any invading germs. I usually go to the bathroom to do it, because it can look a little odd to have a Q- tip up your nose. Pink for girls and blue for boys, please.

But sick fellow travelers are only the tip of the iceberg.

Your tray table is a Petri dish of bacteria, probably not cleaned by the reduced staffs of the streamlined airlines since South Beach real estate was cheap. Jet Blue, a fave for travel between the two areas, does a deep clean every 30 days. But just use a little pack of Sani-Wipes–you will not look odd, I promise. Thinking of using the blanket or pillow? It can also be a month between washings. Forget it. And bring your own headphones for your iPod. Asking for an airline’s headphones is taking a risk of an ear infection, and that is a bummer during a trip. Think it cannot get worse on a plane? Read on.

You know the overhead air vents that you can open up to feel cooler? All they do is recycle dirty air from the rest of the plane. The guy with the bad cough, whom you thought you had escaped because you moved 20 rows away, well, sorry, guess again: He is coming your way through the air vent. Also, there is less oxygen in a cabin than in normal air. That is why you will often get a headache. And it is not helped by cabin pressure, which can make it throb.

In 2004, the Environmental Protection Agency tested drinking water on 158 randomly selected planes and found that 20 tested positive for coliform bacteria, which include E. coli, and that can really ruin your trip. Use the airplane’s water to wash your hands in the bathroom, but don’t drink it. Bottled water, anybody? And remember, no ice. It’s just frozen bacteria.

Okay, so you have made your best effort to avoid the minefield for getting sick on a plane. Now, how do you arrive looking great?

If you want to land feeling really fresh and headache-free, avoid the alcohol. Even if you are a nervous flyer, you are better off having your doctor prescribe a mild anti-anxiety pill than downing a few of those little bottles of airplane booze.

Try to keep the coffee and tea to a minimum. Drink plenty of water-and remember, bottled only-to stay hydrated, as the air is not humidified. One or two glasses an hour will do the trick. And before the plane takes off, pop a decongestant such as Sudafed. It will keep you from getting stuffy. Get up and walk every hour-just not too close to the cockpit or you will be tackled by the undercover air marshal.

If you are in coach (I know, I hate it, too), bring along your own food. Leave behind the Quiznos subs and the bags of pretzels and chips. Those sodium-laden foods will leave you looking like a puffball when you get off the plane. Get some almonds, trail mix, fresh fruit, a salad from Starbucks, just healthy and light. And if you are in first class, good luck. I find that every cheese casserole or medallion of beef would be returned if served at a real restaurant. But it is better than nothing. At least they have stopped giving out those silly plastic utensils.

A nap always helps. But during a day flight, the light used to keep me awake. The black eye covers that are on the plane are a sure way to get pink eye. Not attractive. Instead, the best I have found are at peepersleepers.com. They are simply the softest, block out every bit of light and leave no mark on your face. If airplane noise bothers you, try one of the many noise-canceling headsets, such as those from Bose.

And if you feel queasy during the flight, try pressure bands. They look like wrist sweatbands that you would use at a gym, and they really work. They are based on the ancient Chinese principle of acupressure. Air-pressure changes bother you on landing? Chew some gum.

Now, if you really want to pamper yourself and get off a plane with dewy and fabulous skin, I have something for you girls and boys who want to steal a little secret from the stars. It is the new 02 Intraceuticals “oxygen facial.”

“I love the treatment, and so does my face,” says Madonna, who owns three of the machines. Other fans include Halle Berry, Heather Locklear and Molly Sims. Celebs love to do it before a flight. It is a 30- minute noninvasive procedure in which a small wand is passed over your face, applying oxygen under hyperbaric pressure. It firms and tightens the skin, minimizes the pores and little wrinkles and gives you a flawless complexion. Locally, you can get it done by “oxygen therapy specialist” Wendy Hartway at Dr. Fredric Brandt’s Coral Gables office. If you are somewhere else, check out Michelle Peck, who bills herself as “facialist to the stars.”

So that’s it. Who said flying has to be a downer? With a few tricks of the trade, now you can bounce back and forth between South Beach and New York and stay healthy, feel good and look fabulous.

Real Men Moisturize

Procedures to Reverse the Signs of Aging Are No Longer Just for the Fairer Sex Remember actor John Wayne back in the day? His cowboy leading-man role was tough and manly. That meant squinty eyes- I guess those were supposed to scare the bad guys-a leathery face full of sun-induced wrinkles that resembled a road map, and a forehead that looked like an accordion. If high-definition television had existed then, Wayne would have made cosmetic surgeons hyperventilate. Fast forward to today. Brad Pitt. He has smooth, mostly wrinkle-free skin, a great head of hair, and a bod in super shape. It’s why the 43-year-old actor looks at least a decade younger.

And it’s not just Photoshop. Times have changed. Today’s hip men (don’t even think about the “metro” word, I hate it) use just about every health and beauty trick to shave off years and look their best. It’s just a fact of modern life: Real men moisturize.

Sure, not smoking, not drinking excessively and getting only a little sun keep your genes their best, but what if your gene pool stinks? What can you do if the men in your family lose their hair in their 30s, you’re stuck with a body that stays flabby despite gym workouts, and your face seems more like sandpaper than velvet? Don’t despair. There are bundles of fixes available, from your local drugstore to the doctor’s office.

As a Brit, I know a secret. For decades, European men-such as David Beckham-have stolen skin- care products from their girlfriends. After all, both sexes confront the same type of stress through wind, sun and pollution. Sorry, fellows, you don’t get a free ride when it comes to wrinkles and skin damage.

The easy part starts at the skin-care counter. Every night (it sounds tough, but isn’t-after all, you brush your teeth daily, right?), you should use a gentle exfoliating cleanser to remove the day’s dirt and grime. A good product, and there are plenty, won’t irritate your skin or clog your pores. Then apply a rich moisturizer. If you’re really into it, use a separate eye cream that targets puffiness and black circles. If you don’t want just a moisturizer Band-Aid, you should opt for a tretinoin-based prescription cream such as Retin-A or Tazorac. They are FDA- approved and restore the skin’s surface while eliminating tiny wrinkles. A little dab goes a long way, so don’t overdo it. As these are available in different strengths, start low until you see how your skin Anti-aging measures have long been the domain of women, but these days an increasing number of men are embracing advanced skin care, hair replacement and dental procedures to help make them look younger. reacts. They also make you a little more sun-sensitive, so limit your poolside visits. But if you use them regularly, you’ll see your small facial lines dissolve away. So now you’re into moisturizers, using Retin-A and liking the newer you, but you want to erase even more years. Okay, you have the youth addiction. Now let’s get to the serious stuff, where moisturizers seem like child’s play. Want to blast the skin and remove accumulated damage all at once? Try Fraxel or IPL (Intermittent Pulse Light). The first is a laser and the second a milder technology. Both will clear your skin of aging spots, tighten pores, plump the collagen and provide a smooth appearance. Technologies such as Titan and Thermage tighten your skin to what it was a decade earlier, and these are lunchtime procedures, with no downtime. Cool. If you want to keep it up, you’ll need two or three a year, and they run about $1,000 each. But hey, no one said looking great would be cheap.

So your skin is now in good shape, but what about your balding or receding hairline? Skip the toupee unless you like furry hats. A comb-over? Donald Trump will cure you of that thought. You can use over-the-counter products such as minoxidil that sometimes stimulate a little growth. The same is true with prescriptions such as Propecia. But the gold standard is still a hair transplant-and I don’t mean your father’s transplant, where a treated head ended up with a few sprouts here and there. Today, microsurgery has perfected the art of restoring almost a full head of hair. But beware: The balder you are, the more it costs, so start early. And once you have the hair you want, a little dye or highlighting can help you keep it looking perfect. Just remember, if you toy with your color, you don’t want it to look like shoe polish.

Now you have the hair and skin. Bad teeth? No problem, just get some clear braces to straighten out the crooked smile, and then blast them with a professional brightening system such as Zoom! or BriteSmile. And if your teeth are beyond help, remember veneers; they’ll give you white chicklets for just a small mortgage. Too lazy for the gym? Save your money on personal trainers and go to a cosmetic doctor. Liposuction is great for getting rid of love handles that are embarrassing when you remove your shirt, or cleaning up a fat neck where a double chin has become your trademark. Want more than mere fat removal? There are pec, butt and calf implants for that “I work out hard six times a week” look. Sure, it’s cheating, but if you have the money and can set aside the recovery time, it’s body building without the sweat. And if your face needs serious work, your plastic surgeon can help. Lifting droopy eyes and removing under-eye bags can erase years.

When the whole face is a goner, remember that almost 20 percent of face-lifts are now for men. Sure, you’ve seen the bad ones-Burt Reynolds?-but there are plenty of good ones that you almost never notice. Do I hear Arnold Schwarzenegger? So remember, fellows: In our culture, looking your best, and as young as possible, is not an option but a necessity. From business to dating to just simple socializing, we all make instant judgments about people we meet by how they look. Why live with the face you were born with when you can do so much to make it the face you wish you were born with? Go ahead, shave off some years, protect it with good creams, and then just tell your friends you’ve only had a relaxing vacation on the French Riviera.

Filling a Gap in the Treatment of Facial Wrinkles

Injectables are dermatologists’ newest weapons in the war against aging.

It used to be that the only way to shave off years- other than airbrushing-was to go under the knife for face-lifts, eye jobs and brow-lifts. Now, don’t get me wrong: Cosmetic surgeons are called that because they still do plenty of surgery, from curing weak chins and cutting away loose skin to administering pec, butt and calf implants to make people look like they’ve been working out at a gym for years. And don’t forget liposuction, a little procedure that can make saddlebags disappear or an inch melt away from a runway model who ate a fudge sundae the week before her show.

But surgery is no longer a must. The latest route for the savvy youth junkie is using fillers, injectable products that rejuvenate the face, which are now a $250 million annual business. You may have seen the results of these procedures around South Beach: puffy lips that look like they’ve been stung by a swarm of bees. But those superplumped lips are just one thing fillers tackle. They can, among other things, fill in wrinkles, reshape the face, add volume to shrunken cheeks and straighten out bumps along the bridge of a nose. In talented hands, fillers can postpone, or in some cases help you avoid, surgery. And a whole new range of products is coming out in the nick of time.

Botox, a watered-down version of poisonous botulism, paralyzes the muscles into which it is injected for four to six months. That means smooth foreheads, no frowns when you get angry and no crow’s-feet. But the downside is that a bad doctor can give you droopy eyes or leave you with no expression at all-think a bowling ball with two eyes and a mouth. Bad. And the Botox monopoly will soon be challenged by a slew of brands that aren’t yet household names, such as Reloxin, Xeomen and PurTox, based on the botulism strain. All promise the same effects but with longer staying power and lower prices. And Myobloc, yet another version, will be marketed as a much cheaper, almost generic Botox. That’s good for consumers: You’ll be able to get your face rejuvenated and still have money to shop at Bal Harbour.

Hyaluronic acid is a staple for cutting-edge dermatologists. It’s a natural substance present in every body tissue, with the highest concentrations in skin. Injections fill in lines and wrinkles around the eyes and those annoying ones that run from the edge of the nose to the corner of the mouth (nasolabial folds), as well as enhance lips. They are often used in conjunction with Botox and last about six months.

Restylane has been around a few years and virtually had the market to itself. But Juvèderm, which just received FDA approval, is launching a major marketing push. About 20 more products are on its heels, so expect lots of competition. Products most talked about are Restylane Touch, which injects easily and is supposedly excellent for lip enhancement and fine lines. Perlane is injected deeper and designed to fill deeper wrinkles, restore volume to sunken cheeks and make deep nasolabial folds disappear. SubQ is designed to treat severe wrinkles. Puragen promises longer-lasting results and will be one of the first with a built-in anesthetic to minimize pain (all injectables cause pain, even though the area is usually prepped with a numbing cream such as lidocaine).

You’ve probably heard of collagen, such as Zyderm, the 20-year-old mainstay for filling in face wrinkles. It is made from cows, and not only are some people allergic to it, but it also lasts only a couple of months. Now there is CosmoDerm and CosmoPlast. They’re derived-get ready to be grossed out-from the skin of babies. But don’t worry: It’s grown in labs from skin cells. The great news is that since they’re based on human skin, they can’t cause allergic reactions. That means you can walk into an office during your lunch hour and leave looking better. There is no downtime (unless you’re one of the unlucky ones to bruise), and it lasts twice as long as original collagen. Coming soon is Dermalogen, touted to last longer than existing products, Dermalogen XL for deep wrinkles, and Evolence and Evolence Breeze, collagens derived from pigs (there goes the kosher market). These are widely used in Europe, are great for enhancing lips and can last a year.

There are also fat injections, though they’re a bit nasty, too. Fat taken from your thighs, butt or abs with a syringe is injected into facial lines. There is no chance of rejection and it’s a great natural filler, but there is a bit more downtime and it lasts only a few months.

If you’re looking for something semipermanent, try Radiesse. Originally designed for dental, bone and vocal-cord reconstruction, dermatologists found that this synthetic bone-like substance, when injected, stimulates human collagen to grow around it. It is great at filling in lines (be certain to get a seasoned doctor, as an amateur can leave small bumps) and lasts between 12 and 18 months. And there is Sculptra, whose particles also stimulate collagen growth. Originally used to fill in the sunken cheeks typical of HIV/AIDS patients, it is now regularly used to rejuvenate the backs of hands and erase nasolabial folds. Usually you’ll need two to three treatments.

If you want a filler that will last until you die, there’s silicon-not the type used to caulk your bathtub, but microdroplets. In skilled hands it fills in small lines near the mouth, erases scars from chicken pox and can even straighten a bump on the bridge of the nose by building up sunken spots on each side. Hello, filler, good-bye, nose jobs. ArteFill is also FDA-approved, and like silicon, is a permanent filler.

But remember, the efficacy of these products relies on skilled derms and doctors, so don’t price shop. Someone chosen from a flyer given to you at a nightclub might offer diluted Botox or be a doctor whose degree was earned through a correspondence school. You also have to prepare yourself. For about a week before your procedure, stop smoking, drinking and taking vitamins such as E, aspirin, and Advil. They all increase the risk you’ll bruise, swell or be tender for a few days. 0

Fillers can postpone, or in some cases help you avoid, surgery. And a whole new range of products is coming out.

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.

South Florida Specialists – The New Face Of Cosmetic Enhancement

Dr. Mark Nestor’s State-of the Art Combination Therapy Is Cutting-Edge

Dr. Mark Nestor, the director of Aventura’s renowned Center for Cosmetic Enhancement, is one of the foremost authorities on erasing years from the faces of South Florida residents. “In a place where the sun is harsh almost all year long,” he recently told us in his large, professional office, “that is no easy task.”

But if anyone is cut out for it, it’s Nestor. The 51-year-old, baby-faced doctor might be his own best personal advertisement. His peers acknowledge him as being at the forefront of cosmetic laser and light procedures, and his Aventura office has 32 cutting-edge devices, more than any other South Florida practice. Nestor has created a one-stop shop for rolling back the years.

“We are unique,” he told us. “There are actually very few like us in the world. We have so many devices to effect changes, both medical and aesthetic. We do not just make people look better, but also make them healthier. Here, we don’t just zap away wrinkles and fill in crevices on the face, but we also help people eliminate everything from acne to rosacea [a blood-vessel condition that creates redness on the face].”

Nestor actually oversees a mini cosmetic empire of 23 offices and 35 dermatologists. Married 18 years to Eva Ritvo, a professor at the University of Miami’s School of Medicine and chair of Mount Sinai Medical Center’s Department of Psychiatry-the two met in medical school in California-he also has two children. And in addition to his family and running a dermatology office that often has a one-month waiting list, he finds time to serve as president of the International Society of Cosmetic and Laser Surgeons, as well as president of the American Society for Photodynamic Therapy, two of the industry’s most respected organizations. And somehow still he manages to do clinical research.

I understand the trials and tribulations of trying to do so much,” he says. “But I really love what I do, so that makes it a lot easier to work so hard.”

What makes Nestor different from many other dermatologists is his extensive stable of devices, which allow him to offer “combination therapy, where we can combine various treatments to produce the best possible results for each patient.”

He has a point. The devices used in cosmetic dermatology can be prohibitively expensive. For instance, Fraxel is a laser treatment that is the choice du jour for many cosmetic-surgery junkies. At $1,000 a treatment and six to nine required to maximize its benefits in eliminating skin imperfections from aging or sun damage removing stretch marks, acne scars and dark spots, the cost can seem high to

patients. But the Fraxel machine itself costs more than $100,000. Titan’s CoolGlide Xeo, which combines laser technology with the next generation in pulsed-light treatments, is used for hair reduction, vascular treatments and skin resurfacing and costs about $150,000. Sciton’s Profile Laser unit, used for hair removal, obliteration of spider veins, and to treat rosacea, sets a derm back about $125,000. Even Thermage, wildly popular for using noninvasive radio-frequency technology to restore collagen, is a $50,000 unit.

Nestor also gave us a tour of some of his newest age-zapping tech toys, including IPL (intermittent pulse light) for zapping brown spots and enhancing collagen, and erbium laser, the latest for treating aging and sun-damaged skin. These devices are so expensive that most derms usually have to settle on just one or two therapies and push those to all their patients. Nestor has a remarkable advantage by being able to afford almost every device on the market. When you sit in his waiting room, a large, wall-mounted plasma television recycles before-and-after pictures of patients who have received his treatments. Only Photoshop could make them look better.

“Fifty percent of my practice is cosmetic and the other half is medical,” he told us. “But no matter what a patient comes to us for, we offer a range of procedures for different needs, precisely tailored to the patient.”

In addition to the regular treatments found in any modern dermatologist’s office-Botox and a battery of fillers, from hyaluronic acids to collagen to Restylane and Radiance-it’s Nestor’s approach that sets him apart. “I want to tackle both the beauty needs as well as the health of my patients.” For instance, when someone with severe acne, or melasma, a skin blotchiness, comes to him, he’s convinced that when they leave looking better, their overall health improves since their self-esteXri is boosted while their stress-fretting about their condition-is reduced.

“Expectations are key as to how someone views their results,” he says. “If people are realistic about what can be done cosmetically, they will be very happy. If someone wants to roll back several decades with a one-day procedure, they might not be pleased.”

Financial and time considerations are also issues for many patients: Some don’t have the money to do everything they want; others are so busy with work they can’t afford the downtime. “So I work with them on an individual basis,” Nestor says, “asking what they want and how we can work out a program that works for them and their lifestyle.

“Some people are afraid of undergoing surgery,” he adds. “They have a fear of the knife. That’s why our services are so important. We can, with the combinations of therapies available in our office, reproduce many of the results of far more invasive procedures, and we can do it with fewer side effects. With our work, you can postpone a facelift for many years. That’s the power of great dermatology. That’s what we offer.”

Nestor reminded us that his office gets busier at this time of the year. “I don’t know if anybody would appreciate opening a gift and seeing $1,000 to get rid of wrinkles,” he says. “But a lot of people say they give it to themselves as a holiday gift.”

Spa Daze

Melt Away Holiday Stress

Everywhere you turn someone is counting down the days until Christmas. You’re trying not to binge on holiday food and drink, while also searching for gifts that don’t max your credit cards. No wonder holidays can be so stressful.

That’s why, girls, this is a super time to fine-tune the art of relaxation, de-stressing from head to toe. You could spend hundreds of dollars at a luxury spa, but I prefer getting the same results at a fraction of the cost in the comfort of home. A quick trip through your local drugstore can get you ready for some pampering.

First, set aside a day free of interruptions. Transform your bathroom into a retreat with some candles. Parfums de Coeur has great fragranced ones in scents like Cucumber Melon.

A little trick is to pop your bathrobe and towel into the dryer, so that when you’re ready for them, they’re toasty warm. Now prepare your bath. Add in bundles of luscious crystals, beads and bath oils for silky smooth skin. And don’t forget bubble bath and scented soaps. Pure Spring has super spa products in great scents, namely Brown Sugar and Pomegranate. The Healing Garden also has invigorating body soaks, including luscious-smelling Tangerine Therapy and Jasmine Therapy-both include energizing natural extracts like tea tree, ginseng and balm mint.

If you are not a bath girl, take to the shower. St. Ives Body Washes are an affordable luxury in divine flavors from Fresh Berry to Apple Blush. Formulated with Swiss glacial water and blended with a unique combo of herbs, these are also great bargains under $4 each. And just as good is Suave’s new moisturizing body washes, including a Tropical Coconut that reminds me of being on some Caribbean island.

Don’t forget to exfoliate away dry skin. My new favorite is Pure Spring’s Brown Sugar Granulated Sugar Body Scrub. This yummy-smelling scrub polishes and buffs dry skin with the natural ingredient of sugar.

Out of the water, it’s time to slather on body lotions. Just as you will layer on the latest fashions this winter, it is essential to layer on the right combination of products to provide foolproof protection from the elements. I like St. Ives’ 24 Hour Moisture for dry skin, as well as Johnson & Johnson SoftLotion, a grown-up version of its classic baby lotion that moisturizes for 24 hours. For a subtle glow to warm winter skin, smooth on Jergens Shimmer Moisturizer.

Now that you’ve cleansed and moisturized your skin, slip on your warm bathrobe. This is a great time to open your pores and remove impurities by spending 10 minutes with your face over a bowl of steaming water. If you want to skip the steaming, opt for a facial mask, something like Neutrogena Hydrating Facial Cloth Mask that will draw out impurities.

Now that you’ve given your face the spa treatment, it’s time to spoil your hands and feet. Nothing is as relaxing as a slow, careful manicure and pedicure. There are many terrific products, but two standouts are Sally Hansen’s Grande Salon nail set-from a bargain $4.99 to $9.99 -and Trims’ manicure and pedicure set with all the necessary tools, under $10. As for nail polish color, go for festive ruby reds on fingers and toes.

Now that your nails are dry and you’ve removed your facial mask, apply some more moisturizer. This would be a great time to get a massage, but unless you can persuade your partner to give you one, you’ll have to settle for a Pure Spring Mini Gel Eye Mask that has been sitting in your refrigerator. Lie on your bed, lay the cooling gel over your eyes, turn on some great music, light some more candles and let yourself daydream. After a spa day at home, you’ll be ready to tackle the holidays with a newfound, stress-free zest.

Youth in a Jar

You don’t have to spend a fortune to maintain a youthful glow

Curious to see what was new in the fast-changing world of skin care creams, I recently popped into one of New York’s famous luxury department stores. I was price-shocked. A yam and soybean cream was $500 for 1.7 ounces! Another seemed a bargain at $375. When I examined the ingredients, I instantly realized I could duplicate these outrageously priced fountains-of-youth from the shelves of my local drugstore.

Beauty mantra: Moisturize!

It’s never too early to start moisturizing. Many young girls think it’s not necessary, but trust me, the time from your first kiss to your first anti-aging cream is shorter than you think. By 20, skin starts losing its elasticity. Environmental factors like second-hand smoke, sun and pollution take a toll. I’ve been moisturizing since my teens, and while genes help, good skin products keep the aging clock at bay. And remember these are not your mother’s moisturizers-the smart shopper can take advantage of scientific breakthroughs in skin care.

Breakthrough ingredients: Good-for-you vitamins like antioxidants A, C and E are now in everything from sunscreens to moisturizers. Minerals like copper, aluminum and zinc have spilled over to the skin care shelves. Copper: A natural collagen-building mineral essential for firm skin. Scientists have figured out how creams can deliver minerals like

copper deep into the skin where they are effective. One of my favorite lines is Neutrogena’s Visibly Firm, whose products gently replenish the copper your skin loses. Lab tests show that after a few weeks, users have firmer skin, softer lines and less puffiness. Both the face lotion and eye cream contain sunblock, so they’re great to use before running out of the house.

Peptides: Olay has followed the latest developments with its Regenerist line-ranging from daily serums to perfecting creams to night moisturizers. All have an “Amino-Peptide Complex.” Behind the fancy name is a great skin saver, including an amino acid compound (not real acid, so don’t worry about the skin!) that stimulates collagen. Olay throws in vitamins like B and E, and some light-diffusing ingredients that soften the skin’s appearance. Studies show that 80% of women thought their skin looked better after eight weeks.

L’Oreal has stayed abreast of what’s new with their Revitalift line. It has Dermo-Peptides to freshen the skin, while the L’Oreal Visible Results

creams have “active-cell” to encourage the body’s own vitamins to more thoroughly protect your skin.

Coenzyme Q10: Not to be left out, Nivea Visage Q10 Plus is one of my faves. The line includes day, eye and night creams, and also a daily lotion. All have vitamins A and E, sunscreens and, more importantly, two of the skin’s natural age fighters, Coenzyme Q10 and Biotin. Q10 is the body’s wrinkle control agent and Biotin aids skin in restructuring for firmness. Combined by Nivea, these products give back the anti-wrinkle power your skin loses with age.

Soy: Finally, don’t overlook soy, Asia’s wonder ingredient. Studies show that active soy added to moisturizers minimizes the appearance of unwanted facial hair, making it softer, finer and less noticeable in as little as two weeks. Try Aveeno Positively Smooth moisturizer to help reduce troublesome hairs.

Zinc oxide: Used in ancient Egypt to heal wounds, Zinc Oxide has found new life as the best sunblock available. You don’t want to make your skin look flawless and then destroy it with too much sun, so start using year-round products like Neutrogena Healthy Defense Daily Moisturizer. It has a 30 SPF, is non-oily and goes on sheer, and comes in tinted or untinted.

Want to keep your face looking luminescent, even-toned and youthful?

Remember a few simple rules.

Use gentle non-soap cleansers like Cetaphil, put on sunscreen before going outdoors and moisturize morning and night. You can look great without buying those ridiculously priced face creams, and you’ll have saved money to spend on other fun things.