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Lunch Menu

In less than sixty minutes, you can erase lines, plump your pout or zap age spots. Take your pick.

Botox

A purified protein produced by the neuromuscular toxin Clostridium botulinum, Botox Cosmetic is FDA-approved to temporarily deactivate muscles to smooth brow lines, crow’s feet and the crease between brows. It takes a couple of days to see the full results.
Cost: $300 to $500 for twenty units, enough to treat the crease between brows.
Fear factor: A brief pinching sensation, similar to a bee sting.
Risks and side effects: Slight bumps and redness for a few hours. If too much Botox is administered or it’s placed in the wrong area, patients can develop headaches, temporary loss of muscle function or droopiness. Since Botox is a powder that must be mixed with saline solution in order to be injected, an overly diluted dose will be less effective. While Botox has raised no safety concerns in its history of use, cheaper black-market imitations can be extremely dangerous or fatal.
Lasts: Three to five months. Continued use over time further weakens the muscles, improving its effectiveness. After numerous treatments, patients will see better and longer-lasting results.

Fillers

Fillers are used to plump up lips and lines under the eyes and around the mouth. Ten years ago, collagen was the filler of choice. While it is still used today, modern science has introduced new fillers that outlast collagen’s six-week to two-month life-span and pose almost no risk of allergic reaction, unlike bovine-based collagen. Juvederm and Restylane are two of the most popular brands of hyaluronic acid treatments, which draw in water to add volume, literally filling in wrinkles. The fillers are available in different “bead” sizes targeted to various lines on the face: microscopic for the eyes and a heavier gauge for the naso-labial fold.
Radiesse is another popular volumizer that is composed of calcium particles to smooth lines. “Radiesse and the hyaluronic acid fillers work exceedingly well,” says Dr. Zienowicz. “They’ve been around for at least five years and are well tolerated with very few side effects.”
Instead of synthetic fillers, doctors may use a patient’s own fat. The procedure is slightly more involved because it requires fat removal, usually from the belly button area via a tiny incision. However, it can be performed in an office operating room with intravenous sedation in about an hour.
Cost: Prices vary depending on the strength of the formula and the amount used. Juvederm is about $550 to $900 for one syringe; filling and contouring with natural fat is more expensive.
Fear factor: Slight burning sensation during injection. A topical numbing cream soothes sensitive places such as the lips.
Risks and side effects: Patients may experience temporary bruising, swelling or lumpiness. Radiesse has led to granuloma (red inflammatory bumps) when injected in areas such as the lips or under the eyes.
Lasts: Longevity depends on the density of the formula. The effects of hyaluronic acid last for about six months; fat much longer.

Lasers

Lasers can be used to treat everything from broken capillaries to facial hair. Non-ablative lasers resurface the skin without peeling it, making micro-wounds deep in the skin to stimulate collagen and improve texture. Intense pulse lights are used to treat spider veins and age spots; some devices blend light and radio frequency waves for a more intense treatment. (Radio frequency lasers deliver heat that tightens sagging skin and generates new collagen.)
Lasers can be adjusted for depth so that someone may be able to have a treatment during lunch and then return to work with mild redness. However, the devices are more effective when they can penetrate deeper. Usually a series of treatments are required.
Cost: Starts at $300 per treatment and can climb into the thousands.
Fear factor: Some patients describe the sensation from radio frequency lasers as static electricity from a television, while non-ablative lasers “feel like a sunburn” and intense pulse lights feel like “the snapping of a rubber band.”
Risks and side effects: Lasers can cause mild swelling and redness. There is a risk of burns and scarring (intense pulse lights are riskier on darker-toned skin). Laser hair removal is more effective on dark hair; lighter hair requires more treatments.
Lasts: Months to years, depending on the number of treatments, type of laser and the individual. “Lasers are still in an evolutionary period,” says Sullivan. “The older CO2 lasers have been implicated in scarring in inexperienced hands, and the newer ones frequently do not give us the results that companies promise.” —Denise Dowling

Lunchtime Lipo?

A number of plastic surgeons are still skeptical about “SmartLipo,” which touts decreased downtime and received FDA approval in 2006. After a small incision is made into the target area, a laser inside a tube is inserted under the skin to liquefy the fat cells, which are then suctioned out. As with liposuction, the zapped cells do not return; however, new fat cells can take their place if patients do not exercise and maintain weight loss. Many plastic surgeons report that the results don’t equal its marketing hype. “Advanced forms of liposuction have proven to be more effective and require about the same recovery time as SmartLipo,” says Dr. Patrick Sullivan. “And SmartLipo has only been FDA-approved for the removal of relatively small amounts of fat.”

Yet another take on traditional liposuction are procedures like Lipodissolve, an injection of chemicals to dissolve fat cells. There is concern over risks posed by where the fat can travel afterward (to the liver, for example). The chemicals are not FDA-approved and at least two states are looking to ban the procedure. —Denise Dowling