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<< Previous   of   Next >> (click to enlarge) Results of Sedy's Radiesse injections are immediate. Her right cheek has been injected, but facial lines are still apparent in her left, untreated cheek. Because injections tend to slightly over correct problems at first, puffiness and redness are apparent. Both gradually decrease after the procedure. Suzanne Schmid / The Herald  (click to enlarge) Dr. Gail de Imus injects Pam Sedy's skin with Radiesse, a nonsurgical procedure that helps restore a youthful appearance, at the Everett Clinic Skin Surgery and Laser Center. (click to enlarge) Sedy squeezes a tension ball to stay relaxed during a treatment of injectable facial fillers.   ADVERTISEMENT   What's available? Here's a sampling of some the most popular nonsurgical cosmetic procedures offered through The Everett Clinic. Prices are per visit. Filler injections ($450 to $2,000): Improve facial lines, wrinkles and scars by replenishing the layers beneath your skin. Fillers can be used to enhance thin lips and to fill in facial lines for a younger refreshed look. Common fillers include Restylane and Radiesse. Effects of many fillers typically last six months, but some patients have reported lasting effects for up to two years. Botox ($375 to $900): Reduce and soften the look of facial wrinkles, worry lines, frown lines, laugh lines and crow's-feet. Effects last about four months. Chemical peels ($70 to $750): Improve skin texture and tone using medical-grade chemical solutions. Remove superficial wrinkles, age spots, sun damage and acne scars. Microdermabrasion ($120): Use light pressure and ultrafine particles and suction to remove the outer layer of damaged skin to reveal more radiant skin below the surface and improve the look of fine wrinkles, blotchiness, sun damage and age spots. Laser treatments ($350 to $480): Get rid of superficial vessels, spider veins and other aberrations on the face to improve sun damage and rosacea with laser technology. Thermage ($2,000 to $4,000): Using radio frequency waves, Thermage helps improve facial lines and wrinkles. This nonsurgical technique can be done on the entire face and neck or on specific areas to help elevate the eyebrows, redefine the jaw line and tighten loose skin. Thread lift ($1,800 to $6,400): Using a fine needle, a doctor pulls special threads under the deeper layers of skin to lift the face. Skin care: Individualized regimens can be a good way to start skin rehabilitation and anti-aging care. The Everett Clinic's Facial Rejuvenation Center offers a variety of regimens, including the Obagi system and Jane Iredale mineral-based makeup.   CONTACT THE HERALD Melanie Munk, Features Editor munk@heraldnet.com   Published: Tuesday, January 15, 2008 About face: Injections, other procedures offer short-term, virtual facelifts without surgery By Sarah Jackson Herald Writer Pam Sedy needed a boost. She had always cared about her looks, but sun exposure and natural aging had made her feel old in a world that seemed to get younger every day. "I found myself at 50 years old and single again after years of marriage," said Sedy, now 52. "I wanted to look better." Sedy didn't like her gradually sagging cheeks, crow's-feet and the "Pinocchio" lines that seemed to run ever darker down the front of her face. Sedy's dermatologist, who had been helping with her overall skin health, referred her to Dr. Gail de Imus, a cosmetic dermatologist and skin cancer surgeon at the Everett Clinic Skin Surgery and Laser Center. "She handed me a mirror and said, 'Talk to me about what you don't like about yourself,' " Sedy said of her first meeting with de Imus. "I thought I needed a facelift." But de Imus surprised Sedy. She had other options. Thermage. Filler injections. Laser treatments. It was only the beginning of a long menu of facial enhancements available without surgery. "There were so many different options," Sedy said. "I didn't know." Though Hollywood stars are well acquainted with all the hottest cosmetic procedures, an increasing number of mere mortals are discovering their own fountains of youth. 'Affordable' injectables These days, Sedy feels great. "I never get anybody who can guess my age. Ever. Ever," said the ER nurse from Marysville. "A lot of people guess I'm in my early 40s. I just want to look as good as I can. It's great for your self-esteem." Sedy sees de Imus at least once a year for a variety of combination treatments. Her most recent visit included injections of three facial fillers, including the brand names Radiesse and Perlane, which add more volume, and Restylane, which helps with fine surface lines, wrinkles and lip fullness and definition. "We just do a little every year," said Sedy, who spends from a few hundred dollars to $1,500 per visit. "It's affordable that way." Boomers going strong It's all part of a hugely popular, fast-growing segment of the medical profession know as facial rejuvenation led by baby boomers who want to look as good as they feel, said Dr. Ronald Krueger, a cosmetic surgeon and ear, nose and throat doctor who runs a separate practice, the Facial Rejuvenation Center, at the Everett Clinic. Baby boomers, when compared to their parents' generation, are healthier and expected to live and work longer. But their looks don't agree, a phenomenon Krueger calls "mismatch." "Fifty is the new 40," Krueger said. "I believe that. It's a whole different generation we're seeing right now. There's a huge demand." Botox, which came about as a remedy for vocal chord and muscle spasms, became popular about 10 years ago for cosmetic use. Shortly after that, the cosmetic industry exploded with companies working on filler injections and other treatments. "It's called volumetric expansion," de Imus said, adding that injections create a fuller, more youthful look by filling in where facial support structures have failed over time. "You lose a lot of subcutaneous fat and tissue. It's like a divot in the road. You need to fill that divot. It's a tighter look." Aging tends to make faces look angry or sad. Cheeks droop. Corners of the mouth start to point down. Eye sockets seem to sink and become darker. Lips lose definition. "It's not about changing your look," de Imus said. "It's about looking happy and less angry to reflect the inner you." Patients today don't necessarily want the major transformation that a surgical facelift provides, de Imus said. "That's not where people are going now," she said. "People are going to say, 'I still want to look like myself. I want to look my age, but I want to look good for my age.' " Aches, pains, recovery Injections aren't completely painless. Right now, Sedy is sitting in a chair while de Imus injects her face with fillers, a process that takes about 30 minutes. Though it's possible for de Imus to strategically numb parts of Sedy's face as if she were at the dentist, Sedy chose to go for only a topical anesthetic, Lidocaine, and ice packs to desensitize her face to the needles. Sedy squeezes a green ball to relieve the tension and the aches she feels when de Imus injects repeatedly into each area, followed by intense massaging to spread the material evenly into the correct areas. "It's uncomfortable," Sedy said. "It's like a toothache." It's possible to see the results of the injections right away as de Imus painstakingly works Sedy's face. Her right side, already injected, looks fuller. And the corner of her mouth, when she is not smiling, is straight instead of turned slightly downward like the left side of her face. "It's immediate," de Imus said, adding that injections tend to slightly overcorrect problems at first. "You're a little swollen," she said. "I always tell people: 'Do not judge the work for three weeks.' " Injections, laser treatments and other options won't necessary offer the right kinds of improvements for all patients, de Imus said. "If you need a facelift, you need a facelift," she said. "If you want a Mercedes and I give you a Toyota Camry with all the bells and whistles, you're not going to be happy, no matter what." Redness, swelling and bruising are common side effects of injections. There is also a risk of infection. But Sedy, who de Imus said is an average patient, doesn't worry much about recovery time. Her bruises from injections are usually no larger than a dime and the redness is minimal. Not all patients are so lucky. De Imus recommends having injections done at least six weeks before a major event, such as a wedding, to ensure enough time to heal. Youthful effects of most injections are supposed to last at least six months. Sedy's results, according to before and after photos, appear to have lasted nine months or more. Patients should think of fillers as maintenance. They are not one-time fixes. "It's like a perm," de Imus said. "This is just turning back the clock. But the clock is ticking." Skin care is key Krueger said medically managed skin care regimens shouldn't be overlooked when it comes to facial rejuvenation. Not everyone is comfortable with injections because of the cost and maintenance commitment. Unlike de Imus, Krueger and his Facial Rejuvenation Center offer a full line of skin-care products, including the Obagi skin care system and Jane Iredale mineral-based makeup. Krueger was skeptical at first of the medical-grade products and their price. But then he saw what women were paying for products at department stores. He also noticed much better results in patients undergoing other cosmetic procedures, including injections and full facelifts, when combined with strategic skin care. "You can reverse some of the effects of solar change and aging," Krueger said. "It's the skin quality that changes." Krueger says improved skin responds better to surgical manipulation and injections. "What am I doing selling soap?" Krueger said. "It works. It improves results. I sell makeup. I never thought I'd say that in my career." Krueger, who works closely with a medical esthetician and a registered nurse, said he loves helping patients find their "inner swan" through a wide range of services. "What I've learned in this practice is that outlook on life is better," Krueger said. "It's better than anti-depressants if you ask me." Reporter Sarah Jackson: 425-339-3037 or sjackson@heraldnet.com. Resources Dr. Gail de Imus The Everett Clinic Skin Surgery & Laser Center 3726 Colby Ave., Everett 425-257-1450 www.everettclinic.com Dr. Ronald Krueger The Everett Clinic Facial Rejuvenation Center 3927 Rucker Ave., Everett 425-257-1455 www.everettclinic.com "Facelift Alternative: The Mini Lift": The Everett Clinic Facial Rejuvenation Center will present a free class about alternatives to a traditional facelift from 6 to 8 p.m. Feb. 13 in the Pilchuck conference room at the Everett Clinic, 3830 Hoyt Ave., Everett. Call 425-257-1440 to register. Free advice: The American Academy of Cosmetic Surgery offers advice on choosing a cosmetic practitioner at www.bewiseaboutbeauty.org.

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