-- Many procedures designed to make people look younger don't require cutting, hospitals or even doctors' offices, but should still be done by well-trained medical personnel.
If you're squeamish about surgery, several less invasive — and less expensive — procedures can reduce the appearance of wrinkles and improve skin tone.
But a botched procedure can still leave a patient permanently scarred, so patients should consider the risks and shop around before settling on a doctor, nurse or physician's assistant to do it.
These high-tech procedures include:
Laser:Zapping away old skin
These procedures typically burn away the older-looking top layer of skin and create tiny wounds in your skin's bottom layer. When your skin heals, it heals thicker, and wrinkles are minimized. The risks are far fewer than with cosmetic surgery but still exist. Laser treatments can be painful, though they now often use chilled tips that minimize pain and discomfort, says Drew Varano, an internal medicine doctor in Washington, D.C., who specializes in cosmetic procedures. Still, sedatives and painkillers or local anesthetics are often needed, and some laser procedures even involve intravenous or general anesthesia.
Dianne Cooper, a former laser patient and administrator of an online support group for those harmed during laser and IPL (intense pulsed light) procedures, says she's been in touch with more than 1,000 victims. Laser and IPL treatments can cause similar damage, she says.
"The worst has happened even at the hands of some of the foremost laser guru doctors in the country," says Cooper, noting several victims have contemplated suicide.
When Cooper had laser resurfacing five years ago, she thought the laser would only skim off older-looking skin around her eyes and thicken her skin by stimulating collagen, a structural part of the skin. What she didn't expect was to be "left with hanging bags" under her eyes and redness for six months after doctors had promised.
"I looked like a raccoon with red rings," she says.
When burns occur in laser patients, it's typically those with darker-toned skin, because lasers focus more on melatonin in the skin, says Varano. The most common side effect, he says, is darkened or lightened skin. When skin gets darker, it typically fades in six months, he says.
Fraxel, another laser treatment, lists only side effects such as redness, swelling and "bronzed skin."
"There's almost no risk involved," says Stephen Fanning, CEO of Solta Medical, which owns Fraxel.
IPL:Shining light on problems
This technology, which is similar to laser, uses a bright pulse-like light that can be focused on whole areas such as necks or problem areas of skin, including redness and broken capillaries. It is also known as a photo facial. Varano says IPL was one of the first "breakthrough" facial treatments for skin rejuvenation about 10 years ago. Laser technology has improved since then for helping skin, but IPL still remains a less aggressive but "viable, popular and useful option" for some conditions, including age spots, he says. This procedure has benefits — and risks — that are similar to lasers.
Kira Yager's IPL caused problems including a permanent burning sensation in her face. She had two IPL procedures when she was 35, then 36 to address early signs of aging. Instead, she wound up with indentations in her skin and what's called "microscarring" or tiny wrinkles. Yager, now 37, says she was told the IPL was "perfectly safe and that nothing could go wrong."
Everyone has heard the comments about Botox-filled Hollywood actresses who can hardly move their faces. While that's unlikely to happen to the average patient, Botox does work by freezing the muscles that scrunch up your face.
The main risk is that it might get injected in the wrong place.
"If it's placed too low to your eyebrow, it can cause your eyebrow to fall down," says Anne Chapas, a New York City dermatologist who offers Botox treatments. "You can even have an eyelid close."
And don't expect long-lasting results. Botox leaves you wrinkle-free for only three to four months before the procedure must be repeated.
Your own fat might seem like the most natural solution to plump up a saggy face, but there can be unexpected complications.
Two surgical sites — one to take the fat out, and one to put it somewhere else — mean twice the chance of infection.
Plus, fat is unpredictable, doctors say. The cells could survive and last for years, or die off and leave you with nothing to show for it. "The issue is that fat doesn't automatically take," Chapas says.
Worse yet, to compensate for some cells dying, a doctor could use too much fat, and you could wind up overplumped.
Fillers:Puffing up wrinkles
There are all sorts of injectable fillers available to puff out wrinkles, each used for a different kind. Like Botox, they also must be regularly retouched.
If it's injected into a blood vessel, a patient could wind up with skin that dies and turns black, says Varano, adding that this is very rare.
As with any laser or injectable, the key is finding a medical professional you can trust. Varano suggests asking how long and how often they've been doing the procedures.
"These procedures have to be in the hands of experts," agrees Chapas.