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The no-shame guide to Botox & other cosmetic facial treatments

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Photo credit: loonger/Getty Images

With today’s widespread availability of Botox procedures and techniques that enhance the aesthetics of your face, curiosity seems sort of inevitable, doesn’t it? Here’s the problem: People run the risk of getting lots of unsolicited feedback if they express an interest, because even light cosmetic treatments are still extremely stigmatized.

Well, not here, friends. Been dancing around the idea of Botox? We’ve got some deets for you. Wondering if you should get fillers? Let’s discuss your treatment options.

Consider this your easy-to-read, no-nonsense guide to the various cosmetic surgery facial procedure options available to you. With no judgement! Because, seriously, there’s no shame in self-care — and if that includes the occasional injection or skin lift, so be it.

Cosmetic surgery vs. plastic surgery

Let’s start by making a simple distinction. Cosmetic surgery and plastic surgery are not technically the same thing — they are actually two closely related specialties.

With cosmetic surgery, which we’ll focus on here, the main focus is simply on enhancing a person’s appearance or improving their aesthetic appeal. Because the treated areas function properly, cosmetic surgery is elective. These treatments are performed by a wide variety of doctors, including dermatologists, ophthalmologists, otolaryngologists and, yep, plastic surgeons.

Plastic surgery is reconstructive in nature. The goal is to correct areas of the face and body that are dysfunctional or have defects/damage due to birth disorders, trauma, burns and disease.

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Cosmetic facial treatments

For the purpose of this guide, we’ll explore cosmetic surgery procedures that fall under the umbrella of cosmetic facial treatments. To learn more about these, we asked Dr. Erum Ilyas, a board-certified dermatologist outside of Philadelphia (and Tory Burch Fellow 2019), to walk us through this category of cosmetic improvements.

“I break down cosmetic procedures to my patients into three categories: restorative, enhancing and transformative,” Dr. Ilyas explained. “Restorative is focusing on restoring volume loss that results in deep lines and wrinkles. Commonly this is the under-eye area, nasolabial folds, jowls, etc. This is the most common type of procedure I do as I find that the majority of my patients are looking to ‘look like themselves’ again and do not have unrealistic goals. They may feel as though their lines make them look ‘tired,’ ‘upset,’ ‘concerned’ or ‘sad’ when in fact they feel great! Their appearance doesn’t match how they feel.”

A step further into cosmetic skin rejuvenation treatments are enhancing procedures. “[These] take a feature we have and augment or enhance the feature to draw attention to it. Examples of this would be lip-enhancing or cheekbone augmentation. I find that this is a wonderful way to improve self-confidence without dramatically altering your look,” offered Dr. Ilyas.

The final category, and the most dramatic, is transformative procedures. “Transformative procedures are when I have a patient who comes in with a photo of a feature they do not have and wish to transform their look to include it,” said Dr. Ilyas, elaborating, “Most commonly this would be significant lip augmentation.”

Anatomy of a wrinkle

According to Dr. Ilyas, “All of these treatments can use hyaluronic acid (HA) fillers and/or Botox. The key here is understanding the anatomy of a wrinkle. I break this down as three features: loss of volume/fat, thinning of skin, and muscle contraction. Loss of volume is where HA fillers work. Thinning of skin can be enhanced by topical retinoids and alpha hydroxy acids or radio frequency devices. And muscle contraction is addressed through botulinum toxins (Botox).”

So, if you’re interested in restorative cosmetic procedures, this further breaks down into three categories: skin resurfacing, Botox, and filler treatments. Skin resurfacing is basically exactly what it sounds like — the use of skin therapy to restore skin’s youthful complexion by removing the most damaged outer layers of skin. Options in skin resurfacing treatments include laser skin resurfacing, chemical peels, microdermabrasion, dermabrasion, microneedling, and IPL photorejuvenation.

“The choice of which procedure to consider really depends on what the primary concern is,” said Dr. Ilyas. “For thinning of the skin that causes tissue-paper-like wrinkling and fine lines, then laser resurfacing, microneedling or radiofrequency tightening of the skin may help.”

Deeper wrinkles have you down? “The upper face is where Botox can work to relax facial muscles to reduce the appearance of deeper wrinkles. Botox, when used in the right quantities and locations, can give a very natural appearance. I strongly recommend only seeing a board-certified dermatologist for Botox, as understanding Botox, training and techniques are a part of our board certification process,” explained Dr. Ilyas.

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If deeper lines have formed — especially mid-face down — Dr. Ilyas says fillers can be used to restore volume loss, facial contours and wrinkles for a very natural appearance (when used in the right quantities and locations). But again, Dr. Ilyas cautions that choosing a board-certified dermatologist who has received the proper training is imperative for both safety and aesthetics with these treatments.

As for enhancing cosmetic treatments, Dr. Ilyas notes that there are various safe and effective options for facial rejuvenation depending on your needs. “As we age, our skin thins, we lose volume, and we lose some bony structure in the face. The cheekbones are not as prominent and the jawbone retracts slightly,” she pointed out. “Early on, a ‘chemical’ facelift with the help of a well-placed filler can achieve an impressive result by restoring facial contours and volume. This can improve the look of nasolabial folds and jowls.” However, if the excess skin from volume loss is significant, Dr. Ilyas recommends seeing a reputable board-certified doctor who can perform a surgical face lift.

So, when it comes to cosmetic facial treatments, there are few major takeaways. First, don’t feel ashamed or guilty if you want more information. There’s nothing wrong with making a choice regarding your body that you feel is right for you. Second, to get the safest and most effective treatments, you have to start with the best foundation possible — a reputable, board-certified doctor with training specifically in the procedure you’re interested in.

Third, and finally, don’t be afraid to ask questions! As Dr. Ilyas made very evident throughout our interviews, reputable doctors are more than happy to walk you through all of the treatment options to make sure you find treatment options that best align with your wants.

Radiant skin starts from within, as they say. Make sure you’re staying hydrated. Check out our water taste test below.

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