7/28/2019 Under Your Skin

1/2

106 WMAGAZINE.COM

WHAT SHAPE SHIFTERS

C

UNDER

YOURSKIN

From fat melters tonose sculptors, the latest

injectables are makingBotox look like childs play.

By Joanne Chen

osmetic surgeons wieldingneedles arent simply, as one doctor put it, wrinkle

chasers anymore. With highly evolved perspec-tives on what truly constitutes a youthful look,doctors are now injecting a host of compounds tolift, mold, and contour. Most visits last no morethan an hour, and recovery times are equally swift.Its enough to make a scalpel seem downrightcrude. So whos shooting what where?

Refation RevolutionAccording to Beverly Hills dermatologist AvaShamban, when it comes to aging, the main culpritis deflation. By age 50 or 60, she says, most of ushave lost around 20 percent of our facial bone andfat, and as a result, our faces sag and look gauntnot unlike a pillowcase over a shrunken cushion.

To pump up the volume, Shamban offers a pro-

cedure that was developed in the U.K. and is aptlycalled Reflation. Unlike more superficial wrinkle-erasing treatments, Reflation entails injecting ahyaluronic acidbased filler well beneath the der-mal layer, where it sits on top of the bone and propsthe skin up, especially beneath the eyes, aroundthe cheeks, at the nasolabial folds, andmostefficaciously, Shamban saysat the temples.

Aging temples? Indeed. They sink over time,and even the most expertly done face can lookoff if the temples are left lying close to the skull,Shamban points out. But shoot a syringe of fillerinto them and they look fantastic, she says.

A total refill takes two or three visits, at a cost of$2,000 to $3,500, and the results last for about sixmonths. Subsequent sessions, however, requireless fillerand come with a smaller price tag.

The Liquid Nose JobThe nose is not immune from the aging process:Over time it can droop and appear flatter and lon-ger. Bony irregularities that were camouflagedby the thicker skin and lipid layer we had in our20s become more noticeable.

Now fillersplaced on top of the bone, carti-lage, or tipcan give an old nose a youthful boost.

The padding softens the features, says Coral Gables, Florida, cosmetic dermatologistOscar Heviaas long as the physician has a sculptors vision. A millimeter can make ahuge change, cautions Stafford Broumand, an associate professor of plastic surgeryat Mount Sinai Hospital in New York. The in-office procedure can be completed in aslittle as half an hour and starts at $700a universe apart from the traditional two-hourrhinoplasty, which can set you back around $8,000.

Lip ServiceThey say a genuine smile never grows oldbut try telling that to a cosmetic surgeon.Jeffrey Spiegel, the chief of facial plastic and reconstructive surgery at Boston UniversityMedical Center, points out that as we age, our lips lengthen horizontally and fine linescreep up above them, vertically. The upper lip also drifts down, hiding teeth. DarrickAntell, an assistant clinical professor of plastic surgery at Columbia University, injectsfiller not into the lips but into the roll of skin that surrounds them. It gives a fuller lookwithout appearing ducky, Antell says.

And those vertical lip lines? Cosmetic physicians are over the moon about BeloteroBalance. Like most fillers, it is FDA-approved for deep nasolabial folds, but doctors arenow using it for more-superficial linessomething thats not possible with other fillers,which have a blue tinge that shows through skin if injected close to the surface. Its likePhotoshop, says Miami dermatologist Leslie Baumann. The lines immediately plumpup. The downs ide? Considerab le bruising for 5 to 10 days. A session costs $650 to$750, with results lasting about six to nine months.

Photograph by LIZ COLLINS Styled by JANE LARKWORTHY andTAMARA ROTHSTEIN

7/28/2019 Under Your Skin

2/2

108 WMAGAZINE.COM

Carbon DatingOnce upon a time, carbon dioxide therapy was a little knownmedical practice used to improve circulation. Then, in 1998,beauty-minded scientists at the University of Siena, Italy, be-gan injecting the gas into saggy knees, thighs, and bellies. Theresult: blood vessels dilated, sending a rush of oxygen into theproblem areas. After six semiweekly sessions, skin density im-proved, and the area looked tauter. Enhanced circulation seems

to flush out fluid buildup, improve fat metabolism, and pro-mote collagen production, says Cesare Brandi, M.D., who wasthe lead author of the study. Subsequent research suggests thatcarbon therapy can be used as an adjunct to liposuction, to im-prove skin elasticity and smooth small lumps.

Carboxy, as the treatment is called, gained popularity in 2002in Brazil. But, perhaps because practitioners would have togo abroad to learn the technique, it has yet to catch on withAmerican doctors. There are, of course, outliers. Lisa Zdinak,a Manhattan ophthalmic plastic surgeon, uses a tiny needle at-tached to a gas tank to inject small puffs of CO into the skinaround the eyes to treat dark circles. It improves the capillarynetworks and reduces the bluish tinge by about 50 percent,she says. Zdinak has also found carboxy to be brilliant forbaggy lower lids. The best results require six 20-minute ses-sions, at a cost of $250 each, and last about 6 to 12 months.

Scalpel-Free SculptingAs of this writing, Voluma has yet to be FDA-approved, but theenthusiasm for this filler can be heard from across the Atlantic.It has completely changed my practice, says Herv Raspaldo,a facial plastic surgeon in Cannes, France, and a consultant forAllergan, the company that manufactures Voluma. Created bythe same French lab that invented Juvderm, Voluma, which isthicker than its forerunner, can be injected under the musclelayer and massaged into the desired shapeoffering a scalpel-free way to attain a stronger chin or jaw line or more definedcheekbones. If you tried this with previous fillers, you wouldhave gotten big lumps. But Voluma doesnt move, says Raspaldo,who performs such transformations in a rather astounding 5 to15 minutes. The results last about 18 months.

Good FatIt almost sounds too easy: Take fat from where you dont want itand inject it where you do. Once considered a fringe technique,fat grafting is becoming an increasingly viable option with theadvent of more-precise instrumentation and a better under-standing of fat-cell biology. In Boston, the plastic surgeon Dan-iel Del Vecchio harvests fat cells from a patients thighs, knees,and belly and uses them to enlarge or round out breasts. A typi-

cal procedure takes one to two hours and costs around $10,000.In expert hands, fatusually softer and more fluid than

fillerscan also brighten the thin skin around the eyes. Aninjection not only smooths wrinkles and fills hollows but alsoacts as a barrier between skin and underlying facial muscles andblood vessels, hiding dark c ircles, says the New York plasticsurgeon Sydney Coleman. Whats more, researchers suspectthat the stem cells in fat can actually promote the productionof collagen and elastinand therefore eventually improve thequality of the skin. A session for the lower lids takes about 90minutes and costs from $5,000 to $10,000.

Complications can arise, howeveroften due to overzealousinjecting. When this occurs, little divots emerge where a dearthof oxygen has caused the fat cells to die. You cant do fat graft-ing casually, cautions Coleman, who uses tiny increments andas many as 50 passes to complete a procedure around the eye.

Stimulus PackageDespite its name, LIPO-102 isnt liposuction at all. Instead, thepromisingbut not yetFDA-approvedprocedure targetsand stimulates tissue metabolism to reduce fat. Cur rently,technicians are zeroing in on the precise dose needed to meltaway belly fat in average-weight individuals. Its a tiny needle,the medicine doesnt sting, and theres little bruising, saysLong Island, New York, dermatologist Marina Peredo, whohas been involved in product trials. In one study, patients lostup to 1.2 inches after eight weekly sessions, each consisting ofabout 20 shots around the navel. It may be a couple of yearsbefore the FDAokays LIPO-102 for the belly, but once thathappens, doctors are sure to be using the needle to addressstubborn chin fat and saddlebags too.

JADORE

AnnaMouglalis

Far left: Mouglalis, wearing oneof her hand-jewelry pieces.Above: Some of her favorite things.

MARINA TSVETAEVA

When I was pregnant with mydaughter six years ago, I startedto read literature by womenwriters. I discovered MarinaTsvetaeva, who immigrated toFrance af ter the Ru ssianRevolution. Whats funny is thatbefore I met Xan, I was tryingto direct a vampire movie myself,adapted rom a poem byTsvetaeva about a girl who allsin love with a demonlike creature.

LEONOR GREYL HAIR CARE

When youre modeling, your hairgets in a bad state. The productsrom this brand smell so good,and theyre all-natural. Theresa shampoo made with bamboo(above right, on the right)and a jasmine hair mask. I evenuse them on my daughter.

MY JEWELRY LIN E,

EGO SUR ME SURE

Trying to direct my frst moviemade me crazyall anybodytalked about was money.To ree my mind, I decided to dosomething with my hands. Fora long time Id wanted to wearbody jewelry, like belly chains andanklets. So I did a collectionwith the jewelry designer Myrtille

Beck that was presented earlierthis year at Colette in Paris.

SANTA MARIA DI NOVELLA

ACQUA DI COLONIA

I came across this very delicateresh scent (above right, onthe let) while I was shooting in

Italy seven years ago. Everytime I go there, I buy it. I know

I can get it in France, butsomething about buying it in

Italy makes it more special.

KARL LAGERFE LD

Hes the object o my admirationand a source o inspiration.

Karl is the most curious personIve ever met. He is alwaysworking on something, and hedescribes himsel as a permanentimprovisation. He has suchamazing taste! I got my ashioneducation when I frst became amodel and ambassador orChanel. I learned all about thevoluptuousness o clothesthatquality that makes getting dresseda pleasure. One o my avoriteChanel items is a pair of bikerboots Ive had or 10 years. Imlucky to also own haute couture

pieces that I wear in everyday life.

The French actress Anna Mouglalis has had her share ofseductive lm roles (Coco Chanel in 2009s Coco Chanel &

Igor Stravinsky; Juliette Grco in 2010s Gainsbourg: A HeroicLie). But none more so than Xenia, the sharp-toothedChanel-clad vampire diva in Xan Cassavetess debut eature

Kiss o the Damned, in May. Much like Catherine Deneuves

character in Tony Scotts stylized 1983 tale The Hunger, theimmensely chic Xenia develops an attraction to a young,plasma-rich woman. Here, Mouglalis discusses a ew otherthings that get her blood fowing. karin nelson

They say agenuine smile

never growsoldbut trytelling that

to a cosmeticsurgeon.

WHAT SHAPE SHIFTERS