Reverse the Signs of Aging

Botox Injection example

For years, Sue Hazen watched as the effects of time and a long-term smoking habit took their toll on her 53-year-old face. At the end of January, the Port Jefferson Station resident decided to investigate some alternatives for turning back the clock. She and her husband, Peter, attended a seminar given by renowned Manhattan cosmetic plastic surgeon Stephen T. Greenberg held earlier this month. Dr. Greenberg, who was speaking at the Spa at East Wind in Wading River, is frequently interviewed and asked to discuss his knowledge of the latest cosmetic surgery techniques. 


At the end of Dr. Greenberg’s 60-minute informal lecture, Ms. Hazen, who quit a year ago after smoking for a decade, decided to take the first step in recapturing her youth. She underwent a serious of injections, which were administered by Dr. Greenberg, to hide lines and wrinkles on her face. “I guess I’m just not doing well with getting older,” said Ms. Hazen, who received Botox injections to temporarily paralyze muscles in her forehead, and Restylane to hide the wrinkles around her mouth and cheeks. “The injections pinched a little bit,” Ms. Hazen admitted, while holding an ice pack on her slightly swollen face immediately following the procedure. “As for how it comes out, I’ll have to let you know.” During his lecture, Dr. Greenberg explained various options, from facial creams to invasive surgery, to help turn back the clock. The surgeon, who has also appeared in national magazines such as Harper’s Bazaar, Cosmopolitan, More, and Elle, gave a “head to toe” analysis of the latest alternatives now available. Starting with the face, Dr. Greenberg explained that wrinkles and sagging—commonly known as jowls—and/or loose or thin skin near the neck are some of the most detested effects of aging.


He explained that as we grow older, our skin becomes thinner and less radiant with loss of elastic tissue and fat cells known as collagen. “The effect of gravity causes skin and tissue to sag downwards from the face, toward the chin, lower face and surrounding neck,” Dr. Greenberg said. “People come to me and say ‘I can’t believe I have jowls,’ but we all age the same way … The fat that once was in our cheeks has drifted down your face into your jawline.” Other contributing factors that can contribute to wrinkles include reduction of muscle mass, sun exposure, smoking, genetics and even diet, he explained. Dr. Greenberg noted that until recently, invasive plastic surgery was the only effective method to hide jowls and facial wrinkles. But new injection gels, known as Restylane and Perlane, are providing some non-surgical relief, too. Restylane and Perlane are trade names for a specific formulation of non-animal sourced fat replacement gel, known as hyaluronic acid, which is most commonly used for lip augmentation.


At Dr. Greenberg’s lecture, Lisa Paveglio of Centereach asked about the differences between Restylane and Juvaderm, the latter being a new product touted in television and magazine advertisements. Dr. Greenberg held up both a box of Restylane and Juvaderm to the audience and explained, “Juvaderm has a prettier box,” he said, pointing to the multi-color Juvaderm box in contrast to the plain white-and-black box holding the Restylane. “The Juvaderm box is a little bigger, but that’s about the only difference,” he added. In the United States, Restylane has been approved by the Food and Drug Administration for cosmetic injection into subdermal facial tissues. Restylane is injected under wrinkles and aging lines of the face, including the nasolabial folds on either side of the nose and the melomental folds around the eyes. Restylane can also be used for filling aging-related facial hollows and orbital troughs located under and around the eyes. The process has a recovery time of two to three days. Costs for the treatment can range between $300 and $500 per visit.


However, the treatment is not permanent and lasts only about six months, Dr. Greenberg noted. He recommend getting reapplications every four to five months so that the visual effect is not as noticeable. “You don’t want to keep going from looking great, to looking tired, to looking great, to looking tired,” he said. “Everyone’s body absorbs the gel differently, so it might be six months for some, but four or five months for others.” Dr. Greenberg stressed that Restylane injections are only for people with moderate wrinkling, namely those between 40 and 60 years old. He noted that those with advanced aging would require plastic surgery. A face-lift is the only option for eliminating extreme sagging beneath the jawline—often referred to as turkey neck—according to Dr. Greenberg. One such surgical technique uses a wire with small barbs that is inserted along the jaw line. The barbs catch on tissue and the wire is pulled up toward the skull, thus lifting sagging skin. Aside from the painful-sounding description of the procedure, there is another drawback to this technique, the doctor noted. “The problem is, it doesn’t last,” Dr. Greenberg said. Also in attendance at the talk were Jean Giroux of Holtsville and Jeane Zinser of Stony Brook. The two friends, both of whom are 75 years old, said they wanted to learn more about a new procedure known as the Lifestyle Lift.


Dr. Greenberg said the $6,000 procedure is a form of “mini-lift” and focuses on specific areas of the face, such as the neck and the folds of the nose. Using smaller incisions, the surgeon lifts, repositions and removes facial tissue. The surgeon then repositions the skin with sutures. “The Lifestyle Lift is very scary,” Dr. Greenberg said emphatically. “The problem with the procedure is that it’s being mostly performed by doctors who have little or no plastic surgery experience, and you’re taking big chances when you don’t go to a board-certified plastic surgeon.” Though the most common form of plastic surgery sought across America is breast augmentation, Dr. Greenberg noted that women are not the only ones seeking plastic surgery these days. He added that between 20 to 30 percent of plastic surgery patients nationwide are men. According to the American Society of Plastic Surgeons, roughly 350,000 women had breast augmentations in 2008, making it the number one cosmetic plastic surgery procedure performed that year. Dr. Greenberg noted that breast implants could last up to 10 years or more.


He recommends a new silicon gel implant, noting that it does not leak as did past silicon implants. Tabitha Silva, a Manorville resident who is currently studying esthetics at Long Island Nail and Skin Care Institute in Levittown, asked how long it takes to switch breast implants. Dr. Greenberg reported that it was quick procedure, because the pocket for the implant was already in place under the chest muscles. “It takes about 10 minutes,” Dr. Greenberg said, smiling. “I can change breast implants faster than I can change a tire.”

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