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Smooth-Skin Solutions

By Beth Janes

WebMD Feature from "Good Housekeeping" Magazine

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For most grown-ups, needle pricks and pokes are the necessary evil of flu vaccines and blood tests. But more and more women are getting shots to stave off the signs of aging. In fact, recent statistics from the American Society of Plastic Surgeons (ASPS) show that Botox injections and other noninvasive cosmetic treatments are still on the rise, despite the crummy economy and a dip in cosmetic surgery procedures. The reason: They deliver almost instant gratification. They're also cheaper and involve less downtime than plastic surgery. Here's the crib sheet on what's available now, what's on tap, and how to get the best outcome.

The Shot: Botulinum Toxin Type A

Botulinum toxin type A (a.k.a. Botox and its new competitor, Dysport, which the FDA just approved in April).

How it works. The toxin temporarily paralyzes muscles so they can't contract, helping to smooth wrinkles that are created — and reinforced — whenever you make facial expressions (like furrowing your brow). "Dysport, which has been used in Europe for years, is very similar to Botox," says Anne Chapas, M.D., assistant professor of dermatology at New York University School of Medicine, who performed trials on the drug. The differences between the two are subtle and mainly in formulation, not performance, she says.

Best uses. Botox and Dysport are both approved for smoothing wrinkles between the brows. But doctors also inject the toxin to relax forehead lines, crow's feet, and sinewy-looking neck muscles resulting from fat and collagen loss, as well as to soften muscles pulling down the corners of the mouth. These uses, while generally safe in experienced doctors' hands, are considered off-label. (Once the FDA approves a shot for one area, doctors often inject it in other spots, too.)

Potential pitfalls. In untrained hands or if overused, injecting this toxin could lead to a face-freezing or drooping effect (imagine a lopsided smile). And Dysport spreads out more than Botox during injecting, Dr. Chapas says. This diffusion can be a good thing — if you have a large forehead, for example, you'll probably need fewer shots — but your dermatologist or plastic surgeon must take it into account to avoid freezing unintended muscles.

How long it lasts. Dysport lasts about six to nine months, says Dr. Chapas, compared with Botox's three or four. The reason: Dysport contains fewer proteins than Botox, so your body breaks it down more slowly. Dysport also seems to take effect more quickly: within one to two days, versus Botox's three to five.

Cost. Starting at about $400 per treated area; Dysport could be about 15 percent cheaper. "The makers may try to win over Botox patients with lower pricing," Dr. Chapas says.

The Shot: Hyaluronic Acid

The most widely used forms of the sugar-derived gel, hyaluronic acid (HA), currently include Restylane, Juvéderm, and Perlane. But even more options are poised to flood the market by next year, including — attention, pain-phobes — Restylane and Juvéderm paired with lidocaine (the same mild anesthetic your dentist uses).

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