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Old, tight face lifts are out, more natural-looking rejuvenation is in

October 28, 2008 |

Jonathan Van Meter, in an article for New York magazine, called this more natural-looking rejuvenation a new beauty aesthetic and dubbed it the “new new face.” The gaunt, pulled-tight look was over, he noted. Replacing it was a plumper, more filled-out face, he wrote, not unlike “a slightly tired but still very stylish down-filled sofa that looks almost new if you keep those cushions fluffed.” But if older women are aging more beautifully, it is surely because now they can. Using a combination

of new techniques and technologies, an older woman can have a face more like a juicy peach, if not quite a fresh-picked one, if she can afford it. And she can do it in Memphis.


“I’m sure they’ve had fat-grafting,” said Dr. Robert D. Wallace, examining photos of Moore and others. That means they’ve had fat liposuctioned from one part of the body and used it to add volume to the midface.

Almost certainly they have benefited from new methods of “doing” eyes, he said. Instead of simply removing fat around the eyes, surgeons are taking the fat, such as in bags below the eyes, and using it to fill up hollows, such as in the tear troughs.

“All of that is done here,” said Wallace, associate professor and chairman of the Department of Plastic Surgery at the University of Tennessee Health Science Center. People are “having less extensive surgery and using more nonsurgical techniques, such as fillers and Botox and nonsurgical lasers that produce thicker, tighter skin,” he said.

The deep plane face lift, touted in the New York article as more advanced, was used and later dropped by Wallace.

“It prolonged recovery and most who did it found they didn’t get that much of a greater result,” he said.

Wallace prefers the MACS Lift, a minimum access cranial suspension lift, also called the S Lift developed four or five years ago. The surgery, performed under general anesthesia or sedation, uses fewer incisions than a more standard face lift, reduces scarring and allows a quicker recovery. The result is tighter cheeks, jaw and neck and improved deep nasolabial folds and jowls.

In Memphis, expect to pay a surgeon between $4,000 and $6,000 for a face lift. If you also opt for a temporal brow lift, you will pay $1,500 to $2,000 more.


“I’m not looking for the fountain of youth,” said Jeannie Wright, 60, of Memphis. “I don’t want magic, but just to look the best I can at my age.”

In February, Wright tried Pearl, one of the city’s newest technologies to treat multiple brown spots on her face. Pearl uses a controlled thermal effect to vaporize part of the epidermis. It treats sun damage, hyperpigmentation, uneven textures and fine wrinkles and stimulates collagen production.

Wallace found the results of his surgery could be enhanced by lasers, so two years ago he joined with Mona Sappenfield in a new medi-spa, Mona Spa & Laser Center-Germantown, where Wright was treated with Pearl.

“Combination is where it’s at,” said Sappenfield. One of her most popular treatments is a laser double-punch: Laser Genesis for pores and redness and to jump-start collagen production, and Titan, which goes deeper into the skin and actually tightens it.

Pearl is a more aggressive treatment and may come as a surprise to laser users accustomed to just a few stings and no down-time. To get Pearl, your skin must be numbed with ointment. You’ll spend the next three days with your face slathered in Vaseline to keep it from hurting, and after that come two or three days of peeling.

It was well worth it for Wright, who saw, to her astonishment, nearly all of her spots literally drop off her face. Improvements have continued.

“My skin has gotten smoother and my pores tighter. … I don’t have a wrinkle on my face,” said Wright.

Pearl must be done twice for full results and it works only on light-colored skin.

Packaged with one laser Genesis treatment and postcare creams, the first session with Pearl costs $1,800 and the second is $1,200.


People seem to shoot everything into their wrinkles these days. A charlatan even injected Priscilla Presley with auto lube. But you can’t get volumized without getting pricked.

“A face lift won’t make the skin look better or the hollows come out and that’s where fillers come in,” said Dr. Phillip Langsdon, a plastic surgeon.

Perhaps the wrinkles women hate most are the scowl-makers: smile creases that run from the nose to the mouth and furrows between the brows. As everyone knows, Botox, which temporarily paralyzes facial muscles, is smoothing brows everywhere. Now Langsdon has a new weapon against smile lines. Evolence, a purified pig collagen recently approved by the FDA, is a quick, natural-looking way to fill in those mouth gutters and is said to last six months to a year and possibly up to 18 months, he said.

Other fillers he uses are Juvederm (hyaluronic acid) for superficial smile lines and Sculptra (poly-L-lactic acid) for deep ones. Sculptra stimulates collagen production and may last two years. But it requires a series of injections and results take three or four months.

Expect to pay $200 to $400 to Botox your frown wrinkles, $500 to $700 to fill mild smile lines and $600 to $1,200 for deep ones.

Chemical peels

Isn’t there a way to get a younger face without paying through the nose?

Yes, said Dr. Robin Friedman-Musicante of Memphis Dermatology Clinic. But she’ll try to talk you out of it.

A medium-depth peel can have a pronounced effect erasing years of sun damage, improving wrinkles, dark spots and precancerous growths and even tightening skin. And you can get it for $250 to $500.

But a medium peel (she uses Jessner’s solution and 35 percent trichloracetic acid) can be painful, you’ll look like a burn patient for up to 10 days, you’ll risk infection, scarring and prolonged redness, and you’ll probably have to do it twice.

(Friedman-Musicante doesn’t do deep peels and doesn’t know anyone in Memphis who does.)

For fine-to-coarse wrinkles, she will often recommend Botox, fillers or lasers. “Results with lasers may not be as impressive,” she said. “But you can keep working.”

Another option is the “lunchtime peel,” a superficial peel that can diminish fine lines and wrinkles, give a more even skin tone and make skin feel smoother. But it’s best for people under 50, you’ll likely need need five peels at $100 to $150 each, and results won’t be as pronounced as with even one medium-depth peel. For these peels she uses 20 to 30 percent glycolic acid or 7 percent salicylic acid or Jessner’s solution, a combination of acids.

Again, think multiple weapons, said Friedman-Musicante: using superficial peels, lasers, a good skin care regimen and, of course, protecting your skin from the sun, can go a long way to regaining that youthful glow.

Clicking it all up on a calculator, we find that the new new face, achieved with scalpel, lasers, fillers and chemicals, will cost somewhere between $9,700 and $13,100 plus maintenance costs. Seen in this light, perhaps our old faces begin to look much more attractive.

More information online

Want to know more? The American Society for Aesthetic Plastic Surgery at, the leading organization of board-certified plastic surgeons specializing in cosmetic plastic surgery, offers a wealth of information on procedures, treatments, trends, statistics and referrals.

Longtime cosmetics consumer reporter Paula Begoun at gives the skinny on skin-care products — what works, what doesn’t — as well as information on new technology. Click on “skin care,” and “learn.”

Find out about chemical peels, microdermabrasion and more at


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