Want to enhance your appearance? If you’re looking to go beyond highlights and a newhaircut, you’ll be pleased to know there are a number of technologies available that stop short of surgery.

Whether you’re considering cosmetic procedures to get a leg up in the workplace or simply want to boost your self-confidence, here are some of the noninvasive options that can rejuvenate your look.

   Botox — Approximately 5 million Botox injections were performed in 2008, making it the most sought-after nonsurgical procedure. It temporarily paralyzes overactive facial muscles around the eyes, nose, lips and brow and typically lasts four to six months. It can even reduce the appearance of the linear bands on the neck produced by overactive platysmal neck muscles.

   GFX Nerve Ablation System — New on the market is a device that uses minimally invasive radio-frequency energy selectively to weaken nerve signals. The use of this technology on nerves that control the muscles of the forehead may reduce the appearance of frown lines, or glabellar furrows. If you’re concerned about injections, this might be an alternative therapy for you.

Injectables

   Complementing facial rejuvenation procedures, injectable soft- tissue fillers help patients achieve a more youthful and enhanced appearance. Fillers and other injectables improve skin texture and form and can augment facial features.

   There are a number of injectable fillers on the market today. Here is an overview:

   Restylane is a purified substance of nonanimal sources that occurs naturally in all living beings. It has been approved in the United States for use to diminish the visibility of fine lines and wrinkles in the skin. Because it is only minimally allergenic, a skin test is not required before injection. Restylane usually lasts six to nine months.

   Juvederm Ultra Plus consists of more highly cross-linked hyaluronic acid than Restylane and flows a bit more easily, which sustains its effect. It is used for lip volume enhancement and filling nasolabial and marionette lines. Pleasingly, it has been lasting 12 to 15 months in the lips. It is "smoother" to inject than Restylane, and patients generally prefer it in the lips. Perlane is another hyaluronic acid filler, but it doesn't have the durability of Juvederm.

   Radiesse is an FDA-approved biodegradable calcium hydroxylapatite microsphere filler that lasts longer (10 to 15 months) than the hyaluronic acid fillers. It is used mainly for nasolabial and marionette lines. It should not be used in lips. Because it is injected more deeply, it has more "lifting power" than hyaluronic acid fillers. It can even be used as a nonsurgical rhinoplasty ("nose job") in some patients if part of the nose needs added volume.

   Sculptra is used as a volume filler for cheeks and marionette lines (not lips), producing a "lifting" effect as well. This is helpful for thin, fit women or men who have lost facial cheek volume (lipoatrophy) and have resultant looseness and wrinkling in this area. Lasting two  years (or more), it has been called a "liquid face-lift." Typically, three sessions are required for optimum correction.

   Evolence is a new dermal filler that is made with natural collagen. This is an advanced form of collagen that has been cross-linked to last at least six months. It can be used in the face to soften unwanted wrinkles and folds and to restore structure and contours in areas that have become depleted.

   Some dermatologists warn against the use of permanent fillers because they will show as an unsightly linear nodule with age.

Laser rejuvenation

   The desire to reduce the visible signs of aging or reinvigorate a seemingly tired appearance often leads patients to facial rejuvenation. One method is laser rejuvenation (or nonablative laser resurfacing). It is a relatively new and promising minimally invasive procedure using a laser to reverse signs of aging. A long-pulsed Nd:YAG laser stimulates collagen and ground substance production in the skin and improves facial and neck fine wrinkling, resulting in modest tightening and acne scar improvement. A series of treatments (usually six) over the course of a year constitutes the typical regimen. This is a no-downtime treatment, producing minimal redness for less than an hour. It is relatively inexpensive.

    Various lasers can also be used to treat scars, shaving bumps, excessive redness, rosacea and pigment changes

Chemical peels

   Chemical peeling is a technique used to improve the appearance of the skin. It is typically performed on the face, neck or hands. In this treatment, a chemical solution is applied to the skin that causes it to peel off. The intensity of the chemical preparations varies. The new, regenerated skin is usually smoother and less wrinkled than the old skin.

Microdermabrasion

   Microdermabrasion is a skin-freshening technique that helps repair facial skin that takes a beating from the sun and the effects of aging. A doctor uses a device like a fine sandblaster to spray tiny crystals across the face, mixing gentle abrasion with suction to remove the dead outer layer of skin. As with other skin rejuvenation techniques, more than one treatment may be needed to reduce or remove fine wrinkles and unwanted pigmentation.

Superficial varicose vein therapy

   "Spider" veins are abnormal small superficial red or blue blood vessels on the legs or face. They are usually dominantly inherited. They can cover a large area of skin and be quite unattractive.

   If spider veins are unsightly or uncomfortable, they can be treated with a long-pulsed Nd:YAG laser, a pulsed dye laser or by injection sclerotherapy (hypertonic saline or Sotradecol) that will cause them to disappear or become much smaller. Sclerotherapy is the most efficient method if there are large numbers of vessels. Support hose are usually recommended to be worn for a few days to a week after the procedure.

Laser hair removal

    A wide range of treatment options for managing unwanted hair have been available over the years, such as shaving and waxing, but these methods are temporary and offer varying degrees of success.

   Until recently, patients with light skin and dark hair were the only good candidates for laser hair removal. However, the new longer wave length lasers and skin-cooling devices have made it possible to treat patients with darker skin types. Multiple treatments, typically six, are necessary to achieve satisfactory hair reduction.

Amazing lashes

   Initially used to treat glaucoma, or high pressure in the eye,  LATISSE® solution is a prescription treatment used to grow eyelashes, making them longer, thicker and darker. LATISSE® combats eyelash hypotrichosis, which means having inadequate or not enough eyelashes.

   A couple of warnings about this preparation, though: It may cause eyelid skin darkening, which may be reversible, and there is potential for increased brown iris pigmentation, which is likely to be permanent.

Choose a board-certified doctor

   By choosing doctors who are board certified within their specialty (e.g., plastic surgeons are certified by the American Board of Plastic Surgery; dermatologists are certified by the American Board of Dermatology), you can be assured that the physician has graduated from an accredited medical school and has completed a three- to five-year residency. To become certified, the doctor must then successfully complete comprehensive written and oral exams. Board certification is a voluntary process.

   However, buyer beware when it comes to advertisements touting “board certified” that don’t specify which specialty or certification board. If an ad doesn’t tell you which certification board, that’s a red flag. It’s a good idea to verify that information.

   You can search online at the American Board of Medical Specialties( www.abms.org) by specialty and state to find a list of board-certified physicians.

  Be sure to ask for referrals. Physicians specialize in many different areas of cosmetic treatment, and most are not experts in every area. Don’t be afraid to consult with more than one cosmetic surgeon or dermatologist to discuss varying techniques and your desired outcome.

Cosmetic Procedure Resources:

The American Academy of Cosmetic Surgery

(312) 981-6760

www.cosmeticsurgery.org

The American Academy of Dermatology

(866) 503-7546

www.aad.org

The Food and Drug Administration

(888) 463-6332

www.fda.gov