Beauty

Beauty on a Budget

By Leslie Garisto Pfaff

The mirror tells you it’s time. The financial pages tell you to hold off. Is there any way to break the stalemate between beauty and the beastly economy? “It’s a conversation I have every single day,” says Brian S. Glatt, M.D., a plastic surgeon practicing in Morristown. “Patients say, ‘I know I need a facelift, but I don’t have that much to spend right now.’” Happily, given the advances in plastic and cosmetic surgery, it’s almost always possible to approximate — or even achieve — the results you’re looking for on a less-than-optimal budget. Here, four of the state’s top surgeons share their cost-paring secrets:

Fill in the blanks. “Facial aging has two basic components: descent of the soft tissues and loss of volume,” notes Dr. Glatt. While injectable fillers like Restylane and Sculptra can’t lift what’s already succumbed to gravity, they do a great job of restoring lost volume in areas like the cheeks and the hollows under the eyes. Fillers, says Peter Hyans, M.D., a plastic surgeon with the Summit Medical Group, can even be used to camouflage jowling: Doctors inject the filler in the area between the chin and jowl to create a smoother jaw line. “Fillers won’t replace a facelift,” says Dr. Hyans, “but in a younger patient, they’ll buy time, and in an older patient, they provide improvement and camouflage without surgery.”

Mix it up. A combination of procedures can approximate the look of a full facelift at a significantly lower cost. “We tend to look into someone’s eyes when we first meet them,” observes Dr. Glatt, which is why he often recommends that patients start with surgery around the eyes (the upper or upper and lower lids, or the upper lids in combination with a brow lift) and treat the mid and lower face with fillers or resurfacing, either with a laser or a chemical peel. William K. Boss, M.D., a Hackensack surgeon, developed his Cool Lift to deliver surgical results with a combination of mostly non-surgical procedures: He runs a laser beneath the skin to tighten deep tissues and dissolve unwanted fat, then places barbed “suspension” stitches (a procedure sometimes marketed as the Lifestyle Lift) to elevate and further tighten facial tissues, removing a small amount of skin — all under local anesthesia.

Take the local. In fact, choosing procedures that don’t require general anesthesia can save you a bundle — not just on the cost of an anesthesiologist but sometimes on the expense of a surgery center as well, since many of these procedures can be performed right in the doctor’s office. Dr. Boss, for instance, is perfecting the art of body sculpting with only local anesthesia. Soon, he believes, “we’ll be able to perform lipo under local on almost all areas of the body.” The only tradeoff is that the procedure will take longer under a local anesthetic, but the savings should be significant. Further reducing costs, Jeffrey Rapaport, M.D, a dermatologist in Englewood Cliffs, uses Thermage, a treatment involving radio frequencies, to recontour the lower tummy, the posterior thighs, and the “saddlebag” areas. “It’s not the same as liposuction or a tummy tuck,” he advises, “but it can recontour areas that are robust with fat.”

Go with the champ. “Bang for your buck” is a favorite phrase among surgeons to describe the benefit-vs.-cost ratio of the reigning champion of cosmetic procedures: Botox. “What Botox does for the upper face is really hard to match with anything else,” says Dr. Rapaport. His “liquid facelift” involves using Botox to smooth out forehead furrows and crow’s feet, then plumping up the cheeks and under-eye hollows with a long-lasting filler like Sculptra and erasing the nasolabial folds (the “parentheses” running from nose to the outer mouth) with a hyaluronic acid filler such as Restylane. Botox can also be used, says Dr. Hyans, “to uplift the smile in the corner of the mouth, elevate the eyebrows, and tighten the neck area.” While Botox isn’t permanent (treatments typically last four to six months), it nevertheless delivers world-class results.

A Note on Costs

When consulting with your surgeon, make sure to ask for the costs of the procedures you're hoping to approximate for the sake of comparison, and keep in mind that neither fillers nor Botox offer permanent results. Below are some typical costs for non- and minimally invasive procedures:

Fillers: Polylactic acid (e.g., Sculptra): About $1,200 per vial. An average procedure, says Dr. Rapaport uses two to three vials, with a discount on subsequent vials. Hyaluronic acid (e.g., Restylane): $500-$750 per vial.

Botox: $300-$500 per area

Thermage: About $2,200 per treatment

Dr. Boss's Cool Lift: Between $4,035 and $7,500