Looking Better for Less

If you have $1,000, a little help with your appearance could be just what the doctor ordered.

Some minimally invasive procedures are cheaper and offer less down time than many surgical procedures. “They’re tremendously popular and tremendously effective,” says Dr. Joseph J. Thornton,  a Newark plastic surgeon. “They’re subtle improvements that people notice. Something about you looks good.”You’ve faced the fact. That long-awaited tummy tuck will have to wait for next year’s budget. But that’s fine. There are plenty of less expensive procedures you can afford that will have just as large an effect on your look.

Minimally invasive cosmetic procedures have increased 5 percent over last year, even as the number of other procedures has plummeted. Tummy tucks may be down 18 percent from March 2009, just as breast reductions are down 16 percent, but people still want modern medicine to help them look good.

The fact that procedures including Botox and fillers have a lower price tag and offer less down time than most surgical procedures is a plus. “They’re tremendously popular and tremendously effective,” says Dr. Joseph J. Thornton, a Newark plastic surgeon. “They’re subtle improvements that people notice. Something about you looks good.”

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So if you’re counting your pennies, here are some procedures for around $1,000 or less. (Prices vary. Factors may include whether the service is offered in a med spa or doctor’s office and whether a doctor, nurse or aesthetician is administering the treatment.) 


It just keeps getting better and better for the manufacturer of Botox, sterile, vacuum-dried and purified botulinum toxin type A. “The satisfaction is so high—about 99 percent,” says Dr. Christopher Saunders, who has offices in Chadds Ford, Newark and Brandywine Hundred.

Pluses Injected into fine lines, such as those across your forehead or between your eyes, Botox reduces the muscle activity that causes the lines, thereby creating a smooth appearance. Recovery is limited to some redness.

Minuses Botox can’t erase deep furrows, crevices and folds. Nor can it plump up hollow cheeks.

Lasts Three to four months.

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Cost $280 to $650, depending on the amount of coverage.

Considerations Even with something as common as Botox, experience counts. Incorrect application can result in droopy eyelids and, as a result, dry eyes. A new product, Dysport, has a similar formulation. It costs less per vial than Botox, but because of the formulation, you need more of it, so the price evens out.

Page 2: Non-Animal Stabilized Hyaluronic Acid


Non-Animal Stabilized Hyaluronic Acid

You probably recognize hyaluronic acid, a gel, by its brand names: Restylane, Perlane, Juvederm Ultra and Juvederm Ultra Plus. By any other name, the product has the same goal: plump up deep creases and folds and fill in crevices. The difference between them boils down to particle size and consistency. Restylane and Juvederm Ultra have smaller particles, making them good for the lips and areas near the skin’s surface. “With the lip we use smaller molecules because we don’t want the area to be palpable,” says Dr. Abdollah Malek, who has offices in Newark and Lewes. The larger molecules in Perlane and Juvederm Ultra Plus pump up the deeper layers.

Doctors often have preferences. Dr. Mehdi Balakhani, for instance, prefers Juvederm. “It works better in my mind,” says the Newark plastic surgeon. Others are fans of Restylane.

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Pluses Results can last six months to a year. Redness and swelling are the main side effects.

Minuses You could develop temporary lumps or skin firmness. To get lips to a pouty fullness, you may need several visits—which is also a plus, considering the goal is to avoid the platypus look. Yet because the lips have so much movement, results there may not last as long as those in other areas.

Cost $650 to $850 a syringe. (Nasolabial folds typically take one syringe.) Often, the more areas you treat at once, the lower the price drops, says Dr. Peter Coggins, who has a Greenville practice. That is also the case with Botox.

Considerations Find an experienced practitioner who knows how deep to go, how much to use, and which brand will deliver the results you’re seeking. Consider combining. “We’re finding that injectibles can last longer when combined with Botox,” Thornton says. “It improves the result.”

For a more permanent solution, consider fat transfer from one part of your body to an area such as the nasolabial folds, Coggins says. The procedure can be performed with local anesthesia for less than $1,000.

Page 3: At-Home Teeth Whitening


At-Home Teeth Whitening

Teeth-whitening gels sold in the doctor’s office can deliver more impact than those sold over the counter. Credit the amount of whitener in the solution. Moreover, the doctor eschews a cookie-cutter approach. For an at-home system, practices like Enhanced Dental Care in Rehoboth Beach make custom trays that fit snuggly onto your teeth, holding the solution in place.

Pluses You do it on your own time, and it’s less expensive than in-office laser treatments, which can run a few hundred dollars more. You’ll always have the trays in hand for touch ups. Just buy more solution.

Minuses It requires discipline to do it on your own. Teeth could become sensitive.

Cost $400 to $500, depending on the practice, for both upper and lower trays and the whitening solution.

Considerations At-home kits won’t deliver the quick results that in-office laser treatments provide. If you’re in a hurry or forgetful, consider the in-office whitening.

Page 4: Sclerotherapy



To get rid of unsightly spider veins and small varicose veins in the legs, doctors use a tiny needle to inject a chemical solution into the vein, causing it to collapse.

Pluses It’s still considered the gold standard. “It does a good job,” Malek says. Pain is usually limited to an initial stinging. Some patients require no local anesthesia.

Minuses Some doctors recommend compression stockings afterward.

Cost The procedure is usually priced by syringe and the time it takes to perform the treatment. The price usually runs from $100 to $400.

Considerations Talk to your doctor about laser treatments, which can zap red or brownish veins. Larger veins will require more in-depth treatments, including endovenous laser treatment, which uses heat to collapse the vein.

Page 5: Intense Pulsed Light


Intense Pulsed Light

You might see IPL advertised as a FotoFacial or PhotoFacial. Either way, IPL addresses sun damage (redness and brown spots), wrinkles, pore size and flushing. The device is not a laser. Instead, it emits a broad spectrum of light with each pulse.

Pluses You can treat several issues at once.

Minuses You’ll apply a numbing cream before the treatment, but it still stings. In some places, like around the nostrils, it stings a lot. Ice will alleviate swelling and redness afterward.

Cost $200 to $300 per session, but it could take four or more treatments before you’re happy with the results. Most spas and practices offer packages.

Considerations Some areas are better hit by a true laser. Discuss the options with your doctor.

Page 6: Laser Skin Treatments


Laser Skin Treatments

Lasers can target just about anything from spider veins on the nose (the pulsed-dye or VBeam laser) to vascular lesions (argon laser) to tattoos to café au lait-colored stains (Yag laser).

Pluses You can lose an irksome blemish—including your ex-boyfriend’s name—with a zap that feels like a rubber band snap delivered by a class bully. It hurts, but it’s bearable, especially with numbing creams.

Minuses The pulsed-dye leaves purple bruises that can take up to 14 days to disperse. Redness is common afterward, and there might be swelling. Today’s stubborn tattoo inks can be hard to erase totally.

Cost Depends on what you’re doing and how many treatments you need, but usually the total treatment costs less than $1,000.

Considerations Multiple sessions might be necessary. Spider veins can return.

Page 7: Laser Hair Reduction


Laser Hair Reduction

Chin whiskers aren’t flattering on a woman, and a hairy back is hardly a babe magnet. Enter laser hair reduction, which today encompasses many different types of devices. Take the CoolGlide Laser and the ProWave, both suitable for all skin colors. Dr. Paul Sabini offers both at his Newark office.

Pluses Less shaving—if any at all. No downtime. Recovery involves some sunburn-like redness.

Minuses There is the rare risk of blisters, scarring and a change in skin texture.

Cost About $300 per session, depending on the device the practitioner uses and the size of area covered. Because hair grows at varying rates, you’ll need more than one session, which bumps up the total price.

Considerations Note that the procedure is called “laser hair reduction,” not “removal.” Hair may grow back. Cool-touch lasers take the burning sensation out of the process.

Page 8: Peels



Peels come in all strengths. Lighter peels are made with alpha hydroxyl acids and beta hydroxyl acids. You’ll find these at salons and spas. Trichloroacetic acid —TCA for short—sloughs off the skin’s outer layers and encourages regeneration. Balakhani swears by the Obagi Blue Peel, developed by Zein Obagi. (Balakhani is also a fan of the skincare line. “I can’t find anything better.”) The solution includes ingredients reported to hasten healing and neutralize the TCA.

Pluses At the low end, peels slough off the dead cells that sit on the skin, emphasizing wrinkles and making the skin look dull. At the high end, stronger peels remove fine lines, even out skin tone and address irregularities.

Minuses After a strong peel, you’ll experience swelling. Allow yourself a week after these peels to recover. Most peels produce a burning sensation, but you’ll definitely feel the sting of an agent like TCA. Some patients ask for sedation.

Cost $75 to $750, depending on the depth of the peel.

Consideration You may need a series, depending on the peel’s strength. Avoid sun afterward. If your budget allows, consider pairing a peel with a laser treatment.

Page 9: Fractional Laser Treatments


Fractional Laser Treatments

When it comes to brand names, Fraxel is becoming the Kleenex of laser resurfacing. But Pixel is another brand name for an instrument based on the same approach, which involves fractional laser resurfacing.

Rather than removing a layer of skin, leaving your face red and weepy for weeks, the laser devices make several teeny-tiny dots in the skin, which results in a speedier recovery. Dr. Joseph Danyo of Greenville compares it to aerating a lawn to foster new growth.

There are non-carbon dioxide lasers (CO2) and now there are fractional CO2 lasers, which can go deeper, creating more injury. Because the injury stimulates collagen production, you’ll get better results.

“It’s very effective, and there’s much less risk of pigment issues post-op,” says Dr. Jonathan Pontell, who practices in Media, Pennsylvania. You can also treat the neck instead of stopping at the chin, which was the case with the old CO2. What’s the difference?

Fractional treatment, erbium laser

The erbium usually requires a series of treatments. It’s good for treating photodamage, mild-to-moderate eye wrinkles, acne scars, surgical scars, melasma and actinic keratosis. The patient can return to normal activities in a day or two. The cost is about $700.

Fractional treatment, CO2 laser

The CO2 typically requires one treatment, although more might be required. The device is good for treating wrinkles, irregular texture, age spots and sun spots. Because it causes more injury to the skin, the treatment promotes collagen production. Downtime is usually a week or less. The cost is $600 to $1,200 per treatment.

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