All in all I’ve been happy (actually, really happy) with the results I’ve experienced from the medical corrective procedures I’ve chosen. I do look younger, my tummy is flat (even though I’ve gained some weight since the operation), my face is doing great (no surgery, just Botox, dermal injections, and laser resurfacing), and my breasts have held up pretty well (no pun intended).

The problems I’ve experienced along the way was due to my tummy tuck (pretty major complications) and with the form of dermal injection I chose, Artecoll (also called ArteFill).

Why did I choose Artecoll? Well, I’m pretty high maintenance as it is, given how often I have to get my hair and nails done for media appearances and photo shoots. I already get Botox once every 6 to 7 months. So, anything I can do to spread out appointments, especially those requiring downtime, I’ll do.

I chose Artecoll because it lasts for years. Some would say it lasts “permanently” (but permanent needs qualifying because while Artecoll doesn’t break down the face will still “age” and the younger appearance will diminish).

The first time I had Artecoll injected was in 2000, and though I probably could’ve waited another two or three years at least. At the time, I wanted to get my lower lip done anyway and adding a little more along my upper lip and the fold that runs between the nose and lip made sense. I wanted a fresher, but still natural, appearance.

I know all the risks with dermal fillers. Artecoll shares the same risks with every other filler but Artecoll has an additional twist. Because Artecoll is a “permanent” filler the problem is that when something goes wrong the complication often remains. That was what happened for me. I got small, relatively imperceptible granulomas (little hard bumps) that I could slightly feel around my lips. Those little lumps did eventually go away (at least as far as I could feel). However, even now, if I press too hard on my lips to remove lipstick or once in a while in the middle of an intense kiss, it does ache. Not the best, but damn it does look good!

I’m not one to keep my beauty secrets a secret. Why bother. It just creates a distance between women and clouds reality. If your boobs are fake so what? From any perspective plastic surgery or cosmetic corrective procedures such as Botox, dermal injections, or laser resurfacing, should not be shocking or embarrassing. They are just choices like having sex, going on vacations, or dieting, and how much you do or don’t do is up to you.

For me, because I’m in the public eye more then most, I also don’t want people guessing at what I’ve had done. Sort of like we all do to celebrities, wondering what happened to Meg Ryan’s lips or Melanie Griffin’s face, or Penelope Cruz’s nose, or the fact that no celebrity or model over the age of 40 can raise their eyebrows (that’s Botox). And I surely don’t want to mislead people thinking that my face looks like it does simply because I use my products.

So for the record, I had breast implants in 1984 (I have not had them redone, they are the same ones and still look pretty good), a tummy tuck in 2006 (that looks great but I had serious complications after the surgery was over), dermal injections (twice now since 2000), Botox (every 6 or 7 months for the past several years), Thermage (that was not worth the trouble), IPL (about 4 times, which worked pretty well for brown skin discolorations and red surfaced capillaries), and FRAXEL (which has been very good for smoothing and firming).

As I do more, which I’m sure I will, I’ll let you know how it goes and why I made the choices and decisions I’ve made. Mostly I’m trying to avoid plastic surgery for as long as possible, that step seems truly scary as there are just too many examples of where people just don’t look the same and if anything they look really weird or other-worldly.

“A famous scientist [doctor, chemist, pharmacist, dermatologist, or whatever—I've heard it all] created this formula and it is only now available to the public.”

Lots of doctors and chemists are involved in creating all kinds of products in the world of cosmetics, but all cosmetics contain standard cosmetic ingredients. They can’t contain anything else, as drugs do, or they would be regulated quite differently.

My favorite example of this type of claim is Estee Lauder Creme de la Mer. Quite a story accompanies this very costly little cream! It was created by Max Huber, a NASA aerospace physicist, supposedly to take care of burns he received in an accident. He sold and marketed this product himself. After his death, his daughter continued selling the cream until recently, when Estee Lauder purchased the rights to manufacture and distribute it.

The reality is that this very basic, and I mean really basic, cream doesn’t contain anything particularly extraordinary or unique, unless you want to believe that seaweed extract (sort of like seaweed tea) can somehow be worth this much money, or that it can in some way heal burns and scars. According to Susan Brawley, professor of plant biology at the University of Maine, “seaweed extract isn’t a rare, exotic, or expensive ingredient. Seaweed extract is readily available and used in everything from cosmetics to food products and medical applications.” Creme de la Mer contains mostly seaweed extract, mineral oil, petrolatum (similar to Vaseline), glycerin, waxlike thickening agents, plant oils, plant seeds, minerals, vitamins, more thickeners, and preservatives. How expensive can it be to stick some seaweed and vitamins in a cosmetic? According to the cosmetics chemists I’ve interviewed, it costs pennies, not hundreds of dollars.

Moreover, several additional products with formulas that are unrelated to the first now accompany Creme de la Mer’s original miracle product. If the first one was so spectacular why did it need company, and why did the subsequent products have completely different formulations? I guess the original wasn’t quite the miracle formula they thought it was.

“We only use natural ingredients; synthetic ingredients are bad for your skin because they are fake and made from gasoline, such as mineral oil and petrolatum.”

I have yet to see any cosmetic that is “all” natural. Some synthetic ingredients are awesome for your skin, and regardless of the protestations of cosmetics companies to the contrary, every cosmetics product in the world contains its share of synthetic ingredients.

Synthetic ingredients are derived from many sources, but they all start as natural because everything comes from our environment; nothing is created via alchemy. Petrolatum and mineral oil are indeed by-products of the gasoline industry, but what is unnatural about that? Ironically, gasoline, which is derived from crude oil, is decidedly natural in and of itself as it comes from organic material, such as tiny aquatic plants and animals, that has been buried in the earth for millions of years. Petrolatum and mineral oil are remarkably good skin-care ingredients; they are also recognized by cosmetics chemists the world over for being superior emollients and completely harmless (Source: Dermatologic Surgery, June 1998, pages 661–664). Even the claim that these ingredients are occlusive (blocking) and, therefore, bad for skin is also without proof (Source: Contact Dermatitis, September 1996, pages 163–168).

“Our ingredients are high quality; that’s why they are so expensive.”

It would be nice if that were true, but I can’t get any cosmetics company to give me proof of it. I’ve asked for the names of their suppliers to find out what grades of products they are selling and if they have inferior grades that go to some companies but not others. From what I’ve been able to find out on my own after talking to several cosmetic-ingredient manufacturers, the grades of cosmetic ingredients don’t vary that much, and everyone buys cosmetic-grade ingredients, which are all high quality. For example, DuPont is one of the largest suppliers of glycolic acid to the cosmetics industry (they supply over 99% of the industry who use this ingredient), and they supply the same version to everyone.

A story on MSNBC.com caught the eye of an associate of mine. Her email to me was simple, she included the link to the story and said “This is a little creepy”. At first I read “creepy” as “crepey”(meaning wrinkled skin, questions I get asked about a lot), but a quick look at the content when I clicked through proved she was talking about something else.

A bold headline read: “FDA receives 930 reports of wrinkle-filler issues” and then the subhead drove the needle in deeper, “Some suffer facial palsy, disfigurement and other problems after injections.”

The story went on to explain that “U.S. regulators have received reports of serious and unexpected problems in people treated with wrinkle-fighting injections known as dermal fillers, Food and Drug Administration staff said. The problems included facial palsy, disfigurement and rare but life-threatening events such as severe allergic reactions and anaphylactic shock.”

Okay, now that is creepy, but the way this story was being reported was at best superficial and more sensationalistic than the facts warranted. Although there are risks for any dermal filler (and there are over a dozen different FDA-approved dermal fillers a doctor can select), given the millions of dermal injections performed every year, statistically your risk of problems (especially from an experienced doctor) is incredibly small.

Just in case you don’t know, dermal fillers are natural or synthetic injectable materials that a physician fills a syringe with and then typically injects into a wrinkle, a depressed acne scar, or the lip area to make it fuller or plump out the wrinkle. And the procedure works, and almost always, works really, really well.

But back to the risks and the 930 reports of problems. What went wrong? One of the typical problems with dermal fillers is the potential for lumps or bumps to occur in the injected area, or the material can migrate to areas it wasn’t intended for. These are part of the risks but these potential side effects are often poorly communicated by the physician during the consultation. Instead, all that’s paid attention to are the anticipated positive results, as in no more wrinkles or visible scars.

It is also important to note that of these 930 complaints 739 were from the U.S. and 135 were from other countries including China, South Africa and Brazil with Australia, France, and the United Kingdom reporting the most complications

Some of the complaints were actually minor in nature, including reactions that are expected after treatment such as swelling, redness, bruising, some amount of pain or headache, blistering, and itching, all of which resolve in a few days. What should not happen (and it rarely does) are such occurrences as severe hypersensitivity reactions, serious infection at the injection site, and facial paralysis.

Again, there absolutely are risksyou need to know about to make an educated decision about any cosmetic corrective procedure but the MSNBC.com article made it sound far more ominous for dermal fillers than what the reality is. What you can take away from this report is the reminder that any cosmetic treatment performed by a physician (laser, Intense Pulse Light, Thermage, Fraxel, Botox, etc.) has risks that you need to consider before deciding to move forward or decline having the procedure done.

Here are some basic considerations to think about before you decide to use dermal fillers as a way to deal with stubborn lines around your mouth, the crease that runs from the corner of your nose down to your mouth (called the nasal-labial folds), the frown lines between your eyes, or acne scarring:

1. In general, any single dermal filler should not be used to treat all the problems you want corrected on your face. Different fillers offer improved benefits for certain areas compared toothers.
2. Some dermal fillers have limited applications, but often doctors who either don’t know better or consider going outside the limitations to be low risk go ahead and inject it in a questionable area anyway.
3. Dermal fillers should not be used on people with known sensitivities to the filler material, those with severe allergies, or persons with bleeding disorders.
4. Doctors who don’t take a complete medical history risk injecting someone who is a poor candidate for the procedure. If your doctor doesn’t take a complete medical history, find another physician who knows better than to proceed with a dermal injection without this important step completed.
5. Never inject skin when it is inflamed or irritated (that means don’t rush from your facial peel or microdermabrasion to dermal fillers).
6. Injecting someone who has recurrent or recent herpes breakouts in the area being treated will likely cause an eruption.
7. Injecting a patient with a history of keloid scarring, hyperpigmentation, or hypertrophic increases the chances of an undesirable outcome.
8. Be aware that some fillers only last about 6-18 months (with the average duration being 9 months to a year) which means that most bumps or lumps would resolve in that period of time. Semi-permanent fillers would result in problems such as these lasting indefinitely or would require being surgically removed.

On a personal note, as someone who has used dermal fillers, I have experienced some minor problems. I chose to use a semi-permanent filler fully aware that any problems could be longer lasting. I elected to take the increased risk because I loathed the idea of having to go back to my physician on a regular basis to get injected again (not to mention the expense). The small bumps and tenderness around my lips have remained for several years. That’s the bad news. The good news is that the fillers really have lasted and look great. In hindsight, would I do it again knowing what I’d be dealing with? Yes. But as I said, knowing the pros and cons is a must before any cosmetic corrective procedure. The final decision is yours.

“In order for the products to achieve dramatic results you must use all of them; the skin must be properly conditioned to accept all the products in the line in order for any of the products to work.”

This is one of my all-time favorites because its purpose is to convince you to buy all the products from one line. It is a classic sales technique. In essence, what you are being told is that the line’s wrinkle cream won’t work unless all the other products are used first, so don’t bother buying the wrinkle cream unless you are going to buy everything. In my years of reviewing skin-care routines, I have never seen a cosmetics line with products so unique that you couldn’t substitute a dozen other products for them, if not many that would work better. Further, every cosmetics line has products you should avoid because they contain irritating ingredients, or inadequate amounts of sunscreen, or moisturizers that oversaturate the skin. The term to note here is “dramatic results.” What the cosmetics company considers dramatic results may be dramatically different from what you would really like to see the products do—even if you do use all of them.