The topic of my July 29 Online Radio Show (you can link to the archived version here) was how to achieve a face-lift (or a close proximity) without surgery. Our guest was Dr. Brandith Irwin, a board-certified cosmetic dermatologist who is author of The Surgery-Free Makeover.

I know all of you would like The Cosmetics Cop Team to say we found some miracle product with some miracle ingredients from some remote part of the world that can provide the results you can get from cosmetic corrective procedures and surgery, but they DON’T exist. Hundreds of companies tell you otherwise, but they are absolutely lying.

We started out the show having a lot of fun reviewing some of the ridiculous products from Bremenn Labs that are the epitome of what kind of insanity lurks behind almost every infomercial, department store, drugstore, salon, spa, or home shopping cosmetic brand. Bremenn Labs actually sells products called Tummy Tuck in a Box, Boob Job in a Box, Butt Lift in a Box, and Upper Eyelid Lifter. I didn’t know whether to laugh, throw up, or cry. Admittedly, it’s hard to laugh when you know women are wasting their money on this kind of stuff every day.

After explaining why Boob Job in a Box was not even close to the real thing, we talked to Dr. Brandith Irwin. She went over details of what can really be done with cosmetic corrective procedures such as Botox, Thermage, Fraxel, dermal fillers (such as Sculptra, Radiesse, Restylane, or Artefill), and laser and light therapies. I know, I know, they’re pricey, but with all the money you’ll save by not buying useless “Works like [insert cosmetic corrective procedure here] …” skin-care products or pills or drinks claiming to get rid of your wrinkles, sagging skin, and furrowed brow, you’ll be able to afford the things that really work.

Dr. Irwin also touched on expectations and the results you can achieve with different procedures. Botox and dermal injections produce the fastest and most impressive results. Facial peels are also impressive, but that is completely dependent on the strength of the peel and the know-how of the person applying it. Machines such as laser, IPL, or Thermage are less impressive in the short term but are extremely effective when a series of treatments are done.

It is also important to keep in mind that if you have advanced sun damage and sagging that a non-invasive procedure won’t make you look like you just had a face-lift. That’s why it’s important to consider these treatments before you start looking older. Ongoing, preventive maintenance goes a long way to delaying the decision to actually have a cut-and-paste surgical procedure.

I often hear women say to their female friends, “You don’t need anything like a face-lift or lasers—you look fine!” First of all, none of us just want to look “fine.” Second, are women supposed to wait until their friends say, “Wow, your skin is looking like a bad piece of leather and hanging down like a worn pair of drapes!”? The idea is to treat your skin to prevent sagging and wrinkles, not wait until you’re looking in the mirror and wondering who that old lady is staring back at you.

As with every radio show, we took questions from several women and gave away an assortment of Paula’s Choice products. The combination of brilliant skin care along with carefully selected cosmetic dermatologic treatments is the smartest way you can truly look younger, longer. And isn’t that what most of us want? I know it’s what I want and why I see Dr. Irwin three or four times a year for my touch-ups (which include Botox, Fraxel, and fillers). I know some day I will bite the bullet and have full-on cosmetic surgery, but for now, if I do say so myself, I think I look pretty damn good!

I recently received an email from a woman who read my article on facial exercises and passed it on to Carole Maggio. Ms. Maggio runs the Web site www.facercise.com which is devoted to, you guessed it, facial exercises. According to the Web site, Maggio is considered “the world’s foremost authority on facial exercises.” I’m not going to argue with that attribute, but from my point of view that’s sort of like being the foremost authority on how to use a rotary dial phone.

Obviously, Ms. Maggio didn’t like what I wrote about facial exercises, which is that they do not work to reduce wrinkles or improve sagging skin in any way, shape, or form. For any signs of aging, including sagging skin, facial exercises can do more harm than good.

Maggio’s criticism was not only of my information but on my expertise. She states in her newsletter that my “only real tie to the skin-care industry is as a former makeup artist” and that I am not a doctor. It is true I am not a doctor, but I have given presentations at international dermatology conferences; I belong to the Society of Cosmetic Chemists; I have been actively involved in the cosmetic industry for 30 years; and, I have written over 18 best-selling books on skin care and makeup. Oops, I almost forgot, I also formulate all of my Paula’s Choice products. Yes, I am also a former makeup artist but clearly my credentials go far beyond that.

Maggio also wrote that Doctors Nicholas Perricone and Mehmet C. Oz have recommended facial exercises as a means to look younger. I am not surprised Perricone gave a nod to this silly practice, as history has shown he’ll say just about anything to get the attention of those concerned with aging (regardless of whether there’s solid research to support his advice). After all, Perricone sells over a dozen products priced over $100 claiming to get rid of wrinkles, yet like most dermatologists, he has done Botox injections for his patients.

But Maggio is wrong about Dr. Oz. In the book he co-wrote with Dr. Michael F. Roizen, You Being Beautiful, they state the following: “Exercising the facial muscles is a sure way to increase wrinkles. The facial muscles pull on the skin to give you facial expressions. And the repetitive movements of the skin, over the years, combined with the normal thinning of the collagen and elastin of the dermis, will eventually crack the skin, causing wrinkles. Botox is the reverse of exercise; it paralyzes muscles and lessens wrinkles.”

However, despite what Oz wrote in the book, he mentioned on his show a Japanese study that may give credence to the idea that facial exercises work. However, this study was not about facial exercises but about measuring skin elasticity at different ages (Source: Journal of Dermatological Science, September 2007, pages 233–239). Of course Maggio left out the discrepancy between Oz’s comment on his show, the actual study, and what was written in his book.

Speaking of Botox, Maggio was very upset that I’d recommend this procedure over facial exercises. According to her, facial exercises are natural, which they are, but they don’t work, so it doesn’t matter if they are natural. Actually, Botox is natural as well: it comes from a naturally occurring neurotoxin that’s purified and made safe for use in people. You may not know that there are over 4,000 studies showing Botox’s benefit for everything from wrinkles to cerebral palsy, while no such studies exist for facial exercises.

Maggio seemingly couldn’t find any of those 4,000+ studies as she asks in her newsletter, “Where are the studies proving Botox is effective and safe for long-term use?” She should have checked the United States National Library of Medicine National Institutes’ of Health’s web site at www.pubmed.com; they are all there.

Suffice to say, I strongly stand by my article and research about facial exercises. According to abundant research, facial exercises provide no benefit because lack of muscle tone is not the cause of wrinkles or sagging. In fact, muscle tone is barely involved in these at all. The skin’s sagging and drooping are caused by 10 major factors:

1. Deteriorated collagen and elastin (due primarily to sun damage and inflammation)
2. Depletion and movement of the skin’s fat layer
3. Repetitive facial movement (particularly true for the forehead frown lines and for smile lines from the nose to the mouth)—muscle movement causes wrinkles
4. Muscle sagging due to the loosening of facial ligaments that hold the muscles in place, not because muscles aren’t toned
5. Hormone loss
6. Bone loss
7. Gravity
8. Genetics
9. Skin cells stop reproducing as we age
10. SUN DAMAGE!

You can exercise your face if you want, but I would strongly suggest taking the time to exercise your body and applying sunscreen during the day—it will serve you far better than making funny faces in the mirror, manipulating your facial skin toward more wrinkles.

Every day, the emails arrive, asking about the latest anti-wrinkle/firming/lifting/brightening/re-contouring product to hit the cosmetic counters. Message after message implores us to review these items. And all of them are geared toward one burning question: does “Product X” really work as claimed? Don’t get me wrong, we love hearing what our readers want us to review (it is a major factor when we make these decisions) but every now and then I have to step away from my desk, take the dog for a walk, and rant a bit.

Here’s my issue: why do we (as consumers) have such a disconnect when it comes to believing cosmetic companies marketing anti-wrinkle products that seem too good to be true? Why isn’t an air of skepticism our default? Instead, hope springs eternal as month after month all of the major cosmetic lines (and every fashion magazine) herald the arrival of their latest youth-in-a-bottle product. No one ever stops to think about last month’s wonder product because now there’s something new essentially stating it does the same thing.

What never ceases to amaze me is that no matter how many times Paula and I have debunked fantastic-sounding claims (and supported our conclusions with published research) many of our readers remain faithful that the next product will get it right. It doesn’t faze them that Lancome (for example) has had products claiming to work like Botox and lasers, yet none of them performed remotely as claimed. Not a single consumer saw their forehead creases go away or saw their imperfections zapped with laser-like precision. Yet many of us bought the products anyway, hoping against hope (and reality) that they’d work. Now Lancome has a new anti-aging serum claiming to boost the activity of the genes in our skin, resulting in renewed youth. It’s scary how many skin-care products are making ever more remarkable claims, yet rarely are they backed by formulas capable of doing what’s stated in black and white. But still, we believe. We really want to believe these cosmetic companies have our skin’s best interests in mind.

My mother is guilty of this, too. She knows what I do for a living. She’s read the books. She’s met Paula. Yet at least once per month I get an email or phone call from her asking about a line-erasing product or eye cream claiming to tighten bags under the eye and turn back the clock on wrinkles. Every time I tell her the same thing: Mom, stop wasting money on these products and start saving for a cosmetic procedure that really will make a difference—and please Mom, start using sunscreen. I guess she, like many consumers, doesn’t want to face facts. After all, it’s easy to look past the truth when the temptation to get what you want from a readily-accessible skin-care product is all around us.

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.

Quick, let’s cradle our faces in our hands and gently pull back the skin at the bottom of our jaws towards our ears and see who we once were.  You know you do that.  We all do.  Who are we seeing when we stretch our jowls back through time?  To a time when we never thought to push the skin forward for a secret glimpse of who we were to become.

 At first, I see the smoothed gentle skin of my younger face.  Then, I see the me behind my eyes.  The me that Freud referred to as self.  Not the anatomy is destiny, me. It is when I let my jaw down, so to speak, that I look at the older, stranger me I am becoming.  My soul seems to age in dog years, while my body catapults forward in people time.  It really is okay, though.  I know there are options such as Restylane, Botox, and face lifts, but that is a step in the direction of Cher and Joan Rivers I’m not willing to take just yet.

I remember seeing my first serious wrinkle.  I was looking into a rearview mirror to put sunscreen on my face right before a five-mile run. Yes, I know.  You wouldn’t believe that by looking at me now.  But then, I was thirty years old and I noticed, for the first time, on the right side of my mouth a crease, a deep crease, an etched crease, a crease that seemed big enough to need its own tube of sunscreen. 

It surprised me.  “Wow,” I remember thinking, “when did that happen?”  But it was a singularity, a oner.  I didn’t get the foreshadowing.  So, I went for my run while my one-wrinkle face had begun an agenda all its own.

We do indeed focus on our aging skin.  And we all know we have better things to think about.  We all know this attention is existentially foolish.  We all know it’s self-indulgent vanity.  We feel a bit ashamed and a bit shallow.  There are far more important issues.

It’s petty, of course, this preoccupation with our post-menopausal, estrogen-deprived, sun-damaged skin.  Very un-Zen-like.  It’s so hard, however, to watch our beauty leak out through the sieve of time, to watch it sustain the relentless erosion of youth with peaceful detachment, especially when we live in a culture dominated by the priceless commodities of beauty and youth.

Phew, I’m out of breath just writing that last sentence.  And I probably just lost another few skin cells.

Young people, however, really are beautiful. And they’re all around us. We have to watch them for the rest of our lives.  And there will be more and more of them and fewer and fewer of us for the rest of our lives.  It’s like watching your best friend walking around with your ex-boyfriend, who dropped you.  You want him back.  You want to touch him.  You know it’s not fair.

Jaw up.  Jaw down. Yet, I am mainly content and at peace with my saggy skin.  My soft, fluid skin.  My moveable feast of flesh.  And while I know there is blight in the world that makes my facial woes truly insignificant, I’m having dinner tonight in my safe and quiet home with my dog and my husband, not in that order, knowing full-well that wrinkles are a luxury.

A few months back headlines in the British news mentioned that an ad for mascara in a popular fashion magazine wasn’t a picture of the model wearing the advertised mascara but, horrors of horrors, she was really wearing false eyelashes. When a U.S. reporter called to ask for my opinion about this revelation my immediate reaction was, you’ve got to be kidding. I thought this can’t be the first time anyone noticed this! In the 30 years I’ve been part of the cosmetics industry I’m fairly certain I have never seen an ad for mascara where the model wasn’t wearing false eyelashes (at least individual false lashes, meticulously placed).

What I found jaw-dropping is that these reporters and editors thought this was newsworthy. How can this possibly be considered news of any kind? Have these reporters (all women) never really looked at an ad for a cosmetic that closely before? Are we so easily fooled by something this obvious? Talk about missing the elephant in the room! Next thing you know the news will be reporting on the revelation that pictures in magazines are extensively retouched via sophisticated computer programs or that the makeup on the model is rarely, if ever, the product or products being advertised. And any model over age 35 without a trace of visible wrinkles? Give me a break!

Respectfully, I know that on some level we know these ads are phony, but the desire to believe otherwise, to want the fantasy that a mere purchase of a mascara, foundation, or anti-wrinkle cream can truly alter our everyday appearance to the sublime is overwhelming for most women. That’s where our hope turns us into gullible, susceptible innocents at the mercy of the cosmetics industry. We’re ready to believe whatever they tell or show us. And don’t think you aren’t influenced, because you are. Those ads generate humongous sales or companies wouldn’t endlessly spend millions of dollars every month on myriad ads in major fashion magazines and on television to get your attention.

If you want to avoid getting sucked in the next time you pick up a fashion magazine or see an ad on television, here are the basics to remember:

1. Models and celebrities in fashion advertising are already gorgeous, with perfect skin and features. They can be enhanced but they started out with the bar already set above us mere mortals. Every model has been further transformed by talented makeup artists, hairstylists, stylists, and lighting experts.
2. Even after all the coifing, styling, makeup, posing, and the thousands of pictures taken so the best one can be selected, the picture is still extensively touched up to remove or drastically soften any flaws. I’ll never forget the time a model told me that she doesn’t look as good in real life as she does in pictures.
3. The women in hair dye ads do not get that color from the dye being advertised. Those highlights and flowing tresses took experts a great deal of time to achieve. The look was accomplished in a salon after hours of processing and styling, not in the model’s bathroom!
4. The women in the ads for shampoos and conditioners did not get their hair to look that way because of any shampoo or conditioner. It took lots of highlights, blow drying, flat ironing, curlers, styling products, and on and on to achieve the look that finally gets photographed for the ad.
5. Regardless of the claims asserted and the claims about what studies show, if it sounds too good to be true, it isn’t true. All cosmetic companies hire labs to create studies that prove their claims. My favorite example is ProActiv. Their results are stilted and embellished. The research on acne treatment does not support what they claim is true for their products (even Jessica Simpson on her own reality show said Accutane is what cured her acne!).
6. Wrinkle creams don’t replace plastic surgery, Botox, dermal injections, lasers, or light treatments, regardless of the name brand or who is selling the product (and it’s often a doctor who performs the real deal procedures, which is incredibly disingenuous).

There are many products out there that can make a noticeable difference in your appearance. But trying to live up to the images used to sell these products—expecting your results will be the same—is the stuff dreams are made of!