Q: Like most people, I’m short on time. And every day that passes, reinforces that fact that time is moving on—it’s evident from the way my skin has aged overnight. What can I do to look younger that doesn’t take time away from my over-booked life? Help!

A: Fillers are the latest innovation in facial rejuvenation. Juvederm is one product that Dr. Nicolette Picerno recommends for its longer-lasting quality plus its ability to mold smoothly and readily into facial folds. One of the places on your face that shows your age most are the “marionette” lines around your mouth. Starting at the nose, these lines run vertically downward and deepen as time goes on. A filler like Juvederm can be injected into the area of the line to smooth away the crease. Interestingly, it can make your smile appear to turn upward as a result. Have you ever noticed older women with a lip line that seems to be upside down as if it’s a frown? This injectable treatment that takes no downtime and shows immediate results will eliminate that unhappy expression.

Q: What about my jowl line? It seems to be lower every time I look in the mirror. When I use two fingers to “lift” my lower half of my face, even I can see the difference in the mirror.

A: A “lift” that is surgical is not something that can be done without incurring some downtime, even though today’s procedures are less restrictive than lifts of yesterday. Dr. Nicolette Picerno recommends that patients with a slightly falling jowl line opt for fillers in the facial area, below the check line. The fillers used can range from injectables like Juvederm to fat transfers, using fat from another part of your body to plump up your cheek area. Part of the aging “look” you’re noticing on your own face is a result of the area under the cheekbone losing volume, or fat, as it takes on a hollow appearance. That happens because as we age, the collagen in our faces doesn’t reproduce like it once did. Once this area of the face is restored to the healthy, plumper look each of us has when we’re younger, you’ll also notice that your jowls are lifted and years are removed from your face.

Q: What about the hollows under my eyes? Can they be corrected with fillers too?

A: Absolutely. Injectables like Juvederm are ideal for this area. And the results are immediate. One thing to note is that the under-eye area is tender, so you may be one who experiences slight bruising around the injection site. You can cover any bruises with make-up and you’re not prohibited from participating in any of your routine activities. But, you may want to schedule a family photo session for your holiday greeting cards for the week following, so that any bruising has passed. And once your relatives get your greeting card, you can be sure they’ll be calling to say you look younger than ever!

Q: I understand that some procedures are not for the lower face, like BOTOX. What areas of the face benefit most by different treatments?

A: BOTOX is used from the forehead to the under-eye area. The purpose of BOTOX injections is to “paralyze” the muscle tissue just below the skin’s surface so that it disallows your regular facial expressions from creating creases and wrinkles that “age” your face. When used properly, BOTOX can give your eyebrows a lift. Dr. Nicolette Picerno has treated patients with BOTOX injections in the eyebrow area so that the arch of the eyebrow stays higher which visually “lifts” the overall look of your face. Injectables, on the other hand, are most effective from the brow area downward. That’s because as we age, our face loses volume. Injectables restore that volume to the facial areas in which volume has been depleted, restoring a plumper, more youthful look to your face. And one benefit of plumping up in this way is that the jowl line is lifted slightly too, enough so that your friends will be asking you what you “did.”

Q: I’ve heard there is a new laser that doesn’t leave your face raw and red for days? Is that true?

Dr. Nicolette Picerno: At Faces First we use the Harmony Pixel Laser, an erbium laser that treats only 20% of the skin’s surface at any one time unlike previous generation lasers that treat the entire skin’s surface. The difference with the Harmony Pixel Laser is that we apply three passes of the laser to achieve deeper penetration and longer lasting results. But since only 20-40% of the skin is treated at once, there is no raw skin oozing and minimal redness—leaving more of a tanned look to the skin. The skin is completely healed in 3 – 5 days without any downtime. And the procedure is painless.

Q. How does this new laser compare to other lasers.

Dr. Nicolette Picerno: Compared to similar lasers on the market such as the Fraxel Laser, the Pixel takes about the same number of treatments—3—but the Fraxel is painful and requires topical analgesia, costs about $1,000 dollars for each treatment, takes one hour and requires that a blue dye be applied to your face as part of the procedure. The Harmony Pixel Laser, on the other hand, requires no dye, no topical gels or creams, and is not painful. Plus treatments which run about 20 minutes each are only about $675 per treatment. We offer a 10% discount when patients purchase the recommended three treatments.

Q: I have acne scarring. Are there treatments for that?

Dr. Nicolette Picerno: There are very few effective treatments on the market to remedy acne scarring, but the Harmony Pixel Laser is one of them. The Harmony Pixel Laser also tightens and rejuvenates the skin, evens out the tone and texture leaving your face fresh and youthful looking. The three treatments are given two weeks apart and the results are long-lasting. In fact, it takes between six to nine months to see how improved your skin becomes as new collagen generates under the skin.

Q: What age is best for skin resurfacing?

Dr. Nicolette Picerno: Patients between 30 and 60 years old experience the best results from laser skin resurfacing using the Harmony Pixel Laser. The laser is built to respond to hydration in the skin and between these ages, patients generally have not lost all of the hydration in their skin yet and thus see better results—fewer wrinkles and tightening of lax skin—from the treatment. Of course, treatment to remedy acne scaring can be done on younger-aged patients and the results are among the most impressive available today.