SAVING FACE (WITHOUT SURGERY).

Byline: MELISSA HECKSCHER

>LA.COM 

Sure, 3.1 million Americans got Botox last year and 1.5 million more got Juvaderm, Restylane or other "fillers" to plump up fine lines.

And yes, the most dramatic route to a younger-looking face is via one of the "Four R's" -- Relaxing (Botox), Refilling (fillers), Resurfacing (microdermabrasion) or Redraping (face-lift), according to Dr. Han Lee, assistant professor of dermatology and director of dermatologic surgery at USC.

But what's a person to do if she wants to look younger without the help of a syringe or a scalpel? LA.COM looks at four alternatives.

FACERCISE

>The theory: Just like stomach crunches can define the abs, facial exercises can define the face.

>The lowdown: For anyone who thinks making silly faces is just for children, Carole Maggio begs to differ. The 62-year-old former aesthetician pioneered "Facercise," an exercise program for the face designed to minimize fine lines and lift sagging skin. "There are 57 muscles in the face," said Maggio, whose full lips and sculpted face may as well be (but apparently aren't) the work of a plastic surgeon. "Just like the rest of the body has muscles you can work, so does the face." By performing her 10-minute program daily, Maggio said, people can see results in as little as five to seven days. The program entails a series of deliberate facial expressions -- from googly eyes to gaping mouths -- to tone, fill and smooth out the face. Some doctors are skeptical, but that's not stopping thousands of people from following the program. Maggio's "Facercise" book is sold in 18 countries. "Once you see the results, you can't stop," said Patti Booth, a 51-year-old Florida resident who recently traveled to Maggio's Redondo Beach office for her second private lesson.

>Expert's opinion: "It seems counterintuitive," said Dr. Han Lee, assistant professor of dermatology and director of dermatologic surgery at USC. "Dynamic wrinkles are caused by muscle movement. ... (For instance) people who purse their lips get more prominent wrinkles around their mouth." Lee said she would have to see scientific documentation on Facercise's effectiveness before saying anything conclusive about it. In general, though, she said because all the muscles in the face are connected, it would be hard to isolate one muscle group without affecting another. "The muscles in your face don't work the same as the muscles in the body," she said. "It's not the same as your biceps."

>Where to go: Carole Maggio Day Spa (1713 S. Catalina Ave., Redondo Beach, [phone], www.facercise.com/dayspa).

>Cost: $12.99 for the book, available at the Facercise Web site. Maggio offers two-hour private lessons for $600, which includes a personalized audio lesson and follow-up visits.

GOOD NUTRITION, VITAMIN THERAPY

>The theory: Healthy skin comes from the inside.

>The lowdown: You can get a face-lift or a shot of Botox, but what's that really doing to your skin? Nothing, said Dr. Howard Murad, author of "The Wrinkle Cure" and namesake of the Murad Medical Spa and Inclusive Health Center in El Segundo."If you think about a Botox shot, what you're doing is paralyzing the muscle. You're doing nothing to the skin," Murad said. "If the skin is sun damaged, it's still that way." Good skin, he said, depends on good health. Consequently, his "prescription" includes a combination of nutritious foods, vitamin supplements, a stress-reduction program and daily exercise -- all of which can improve not just the condition of the skin, but the condition of the whole body. "Ultimately, your skin is connected to everything else," Murad said. "An ideal situation for me is for somebody to come to me and say, 'Dr. Murad, I need a face-lift and a Botox shot,' and I'll do neither.'" To keep the skin looking young and healthy, he recommends a diet loaded with fruits and vegetables (a good source of fluids), essential fatty acids (walnuts, salmon), protein (particularly eggs), and vitamin supplements (including B vitamins, glucosamine, omega-3s and amino acids). With proper diet and nutrition, Murad said, it can take as little as five weeks to see a difference. "I'm not going to be able to stretch your skin like you can do with a face-lift," he said. "But you'll have more energy and you'll sleep better and most people end up not wanting the surgical procedures anyway."

>Expert's opinion: "Obviously, if you're eating a variety of foods as well as a basic nutritional supplement, that will always be helpful (for your skin)," Lee said. She wouldn't comment on specific vitamin supplements (taking too much of certain vitamins -- including D, B and K -- can be harmful). With proper nutrition, she said, a multivitamin may be all you need.

>Where to go: Call your doctor for a referral to a licensed nutritionist or dermatologist to assess your health before embarking on a diet/nutrition plan. The Murad Inclusive Health Center (2141 Rosecrans Ave., El Segundo, [phone], www.murad.com/mihc/index.html) offers individualized "Prescriptions for Health," which include a health evaluation, treatment and nutrition plan.

>Cost: Varies, depending on treatment and insurance coverage. Murad's "Youthbuilder" vitamin supplements cost $49 and are sold at www.Murad.com.

COSMETIC ACUPUNCTURE

>The theory: By stimulating specific pressure points you can increase cell turnover, stimulate collagen production and

improve circulation.

>The lowdown: Cosmetic surgery may be the gold standard for anti-aging among Western medicine practitioners. But acupuncture has been around for more than 3,000 years, and some say it can reap similar benefits -- without the scalpel. It may mean using words such as "Qi" (pronounced "Chi," and referring to the body's energy fields), but clients swear by the benefits, some of which can include younger-looking, healthier skin. "There's a lot more firmness, and the brown spots are gone," said Charlene Mendelson after three cosmetic acupuncture treatments at Marina Acupuncture in Marina del Rey (practitioners recommend five to 10 treatments for best results). "I saw a friend recently and he said to me, 'What did you do to your face?'" While different acupuncturists have their own way of doing the treatments, Dr. Yun K. Yang of Marina Acupuncture does it by first squeezing out "stagnant" blood, tapping on various points with a needle to stimulate circulation, then inserting about 12 very fine needles into particular points on the skin. By stimulating these points, she said, acupuncture can minimize fine lines, reduce a double chin, lift sagging skin, and brighten the eyes. In addition, balancing the Qi in the body can result in an all-over sense of wellness after treatments. "Everything is connected," she said. "When I regulate the face, it helps the organs all over the body." A licensed herbologist as well as a licensed acupuncturist, Yang can also prescribe Chinese herbs to work in conjunction with acupuncture treatment.

>Expert's opinion: "I can't really discount it. It's been around for hundreds of years," Lee said. "I think Western medicine doesn't know enough about it."

>Where to go: Torrance: OM Spa 23441 Madison St., SkyPark Building 8, Suite 220, [phone], www.orientalmedspa.com. Marina del Rey: Marina Acupuncture, 13400 W. Washington Blvd., Suite 202-A, [phone], www.marina acu.com.

Beverly Hills: Rejuvalife Vitality Institute, 9400 Brighton Way, Suite 405, [phone], www.rejuvalife.md.

Long Beach: Advanced Wellness Center, 6423 Pacific Coast Highway, [phone], www.advancedwellness.org.

Riverside: Center for Acupuncture 4045 Brockton Ave., [phone], www.acupunctureriverside.com.

>Cost: $80-$200 per session.

SUPERSONIC FACIALS

>The theory: Supersonic waves can be used to push essential vitamins and nutrients deeper into the skin.

>The lowdown: A step above a traditional spa facial, "Supersonic" facials use ultrasound waves or electrical currents to exfoliate and push anti-aging nutrients into deeper layers of the skin (most products just sit near the surface). The result, says Annie Morgenthaler of Ona Spa in Hollywood, is firmer, healthier, plumper-looking skin. Morgenthaler said a facial can't compare to surgery -- or even Botox and Restylane (also offered at Ona); nonetheless, clients will see a marked difference in the condition of the skin after just one visit. "The skin will definitely feel tighter and glowing," she said. "It will definitely give a plumper look to the skin." The glow is temporary, however. To maintain, treatments are recommended every few weeks, indefinitely.

>Expert's opinion: "Facials generally exfoliate the top layer of the skin. Whenever you do that it can definitely make the skin look smoother, but it's temporary," Lee said. "As far as manipulating the surface of the skin with ultrasound waves ... I'd have to see scientific documentation."

>Where to go: Hollywood: "Ona Ultimate Environ facial" at Ona spa, 7373 Beverly Blvd., [phone], www.onaspa.com.

Studio City: "DermaSound Plus Ultrasonic Facial" at Peace of Mind Skin Care, 12522 Moorpark St., [phone], www.

peaceofmindskincare.com.

Santa Monica: "Shutters Sunrise" facial at The One Spa at Shutters on the Beach, 1 Pico Blvd., [phone], www.

shuttersonthebeach.com.

Westlake Village: Deep Cleansing Facial & Biomolecular Acceleration at the Aris Institute, 3723 E. Thousand Oaks Blvd.,

[phone], www.arisinstitute.com.

Torrance: "Particle-Free" UltraSonic Facial at DuBunne Spa, 23725 Arlington Ave., [phone], www.dubunne.com.

>Cost: $140-$215.

Melissa Heckscher [phone] Ext.329;

[e-mail].

CAPTION(S):

5 photos

Photo:

(1 -- cover -- color) STICK IT TO AGING SKIN

4 alternatives to the traditional face-lift

(2 -- color) Dr. Yun K. Yang inserts fine needles into Charlene Mendelson's face during a cosmetic treatment.

SCOTT VARLEY>LA.COM

(3 -- color) Carole Maggio takes a client through the paces of "Facercise," her 10-minute daily program.

MELISSA HECKSCHER>LA.COM

(4 -- color) Dr. Howard Murad says good skin depends on good health: nutritious foods, vitamins, daily exercise and less stress.

(5 -- color) Electrodes attached to an algae mask use electrical current to push vitamins into the skin.

EVAN YEE>LA.COM