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Beauty: When laughter lines just aren't funny; Beauty Bible experts Sarah Stacey and Josephine Fairley give their low-down on those treatments that promise to turn back the clock.

Byline: Sarah Stacey and Josephine Fairley

IF you don't want to go down the Botox route, there is a range of ways of plumping out lines and enhancing your facial contours. But as with all forms of invasive treatment, it's a case of `caveat emptor': let the buyer beware.

You should be aware that (as with Botox), the success of these procedures depends on the skill and experience of the surgeon (or their nurse), so always look for someone with a good - and long - track record of this work. Artecoll (formerly known as Arteplast) microspheres of PMMA. a form of plastic, suspended in a collagen solution; useful for filling deep lines, plumping the lip outline evening out the nose and filling depressions such as acne scars or grooves under the eyes. Not suitable for anyone with an allergy to collagen (you must have a sensitivity test first).

This material doesn't leave your body and, in the worst case, may form unsightly lumps.

Autologous Fat Injections: the patient'sown fat is syringed out of the thigh, abdomen or buttock and used to plump out deeper lines and wrinkles (not fine, shallow ones) and depressions such as sunken cheeks. It's also used for hands.

It's your own fat so there's obviously no risk of allergy but fat doesn't always stay where it's put, so the results are not totally predictable. It can also be quickly metabolised so the effects can disappear qu i ck


Collagen Replacement Therapy: alsoknown by the brand names Zyderm (for fine lines and wrinkles) or Zyplast (for deeper ones), these injections top up the body's own collagen (responsible for plump, smooth, `elastic' skin) as it dwindles with age. It's very effective but a sensitivity test is vital four weeks beforehand, as some people are highly sensitive to the purified bovine collagen.

(Some people feel understandably squeamish about this after BSE, although there have been no reported problems). We personally know of a woman who had a very serious allergic reaction to her injections, despite having had the sensitivity test first, and she required many weeks of steroids. Good for lines around the lips, crows' feet, frown lines, and the creases running from nostril to mouth (medically called naso-labial lines). Duration depends on individuals but between two to six months is usual.

Hylaform: this is a derivative of hyaluronic acid, a lubricant found in human and animal tissue (and also used in skin creams as a moisturiser). There is little risk of allergy except for those who are allergic to chicken or eggs (the key compound comes from rooster combs) and it can be used on people who test positive against collagen. Hylaform is used for frown lines and crows' feet (but Botox is probably more effective), nose to mouth lines, acne scars and lip plumping, but not fine lines and wrinkles. Silicone: one of the first and most effective fillers for all facial purposes) also, of course, used in breast implants) but now regarded as the most risky. It's not approved in the UK, but that doesn't mean it's not available, however much some doctors caution against it.

The problem is that you can't remove silicone and it may migrate around the body causing inflammation and/or the formation of inflamed nodules.

WA R N I N G Pregnant women or anyone with an autoimmune condition such as rheumatoid arthritis or lupus or anyone who has an allergy should be extremely careful before having a treatment which involves any kind of foreign substance being introduced into their body. Always check with your own doctor.

SoftForm: this is a permanent(although removable) filler used to enhance thin lips and/or plump out naso-labial lines; like its predecessor Gore-Tex, it's fed in and out of the area to be filled using a needle that's inserted via two tiny cuts.

Looks and feels very natural, although it may slowly be being usurped by a material called Ultrasoft, which performs the same task.


Before you embark on Botox, collagen or any of the other invasive facial fillers, consider spending an iota of the price on one of the cosmetic industry's high-tech disguises forlines and wrinkles. Our favourite include: * Prescriptives Magic Invisible Line Smoother: stroked on lines and deep wrinkles this silicone-based gel behaves exactly like Polyfilla on cracks with the added bonus that it creates a soft-focus effect due to its special `optical diffusers' which bounce back light. Use before and after applying base, patting into crows' feet and furrows. Don't powder , though, or you spoil the effect. * Lancome Touche d'Optimage Line Blurring Concentrate: a creamy-gel product that does what it says. The gel helps fill in fine lines and the light-diffusing compounds visibly soften the area.

* Trish McEvoy's Refiner: not a filler but a moisturiser-in-a-wand, this slim-line product delivers moisturising, light-diffusing ingredients to make lines and wrinkles look softer and dewier .

# The 21st Century Beauty Bible by Jo Fairley andSarah Stacey is published by Kyle Cathie Ltd at pounds 25. WM readers can buy the book at the special price of pounds 23 including free p&p. To order ring 01903 828503 quoting ref. WML/BB. Or e-mail
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Copyright 2003 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Features
Publication:Western Mail (Cardiff, Wales)
Date:Apr 1, 2003
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