Aug. 28, 2004. 08:51 AM
A cosmetic filler is demonstrated at the New You Show in Toronto this spring. Lips that were formerly juicy and dark in colour become thinner and paler with age, prompting many women to invest in cosmetic plumpers.
Sultan of skin connects the dots


"If people get the brown, warty things, that's genetic. If people get the red things, which are angiomas, they're genetic, too. The older you are, the more you have."


Dr. Daniel Schachter is cutting right to the chase and, really, it's the most merciful strategy in the circumstance.

The circumstance is this: The realization that my half-century mark is fast approaching has coincided with the warp-speed multiplication of red dots sprinkled pretty much everywhere on my body, but most alarmingly on my scalp. More exciting: The red spots have launched an assault south of my hairline, appearing first as tiny flat spots, which then sneakily morph into pillowy red moles similar to one I can recall on my mother's face decades ago.

She had the thing sliced off.

I don't remember if she had more than one of these cherry angiomas. She certainly didn't have hundreds.

What to do?

As much as I poke fun at the superficial signs of advancing age, I've never much fretted, seriously, about my face. There are two trenches between my eyebrows that appear to have been furrowed by an ox cart carrying a heavy load. And that's okay. There's the expected fanning of laugh lines at the outer rim of the eyes. And that's just fine, too, so long as no one calls them crow's feet, which is a nasty term that always makes me think "crone's feet." And why the "crow" usage anyway? Why not something that elicits a pretty bird image? Why aren't they called cedar waxwing feet?

There are other facial changes that I hadn't really noticed.

Oh, that is just such a lie.

Anyway, I had heard that Schachter, a Bloor Street cosmetic dermatologist, was the go-to guy for facial fixings. The sultan of skin.

So here we are. Sitting in a clinical setting, Schachter in his white lab coat, a hand-written sign behind him that says "Botox in fridge," as prosaic a reminder as not to forget one's lunch. There are instructions for cryojem filling, whatever that is, printed on a black canister on his desk. And I'm trying to remember: Was Walt Disney frozen and, if so, where is he now?

Incongruously, Schachter's office is decorated with needlepoint images of children at the seashore. I had expected before-and-after pictures, testaments to what plumpers and fillers and wrinkle-smoother-outers can do for you.

This, after all, is the age of Restylane and Perlane and the ubiquitous Botox, the botulism bacterium. Botox is already starting to gain the whiff of the passé, in part because of the explosion of the so-called "cosmeceutical" industry, which promises needle-less, non-invasive, semi-scientific facial rejuvenation. "Cosmeceutical" is a squishy, made-up blending of cosmetic and pharmaceutical, leaving the marketing suggestion that these products have "drug-like" benefits. Yet the products are not drugs and, as such, do not need to seek scientific review and licensing approval. Recent advertisements in the New York Times for StriVectin-SD (eye cream and stretch mark cream) carry the querying headline, "Better than Botox?" and make the "clinically proven" claim "to dramatically reduce the length, depth, and texture of existing stretch marks." The stretch mark cream has, says the company, become the "anti-wrinkle cream of choice," meaning that women are using it for facial lines and wrinkles.

Dr. Brandt is another cosmeceutical outfit in the skin cream sweepstakes. Brandt's "Crease Release," with "13 per cent GABA complex and wrinkle reducer," promises that it "instantly evokes younger-looking, smoother skin." I like the use of the word "evokes" there, as it seems safely unscientific. Dr. Brandt, by the way, is Dr. Fredric Brandt, an American dermatologist who claims to be the largest user of injectable collagen and Botox in the world.

A hot-hot product is Dr. Nicholas Perricone's Neuropeptide Facial Conformer. Perricone is a Connecticut-based dermatologist and author of, among other books, The Wrinkle Cure: Unlock The Power Of Cosmeceuticals For Supple, Youthful Skin. Perricone has launched a line of these so-called cosmeceuticals, and has adopted a mortar-and-pestle logo, a marketing distinction meant to emphasize that the product is the creation of a physician and not some cosmetics giant.

According to a recent article in Newsday, Perricone's facial conformer was placed at Saks, Nordstrom and Sephora and, says Perricone, sold out in a month.

What is so startling about that, you may well wonder. I called Perrcione's office to determine where I could source the magical serum. I was referred to the Lifestyle Wellness Clinic in Fort Erie. The clinic's Louise Bercier confirms that she carries the Perricone line and can hardly keep the products in stock. The facial conformer is only, however, available on special order. The price tag — are you sitting down? — is $798 for the two-ounce bottle.

Some readers may recall the days when the Crème de la Mer "miracle broth" was launched at the eye-popping price of more than $100 an ounce for the moisturizer. Fans included Uma, Oprah and Barbara Black. In the new-age hunt for age defiance, particularly among baby boomers, price has once again proved to be no object.

This isn't the moment for reflection on cultural vacuity. This is the time to get an assessment of my face and the damage I've done to it.

Dr. Schachter is a man of gentle manner, with skin that appears as soft as a baby's proverbial you-know-what.

He hands me one of those magnifying mirrors owned by people who are serious about hunting down facial hairs. This would be an item I do not personally possess, and now I know why. Schachter comes around the side of his desk and joins me in the facial examination. He brushes a — so soft! — finger down my face and cites, albeit gently, what some may see as things that need fixing. Such as: deepening nasolabial folds commencing either side of the nose. (Don't really mind the look of it, but again, I don't like the sound of it.) Broken blood vessels. Uneven skin tone. The beginnings of depressions at the corner of the mouth, or "marionette" lines, as they're creepily called. And the aforementioned furrowed brow and wrinkly siding at the eyes.

It is suddenly self-evident that every facet, every feature, of my mug is either thinning, or down-turning or downright collapsing. When did my face commence this luge run to my ankles?

Need we mention jowling, neck drapery, the corrugated upper lip issue and the crepey, mottled transformation of the décolleté?

Schachter has a very sweet smile. He's in his 50s and has been practising for close to 25 years. I think he highlights his hair, thought I don't ask. I have twice highlighted mine — and is that so different from getting a shot of something between the eyes? Isn't it all vanity?

One minute Schachter is talking about fooling the clock. The next he's talking about my lips. "When you were 20, I bet your upper lip was juicier, and darker maybe. Darker red. And fuller."

That's the thing about age. One becomes less juicy. And I've read, endlessly it seems, that a plump lip is what women want. If I never read the phrase "bee-stung" again I will be a much happier person. I've also read about men having baccal fat pads removed from their cheeks to affect that sunken look.

But that's cosmetic surgery, and Schachter is not a surgeon. He does chemical peels, micro-dermabrasion and photo-rejuvenation to even out blotchy pigmentation. "There are people who are used to having facials, pedicures, manicures, and an extension of that are people who have peels once in a while," he says.

Angiomas, at least in their still-flat stage, can be lasered. One methodology, trade-marked CoolGlide, is described as a cool-zap-cool-zap-cool pulsing of light energy that is also used for vein therapy.

And then there are the injectables. Schachter will shoot the temporary muscle-deadening Botox in problem areas above the nose, and such fillers as Restylane, which promises a "natural beauty lift," in the lower face. Experienced injectors, he says, will use Botox in those lower areas, too, but he cautions that one should be confident that the injector has a track record at this, describing a tricky assessment of opposing muscle groups, the up-swinging ones and the down-swinging ones.

He downplays the criticisms levelled against Botox for launching a league of emotionally flat faces. "I like to think you can express yourself without producing too many wrinkles," he says. Young people, after all, smile without creating laugh lines. "You can smile with your lips and smile with your eyes."

He's smiling and I'm thinking, a little squirt here and there, maybe a little facial sanding, and I'd be good to go. In other words, all of my identified flaws/character enhancements can be attended to. And with luck, my turning 50 could make me look, temporarily, as though I've recaptured 40.

I don't, however, want to recapture 40. I want to appear vital and glowy and without the red things.

Schachter does not ask about my skin-care routine, which is a relief, as a daily wash with whatever men's sport soap is by the sink is not what one wants to admit to at my age. I do, however, buy moisturizers. And I've never smoked. That's one thing in my favour. But my diet has been frequently horrific. And Schachter really drills home the sun message, as in, stay out of it, or slather yourself with SPF.

I considered getting a shot of something for the purposes of this story. But that would be very stunt-like and I'd have to admit that being shot up in the face is just not me.

I am, however, going to do three things. One: I'm going to buy a facial cleanser like other grown-ups do. Two: I'm going to get serious about cardio exercise again, which always used to make me feel happily glowy. And three: I'm going to get the red dots zapped in the fall.

As for all those other flaws? I've worked hard for them. I think I'll keep them.

Jennifer Wells' column appears

Saturday in the Life section and Sunday in the A section. You can e-mail her at

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