Traditional treatments to lift sagging skin and smooth wrinkles have relied on surgery, lasers and chemical peels -- all of which require days or weeks of healing and, often, hiding.
But dermatologists and other doctors who specialize in cosmetic or laser surgery say they are rapidly developing methods to beautify the body without so much as a needle or a knife.
These procedures, loosely referred to as non-ablative therapies (meaning no cutting is involved), are already making their way into the marketplace in major cities.
Unlike more common treatments, which alter the top layers of skin by damaging them, the noninvasive methods focus on tissue beneath the skin. Using special frequencies of light or radio waves, the techniques trigger cellular changes that produce gradual benefits over a period of months. These "rejuvenation" procedures don't produce the dramatic effect that traditional therapies provide -- no one would be a candidate for "Extreme Makeover." But they also don't require seclusion.
"In the past, we've been limited to things in which people have had to take time off work," says Dr. Tina Alster, director of the Washington Institute of Dermatologic Laser Surgery in Washington, D.C. "With non-ablative techniques, we're talking about not destroying the top layer of skin. This is the most cutting-edge we have in lasers and light sources."
The new treatments, which are typically less expensive than surgery, are best suited for people in their late 30s and 40s, when skin usually begins to show signs of aging.
"It is not replacing face-lifts and surgical lifts," says Dr. Ron Moy, a UCLA dermatologist and a leading researcher on new technologies. "It's for the younger age, [people who] just need a little bit of work."
Although some doctors say more data is needed, especially on the long-term effects, others expect the new light and radio-wave techniques to fill a large niche in cosmetic procedures.
Seeing the light
The light-based therapy may seem the more unusual, if not bizarre, of the rejuvenation techniques. Patients sit in front of an array of blinking lights for a few minutes -- then go home.
Several devices based on the principle, known as photo modulation, are in development, but the one that has undergone the most scientific testing is called GentleWaves. It consists of a panel of tiny light-emitting diodes, which use the same low-wattage technology as digital clocks and car dashboards.
The device was an outgrowth of NASA research designed to help plants grow in space. Researchers say the light energizes the cells, much in the same way that a plant absorbs and uses the sun's energy. The diodes, specially calibrated to a certain frequency, stimulate the cell's mitochondria, causing genes to turn on and cells to regenerate, they say. The result is the production of new collagen and elastin, the materials that give the skin plumpness and elasticity.
Honey Selinger, 50, underwent the therapy last year. After donning goggles, she sat in front of the panel of blinking lights for two minutes. She felt nothing.
"I said, 'Is this really going to work?' But I think I've seen an improvement," said Salinger, reporting that the fine lines around her mouth and eyes softened after the treatments. "It's incredible. And it's simple."
Some doctors are already offering the treatment, although it has not yet been approved by the Food and Drug Administration as a medical device. Data presented at a meeting of the American Society for Laser Medicine and Surgery last month suggests that GentleWaves causes cellular changes that improve wrinkles, skin tone and color, and pore size.
One study of 47 patients showed an average improvement of 44% in the appearance of wrinkles, skin tone and texture. Another study, of 90 women, showed that 62% experienced improvement in wrinkles and skin texture around the eyes.
"At first there was a lot of skepticism," says Dr. Robert Weiss, an assistant professor at Johns Hopkins School of Medicine. "But we've done so much science on this."
Dr. Peter Fodor, a Los Angeles plastic surgeon and president-elect of the American Society for Aesthetic Plastic Surgery, says most doctors are awaiting more data before recommending the light therapy.
"Anything that is not vetted first in peer-reviewed journals is usually a very quickly passing fad," he says.
GentleWaves treatments are typically done twice a week for four weeks. Although researchers say there are no side effects, they don't know how long improvements last. Exposure to the sun and progressive aging could undo the benefits over time.
The treatment, which costs about $1,200 for the series of treatments, appears to be best suited for people in their late 30s to mid-50s, Weiss says.
The other new, non-ablative technique uses radio waves to reach deep into the skin, altering cells in the dermis.