NewBeauty Winter 2019

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WINTER 2019

CELEB SECRETS HOLLYWOOD’S HUSH-HUSH SURGERIES

LAUREN HUTTON All Fun No Filter

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CONTENTS

N E W B E A U T Y.C O M

WINTER 2019

IN THIS ISSUE

10

EDITOR’S LETTER

12

MEDICAL ADVISORY BOARD

18

NEWS

21

BREAST IMPLANT RECALL

An update on Allergan’s voluntary BioCell recall 24

SQUAD GOALS

Our editors’ favorite beauty discoveries of the season 27

HOLY GRAIL

The inside story behind Chanel’s iconic La Solution 10 28

32

24 HOURS

Three industry insiders reveal their day-to-night skin-care routines

BLAKE DAVENTPORT / AUGUST

MUSE

Three women who inspire us share what inspires them

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CONTENTS WINTER 2019

34

OBSESSED

Josh Rosebrook decodes the confusing world of essential oils 38

SMART MOUTH

Leading dentists debunk common mouth myths 40

66

SECOND ACT

The best products and treatments to consider at different ages

An in-depth look at menopause and its effects

44

72

VISION QUEST

Three new fragrances brought to life by photographers 48

IF I WAS A RICH GIRL

PARADISE FOUND

The real Hawaiian Beauty: spiritual, sustainable skin care 76

SECRETS OF THE BOUNCE BACK

Experts reveal the beauty treatments they’d splurge on if money were no object

Expert advice to follow after surgery for optimal recovery

52

82

We investigate how probiotics are used in both supplements and skin care

THE GUIDE: AUTOLOGY

A deep-dive into the world of autologous aesthetic treatments

110

58

89

How to get rid of the bulge for a healthier, slimmer you

FLORA FILES

YELLOW LIGHT

A trip to Corsica, France showcases L’Occitane’s hero ingredient 60

LAUREN HUTTON IS A MOOD

The iconic model talks her career, her new skin-care gig, and refusing to conform

THE INNOVATORS

We honor 20 of the industry’s most accomplished game changers 107

THE CLINIC

108

BEAM ME UP

“Lunchtime lasers” that transform skin with no downtime

THE SKINNY ON BELLY FAT

116

THE ULTIMATE DO-OVER

What to know about revision surgery, from rhinoplasty to breast augmentation 122

ASK THE DOCTOR

Top doctors answer the questions our readers are asking

SHINE ON

From barely there neutrals to vampy bolds, basic hues get an upgrade this season with a pretty pearlescent effect.

Four shades we’re loving right now (clockwise): essie Buy Me a Cameo, Tea + Crumpets, Crush & Blush and Game Theory. $9 each, essie.com

DAVIES AND STARR/GETTY IMAGES

NUMBERS GAME

4 NEWBEAUT YWINTER 2019

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Emily Dougherty EDITOR-IN-CHIEF

EXECUTIVE EDITOR

DESIGN DIRECTOR

Elizabeth Ritter

Christine Demetres Giordano

EDITORIAL

PHOTO

BE AUT Y DIRECTOR

PHOTO EDITOR

Brittany Burhop Fallon

Cherry Olivia Imbush

F E AT U R E S E D I T O R

Tatiana Bido

M E D I CA L A DV I SO RY B OA R D

D I G I TA L E D I T O R

CHAIRMAN OF THE EDITORIAL ADVISORY BOARD

Danielle Fontana

Dr. Robert Singer

E D I T O R I A L A S S I S TA N T

EDITORIAL ADVISORY BOARD MEMBERS

Emily Taylor

Dr. Tina Alster Dr. Kenneth R. Beer Dr. Bradley Bengtson Dr. Kelly Bomer Dr. Joel Cohen Dr. Charles E. Crutchfield III Dr. Steve Dayan Dr. Jeanine B. Downie Dr. Steven Fagien Dr. Julius W. Few Dr. Ronald Goldstein Dr. Sanjay Grover Dr. Andrew Jacono Dr. Mark L. Jewell Dr. Laurence R. Rifkin Dr. Renato Saltz

CONTRIBUTORS WEST COAST EDITOR

Crystal Meers

LIFEST YLE EDITOR

Shelby Meade

E D I T O R - AT- L A R G E

Sarah Eggenberger CONTRIBUTING EDITOR

Suzanne Gleiber Sandow ONLINE CONTENT PRODUCER

Leiana Foye

Mike Glaicar E V P, B U S I N E S S D E V E L O P M E N T

Joe Losardo

Sherri Ginsberg

VP OF MARKETING

F I N A N C E & O P E R AT I O N S D I R E C T O R

MARKETING

N AT I O N A L S A L E S

MARKETING DIRECTOR

EXECUTIVE ACCOUNT DIRECTORS

Lauren Decker Lerman Darcie Vukovich Kristin Havens

Olivia Spadafore

D I G I TA L D E V E L O P M E N T D I R E C T O R

Samantha Dana

A S S O C I AT E M A R K E T I N G M A N A G E R

Veronica Schnatterly

ART DIRECTOR, MARKETING & BUSINESS DEVELOPMENT

REGIONAL SALES SENIOR ACCOUNT DIRECTORS CALIFORNIA

Carolyn Kiek

Miche Ratto ART DIRECTOR , ADVERTISING

FLORIDA/SOUTHEAST

SENIOR VIDEO PRODUCER

ACCOUNT DIRECTORS

SENIOR MANAG ER , B R AND DE VELOPMENT

Angelina Dedvukaj Lauren Stonecipher

Katrina Haug

Deborah Singer Zachary Clause

NORTHEAST

Kimberly Broder, Diane Minkoff

MIDWEST

O P E R AT I O N S M A N A G E R

Tracy Bennett INDEPENDENT ACCOUNT MANAGER GEORGIA

Joshua Davis

Mimi Stevens

FOUNDING EDITOR

Yolanda Yoh Bucher

MIX IT UP

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BIWA/GALLERY STOCK

Nicole Wieder

REGIONAL ACCOUNT MANAG ERS

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BROOKE SHIELDS

WarmSculpting patient

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*The SculpSure device is designed to spread heat beyond the edges of the treatment area, facilitating natural-looking results.

The SculpSure device is a non-invasive laser body contouring system, intended to permanently eliminate fat cells through non-invasive lipolysis of the abdomen, love handles (flanks), back, inner and outer thighs, and under the chin (submental). Individual results may vary and are not guaranteed. WarmSculpting treatments are not intended for weight-loss results or for people who are obese. Mild side effects may occur, including temporary tenderness, swelling, or tissue firmness in the treatment area. Please consult with your physician to see if WarmSculpting treatments are right for you. ©2019. Hologic, Inc. All rights reserved. Cynosure and SculpSure are registered trademarks of Cynosure, LLC. WarmSculpting is a trademark of Cynosure, LLC. Hologic, Inc. owns exclusive rights to photography. Use of photography without written permission of Hologic is prohibited.

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PRODUCTION PRODUCTION DESIGNERS

Melissa May Kelly Robert Pracek

SENIOR PHOTO RETOUCHER

Christian Ablan

PHOTO RETOUCHER

Michael Warnock

PAGINATION MANAGER

Jody M. Boyle

TECHNOLOGY DIRECTOR OF INFORMATION TECHNOLOGY

Edward Sanborn

INTERNAL SYSTEMS ADMINISTRATOR

Erik Nicolaisen

HELP DESK ANALYSTS

Dan Balara, Daniel King, Jayson Negron

OPERATIONS OPERATIONS DIRECTOR

Rick Jacobs

PRINT CENTER DIRECTOR

Bart Blackwell

DIGITAL PRINT CENTER MANAGER

Christopher Ferris

MANUFACTURING DIRECTOR

Leonard Sandow SERVICES

Casimira Betancourt, Maritza Severino CIRCULATION NEWSSTAND CONSULTANT

Ron Sklon

Lifestyle influencer and well-being aficionado Arielle Lorre reveals her best advice for winter-proofing her skin-care regimen.

DISTRIBUTION

Curtis Circulation PRINT MANAGEMENT

Calev Print Media

Adam I. Sandow

Follow her path to a healthy, balanced life @ariellelorre

CHAIRMAN AND CEO

PRESIDENT

Erica Holborn CORPORATE CREATIVE DIRECTOR

CHIEF DESIGN OFFICER

Dean Sebring

Cynthia Allen

CORPORATE EXECUTIVE VICE PRESIDENT, FINANCE & OPERATIONS

Judy Safir

DIRECTOR OF FINANCE

Samuel Hotchkiss

CORPORATE MANAGING EDITOR

Pamela Lerner Jaccarino

EXECUTIVE VICE PRESIDENT, DIGITAL

Collagen Powder is key in helping replenish the body’s supply of essential collagen, delivering wholesome health benefits.*

Pamela S. McNally

VICE PRESIDENT, WEB DEVELOPMENT

Mike Lewis

DIRECTOR OF MANUFACTURING & DISTRIBUTION

Fern E. Meshulam EXECUTIVE ASSISTANT TO THE CEO

Stephanie Brady

EXECUTIVE DIRECTOR OF STRATEGIC INITIATIVES

Kathryn Kerns

VICE PRESIDENT, CREATIVE OPERATIONS

Michael Shavalier

DIRECTOR OF CREATIVE OPERATIONS

Keith Clements

ACCOUNTING CONTROLLER

Emily Kaitz

ACCOUNTING MANAGERS

Raquel Howell

ACCOUNTS PAYABLE MANAGERS

Sherry Chelchowski, Shirley Cruz, Shannon Kavanagh ACCOUNTS RECEIVABLE

Emel Emin, Taylor Zeefe DIRECTOR OF ACCOUNTING

Kristen Hitchcock

COLLECTIONS MANAGER

Karyn Guler

COLLECTIONS SPECIALISTS

Christine Asher, Nicole Fiorito HUMAN RESOURCES DIRECTOR, HUMAN RESOURCES

Lisa Silver Faber

HUMAN RESOURCES MANAGER

Ashley Akins

TALENT & CULTURE MANAGER

Laura Salkowski

TALENT & CULTURE ASSOCIATE

Kelly Kriwko

NEW YORK 101 PARK AVENUE 4TH FLOOR NEW YORK, NY 10178 TELEPHONE 917.934.2800

FLORIDA 3651 NORTHWEST 8TH AVENUE BOCA RATON, FL 33431 TELEPHONE 561.961.7600 FAX 561.750.0152

ADVERTISING 561.961.7600 SUBSCRIPTIONS 800.563.9056

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ADDRESS SUBSCRIPTION REQUESTS AND CORRESPONDENCE TO: NewBeauty, Attn: Customer Service, PO Box 15879, North Hollywood, CA 91615-5879 Email: subscriptions@newbeauty.com or 800-563-9056/818-487-2007

SANDOW was founded by visionary entrepreneur Adam Sandow in 2003 with the goal of building a truly innovative media company that would reinvent the traditional publishing model.

Today, SANDOW is a fully integrated solutions platform that includes leading content, tools, and services, powering innovation for the design and luxury industries. Its diverse portfolio of media assets includes Interior Design, Luxe Interiors + Design, Galerie, and NewBeauty. Materials Innovation brands include global materials consultancy, Material Connexion, gamechanging material sampling and logistics platform, Material Bank, and materials reclamation program, Sample Loop. SANDOW brands also include research and strategy firm, ThinkLab. In 2019, SANDOW was selected by the New York Economic Development Council of New York to become the official operator or NYCxDESIGN Week, beginning in 2020.

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2019

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E D I T O R’S L E T T E R

E M I LY D O U G H E RT Y

Editor-in-Chief

See our EDIT TEAM’S current product obsessions on page 24!

#MYNEWBEAUTY

Each issue, I’ll be sharing #MyNewBeauty: a product, either new or old, that currently rocks my beauty world.

During executive editor Liz Ritter’s interview, the iconic Lauren Hutton, StriVectin’s global brand ambassador, massaged the iconic Strivectin SD-Advanced Plus lotion (recently reformulated to give even more collagenboosting benefits) into Liz’s hand. When Liz returned to the office, her hand looked super smooth and crazyglowy. That night, I applied the cream from head to toe, and I won’t stop applying it for the rest of my life. Thank you, Lauren! What’s your #MyNewBeauty?

Show us on Instagram using this hashtag or email me at emily@ newbeauty.com.

SUNSET BOULEVARD / CONTRIBUTOR / GETTY IMAGES, AMERICAN ACTRESS MELANIE GRIFFITH ON THE SET OF WORKING GIRL

T

he movie Working Girl taught this Idaho mountain girl so many things: Don’t combine tequila with something called Valium, the importance of a good briefcase, Han Solo is a fox. But I learned the most from how Melanie Griffith’s Tess McGill consumed information— voraciously, agnostically—dim sum restaurant reviews from W Magazine, business profiles in Forbes, gossip from Page Six and Aileen Mehle. And then synthesized the info to come up with her big out-of-the-box idea.

“So I started to think, Trask. Radio. Trask…

Radio.” I didn’t necessarily want to be bigcity Tess McGill—but I did want to think like her.

For our first-ever Discovery issue, we celebrate the great brains that have changed the beauty industry forever. Not only did Dr. R. Rox Anderson invent CoolSculpting, but his laser innovations have also helped children suffering from skin abnormalities lead normal lives. Dr. David E. Fisher, head of the Cutaneous Biology Research Center (CBRC) at Massachusetts General in Boston, linked endorphin release to sun exposure, explaining why many of us are literally addicted to tanning. Thirty years ago, Shiseido teamed up with Mass General to

launch the CBRC, and findings from the partnership have led to breakthroughs in understanding skin’s immune response, the importance of the lymphatic system, and even pathways that are critical to jumpstarting hair growth. (That’s me, below, with Shiseido’s EVP, chief innovation officer Yoichi Shimatani, and the CBRC’s Dr. Fisher.)

Philosopher Arthur Schopenhauer was more than a little bit obsessed about what makes someone a genius, and summed it up by saying that being talented means we can shoot an arrow and hit a target that no one else could hit. But being a genius lets us hit a target that no one else can see—one that the rest of the world doesn’t even know is there. Some people reflect light, but geniuses, like McGill and Dr. Anderson, glow from within, shimmering all on their own.

Each of us have a spark of genius within us: Here’s to letting your light shine this season.

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Have You Felt the

MENTOR® MemoryGel® Xtra Breast Implant?

In a blinded comparison 9 out of 10 consumers chose MemoryGel® Xtra Breast Implants as feeling more like a natural breast than the other leading brand.*1

@BreastImplantsbyMentor #MemoryGelXtra #MentorBreastImplants #OwnTheDay *Head-to-head blinded in-person tabletop product comparison (MemoryGel Xtra vs. Inspira Responsive vs. Inspira Cohesive) with 452 respondents. 1. Mentor Consumer Preference Market Research Report - July 2017.

IMPORTANT SAFETY INFORMATION MENTOR® MemoryGel® Breast Implants are indicated for breast augmentation in women who are at least 22 years old. Breast implant surgery should not be performed in women: With active infection anywhere in their body; With existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions; Who are currently pregnant or nursing. Safety and effectiveness have not been established in patients with autoimmune diseases (for example lupus and scleroderma), a weakened immune system, conditions that interfere with wound healing and blood clotting, or reduced blood supply to breast tissue. Patients with a diagnosis of depression, or other mental health disorders, should wait until resolution or stabilization of these conditions prior to undergoing breast implantation surgery.

There are risks associated with breast implant surgery. You should be aware that breast implants are not lifetime devices and breast implantation may not be a one-time surgery. You may need additional unplanned surgeries on your breasts because of complications or unacceptable cosmetic outcomes. Many of the changes to your breast following implantation are irreversible (cannot be undone) and breast implants may affect your ability to breastfeed, either by reducing or eliminating milk production.

Breast implants are not lifetime devices and breast implantation may not be a one-time surgery. The most common complications for breast augmentation with MemoryGel® Breast Implants include any reoperation, capsular contracture, nipple sensation changes, and implant removal with or without replacement. A lower risk of complication is rupture. The health consequences of a ruptured silicone gel breast implant have not been fully established. MRI screenings are recommended three years after initial implant surgery and then every two years after to detect silent rupture.

Detailed information regarding the risks and benefits associated with MENTOR® Breast Implants is provided in the educational brochure for MemoryGel® Implants: Important Information for Augmentation Patients about MENTOR® MemoryGel® Breast Implants. The brochure is available from your surgeon or visit www.mentorwwllc.com. It is important that you read and understand the brochure when considering MENTOR® MemoryGel® Breast Implants. © Mentor Worldwide LLC 2019 109944-190320

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M E D I C A L A DV I S O RY B OA R D

E X P E RT TA K E

The Modern World P L AST I C SU RG E RY I S N ’ T A L L T H AT N E W O F A C O N C E P T, B U T F I N D I N G T H E T RU E I N N OVATO RS I S N OT A S I M P L E TAS K .

T

Robert Singer, MD

C H A I R M A N O F T H E B OA R D

@SingerSurgical

he world of aesthetic surgery is both old and new—and a space that is continuing to ever evolve. Ancient Egyptians were preforming fruit peels and rhinoplasties, discussions on skin grafts date back to the 6th century B.C., and there is evidence of detailed publications outlining eyelid surgery circulating from the 15th century.

Then there is the other end of the time line: Botox Cosmetic is younger than the Internet; modern anesthesia as we know it isn’t all that old in the grand scheme of things. And the way a surgical facility looked and operated even as little as 50 years ago? You wouldn’t recognize it if you stepped into one today.

While the perceptions of beauty vary in different cultures and time, there is a changing perception of beauty as it becomes more

global: an increasing number of procedures and improved skin care; more options and less-invasive procedures; more treatments safely performed as outpatient procedures rather than in the hospital; more accessible and more affordable options; and, above all, a more open society with a greater awareness of those options. The next era will have more innovative procedures and excellence, but with all new procedures, valid scientific data is key. If it sounds too good to be true, it probably is!

That is what makes this inaugural Discovery Issue special. The inventors and innovators have cut through the clutter to earn a place on the list, and on the time line of beauty and aesthetics overall. They all have something special that could make a mark on this long and storied history in a way that isn’t fleeting or faddish, all with an eye to safety and improved results. Time will tell if they achieve that goal.

ABOUT DR. ROBERT SINGER / drsinger@newbeauty.com Internationally renowned aesthetic plastic surgeon and noted educator Robert Singer, MD of La Jolla, CA is a diplomate of the American Board of Plastic Surgery and has served as president and chairman of the Board of Trustees of the prestigious The Aesthetic Society, chairman of the Board of Trustees of the American Society of Plastic Surgeons (ASPS), president of the American Association for Accreditation of Ambulatory Surgery Facilities, and president of the Aesthetic Surgery Education and Research Foundation (ASERF), an organization he most recently received a Career Achievement Award from to recognize his contributions to the field.

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M E D I C A L A DV I S O RY B OA R D E X P E RT TA K E

Future Perfect

W H AT M E D I C A L B R E A K T H R O U G H W O U L D YO U L I K E TO S E E I N YO U R L I F E T I M E ?

DERMATOLOGY

Tina Alster, MD

DIRECTOR OF THE WASHINGTON INSTITUTE OF DERMATOLOGIC LASER SURGERY

@drtinaalster

“I would love to see how we can manipulate melanocytes so that a variety of pigmentary concerns like birthmarks and melasma can be permanently treated. To date, we can make these conditions temporarily better at best.”

DERMATOLOGY

Charles E. Crutchfield III, MD EAGAN, MN DERMATOLOGIST

@CrutchfieldDerm

“I’d like to see resolutions to the neurological diseases of dementia, depression and schizophrenia. I would also like better tools to rejuvenate the neck and the backs of hands.”

DERMATOLOGY

Kenneth R. Beer, MD FOUNDER AND DIRECTOR OF COSMETIC BOOTCAMP

beerdermatology.com

“I think it would be incredible to have stem cell renewal treatments that are targeted to enable rejuvenation that is both predictable and durable.”

FACIAL PLASTIC SURGERY

Steve Dayan, MD

CHICAGO FACIAL PLASTIC SURGEON

drdayan.com

“I’d like to see a solution to addictions. Addictive behaviors are difficult to turn off and so destructive to an individual.

An ability to genetically turn off an addiction gene would change the world.”

PLASTIC SURGERY

Bradley Bengtson, MD GRAND RAPIDS, MI PLASTIC SURGEON

@bengtsoncenter

“What I would like to see is something that I’ve been working on passionately: a device that serves as a surgical drain substitute and can effectively hold tissue together to eliminate fluid collection and seromas.”

DERMATOLOGY

Jeanine B. Downie, MD MONTCLAIR, NJ DERMATOLOGIST

@drjeaninedownie

“The medical breakthrough I would like to see happen in my lifetime is curing cancer. Cancer cuts across all races and socioeconomic lines, so it can affect everyone. We also need to know how to prevent cancer.”

FACIAL PLASTIC SURGERY

Kelly Bomer, MD SCOTTSDALE, AZ FACIAL PLASTIC SURGEON

rejuvent.com

“I would love to have a spectrum of hyaluronic acid fillers that last significantly longer than the ones we have now and can still be safely and easily removed when needed.”

OCULOPLASTIC SURGERY

Steven Fagien, MD BOCA RATON, FL OCULOPLASTIC SURGEON

drfagien.com

“I would like to see treatments that are effective in maintaining a youthful appearance by thwarting the aging process rather than treating aging once it has already occurred. I believe we are not too far from achieving this.”

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DERMATOLOGY

COSMETIC DENTISTRY

Joel L. Cohen, MD DENVER DERMATOLOGIST

aboutskinderm.com

Ronald Goldstein, DDS COSMETIC DENTIST AND AUTHOR OF CHANGE YOUR SMILE

@RonGoldsteinDDS

“As a skin cancer surgeon, I always think about how great it would be to have targeted therapy for all cancers, sparing systemic side effects of traditional chemotherapy such as hair loss and malaise, as well as a way to block metastases.”

PLASTIC SURGERY

“With all of the various diets available to humans, I would like to see a scientific breakthrough that would positively prove the best for long life, plus a longevity pill that would work long-term.”

PLASTIC SURGERY

Julius W. Few, MD

DIRECTOR OF THE FEW INSTITUTE FOR AESTHETIC PLASTIC SURGERY

Mark L. Jewell, MD

PAST PRESIDENT OF THE AMERICAN SOCIETY FOR AESTHETIC PLASTIC SURGERY

markjewellmd.com

@JuliusFewMD

“I would love to see nonsurgical skin tightening for the body be a reality for the future, as well as the ability to prevent bad scars from forming! This would create so much natural beauty.”

“The medical breakthrough I would like to see is a way to control abnormal scarring, such as hypertrophic scars and keloids. This is especially relevant to individuals of color and those prone to scarring.”

PLASTIC SURGERY

Sanjay Grover, MD

NEWPORT BEACH, CA PLASTIC SURGEON; DIRECTOR, GROVER AESTHETICS AND LASER LOUNGE

drgrover.com

“I hope to see the ability to control our immune system so we can eliminate autoimmune related–illnesses such as rheumatoid arthritis without inhibiting our immune system from fighting infections.”

COSMETIC DENTISTRY

Laurence R. Rifkin, DDS BEVERLY HILLS, CA COSMETIC DENTIST

@LaurenceRifkin

“I would like to see vaccines be developed for both children and adults that protect against HPV, other oral bacteria and viruses that can cause cancer and other systemic diseases.”

FACIAL PLASTIC SURGERY

Andrew Jacono, MD

NEW YORK FACIAL PLASTIC SURGEON

newyorkfacialplasticsurgery.com

“My dream medical breakthrough would be a device that could create an nonsurgical facelift.”

PLASTIC SURGERY

Renato Saltz, MD

PAST PRESIDENT OF ASAPS AND ISAPS

@saltzplasticsurgery

“I would love to see genetic manipulation to delay skin aging and hair loss, botulinum toxin that does not cause any resistance and lasts longer, and oral collagen stimulators that can be absorbed and actually work.”

The Medical Advisory Board was created with a singular mission: to ensure NewBeauty is the leading resource for aesthetic guidance. Our board, led by Dr. Robert Singer, guarantees that all information published is backed by deep ethical standards and strong scientific integrity.

Find more insight and advice from our board members at newbeauty.com/board

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NEWS

Skin Sense

From a cream that took 100-plus versions to perfect, to the real story on essential oils, here’s what we’re investigating right now.

PHOTOGRAPHER: BRIAN LOVE, MODEL: JENNIFER ROBERTS, MAKEUP: BETHANY GARITA, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

W H A T T O R E A C H F O R A N D WA T C H T H I S S E A S O N

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TUNE IN

MUST-SEE MEDICAL

Did you get The Gist yet? If not, head to YouTube to get honest information about issues related to skin health and everything aesthetics from a roundtable of leading dermatolo-Gists—get it now? Together, cohosts Dr. Doris Day, Dr. Jeanine Downie, Dr. Sabrina Fabi, Dr. Ava Shamban and Dr. Ruth Tedaldi apply their years of experience and training to tackle today’s most common questions about skin and anti-aging. The episodes are funded by Allergan, but non-branded, “as the mission is to grow the market for everyone,” says Dr. Downie. Dr. Day adds, “We saw so much misinformation and even outright false information out there. We’re all board-certified dermatologists in practice for a decade or longer, and we also do clinical research, so we can help educate viewers about the latest and greatest treatments and help them avoid the scams.” While delivering the straight facts makes it a must-watch, it’s the comradery of these superstar doctors that makes it a View-esque experience. “We are great friends who agree on so much, but we also have varying points of view, which really comes out during each show.” To catch The Gist, go to youtube.com/thegistshow.

B ODY B OOST

FIRM & FABULOUS

On the heels of the launch of what seems like 20 new in-office body-sculpting devices this year comes a new crop of body products that go above and beyond hydration claims.

Thanks to skin-firming and cellulite-busting actives—caffeine, coffee extract and microalgaes, to name a few—these next-level lotions help maintain the results of high-tech energy treatments with no downtime. Pictured clockwise: Revision Skincare BodiFirm ($150, revisionskincare.com); Meaningful Beauty Firming & Tightening Body Hydration Treatment ($55, ulta.com); Éminence Organic Skin Care Stone Crop Contouring Body Cream ($68, buynaturalskincare.com) and Augustinus Bader The Body Cream ($165, augustinusbader.com)

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Say hello to a Actual Natrelle INSPIRA® patients.

Individual results may vary.

NEW LOOK

Natrelle ® Breast Implants Important Information Who may get breast implants?

Natrelle ® Breast Implants are approved for women for the following: • Breast augmentation for women at least 22 years old for silicone-filled implants.

Breast augmentation for women at least 18 years old for saline-filled implants.

Breast augmentation includes primary breast augmentation to increase breast size and revision surgery to correct or improve the result of a primary breast augmentation surgery.

• Breast reconstruction. Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. It also includes revision surgery to correct or improve the result of a primary breast reconstruction surgery.

IMPORTANT SAFETY INFORMATION Who should NOT get breast implants?

Women with active infection anywhere in their body, with existing cancer or precancer of their breast who have not received adequate treatment for those conditions, and women who are currently pregnant or nursing.

What should I know before getting breast implants?

INSPIRA® BreastActual implantsNatrelle are not lifetime devices orpatients. necessarily a one-time surgery. If you have your implants removed and not replaced, you may Individual results may vary.experience unacceptable dimpling, puckering, wrinkling, or other cosmetic changes of the breast, which may be permanent. Breast

© 2019 Allergan. All rights reserved. All trademarks are the property of their respective owners.

Natrelle.com NAT128156 09/19 002438

implants may affect your ability to produce milk for breast-feeding. Silicone-filled implants may rupture without symptoms. You should have MRI examinations 3 years after surgery and then every 2 years thereafter in order to detect ruptures.

What should I tell my doctor?

Tell your doctor if you have any of the following conditions: autoimmune diseases, a weakened immune system, planned radiation therapy to the breast or planned chemotherapy following breast implant placement, conditions/medications that interfere with wound healing and blood clotting, reduced blood supply to breast tissue, or a clinical diagnosis of depression, other mental health disorders, body dysmorphic disorder, or eating disorders.

What are some complications with breast implants?

Key complications are reoperation, implant removal with or without replacement, implant rupture with silicone-filled implants, implant deflation with saline-filled implants, and severe capsular contracture (severe scar tissue around the implant). Talk to your doctor about other complications.

Talk to your doctor. For more information see the patient brochures at www.allergan. com/labeling/usa.htm. To report a problem with Natrelle ® Breast Implants, please call Allergan at 1-800-433-8871.

Natrelle ® Breast Implants are available by prescription only.

#ThePowerOfYou @NatrelleBreastAugmentation @NatrelleBreastReconstruction

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HOT TOPIC

PECTORALIS MAJOR MUSCLE

Implants can be placed directly in front of or behind this muscle

U P DAT E

Breast Implant Recall

IMPLANT

Textured breast implant shells feel like sandpaper

FOUR MONTHS AFTER A VOLUNTARY R ECA L L O F T E XT U R E D I M P L A N TS, T H E R E’S ST I L L L I N G E R I N G C O N F U S I O N OV E R W H AT I T M E A N S FO R T H OS E W I T H I M P L A N TS. H E R E , TO P SU RG EO N S S E T T H E R EC O R D ST R A I G H T.

O K H FUNG / SCIENCE PHOTO LIBRARY

B Y TAT I A N A B I D O

ver the past 21 years, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a very rare form of nonHodgkin lymphoma, has been discovered in 573 women who had undergone breast augmentations with textured implants. With more than 25 million women getting implants since 1997, that number seems reassuringly small. Yet, in July, as a safety precaution based on recommendations from an FDA task group, Allergan voluntarily recalled their BioCell textured implants from the worldwide market.

WHAT IS BIA-ALCL?

Unlike lung cancer, which can occur in both smokers and nonsmokers alike, BIA-ALCL

BREAST TISSUE

In most cases, BIA-ALCL is found in the capsule and fluid near the implant

This MRI scan is for illustrative purposes and does not show an actual BioCell implant or ALCL.

is directly connected to textured implants: There have been zero recorded cases of BIA-ALCL connected with non-textured implants. “This is not breast cancer,” says Nashville, TN plastic surgeon and chair for The Aesthetic Society’s Breast Implant Illness (BII) task force Melinda Haws, MD. “It is a lymphoma of the scar tissue around the implant and usually starts in a fluid collection around the implant.” Eugene, OR plastic surgeon Mark Jewell, MD recommends keeping an eye out for “one-sided swelling that may

be fluid accumulation,” as well as being diligent with checking in with your plastic surgeon and not skipping annual mammograms.

“It can also present as a lump in the breast or under the arm,” Dr. Haws says. “If caught early, ALCL is highly treatable.” Currently, 93 percent of BIA-ALCL patients are diseasefree at their three-year follow-up.

WHAT “RECALL” MEANS

As Dr. Jewell notes: “The term ‘recall’ is confusing; this is not like an automotive recall.

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HOT TOPIC

Allergan withdrew unsold, textured-surface implants and tissue expanders.” If you have textured implants, you don’t need to get them removed, says past president of The Aesthetic Society and the Aesthetic Surgery Education and Research Foundation, La Jolla, CA plastic surgeon Robert Singer, MD. “Only this specific type of macro-textured implant is being recalled if it is in stock in doctors’ offices.”

WHY TEXTURE MATTERS

Textured implants became a popular option for patients who wanted to avoid some of the aesthetic irregularities connected to smooth implants, like capsular contraction, or hardening of the breasts from tightening of the capsule. While the addition of texture reduced the risk of capsular contraction, it also created areas for inflammatory bacteria to grow. “We’ve discovered that implants with more texture, or macro-textures, allow for exponentially higher numbers of bacteria on the implant surface,” says co-chair of The Aesthetic Society’s FDA task force, Dallas plastic surgeon William P. Adams Jr. “It’s the bacteria living in all the little nooks and crannies, and not the implant, that causes the chronic inflammation.” Of those 573 cases of BIA-ALCL, a large majority of patients had BioCell implants, leading researchers to believe that the unique BioCell texture led to proportionally more cases compared to textured implants from other brands.

WH Y I ’M KEEPING M Y IMPL AN T S

BY DR. MELINDA HAW S

5%

of all implants sold in the U.S. have a textured shell.

THE FOOD AND DRUG ADMINISTRATION, MARCH 2019

CA R E F U L C O N S I D E R AT I O N

NEXT STEPS

Louisville, KY plastic surgeon M. Bradley Calobrace, MD, who chairs The Aesthetic Society’s BIA-ALCL task force, says those contemplating removal should consider all of the factors: “This is not a recall on implants already placed. Revision surgery is a big surgery, and ALCL is too rare to have patients take out their implants and capsules.”

However, if you do have BioCell implants and want to consider having them removed, speak with your plastic surgeon and go to biocellinformation.com. Through July of 2021, Allergan is providing a complimentary revision set of smooth implants to patients who choose to remove their BioCell versions.

tients may have more concerns and anxiety, they are also much more aware, which has opened the door for us surgeons to offer more education about implants.

I recently had my implants scanned by high-resolution ultrasound, which showed them to be intact and without any fluid around them. There has been no change in their look or feel, so I’m not going to change them out until I’m ready to upgrade the implants or change their size. There are risks to surgery as well, and I also worry about my recurrent capsular contracture risk, so I have chosen close observation of my implants. Each woman gets to make her own decision with all of the facts specific to her, just like I do, and I hope I, and other board-certified plastic surgeons, can help be part of that discussion.”

“In 1998, I had just finished my fellowship and was about to start my practice as a fully trained plastic surgeon when I underwent a breast augmentation with smooth gel implants.

Fast-forward nine years later and three separate incidents of capsular contracture, and I opted to exchange my implants for BioCell textured implants in 2006. Just like that, I had no more capsular contracture.

I first heard of the link to textured implants after my BioCell implants had been in place for a couple of years.

As both a surgeon and a patient, I have been following this issue closely. This at first exceedingly rare occurrence has become less rare. The incidence of BIA-ALCL in patients with BioCell implants is now 1 in 3,200. With the recent Allergan recall, my conversations with patients have evolved. While pa-

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“I perform a lot of breast augmentation and reconstruction surgeries, so I’ve had many patients ask about the recall.

I answer all of their questions about the risks associated with textured devices. If they don’t ask me, it’s still something I discuss. I consider it to be part of the informedconsent process.”

“Although this is a rare condition, we must ensure patients get early diagnosis and treatment. This requires patient education and follow-up with a plastic surgeon. A qualified surgeon will be aware of evaluation and treatment protocol based on current best evidence.”

“I have had dozens of calls from concerned patients. The vast majority are reassured that there is very little risk and they don’t have to replace their implants. A very small percentage are adamant that they want their textured implants exchanged for peace of mind.”

–B. AVIVA PREMINGER, MD, NEW YORK PLASTIC SURGEON

–ROBERT WHITFIELD, MD AUSTIN, TX PLASTIC SURGEON

–JOEL STUDIN, MD GREAT NECK, NY PLASTIC SURGEON

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BUILD MUSCLE & SCULPT YOUR BODY NO SURGERY – NO DOWNTIME Experience the abdominal and buttocks workout without working out. Best of all it’s:

CONTRACTIONS IN 30 MIN

NO SURGERY & NO ANESTHESIA

EMSCULPT.COM | INFO@EMSCULPT.COM

Results and patient experience may vary. Patients shown in the B&A pictures are within +/- 5 lbs of their original weight unless specifi ed. As with any medical procedure, ask your doctor if the Emsculpt procedure is right for you. The Emsculpt procedure is U.S. FDA cleared for improvement of abdominal tone, strengthening of the abdominal muscles, development of fi rmer abdomen, strengthening, toning and fi rming of buttocks. ©2019 BTL Group of Companies. All rights reserved. BTL® and EMSCULPT® are registered trademarks in the United States of America, the European Union and/or other countries. The products, the methods of manufacture or the use may be subject to one or more U.S. or foreign patents or pending applications.

799-79EMCADNB2AENUS100; Emsculpt_AD_New-beauty_9x10.875inch_ENUS100

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#M Y N EW B E AU T Y

SMITH & CULT NAIL LACQUER IN ICE TEARS

“I always gravitate toward darker shades in the winter, and this magical, marine hue not only fits the bill, but also reigns supreme.” $18, smithandcult.com —EMILY TAYLOR, EDITORIAL ASSISTANT

VICTORIA BECKHAM BEAUTY LID LUSTRE IN MINK

EDITOR PICKS

“This lustrous tiger’seye shadow gives my lids a sleek, rusty glimmer.” $36, victoriabeckham beauty.com —TATIANA BIDO,

SQUAD GOALS

FEATURES EDITOR

THE PRODUCTS WE CAN’T KEEP OUR HANDS OFF OF THIS SEASON SLIP SKINNIES

“Scrunchies are a staple no matter your age, and these silky ones are so chic, they can double as bracelets.” $39, slip.com —BRITTANY BURHOP FALLON, BEAUTY DIRECTOR

CLÉ DE PEAU BEAUTÉ SYNACTIF NECK AND DÉCOLLETÉ CREAM

EDITOR IN CHIEF

UZ EYE OPENING LINER

“The latest from Tokyo-based UZ offers up six shades of noir—red, green, metallic (pictured), matte, navy, platinum and pitch black—for every occasion.” $16, uz.team —DANIELLE FONTANA, DIGITAL EDITOR

LORD JONES HIGH CBD FORMULA BATH SALTS

“These give me a guaranteed eight hours of sleep when I take a soak before bed.” $65, lordjones.com —LIZ RITTER, EXECUTIVE EDITOR

TOMALIK / GETTY IMAGES

“The. Best. Neck. Cream.

Ever. This intensely hydrating gel-balm boosts lymphatic drainage—even though I only apply it to my neck and chest, I can see its depuffing magic in my cheeks and jawline.” $435, cledepeaubeaute.com —EMILY DOUGHERTY,

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Actual patient. Results may vary.

Your face. Your decision. It’s time to say see you later to the judgment, oh, and to frown lines. And hello to Xeomin®.

Xeomin is the only clinically proven anti-wrinkle injection uniquely purified to remove unnecessary proteins.* Find a doctor who can tell you all about Xeomin.

XeominAesthetic.com *Studies have not been performed to determine whether the presence or absence of accessory proteins has a long-term effect on safety or efficacy.

Xeomin. By prescription only. A temporary treatment.

XEOMIN (incobotulinumtoxinA) IMPORTANT CONSUMER SAFETY INFORMATION Read the Medication Guide before you start receiving XEOMIN (Zeo-min) and each time XEOMIN is given to you as there may be new information.

The risk information provided here is not comprehensive. To learn more: • Talk to your health care provider or pharmacist • Visit www.xeominaesthetic.com to obtain the FDA-approved product labeling • Call 1-866-862-1211 Please see back of this page for important safety information.

USES: XEOMIN is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults for a short period of time (temporary). It is not known if XEOMIN is safe and effective in children under 18 years of age.

WARNINGS XEOMIN may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems anytime (hours to weeks) after treatment with XEOMIN: • Problems with swallowing, speaking, or breathing can happen within hours to weeks after an injection of XEOMIN if the muscles that you use to breathe and swallow become weak. Death can happen as a complication if you have severe problems with swallowing or breathing after treatment with XEOMIN. • People with certain breathing problems may need to use muscles in their neck to help them breathe and may be at greater risk for serious breathing problems with XEOMIN. • Swallowing problems may last for several months, and during that time you may need a feeding tube to receive food and water. If swallowing problems are severe, food or liquids may go into your lungs. People who already have swallowing or breathing problems before receiving XEOMIN have the highest risk of getting these problems.

• Spread of toxin effects. In some cases, the effect of botulinum toxin may affect areas of the body away from the injection site and cause symptoms of a serious condition called botulism. The symptoms of botulism include: loss of strength and muscle weakness all over the body, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing.

These symptoms can happen hours to weeks after you receive an injection of XEOMIN. These problems could make it unsafe for you to drive a car or do other dangerous activities.

Do not use XEOMIN if you are allergic to XEOMIN or any of the ingredients in XEOMIN (see the end of this Guide for a list of ingredients in XEOMIN), had an allergic reaction to any other botulinum toxin products such as rimabotulinumtoxinB (MYOBLOC®), onabotulinumtoxinA (BOTOX®, BOTOX® COSMETIC), or abobotulinumtoxinA (DYSPORT®) or have a skin infection at the planned injection site.

Before receiving XEOMIN, tell your doctor about all of your medical conditions, including if you: • have a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig’s disease], myasthenia gravis or Lambert-Eaton syndrome) • have had any side effect from any other botulinum toxin in the past • have a breathing problem such as asthma or emphysema • have a history of swallowing problems or inhaling food or fluid into your lungs (aspiration) • have bleeding problems • have drooping eyelids • have plans to have surgery • have had surgery on your face • are pregnant or plan to become pregnant. It is not known if XEOMIN can harm your unborn baby.

• are breastfeeding or plan to breastfeed. It is not known if XEOMIN passes into breast milk.

Tell your doctor about all of the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.

Talk to your doctor before you take any new medicines after you receive XEOMIN. Using XEOMIN with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received XEOMIN in the past. Especially tell your doctor if you • have received any other botulinum toxin product in the last four months • have received injections of botulinum toxin such as rimabotulinumtoxinB (MYOBLOC®), onabotulinumtoxinA (BOTOX®, BOTOX® COSMETIC) and abobotulinumtoxinA (DYSPORT®) in the past. Be sure your doctor knows exactly which product you received. The dose of XEOMIN may be different from other botulinum toxin products that you have received.

• have recently received an antibiotic by injection • take muscle relaxants • take an allergy or cold medicine • take a sleep medicine Ask your doctor if you are not sure if your medicine is one that is listed above.

Know the medicines you take. Keep a list of your medicines with you to show your doctor and pharmacist each time you get a new medicine.

Possible Side Effects XEOMIN can cause serious side effects that can be life threatening including allergic reactions. Symptoms of an allergic reaction to XEOMIN may include: itching, rash, redness, swelling, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you get wheezing or asthma symptoms, or if you get dizzy or faint. See “Warnings.”

The most common side effect of XEOMIN in people with glabellar lines includes: • headache These are not all the possible side effects of XEOMIN. Call your doctor for medical advice about side effects.

You may report side effects to FDA at 1-800-FDA-1088.

GENERAL INFORMATION ABOUT THE SAFE AND EFFECTIVE USE OF XEOMIN Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. You can ask your pharmacist or doctor for information about XEOMIN that is written for health professionals.

Active Ingredient: botulinum toxin type A Inactive Ingredients: human albumin and sucrose Copyright © 2018 Merz North America, Inc. All rights reserved. Merz Aesthetics, the Merz Aesthetics logo, and Xeomin are registered trademarks, and Xperience Program is a trademark, of Merz Pharma GmbH & Co. KGaA. Botox®, Dysport® and Myobloc® are registered trademarks of their respective owners. ML02675-00

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HOLY GRAIL W H AT H A P P E N S W H E N A L U X U R Y F R E N C H FA S H I O N H O U S E T E A M S U P W I T H A T O P A M E R I C A N D E R M AT O L O G I S T ? S K I N - C A R E M A G I C

BY APRIL LONG

MINIMALIST CHIC

CHANEL LA SOLUTION 10 The brainchild of Chanel consulting dermatologist Amy Wechsler, MD (also a certified psychologist), this elegant formulation strips away all unnecessary— and potentially irritating—elements, delivering super soothing hydration and antioxidant-rich protection with only 10 meticulously selected ingredients. $80, chanel.com

BOLD BREW

Precious, Chinese-grown silver needle tea is La Solution 10’s secret weapon: The handpicked leaves contain twice as many antioxidant polyphenols as green tea and downregulate levels of a nerve growth factor that causes sensitivity in skin.

WORLD PEACE

WHY WE LOVE IT A first in luxury skin care, La Solution 10 is free from fragrance, colors, oil, alcohol and fillers, making it one of the cleanest, most skin-comforting products.

The cream was tested globally in environments known to cause reactive skin flare-ups. In heavily polluted Beijing, 79 percent of subjects found their skin was less sensitive after one month. It has also been proven to reduce irritation after harsh procedures such as microdermabrasion.

AGAIN AND AGAIN

GREG MARINO

117: The number of trials it took to perfect the essentials-only recipe at Chanel’s skin-care labs.

NEWBEAUT Y WINTER 2019

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MUSE

MAKING DEW A single bottle of Vintner’s Daughter’s coveted Active Botanical Serum takes three weeks to make—a process founder April Gargiulo describes as “arduous, painstaking, time-honored and worth every second for the powerful and lasting results it delivers to the skin.” —D A N I E L L E F O N TA N A

TA K E T W O Gargiulo has “no interest in filling up drawers with bottles that just take up room.” Enter: Active Treatment Essence, “the hydrating yin to the Serum’s moisturizing yang.”

J AVA J I V E

LIGHT BRIGHT “I use microcurrent and red light almost every day.” Her high-tech heroes: NuFace and Celluma. “I love the results they deliver.” Berry-hued Rodin lipsticks complete her fresh-faced look.

W H AT ’S I N A N A M E ?

“Vintner’s Daughter is actually named after my daughter, not me. I was pregnant when I began developing products, and was running my family’s winery. I am the vintner and she is the daughter.”

N OT E S O N FAS H I O N A look into Gargiulo’s closet reveals her long-standing love for collecting vintage pieces. On her fashion wish list? “Always a vintage Yves Saint Laurent tuxedo suit.”

BLACK BOOK

HAIRSTYLIST

FACIALIST

DERMATOLOGIST

TRAINER

BARB THOMPSON @barbdoeshair

JOANNA CZECH @joannaczechofficial

DR. DAVID MACGREGOR 450derm.com

PILATES PROWORKS @pilatesproworks

“Barb and I just reconnected and she comes to my house, which is such a luxury.”

“Her signature facial massage and bespoke treatments are the stuff of dreams.”

“Dave is a no-nonsense doctor who tells it to you straight. I love that.”

“Michelle Skundrich makes you work! I call her classes Navy SEALs Pilates.”

ANDY CRAWFORD / GETTY IMAGES, MICHEL DUFOUR / CONTRIBUTOR / GETTY IMAGES, JOHNRANDALLALVES / GETTY IMAGES

“I’m obsessed with Lady Falcon Cascara—the husks of coffee cherries—which is higher in antioxidants than green tea or coffee.”

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ACE OF BASE “At 10 years old, I knew I was intrigued by makeup—I didn’t know it was a career option, but I knew I wanted to be around it,” says celebrity makeup artist Pati Dubroff. Cut to present day, her gilded CV includes her early work assisting legends François Nars and Kevyn Aucoin, and now, her starring role as the magician behind Hollywood’s best beauty looks. (Margot Robbie’s yellow eye shadow, anyone?)

S U R FAC E L E V E L “I use Augustinus Bader The Rich Cream every day and Biologique Recherche P50 1970 every few days.” More skin savers: Joanna Vargas Exfoliating Mask, 111Skin Retinol Oil, Weleda cleansers and Sisley’s Black Rose Mask.

E V E R Y D AY C H I C On any given day, you’ll find Dubroff in a Wolford bodysuit, Birkenstocks and a Jennifer Fisher cuff, encrusted with “P+R=B,” a nod to her husband Roberto and daughter Bianca.

Wellness musts also in tow: “Palo Santo from South America and a facial massage tool from China.”

WORK PERK Traveling the world is a huge part of Dubroff’s everyday, but her favorite part has nothing to do with jet-setting. “I love when a woman looks in the mirror and feels confident, like the most gorgeous version of herself, and ready to face whatever she has ahead of her.”

ROBIN BLACK, HG FINE JEWELRY, AMRIT

S TA R P O W E R NOTO Botanics MultiBenne Stain Pot in Genet is Dubroff’s desert-island beauty product. The signature rouge hue found on her celeb clientele?

“It’s Always Sunnies Face Fluffmatte in Major.”

LITTLE LUXURIES Candles from Le Feu de L’Eau are always burning, “especially Le Feu Gris!”

BLACK BOOK

HAIRSTYLIST

COLORIST

FACIALIST

TRAINER

CERVANDO MALDONADO

LIEN SCHERR @limasch

JOANNA VARGAS @jvskincare

TATIANA POGORELOVA

“His cuts are famous for being ultra-flattering.”

“She took me from brunette to now icy blond. People think it’s natural—she’s that good!”

“She is who I turn to for every skin-related question for myself and my clients.”

“A Pilates master. She keeps me pain-free, strong and flexible.”

@cervandohair

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CLEAN SWEEP A successful run in wealth management gave Kuen Rameson a front-row seat to the launch of countless passion-fueled businesses. In 2011, she decided to launch her own.

Gloss Moderne, a high-end, natural hair-care brand, delivers on a tall, long-ignored task: “There’s a disconnect between clean and luxury beauty—we should be able to have both.”

OFFICE ORDER

GREEN QUEEN Natural beauty isn’t just skin deep for Rameson.

“I have drawers full of natural toothpaste, floss, mouthwash and tons of beauty products I’m trying.” A current standout: Dr. Nigma Beauty in a Bottle “for beauty from the inside.”

“I always get dermaplaning, microcurrent, and all of the red and blue lights!”

WHITE OUT

POWER OFF “While very contrasting, I love either meditating or working out.

Both are extremely relaxing and meditative to me in their own way.

And just seeing the ocean always brings me a sense of calm.”

BLACK BOOK

HAIRSTYLIST + COLORIST

FACIALIST

NATUROPATH

@shanidarden

@drnigmatalib

KOJI AT KOJI TOYODA SALON

SHANI DARDEN

“Koji, his wife and family are special and dear friends.”

“I love her expertise and vision.”

@kojitoyodasalon

TRAINERS

DR. NIGMA TALIB

EQUINOX NEWPORT BEACH

“She is so intelligent… and the kindest.”

“I love learning from them.

It’s my happy place.”

@equinox

JARIS HO / GETTY IMAGES, ULIMI / GETTY IMAGES

The clean lines and structure of Rameson’s cherished white Hermès Birkin inspired the branding for Gloss Moderne, an aesthetic similar to her own. “All of my clothes are black, white or gray.” The brand’s latest launch: a Detoxifying Treatment packed with charcoal.

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A DV E RT ISE M E NT

GOLD STANDARD

THE GOLDEN CHOICE A NewBeauty Award winner for six consecutive years, Ultherapy® is recognized as the gold standard for nonsurgical skin lifting and tightening.

PHYSICIANS AGREE Model

KEEPING YOUR NATURAL LOOK IS PURE GOLD Collagen gives skin its strength, and also makes skin firm and flexible with the help of elastin.

Collagen is essential for your skin, especially for keeping a firm, fresh look, because it gives structure to skin cells. When collagen levels become depleted, which happens naturally as we age, the skin has little internal support, causing it to sag and contribute to the formation of wrinkles.

Boost your own collagen! Ultherapy® uses micro-focused ultrasound energy to heat tissue below the skin, stimulating collagen formation to lift and tighten the brow, chin and neck without surgery or downtime.

“The expert physician panel agreed that Ultherapy® is a key foundational aesthetic treatment and the gold standard for nonsurgical lifting of the skin,”* said Dr. Sabrina Guillen Fabi, cosmetic dermatologist and lead author of the Ultherapy® consensus guidelines.

GOOD AS GOLD • Ultherapy® goes deeper than any other noninvasive treatment to boost your own collagen • It is the only FDA-cleared, nonsurgical skin-lifting and tightening procedure that can lift skin and improve lines and wrinkles

The thermal effect essentially jump-starts a process that produces fresh, new collagen. *Reference: J Drugs Dermatol 2019; 18(5): 426-432.

The non-invasive Ultherapy® procedure is U.S. FDA-cleared to lift skin on the neck, on the eyebrow and under the chin as well as to improve lines and wrinkles on the décolletage. The most common side effects reported in clinical trials were redness, swelling, pain and transient nerve effects.

Reported adverse events from post-marketing surveillance are available in the Instructions for Use (IFU). Please see the IFU for product and safety information, including a full list of these events at Ultherapy.com/IFU.

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24 HOURS

POWER PLAYERS O N T H E H U N T FO R S K I N - CA R E I N S P O? TA K E A C U E F RO M T H E S E T H R E E B E AU T Y I N S I D E RS W H O K N OW W H AT R E A L LY WO R KS B Y B R I T TA N Y B U R H O P FA L L O N

DAY

GORETTI HO TAGHVA, MD

NEWPORT BEACH, CA PLASTIC SURGEON

@leaplasticsurgery

“As a plastic surgeon, I pay a lot of attention to the ingredients in my skin care.”

“In the morning, I rinse my face in the shower—I don’t use cleanser because my skin can be a bit dry and I don’t want to dry it out. Then I apply Sulwhasoo Essential Firming Cream ($100, us.sulwhasoo.com), which helps strengthen my skin while also hydrating it. I don’t think I’ve ever left my house without applying LEA Aesthetics Tinted HydraGlow SPF 44 ($58, available at LEA Plastic Surgery), which is great because it protects me from the sun and also acts as a tinted moisturizer, so I do not have to wear much makeup when I go to work.”

I like to keep my morning routine quick and simple so I can let my skin breathe and look radiant without wearing much makeup.

DAY

ARSHIA MOORJANI

NEW YORK–BASED BEAUTY BLOGGER

@arshiamoorjani

“My skin is really dry, so I always look for moisturizing products that make it glow!”

“After splashing my face with water, I apply Lancôme 15% Vitamin C Correcting Concentrate ($65, lancome-usa.com) and Clinique iD Dramatically Different Hydrating Jelly and Active Concentrate for Fatigue ($39, clinique.com) on top.

To keep my skin hydrated, I use Sweet Chef Superfood + Vitamins Moisture Boost ($19, target.com)— Glossier Bubblewrap Eye + Lip Cream ($26, glossier.com) hydrates my eye area. And I can’t forget sunscreen: I love Shiseido Ultimate Sun Protection Lotion WetForce SPF 50+ ($40, shiseido.com).”

DAY

DR. JANICE LIMA-MARIBONA

MIAMI DERMATOLOGIST

@drjanicelimamaribona

“As a busy mom, wife and professional, I keep my skin routine simple yet effective.”

“A spritz of Avène Thermal Spring Water ($18.50, bluemercury.com) helps prep my skin for the products that come next: vitamin C–rich SkinCeuticals Phloretin CF ($166, skinceuticals.com), which is great for those with hyperpigmentation, and EltaMD UV Clear Tinted BroadSpectrum SPF 46 ($35, dermstore .com), which is one of my favorite sunscreen formulas—it also comes in an untinted version.”

I prevent sun damage as much as possible by using high-quality sunscreen every day.

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La Prairie Skin Caviar Luxe Sleep Mask

NIGHT

“I use Banila Co. Clean It Zero Cleansing Balm ($27, banilausa.com) and then apply FAITH Cosmetics Essence Serum ($195, available in select medical offices), which uses a Japanese nano-capsule technology to deliver collagen, vitamin C and hyaluronic acid into skin. To even out my skin tone, I use LEA Aesthetics Antioxidant Serum ($138, available at LEA Plastic Surgery), and on my neck, I use SkinCeuticals A.G.E. Interrupter ($162, skinceuticals. com). To firm and moisturize, I like La Prairie Skin Caviar Luxe Sleep Mask ($385, laprairie.com).”

NIGHT

“I like to double cleanse with Lancôme Bi-Facil ($40, lancomeusa.com) and Peach & Lily Power Calm Hydrating Gel Cleanser ($28, peachandlily.com). Next I layer Fresh Black Tea Age-Delay Firming Serum ($75, sephora.com), The Ordinary AHA 30% + BHA 2% Peeling Solution ($7, ulta.com) and Clinique Moisture Surge 72-Hour Auto-Replenishing Hydrator ($21, ulta.com). Around my eyes, I use dr. brandt 24/7 Retinol Eye Cream ($55, sephora.com). To de-stress and help boost product absorption, I use the Herbivore Jade Roller ($30, sephora.com).”

NIGHT

“I remove my makeup with Avène Micellar Lotion ($28, aveneusa.com) and then cleanse with SkinCeuticals Gentle Cleanser ($35, skinceuticals .com). Skinbetter Science InterFuse Treatment Cream Eye ($100, skin better.com) softens lines around my eyes and SkinCeuticals Triple Lipid Restore ($128, skinceuticals.com) deeply moisturizes my skin. Then I apply one of the following stronger actives: Glytone Exfoliating Serum 11 ($46, lovelyskin.com), Dr. Lima Lines Be Gone 5X ($58) or Dr. Lima Sleeping Beauty in a Jar ($58, baypointedermatology.com).”

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OBSESSED

INSIDE TIP

“Store essential oils in a cool, dark area—exposure to heat accelerates oxidation, which can cause them to lose their therapeutic ability,” says Rosebrook.

ESSENTIAL OILS

LIQUID ASSETS

A

t just 12 years old, Josh Rosebrook would read product labels, test the lotions and potions in his bathroom, and painstakingly compile results. His curiosity about the connection between natural extracts from plants and herbs and true health and beauty led him to create his own products using what he calls “the greatest lab ever created: Mother Nature.” Here, he celebrates one of nature’s greatest gifts and skin care’s prized ingredients: essential oils. —BRITTANY BURHOP FALLON

Founder of Josh Rosebrook Skin and Hair Care

KLASSEN IMAGES / GETTY IMAGES

@joshrosebrook

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THE POWER OF PLANTS

“Considered the ‘spirit’ of the plant by many wellness aficionados, essential oils are a complex mixture of plant chemicals that are physically isolated from plants’ leaves, seeds, peels, stems and flowers by either steam distilling, cold-pressing/expression or CO2 extraction,” says Rosebrook. “This mixture contains therapeutic and aromatic benefits that have been used for thousands of years, and science is finally catching up.”

AROMATHERAPY FIX

Inhaling essential oils in the practice of aromatherapy can provide one of many moodhacking effects, from anxiety relief to an energy boost. “Lavender, rose, lavandin, mandarin, bergamot and frankincense have all been proven to reduce stress,” says Rosebrook, who’s working on his own anti-stress blend to launch next year. “Essential oils are

volatile, so if sprayed, they evaporate. Studies show that when inhaled from a cloth or tissue, the oils are most effective because the vapors move quickly into the brain and lungs. This can change your mood, as well as lower anxiety and cortisol in the bloodstream.”

TOPICAL BENEFITS

When used on the skin and scalp, essential oils “should be pure, organic and not past their shelf life, which is generally three to five years,” Rosebrook says. “They’re also extremely concentrated and must be diluted with a carrier oil—often jojoba or coconut oil—and used in exact concentrations: 20 to 30 drops per 1 ounce of carrier oil. “Applying essential oils without diluting them—referred to as ‘neat’—like applying tea tree to a pimple for example, should only be done after consulting a professional, and should be limited to one drop,” adds Rosebrook.

As far as which oils are best for which concerns, Rosebrook has it down to a science.

Have sensitive skin? Neroli and sandalwood can help soothe. Worried about environmental aggressors like UV rays and pollution?

Blue tansy is a powerful antioxidant. If acne is the issue, rose, geranium and clary sage offer anti-inflammatory, blemish-busting benefits: Rosebrook notes that “rose oil has been found to act as an incredibly effective moisturizing acne treatment due to its antimicrobial properties.” To promote a healthy scalp and hair growth, try oregano, thyme, tea tree, rosemary, or citrus essential oils.

NOT ALL OILS ARE EQUAL

“Hundreds of studies validate that essential oils are extremely beneficial for the skin and scalp, but when they are used in too high of a concentration, or if they’re impure, oxidized or fake, they can be sensitizing and damaging,” says Rosebrook. “This is part of a huge problem that continually affects public opinion of essential oils.” A reason for this, Rosebrook explains, is that inexperienced brands sometimes increase the amount of essential oils to cover the natural nut and seed aromas, often making the concentration too high for topical therapeutic benefits. To avoid an allergic reaction, do a patch test on your inner arm 24 hours before using a new product.

JOSH’S FAVORITES

THE ESSENTIAL OIL–INFUSED ELIXIRS HE ENJOYS YEAR-ROUND

JOSH ROSEBROOK VITAL BALM CREAM

“It’s a protective, skin barrier–reinforcing balm with botanical hyaluronic acid that finishes like a cream.

Blue tansy, lavender and ylang-ylang calm my senses and lift my spirit. I truly don’t know what I’d do without it.“ $85, joshrosebrook.com

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H. GILLERMAN ORGANICS MUSCLE REMEDY

“Hope Gillerman is a passionate pro, and this lavender, basil and spearmint blend is truly effective at relieving sore muscles, especially when my neck is sore. It assuages the pain instantly.“ $48, hgillermanorganics.com

OSMIA ORGANICS RECOVERY SALT BATH

“I melt away from the world when I bathe with these salts. Juniper makes me feel so invigorated, and marjoram soothes my spirit.

The aroma is perfection and truly rejuvenates my skin and muscles.“ $29, osmiaorganics.com

28 LITSEA TOP NOTE WILD CITRUS BODY OIL “This body oil is a proprietary citrus essential oil blend using the highestquality oils that absorb instantly. The invigorating mix of hypnotic wild orange and litsea cubeba leaves me breathless!“ $22, 28litsea.com

MEOW MEOW TWEET LEMON ROSE CLEANSING OIL

“I adore rose, but it needs to be blended with the right essential oil counterparts for me to really appreciate it. This oil is the ultimate in simplicity and a purifying treat. I love it!“ $25, meowmeowtweet.com

10/22/19 11:14 AM

you’re not really cheating on your dentist Supersmile products are available at fine retailers supersmile.com | @supersmileofficial

2

3

4

The zina45 sonic pulse toothbrush 1. First at-home polishing head 2. Patented 45o angled bristles 3. Magnetic touch charger 4. Ergonomic handle 5. Four custom settings Your dentist will be wowed!

1 Available in chromed rose-gold, charcoal + silver

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SMILE

SMART MOUTH From the latest—and not-so-greatest—teeth-whitening hack to the anti-fluoride movement, best-in-class cosmetic dentists debunk top teeth myths. — E M I LY TAY L O R

MYTH 1:

Actually, those few seconds really matter. “In order to properly clean all of your teeth, each with two to three large surfaces, brushing requires two full minutes,” says New York cosmetic dentist Pia Lieb, DDS. On the other hand, as Atlanta cosmetic dentist Ronald Goldstein, DDS notes, more isn’t always more with brushing. “Over-brushers can wind up with receding gums and tooth abrasion, which can cause wear and sensitive roots.”

TRY THIS: “Many electric toothbrushes have built-in timers that help with brushing time,” says Dr. Lieb. “Most of them even split the time into four quadrants so you don’t favor one area more than another.” If you fall in the category of brushing for too long, soft bristles, like those on the M. Sonic Luxury Sonic Toothbrush, can help reduce any additional wear on the gums that can result from too much brushing.

45

SECONDS The average time Americans spend brushing their teeth SOURCE: Academy of General Dentistry

SARAH KRICK / GALLERY STOCK/IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

Brushing for more or less than two minutes won’t make a difference.

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MYTH 2:

MYTH 4:

You should wet your toothbrush before you brush.

Mr. Clean Magic Erasers remove enamel stains.

We stick our brush under the faucet as a force of habit, but dentists say this may not be the best for our oral health: Wetting toothbrush bristles softens them so that they don’t irritate teeth or gums, but doing so may not remove as much plaque. The solution? Bristles that are soft even when dry and don’t require warm water.

TRY THIS: “Using a softer toothbrush eliminates the need to wet it before brushing,” says Dr. Goldstein. “We recommend a very soft electric toothbrush like the Rotadent ProCare toothbrush to remove plaque, but also protect teeth and gums.”

As tempting as it may be to think that the beloved housecleaning scrubbers can lift stains from our delicate enamel like they do bathroom tile, this simply isn’t true. While dental-specific melamine foam sponges, sold globally, have been shown to aid in stain removal, dentists don’t recommend the DIY method with Mr. Clean, as the household buffer can damage soft tissue like the gums and cause serious erosion.

TRY THIS: “I find that using Mr. Clean works very well on my Corian counter tops, but it is much too abrasive to use on natural tooth enamel,” says Dr. Lieb. “I recommend whitening products that remove stains, but not enamel, like hydrogen peroxide–infused Colgate Optic White Toothpaste and Crest 3D White Glamorous Whitening Mouthwash.”

MYTH 3:

Toothpaste with f luoride is bad for me.

While too much fluoride may cause irregularities or stains on the surface of juvenile teeth—called fluorosis—there is no such thing as too much of the mineral for adult smiles, according to San Francisco cosmetic dentist Swati Agarwal, DDS. “Fluoride can only stain teeth when they are developing, and most teeth are done developing by age 6. After teeth have erupted, fluoride in toothpaste helps to maintain enamel.”

TRY THIS: Toothpastes with high amounts of fluoride can help curb cavities. “The last routine I do before going to bed is brush with a soft toothbrush and toothpaste with concentrated 1.1 percent fluoride content,” says. Dr. Goldstein. “If you are an adult and still getting cavities, this type of toothpaste can be of special help.”

According to Dr. Goldstein, we should get less cavities the older we get, because with age, “the surface of enamel hardens and loses the organic material in younger teeth.” If we do get a cavity, a remineralizing toothpaste with fluoride is key.

TRY

DENTAL DARLINGS 1/ BRUSHING UP

1

MYTH 5:

Flossing is irrelevant.

We jumped for joy a few years back when the government’s Department of Health and Human Services dropped flossing from its 2016 guidelines due to a lack of evidence that flossing actually helps remove plaque. But, our dentists weren’t as thrilled. “Not only is flossing necessary to remove food particles between tight teeth, but it can also be useful around implants if prescribed by your dentist,” says Dr. Goldstein. A gap in supporting research doesn’t mean a lack of effectiveness either: Flossing was removed as a best practice solely due to the need for more research.

The Surgeon General, the Center for Disease Control and the ADA still highly endorse the routine.

TRY THIS: To make flossing a bit more fun, Dr. Goldstein recommends the Hydro Floss oral irrigator, a machine that shoots water in between hard-to-reach spaces that can conceal plaque.

With soft nylon bristles and about 37,000 vibrations a minute, the M Sonic works overtime to clean teeth. Choose from four different cleansing modes to control the depth of the wash.

Dr. Jon Marashi M Sonic Luxury Sonic Toothbrush, $275, drmarashi.com

2/ TOP PIK

A one-stop-shop for brushing and flossing, the Sonic-Fusion has two settings: one with vibrations for cleaning tooth surfaces and one with water streams to reach between teeth.

Waterpik Sonic-Fusion, $169, waterpik.com

2

3/ PH POWER

Dissolve one of these natural, coconut oil– and mint-infused tablets in water and then swish around in your mouth to help freshen breath, strengthen tooth enamel, reduce sensitivity and support a healthy pH.

3

Alka-White The Alkaline Oral Cleanse, $20, alkawhite.com

The time of day you brush DOES matter—aggressive brushing, plus the acidity from our favorite breakfast foods, can weaken enamel.

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N U M B E R S GA M E S K I N STAT S

DEW BETTER W H AT TO G E T, S E A RC H FO R A N D S L AT H E R O N N OW, AC C O R D I N G TO TO P D E R M ATO LO G I STS



MEGA MOISTURE

“I recommend a daily facial moisturizer with SPF like the ones from EltaMD.”

K E Y WO R D :

HYALURONIC ACID

QUERIES FOR “HYALURONIC ACID,” KNOWN TO HAVE A POSITIVE EFFECT ON WRINKLES AND SKIN ELASTICITY, HAVE MORE THAN DOUBLED OVER THE PAST FIVE YEARS.

+

HA ALL THE WAY

“SkinMedica’s HA5 is really good when it’s cold out.” +

FEET LAST

“And...Footlogix Cracked Heel Formula to keep your feet soft!”

–ROCHESTER, NY DERMATOLOGIST LESLEY LOSS, MD

“ MY 20- AND 30-YEAR-OLD PATIENTS ALL WANT LIP FILLER, LIGHT BOTOX AND CHEMICAL PEELS RIGHT NOW. THEY’RE ALSO INTO MASKS. I LIKE THE OBAGI PROFESSIONAL-C ONE THIS TIME OF YEAR.”

T R E N D R E P O R T F O R T H E AG E S

“During the winter months, my 50-, 60- and 70-year-old patients get Fraxel to clean up their brown spots. In January and February, they typically all want to work on their hands, because they’re quiet months socially.”

–MONTCLAIR, NJ DERMATOLOGIST JEANINE DOWNIE, MD

Say Cheese “Winter is a great time for many of my patients to do body treatments, such as CoolSculpting, the new CoolTone abdominal-tightening treatment and liposuction. Additionally, Kybella treatments are very popular during sweater season because a turtleneck sweater can hide any swelling. As always, fillers, Botox and newer treatments such as Jeuveau (#Newtox) are in hot demand around the holidays because everyone wants to look just a little bit better for holiday pictures!”

IN THE ISSUE : INGREDIENTS TO LOOK FOR



PROBIOTICS.................................................... p g 52 TURMERIC....................................................... p g 74 ARNICA............................................................. p g 80

4-0

“When you hit 40, it might be time to get microneedling.

It helps all your creams and lotions work better.”

400% –DR. DOWNIE

–OMAHA, NE DERMATOLOGIST JOEL SCHLESSINGER, MD

–PROSPECT, KY DERMATOLOGIST TAMI BUSS CASSIS, MD

“In the winter, search queries related to dry skin double, and those related to windburn increase by 400 percent, when compared to summer months.”

–SAN DIEGO DERMATOLOGIST DAVID LORTSCHER, MD, CEO OF CUROLOGY

STILLLIFEPHOTOGRAPHER / GETTY IMAGES

T h e Fo r m u l a FOR HYDRATED SKIN

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51%

According to Dr. Lortscher, in a recent survey of American consumers, the leading drivers of skin-care purchases are dryness (51 percent), followed by anti-aging (46 percent).

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S P EC I A L A DV E RT I S I N G S ECT I O N

breakthrough

BRIEF

flawless finish Mineral Air mineralair.com

water supply Doctor Rogers doctorrogers.com

Get a new makeup experience that makes achieving even, smooth, healthy, and glowinglooking skin as easy as the touch of a button with the Mineral Air System. This whisper-light Four-in-One Foundation— included in the Complexion Starter Kit—is the ultimate multitasker with primer, concealer, hydrator and color in a single mist-on formula that leaves skin with a soft, satin finish.

Chock-full of clean, plant-based ingredients like squalane, shea butter and coconut fruit extract, RESTORE® Face Cream helps to calm, nourish and soften dull, dry or irritated skin. Created by a dermatologist to deliver intense hydration to all skin types, this luxurious moisturizer helps maintain radiant, healthy skin.

turn back the clock DefenAge defenage.com Three steps to beautiful new skin?

DefenAge Clinical Power Trio’s anti-aging system relies on state-of-the-art molecules called defensins that activate skin cells and the skin’s regenerative properties to deliver just that. This powerful combination dramatically minimizes the effects of aging, for fewer wrinkles and firmer, brighter skin.

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Take a sneak peek at these top shelf–worthy discoveries emerging from standout brands.

mani must-have NoUV by Suzanne Underwood suzanneunderwood.com Love gel manis but don’t want to expose your hands to harmful UV and LED lamps used to cure gel polish? NoUV has your back. Dermatologistrecommended, these one-time-use gloves protect your hands from more than 99 percent of UV rays, which can cause aging in the form of brown spots, wrinkles and even skin cancer. Now you can enjoy gel manicures without the worry.

10/18/19 4:51 PM

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DISCOVERY

ANNA MATTSSO / GALLERY STOCK, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

ISSUE

Welcome to our first-ever DISCOVERY ISSUE, dedicated to the DREAMERS, the INNOVATORS and the FUTURISTS who make the magic behind all things beauty happen.

NEWBEAUT Y WINTER 2019

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VISION

QUEST

We decanted three of our favorite new fragrances into unmarked bottles and sent them to six professional photographers from Whitney Chamberlain’s Yeah Field Trip community. The brief ?

Take a deep breath, then capture the essence of each one. by

BR I T TA N Y BU R HOP FA L L ON

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T H E S U N C ATC H E R

ARMANI/PRIVE ORANGERIE D’VENISE

Inspired by the fresh fruits and aged trees filling the Venetian coast, IFF’s legendary nose Dominique Ropion achieved the perfect marriage of neroli, orange blossom and cedar to transport you to a breezy, sun-soaked escape. Photographer Grace Gruwell got Ropion’s message loud and clear, showcasing a lemon slice and flowers in her still-life trio.

Sunlight was also a universal theme in the images: Hailley Howard sensed “summer notes that sit high and warm, nearly caressing the sun,” like her snapshot of pampas grass standing tall in the light. Jacob Boll recalled “that time of day when there’s just that one strip of sunlight left,” as captured in his portrait of a woman at dusk, and Jonathan Grant brought the “mysterious, yet bright” scent to life with his sunbeams and shadows on the sand.

PHOTOGRAPHY BY: Hailley Howard (opposite page), Jacob Boll (top left), Grace Gruwell (top right), and Jonathan Grant (bottom right)

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THE ILLUSIONIST

GUCCI MÉMOIRE D’UNE ODEUR

Combine Firmenich master perfumer Alberto Morillas’ expansive palette with Gucci creative director Alessandro Michele’s contemporary vision and you get an entirely new (and captivating) olfactive family: mineral aromatic. Without knowing anything about the genderless fragrance, Gruwell described it as “a mystical mix of mineral, floral and woodsy spice,” a spot-on description of Morillas’ cocktail of Roman chamomile, Indian coral jasmine, musk and cedarwood. Even more surprising is Gruwell’s photo of a crystal ball, which echoes Michele’s intent to celebrate the power of memories. Nancy Neil’s image of boulders in the high desert and Howard’s soft, frothy tide reflect two of Michele’s other inspirations—nature and freedom— which give the scent its cool, laid-back vibe.

PHOTOGRAPHY BY: Nancy Neil (bottom left), Hailley Howard (top left) and Grace Gruwell (right)

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THE SHINING

TOM FORD MÉTALLIQUE

Leave it to fashion maverick Tom Ford to dream up a fragrance inspired by the idea of an armored, embroidered dress.

Givaudan perfumer Antoine Maisondieu’s translation is a juice that’s fearless, feminine and full-bodied with distinct layers, each of which was sensed by the photographers.

At first spritz, the scent zings with metallic aldehydes, zesty bergamot and pink peppercorn—an aroma Howard calls “psychedelic sweet,” as represented by the neon pink aura in her photo. Anna Powell Teeter captured the floral heart, full of delicate aubépine and muguet, with her field of white blossoms, and Gruwell spilled honey and vanilla extract onto oxidized carbon steel, evoking the warm, creamy drydown of vanilla and sandalwood.

PHOTOGRAPHY BY: Anna Powell Teeter (bottom left), Hailley Howard (top left) and Grace Gruwell (right)

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BIG BUSINESS

On average, women use 16 beauty products every day—so it’s no surprise that the beauty industry was valued at an estimated $532 billion in 2019.

BILL DIODATO / GETTY IMAGES, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

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Money can’t buy happiness, but it can make younger-looking skin a whole lot easier to achieve. J.Lo and Jennifer Aniston are both rumored to have their own Ultherapy machines, and Kimora Lee Simmons has claimed to use La Mer eye cream from head to toe to keep things taut.

What would a typical skincare regimen look like if your last name was Bezos, Gates or Arnault? These beauty experts give us a peek at what the ultimate future-proofing playbooks look like. by

DANIELLE FONTANA

10/18/19 6:03 PM

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TOX TALK

LUST LIST

BODY ROCK

If thousands of dollars in serums and lotions lined your medicine cabinet, why stop at your neck? A full-body cocktail of wrinkle-plumping SkinMedica TNS Essential Serum, Retin-A and La Prairie Skin Caviar Luxe Cream would replace any old body lotion for Boston facial plastic surgeon Caroline A. Banks, MD. New York facial plastic surgeon Jennifer M. Levine, MD offers up a casual solution to slack, less-than-camera-ready skin: off-label use of hyperdiluted Sculptra Aesthetic from head to toe.

To eliminate dry, dull skin for the foreseeable future, New York cosmetic dentist Pia Lieb, DDS would drench herself in Clarins Body Balm each morning and evening; New York dermatologist Rita Linkner, MD would swap her usual hydrator with collagen-boosting Alastin Regenerating Nectar, and, before coating every inch of skin with Biologique Recherche Sérum Placenta and Creme Masque Vernix, New York City facialist Autumn Henry would end every long week in the most chic, drool-worthy way: relaxing in a CBD-infused milk bath in an amethyst tub.

NEEDLE WORK

FAT FREEZE

Dr. Waldorf is currently living our fat-freezing dreams. “‘See a bulge, freeze a bulge’ has kept me fit and fitting into my wardrobe,” she says. “When I lecture on CoolSculpting, I often do my ‘CoolSculpting macarena’—my hand movements mirror all the places and times I’ve had it done: lower belly, upper belly, waist, flanks, bottom of my butt, upper arms…and repeat! I think I’m up to 18 cycles since 2012.”

LIGHTEN UP

To undo the photodamage he incurred as a kid, New York dermatologist Joshua Zeichner, MD says he would Fraxel the entirety of his sun-exposed skin. “Forget cost—if social downtime wasn’t a factor, I would microneedle my face with PRP every month,” says Greenwich, CT dermatologist Kim Nichols, MD. And for the most relaxing dose of brightening power, Englewood, NJ plastic surgeon Shwetambara Parakh, MD would top her monthly whole-body HydraFacial sessions with bottles of SkinCeuticals C E Ferulic.

1. RED HOT ”An LED light-therapy bed would be up there on my wish list,” says cosmetic formulator Stephen Alain Ko. ”While the research isn’t particularly convincing, the thought of laying in a warm, quiet, meditative space—with proper eye protection, of course—while doing my skin care really appeals to me.”

2. GET EVEN Skin-care superstar Caroline Hirons′ full-body cocktail includes La Mer Body Cream and her secret weapon: ”Kate Somerville Deep Tissue Repair Cream twice a day, head to boobs.”

3. CLOCK WORK ”I would buy a time machine and start using products earlier to preserve my youth—and get my NeoGraft hair transplant 15 years earlier,” says Grand Rapids, MI plastic surgeon Bradley Bengtson, MD.

Gravity doesn’t care if you’re rich, famous or an MD. To beat it, Miami dermatologist Stacy Marie Chimento, MD daydreams of having Profound RF radio-frequency microneedling treatments done on her face, neck, stomach and thighs every two years—paired with the dimple-blasting powers of VelaShape, of course—for lifting, tightening and cellulite-busting.

Dr. Linkner thinks like us: “I’d get out my Pro-Nox and Ultherapy my entire body.” New York dermatologist Sapna Palep, MD agrees, though she’d alternate between Ultherapy and Titan. To cut down on trips to and from the office, Dr. Fichtel would buy her own Emsculpt device to leave at home. “The ultimate home gym equals Emsculpt, couch, boxed wine and Netflix.”

We wouldn’t make any lofty requests on House Hunters, just a chakra-balancing bathtub, preferably made out of Brazilian amethyst. All in the name of wellness, right?

DANITA DELIMONT / GETTY IMAGES

Sweat seems to be enemy number-one when money is no object. Franklin, TN dermatologist Jill C. Fichtel, MD says targeting “all sweaty areas every six months” is at the top of the to-do list, and Nanuet, NY dermatologist Heidi Waldorf, MD has her sights set on “Blowtox.” “I already ‘tox the back of my neck every five months—the bottom of my hair curls and frizzes as sweat travels there—but, ideally, I would treat my entire scalp every three months ($1,500).”

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MOST WANTED

BILL DIODATO / GETTY IMAGES, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

More than $1 billion was spent on injectables in 2018.

Of them, Botox Cosmetic ranks number one on the list of aesthetic procedures performed by plastic surgeons.

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FiLeS i We drink kombucha and sleep in probiotic-infused face masks because it’s “healthy” for our gut and skin, but what does “good bacteria” really mean? We investigate. by

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GuT

FEELINGS

“Beauty begins in the belly,” is not only the motto of Aussie brand The Beauty Chef, but also a phrase becoming more and more popular with dermatologists looking to help patients with complex skin issues. The reason: “More than 39 trillion bacteria live in and on our bodies, and the majority of them are in the gut,” says gastroenterologist Will Bulsiewicz, MD. “Only 13 years ago, we knew very little about the gut microbiome— the community of microorganisms inside our digestive tract—but a new laboratory technique in 2006 completely opened it up to us for study. What we’ve learned since is that our gut microbes aren’t just along for the ride, thriving off the food we eat; they’re central to our health, and we can’t live without them.”

Not only do they boost our immune system, but Dr. Richard Firshein, integrative medicine expert and founder of Firshein Center, says these microorganisms (predominantly bacteria, aka flora) also have great control over our metabolism and hormones, and even our mood. “Our brains are constantly communicating with our ‘second brain’ in our digestive tracts,” he explains.

“For instance, messages from the gut tell the brain when to seek food, while messages from the brain may trigger ‘gut feelings’ in response to stress.”

PROBIOTIC FIX To keep the good bacteria thriving and the bad bacteria at bay, we rely on a healthy diet and probiotics. “The word ‘probiotic’ means ‘for life,’” says New York dermatologist Whitney Bowe, MD. “Probiotics are living organisms that support the health of the ‘good bugs,’ or bacteria, that make up our microbiome and sustain the barrier function in our gut. When barrier function is compromised, ‘leaky gut’ can occur, meaning the gut lining allows toxins, undigested food particles and bad bacteria to ‘leak’ out of your intestines and travel through-

out your body via your blood. Our immune system marks these foreign substances as threats, and therefore attacks them, leading to substantial health issues.”

In 2008, Jamie Lee Curtis's Activia ads had us all studying yogurt labels in search of “live cultures.” Since then, kombucha and kefir started taking up space in our refrigerators, and kimchi became the “it” ingredient at five-star restaurants. “Although we can all benefit from eating probiotic-rich foods, that doesn’t mean we should be drinking 32 ounces of kombucha on a daily basis,” says Dr. Bulsiewicz. “A healthy gut is about diversity, not overdoing it on one thing we like.”

Additionally, these “good bugs” aren’t only found in foods: Gastroenterologists prescribe daily probiotic supplements—they’re also available over the counter— to patients to establish a healthier gut, as well as treat gastrointestinal issues such as IBS, bloating and constipation. “Current research also supports their use in weight loss, IBS, depression and anxiety, gut repair after taking antibiotics, food allergy prevention in children, and gastroenteritis, to name a few,” says Dr. Firshein.

“Although probiotics are generally considered very safe, not everyone needs a supplement-strength version, which is typically used with the intention to correct a specific medical issue,” Dr. Bulsiewicz adds. “There’s a lot of room for probiotic science and education to catch up with the hype.”

DAMAGE CONTROL Perhaps the most widespread use of probiotics is to counteract the effect of antibiotics on our microbiome.

“Doctors typically recommend taking the supplements during and after a round of antibiotics to replace the good bacteria the medicine destroyed,” says Dr. Firshein.

That daily Diet Coke you reach for around 4 p.m. can also wreak havoc. While artificial sweeteners add no calories to our diet, they do damage the naturally occurring bacteria in our gut, Dr. Firshein explains. “So the problem isn't just Diet Coke; it's all the products that use these sweeteners—they're found in many desserts, cakes and even bread—which cause our bacteria to produce compounds that are toxic to our bodies.”

According to Dr. Firshein, one of the main concerns with taking probiotics is that they are not broad-spectrum enough to fill the needs of the average person.

“Considering there are only a handful of strains in most probiotic supplements and up to 1,000 different types of bacteria in our guts, experts question whether ‘unbalances’ could promote the growth of harmful strains in certain individuals, or in some cases, limit the variations in the gut biome that a healthy person needs.”

39 TRILLION

The estimated number of bacteria that live in and on our bodies, which Dr. Bulsiewicz says is more than the stars in 100 Milky Ways, and weighs nearly three to seven pounds.

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B AC T E R I A B A S I C S DID YOU KNOW THERE ARE PREBIOTICS AND POSTBIOTICS TOO? HERE’S HOW EACH ONE WORKS IN BOTH GUT HEALTH AND SKIN CARE. WHAT THEY ARE

GUT HEALTH

SKIN CARE

Dr. Bulsiewicz tells his patients to think of the gut as a garden: “Prebiotics are the fertilizer, and are almost exclusively found in food—predominantly plant fiber. They are the part of our food that has an effect on our microbiome. Benefiber is actually a prebiotic, and I like to mix it into my morning coffee—it doesn’t change the taste or texture, and improves gut health.” Other prebiotic foods include garlic, asparagus and dandelion greens.

“Prebiotics are types of ‘food’ that bacteria on the surface of the skin can use to do their job,” says Jeff Rosevear, founding scientist and head of product development for SKINSEI, a prebiotic skin-care line. “For example, the microbiome produces fatty acids, which are then used by the skin to maintain barrier health. Emerging science suggests that by giving the right food to the right bacteria, one can support the overall microbiome.”

PROBIOTICS

These are living organisms in foods and supplements that help maintain good bacteria in the gut for a healthy, balanced microbiome.

“Probiotics act as the seeds in our gut garden,” says Dr. Bulsiewicz. “You can’t grow a seed without watering it and nurturing it with the right nutrients—in this case, prebiotics. When the two come together, there’s a synergy that creates postbiotics, like short-chain fatty acids.”

In skin-care products, probiotics are either living bacteria, bacteria that has been deactivated (killed), which is called a lysate, or the product of a bacteria, called a ferment. “Live bacteria are very challenging to formulate with in cosmetics, so it’s more common to use lysates and ferments, and there is scientific support to show that they both offer benefits to the skin,” says Rosevear.

POSTBIOTICS

Postbiotics are the byproducts created when prebiotics and probiotics combine. But, “you can’t just take a postbiotic supplement like butyrate because it would get absorbed in the small intestine and never make it to the colon, where it needs to be to work,” says Dr. Bulsiewicz.

“The best way to get postbiotics is by eating a diversity of prebiotic-rich plants.”

These are the metabolites, or byproducts of living organisms: “the enzymes, organic acids, polysaccharides, peptides, etc. that further reinforce the skin’s healthy barrier,” says Dr. Bowe. According to the FDA, 90 percent of cosmetic products that have “probiotic” labels actually contain postbiotics, but are marketed “probiotic,” similarly to the way “natural” and “organic” have been overused in skin care.

DENNIS KUNKEL MICROSCOPY/SCIENCE SOURCE

PREBIOTICS

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SKi N

SERVICE

It is scientifically established that gut health has a strong impact on skin health. “If the good and bad bacteria aren’t balanced in your gut, then conditions can result,” says gastroenterologist and founder of TULA Skincare, Roshini Rajapaksa, MD. “I was inspired to research the topical benefits of probiotics after noticing how much better my patients' skin looked once their health had improved with oral probiotic treatments.”

What Dr. Rajapaksa learned is that our skin has its own microbiome, which acts as its first layer of defense from climate changes, pollution, sweat and other assaults.

“The skin microbiome is amazing, adaptive and resilient when it’s healthy, but fragile when it’s not,” says Rosevear.

“Everyone has a unique skin microbiome because it is the result of everything an individual's skin has been exposed to over the course of their lifetime.”

Dr. Bowe explores this further in her book, The Beauty of Dirty Skin: “We know about ‘leaky gut,’ but there’s also ‘leaky skin,’ which is the compromise of our skin’s natural barrier due to an unbalanced skin microbiome,” she says. “Our obsession with antibacterial soaps and highpH cleansers often strip our skin of its healthy bacteria, which causes inflammatory issues and sensitivity.” In 2016, the FDA banned the use of triclosan in antibacterial soaps, affecting nearly 2,100 products. Manufacturers have since removed the ingredient from other products too, including toothpaste. “It can kill off healthy bacteria

COLD FAC T S

in some and promote drug resistance in others,” says Dr. Bowe. “Additional ingredients that can affect the skin microbiome include sulfur, benzoyl peroxide, sulfates, and high levels of harsh alcohols, surfactants or preservatives.”

However, this science is very new, and experts are just learning how each ingredient affects the microbiome.

“For example, certain preservatives at low concentrations might only create a very transient dip in certain strains, and people with healthy skin might be able to recover within minutes or hours of exposure,” Dr. Bowe explains.

“These are all questions companies are researching right now—Dove is conducting tests to ensure its cleansers don’t induce negative changes in our microbiome over time; Mother Dirt is using a live, ‘peacekeeper’ strain of bacteria to restore essential bacteria that have been removed by modern hygiene. It’s not enough to be clean these days; brands also want to be biome-friendly.”

BEAUTY BIOME Hence, the surge in prebiotic and probiotic products, which have anti-inflammatory effects on the skin (effects on the scalp are also being studied). This makes them a great option for those with acne, redness, psoriasis, dry skin and/or eczema—“when used topically, lactobacillus plantarum has been proven to decrease the number and size of acne lesions, as well as redness, and may also help with rosacea flares,” Dr. Bowe says. But, it’s important to know that topical probiotics aren’t a magic bullet for eliminating inflammatory conditions. “The challenge with this category of skin care is that many consumers are focused on immediate results,” says Rosevear. “They need to shift their mindset to think more about the longterm benefits of an anti-inflammatory regimen.”

Some interesting tools are also emerging that may allow prebiotic and probiotic skin-care products to become more personalized and effective. “A handful of companies are researching the ability to test an individual’s gut and skin flora,” says Dr. Bowe, comparing the technology to that of genetic testing companies like 23andMe. “For example, ProdermIQ can analyze the bacteria that exist on your skin after a single swab. The hope is to use this data to develop customized, efficacious skin-care lines.”

Will products that contain probiotics “die” if they aren’t refrigerated? Rosevear explains that preservatives can kill live bacteria, which is why it is difficult to formulate skin-care products with them because they'd require refrigeration, and most of us aren’t willing to do that. (However, with mini skin-care refrigerators becoming deskside staples, this could soon change.) To circumvent this issue, Dr. Rajapaksa says many companies, including her own TULA Skincare, have found a way to “extract the beneficial metabolites— postbiotics—from probiotic bacteria, isolating the specific actives that are effective on the skin. This ensures our products remain both shelf-stable and effective without the need to refrigerate,” she says.

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THE KIT

S P O N SO R E D

THE TOP SUPPLEMENTS AND SKIN CARE TO TRY NOW

YOUTHEORY SPORE PROBIOTIC POWDER Mix one scoop of this flavorless powder with water to support and replenish the healthy microflora in your gut. $28, vitacost.com

TULA KEEP IT CLEAR ACNE FOAM CLEANSER

This blend of salicylic acid and probiotics cleanses skin and treats breakouts in one step to keep complexions calm and clear. $34, tula.com

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HUM NUTRITION SKIN HEROES PRE+PROBIOTIC

The nine probiotic strains and prebiotic konjac root in these vegan capsules help combat non-cystic acne from the inside out. $40, humnutrition.com

SKINSEI LUCID BEAMING SERUM NO. 219

Part of SKINSEI's personalized, prebioticinfused regimen, this serum reinforces the skin barrier and takes down inflammation. skinsei.com

THE BEAUTY CHEF GUT PRIMER INNER BEAUTY SUPPORT An exclusive Flora Culture blend powers this powder's ability to reduce digestive discomfort and aid in healing leaky gut. $69, us.thebeautychef.com

MOTHER DIRT AO+ MIST

Spritz this expertfavorite live probiotic spray on twice a day to restore clarity to unbalanced skin— clinical research shows results in four weeks. $49, motherdirt.com

PLANT-BASED PROBIOTIC

THE NUE CO. PREBIOTIC + PROBIOTIC

Fight bloating and symptoms of IBS with these daily time-delay capsules that go easy on the stomach and offer skin benefits, too. $75, thenueco.com

GLOWBIOTICS HYDRAGLOW CREAM OIL

Bring dry, unhappy skin back to life with this creamy oil that contains both probiotics and light-reflecting minerals to impart a serious glow. $59, glowbiotics.com

Skin doesn’t need to sacrifice efficacy for clean beauty.

DERMA E provides a wide range of proven clean beauty solutions. Combining nature’s best ingredients with targeted vitamin solutions, DERMA E has created safe, clean, 100-percent vegan and cruelty-free products that actually work. One of our top picks? Vitamin C Intense Night Cream. The blend of anti-inflammatory probiotics, potent vitamin C and mineralrich rooibos in this luxurious overnight moisturizer support the natural rejuvenation of environmentally stressed skin.

Probiotics help guard against daily environmental aggressors, while stabilized vitamin C and antioxidant-rich rooibos work to reduce the appearance of age spots, wrinkles and uneven skin tone. The bottom line: A healthy skin microbiome goes hand in hand with a brighter, more youthful-looking complexion.

AVAILABLE AT: DERMAE.COM

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Y E L L OW

LIGHT

How does a mall mainstay remain relevant for 40-plus years?

Family farms. by

ELIZABETH RITTER

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M

My first foray into fancy beauty products came in the form of a very generous gift from my good friend Kate: a duo of L’Occitane’s Verbena Shower Gel and Hand Soap, a single sprig of lavender on top. The set was worth more than anything else sitting in my shared 300-square-foot studio apartment, but it was that smell—an intoxicating grown-up, fresh, somewhat citrusy scent—that had me hooked. There was something simply magical about the green-hued liquids and textured label that I had never experienced before—a precursory jaunt into my future beauty-editor path.

They were special. I was in love.

The only logical thing to do: Enforce extreme rationing. The soap stayed under the sink until guests visited; my roommate had strict instructions not to use the gel without approval.

Fast-forward to a few months ago when I visited Corsica, a sun-kissed island off of the South of France. It might be a land of endless beauty, sunflowers, good food and wine, and the birthplace of Napoleon, but it’s also the place where L’Occitane, my beloved brand from years ago, grows many of their powerhouse botanicals: rows and rows of lavender, verbena and the star of the show, the immortelle flower, a bright-yellow potent antioxidant bloom­. (April Franzino, beauty director at Good Housekeeping, says she has an immortelle bouquet that has stayed intact for a decade; I still don’t know how that’s biologically possible, but I trust her.)

This is the place of beauty-ingredient dreams.

Alas, it’s also the place where one could have experienced some life-altering heat this past summer. The particular day I meet mother-of-three Pascale Chérubin to see her organic farm, the temperatures hit an all-time high of 117 degrees—a temperature I had previously only been exposed to in the hottest of dry saunas.

You can see, and feel, the effects of global warming here: A fire in 2015 burned at least half of Pascale’s immortelle crops.

After the fire, the brand helped her replant and rebuild everything, she says. “I don’t have an exclusivity clause with them, but I choose to sell the flower to only them.” She’s also the first woman the brand had contracted to grow the plant, a claim

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she’s particularly proud of, considering most of the farmers in the region are male.

And she needs to grow a lot: It takes no less than 800 immortelle flowers, picked on the summer solstice, to make one single jar of the brand’s Divine Cream. Verbena is equally as tricky to get right: The short and stocky leafy greens have to be replanted every year and they’re not indigenous to the region—although they’ve clearly become an integral part of the traditions. The success of both harvests also relies heavily on what the farmers refer to as a “patchwork,” where wildflowers surround the main crops to help the pollination process.

Although L’Occitane products can be found in 80 countries and 1,500-plus stores around the world, stories like Pascale’s show that the brand is still run with the soul of a small family business in so many ways. The hand creams and hockey puck– shaped shea butter lotions might be easily found in many malls and airports, but the heart—and the descendants of my sprig of lavender from that studio apartment many moons ago—are still alive and well, growing under the watchful eyes of very dedicated families some 4,000 miles away.

That night, back in my hotel room, the temperature is a bit cooler. And I break open a jar of the precious Divine Cream.

I smile as I apply it; there’s a big part of Pascale’s backyard in this one jar. Although I no longer have a roommate, I’m still not sharing.

Extracting the immortelle flower is a fine-tuned distillation process where the floral water is separated from the other parts of the plant.

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LAUREN HUT TON

MOOD is a

The iconic model never conformed to anything—and she’s not about to start now. by

ELIZABETH RITTER

IT’S FUNNY HOW IN THE MIDDLE OF NEW YORK, THE TINIEST REPETITIVE NOISE—the chewing of gum on the subway, the click of lightening-speed texts with the phone volume on high—can be a colossal annoyance.

For Lauren Hutton, it’s the banging of a curtain cord, courtesy of an open-window breeze at The Plaza Hotel.

“What’s that noise? Yoo-hoo, can someone come in here? Where’s the noise coming from?” she asks, apologizing in the process.

A man darts out of a second room and closes the window. “This is my assistant, Morthon,” she says, introducing us and then switching gears in the same breath.

“Wait! We didn’t ask if you wanted a glass for your water!”

Seconds later, I’m whisked into another room that reveals a full-on glam squad setup that’s there to prep Lauren for a gala she’s attending at the hotel that night.

There’s a hairstylist reading on the bed, luscious bath-

robes on a rack, and a makeup table organized with the care of a sushi chef plating fugu.

“This is my dress,” the 76-year-old says, holding up an off-the-shoulder navy suit that she wants me to touch to feel the fabric. “I don’t wear black—it doesn’t work for me. It works for you, but not for me. I have too many yellow undertones.”

I’m still conscious of our time as she leads me over to her skin care–makeup station to show me the products she loves. I have to get her back to that sofa so we can chat, or else I won’t have a story. I take a deep breath as she starts to massage her favorite serum into the back of my hand to show me how well it works. And then, in one of the breaths, I acquiesce. This is Lauren Hutton: I will relax, try the products and let her tell me when she’s ready to talk. She is in charge. And she will start when she is ready.

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And then she was ready to talk. “I’ve read all your stories on sunscreen,” Hutton says. “If only I had read them earlier because I never wore anything. Well, to be fair, they used to not really have it. But I never even wore a hat— even when I was in Africa. Africa was my first stop out of the States. I gave Eileen Ford a wink and said, ‘I’ll be back in two weeks.’”

SUNSCREEN IS KIND OF MY THING.

It’s funny. Every generation gets younger and younger because we learn more. We have more information, more stuff to use—like really good SPF and things like that.

And we’re smarter, and we’ve got jobs.

I was lucky. At 18, birth control pills came across the counter. And then I got a job as a waitress because that’s where I could make money at night. I put myself through college, mostly in New Orleans, by working on Bourbon Street at night in a jazz club. It was a fantastically interesting time. Our first guest was Dizzy Gillespie. Then, after that, it was just one great after another. I learned so much. I learned much more on Bourbon Street than I learned in school, and it was a very good school.

EVERYONE SHOULD HAVE TO WORK AS A WAITER OR WAITRESS AT LEAST ONCE.

Good girl! It should be national service. It should be something that every person does, no matter what class.

Even if you’re Zuckerberg’s kids, you should have to do it because you meet every kind of person and you start to understand. I got so much better of an education. Believe me, I have thought about going back to it too. Around 60, I started thinking, “What if I won’t be able to waitress again? So, I better not lose all my money again.”

YOU’VE RECENTLY TALKED ABOUT OTHER THINGS IN THE PAST—SPECIFICALLY HARVEY WEINSTEIN.

I had forgotten about it until I started seeing all this stuff coming out about Harvey and something just kept going Ping! Ping! Ping! in the back of my mind. Then finally, I remembered this meeting—the whole thing took place in what was probably 10 minutes. I think, for him, it was that maybe he’d seen a picture of me recently and thought, “Gee, how did I miss her?” What an idiot. Suddenly, the door opened and I looked up—it was a tiny little place too. I looked up and he was in this dirty old

bathrobe. It was sort of tied, but not real tight, and he was standing there with his hand on the thing, and he looked up and he passed me—then he stood there for seconds.

So, I’m looking up, and it was so odd that I was just looking at him, and then he shuts the door and went back in.

Then, about five minutes later, one of the secretaries said something came up for Harvey unexpectedly. I think he probably thought, “She’s too old. I can’t do it.” Maybe he heard something in his head saying, “I better not even try because this is dangerous.”

HAS IT GOTTEN BETTER?

Oh, much better. Guys aren’t such big fools. The guys now have mothers and grandmothers from my generation who got birth control at 18 and jobs by 20, maybe by 25. Little by little, it got better.

The thing that I’m most proud of is that American Gigolo came out when I was almost 40. You can’t—at least you couldn’t back then—have a lead in a movie unless you’re NOT that age. And it just got more popular over the years, to the point that it’s now a cult-classic.

After that, I started making five bad movies a year.

“Bad” in the sense that I wouldn’t want to see them. I think it was because I was having problems in my personal life, so I was trying to stay away from conflict. So, for a couple of years, that’s what I did. Then I realized, looking in magazines, that, in fact, I could be somebody if I forced my way back in. There had never been such a thing for a 30something. I snuck in with Revlon at that age because they thought I was much younger. So, I thought, “If I get myself back in, and I’m the one who can do it because I was just so well-known, that it would be good for women.”

Because we had gone into everything else—we were in the Supreme Court! We were in pretty much everywhere else a tiny bit, except when it came to our actual image.

IT’S TRUE. YOU WERE IN YOUR 40S WHEN YOU LOST THAT REVLON CONTRACT...

I was 47. I was 31 when it first happened, and it was my idea. It was a good idea, but it didn’t change everything.

YOU MUST FEEL DIFFERENTLY NOW, BEING THE FACE OF STRIVECTIN’S CAMPAIGN.

I’m really pleased about it. There’s been no one out there that’s been 60. There’s Cindy and Naomi, Christy and a

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few others. And then Linda, of course. The great Linda!

But they must be…50? Who is 60? Maye Musk, maybe, but it’s different because her son is a trillionaire. A genius trillionaire, but nobody grew up with her around. It all means we finally have a place to grow to! My mother was parked at 30 in her generation. She was born in 1923 and it wasn’t so long ago that, at 43, we were certainly supposed to be parked—and that was progress. That was the silly boy’s idea of progress.

So, yes, I’m very pleased with StriVectin for being hip enough to go with me—a woman in her mid-70s. It’s a very interesting company. It was started by two doctors, a married couple who was looking for burn and woundhealing stuff for the skin, and I love that the current CEO is a woman. They know what they’re doing. I’m approached by a lot of brands, but not really beauty brands anymore; seems more like car brands and things like that are interested in me. But this is the product I put on, the product I send to my three sisters, the product I got good reports back on right away, the product my friends ask me: “What did you do? Did you shoot something in your face?” It’s real stuff. It’s real medicine. I like to layer it all on.

AND YET YOU STILL SWEAR BY COCONUT OIL!

I was around it as a kid because it was good for your skin and then you’d put it in your hair. I doubt if you can still do this now, but it used to be that I’d be able to get it where they were actually taking the husks and pressing them—where they’d make copra. I even think the Hawaiians have something like 300-some different names for the stages of coconut—of the growth and all the different things you’d do with each one. You used to be able to get it in this old bottle that had an unbelievably beautiful amber color, and you’d put it on and smell like peanut butter—the best peanut butter cookie you have ever had in your life.

YOU DON’T SEEM TO LIKE TO CONFORM.

There are so many ways people ask you to change. Do you know Lillian Gish? Broken Blossoms is one of her wonderful movies. She made a lot of silent films but she taught, too. We were all in A Wedding together. It was wonderful and I got to know her. Then we did some press for the movies together. I remember they asked me my age and I was just about to say it, and she said, “Lauren, a woman who will tell her age will tell anything.” Back then, you were probably ruined if you said your age. Now, we’re a little hipper and a little bolder, a little smarter.

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“ I’M VERY PLEASED WITH STRIVECTIN FOR BEING HIP ENOUGH TO GO WITH ME.” ONE WOULD HOPE.

I’ve never been much of a good shill. In the sense of if I don’t believe it, I can’t back it. I never did cigarettes, even back when everyone would have a cigarette. The first big bunch of money I was ever offered as a model was for those long cigarettes made for women, and I thought, “Boy, I might be a user, but I’m not a believer.” And I turned it right down. I got a lot of complaints from agents about it, but I still didn’t do it.

YOU MUST HAVE SOME THOUGHTS ON SOCIAL MEDIA.

I’ve never had social media. I had this makeup company, which was really good for a bit, and they were spending 300 million in advertising, but it was just my mouth on TV and I think they had a Facebook page. That’s the only time I really dealt with it. I don’t do it, I’ve never done it, and I won’t ever do social media. I don’t follow anything or anyone, and I don’t know about it. I use my phone and I text. I’ve never liked machines.

It was a very long time before I even learned to drive a car. When I started making movies, I had to learn to do it, but for a long time, I hitchhiked. I used to hitchhike outside the Chateau Marmont. I didn’t want to wait for a taxi to come, so I’d stick my thumb out. I was like 25 and a big deal in New York as a model, and it wasn’t smart nor safe.

WHEN YOU’RE NOT FROM A BIG CITY, SOMETIMES YOU DON’T KNOW…

Well, that’s all from my previous life. I was born in Charleston. Then we went to Florida—my mother sort of

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...THAT VIDEO, JUN ROPE’, IS HAVING A MOMENT.

With Dick, I was trying to be Veruschka, and meanwhile, I was about six or seven inches shorter than her, and I wasn’t smart enough to understand it was about bones and the length of bones. Veruschka could go into these poses that looked like abstract art because she was probably six foot one, but when I tried to do it—I was trying to act like a gazelle or something. I can still remember what Dick looked like. We became very close friends and worked together for probably 15 years or so. He said, “Where did you come from?”

He didn’t want to say, “Stop trying, you idiot.” He was too kind. I said, “Well, Florida.” He said, “Florida?” I said, “Yes, up in the woods, and he looked up and he said, ‘Woods?” And this was a huge studio, he’s lying on the floor, and he had this little Rolleiflex, and he laid there because that makes you look taller, and he was saying, “What did you do in the woods?” And I remember being 10 and 11 and 12, 13, and the woods behind us were all giant—those trees, the huge trees, and those bushes and there was a lot of snakes, big rattlers, really big most poisonous ones. We had them.

I’m telling him and he said, “Jump? You jump over the turtle logs?” And I said, “Yes, I didn’t want to step on them.” And he’d say, “OK,” and he jumped up, and he made a little X in the middle of the white paper that was in the middle of this big, dark studio because he didn’t want any distracting lights, and no one’s allowed in. They have 30 people standing around doing nothing, but those were sacred spaces! And he said, “OK, go from there,” and he made another little mark here on the side and that side, and he said, “Run! Take it from here! Run and jump over that X.” So that was the focus, and I did it. We had some of the best pictures I ever took—just like that.

IT’S ICONIC.

That was after we’d been working together probably eight years or something. I just saw the video the other day. I had no idea it was being looked at. I haven’t seen it since Dick first showed me it. But, yes, it was fun. What was interesting about that is it’s like a burlesque and he was a wonderful director. By then, I was traveling for four months. Like two on and two off—or three on, two off, and then I’d come back and work again for a few months.

But both Dick and Penn said that my face changed.

THAT’S A FAMOUS QUOTE: EVERY TIME YOU TRAVELED, YOUR FACE WOULD CHANGE.

Yes! And I was usually traveling a lot, and often sleeping on the ground, and it was certainly intense. I was lucky.

The first thing you see is there’s a beautiful woman everywhere—one of every size, every shape, every combination, and there’s also beautiful men, but especially women. Then I started to think, “What in the world are we doing with just our big, tall, skinny whites?”

And that changed. I hoped that would change. Yes, I did. I hoped that because I, well, for starters, I was tanned and no one was very tanned in those days. But I just couldn’t stay out of the sun because I’d grown up in it, I felt good in it and my skin could take it. One day, we were reshooting a cover for the second time, maybe even the third time, and it was a Saturday, and suddenly, in the doorway to the dressing room, which was very rare because there was no one out front to keep people out—I mean, it was someone who obviously had an appointment—there was this beautiful girl, Beverly Johnson.

I just remember saying, “Look at her.” Because usually, you look through the mirrors and it’s not clear. I looked over and there was this beautiful African-American girl.

I said, “Why shoot me? Shoot her.” I don’t think I even had anything to do. I was of whatever it is, the social ideal, but that isn’t where my sympathies were…

I’M SURE. CAN YOU PINPOINT YOUR FAVORITE COVER?

I have many of them. I was lucky I did a lot, but I did one with daisies. It was an early Vogue cover and I have really big eyes. That’s a great one.

I had some great ones...if you give me your phone number, I promise I will call you back and tell you more.

MODEL CITIZEN

From a life of travel, travel, travel (shown, at right, in Paris and New York’s Central Park) to her latest gig as StriVectin (she refers to the products as “real stuff, real medicine,” the products she shares with her sisters) spokesperson and a whole bunch of modeling, movies and iconic covers in-between, Lauren Hutton is #goals.

JEAN-LOUIS URLI / CONTRIBUTOR / GETTY IMAGES, SHUTTERSTOCK, BERNARD GOTFRYD / CONTRIBUTOR / GETTY IMAGES, GIANNI PENATI / CONTRIBUTOR / GETTY IMAGES

ran away. My father was in the War, but we were still inside the Charleston bubble. We stayed in that bubble until she met a guy, and two weeks later, she married him, which was a big mistake…well, I guess it wasn’t. I got good sisters out of it. He moved us to a swamp on the west coast of Florida, outside of Tampa, which was a three-syllable word back then. I would still go back to Charleston for weddings, funerals and family stuff, so I had these very diametrically opposed things. My stepfather also lost all his money in a short time—like six months—and for my mother, it was a surprise. But he was a very good man, and knew about the woods and that was great. So, suddenly, I got to be out in the trees— more animals than I’ve ever seen anywhere. I mean, not big like East Africa, but some serious animals. That was the thing about Dick [photographer Richard Avedon]…

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I remember the call from my mom: “I think I’m going through the change,” she said, detailing her erratic temperature shifts, her lack of sleep and the “pooch” below her belly button that used to shrink with exercise, but no longer budged. I could hear the uneasiness in her voice, like she couldn’t believe she’d reached this point in her life.

Duxbury, MA plastic surgeon Christine Hamori, MD hears this often from patients: “The topic of menopause has been under a shroud of shame and guilt for too long,” she says. “All women experience it, and it’s important that we discuss it,” especially as studies reveal that more than 50 million women in the U.S. will enter this phase of life by 2020.

BRITTANY BU R HOP FA L L ON by

THE 3 STA G E S O F M E N O PA U S E

The “Ovarian Retirement Plan,” as Louisville, KY obgyn Rebecca Booth, MD calls it, has three unique phases. Here’s the scoop on each.

1

PERIMENOPAUSE is considered the winding down of a woman’s biological clock in her late 30s or early 40s. “Menstrual cycles begin to shorten, periods often change and PMS may become more dramatic,” says Dr. Booth. Perimenopause is also not to be confused with “Premature Ovarian Failure (POF), which is the loss of ovulation before age 40 and affects as many as 1 percent of women,” she adds. “The cause is usually unknown, but diabetes, autoimmune diseases and smoking often contribute.” (“Smoking has been found to put women into menopause two years earlier on average,” says Hamilton, NJ obgyn Omnia M. SamraLatif Estafan, MD.) Rochelle Weitzner, CEO of Pause WellAging, a menopause-centric skin-care line, says that in certain circumstances, women can be thrust into menopause early. “Induced menopause can result from chemotherapy, radiation, autoimmune or thyroid diseases, and IVF treatments; surgical menopause occurs immediately after a woman has her ovaries removed,” she explains. “In this case, her symptoms may be more severe because of the rapid change to her body.”

2

MENOPAUSE marks the cessation of ovulation—going a full year without a period. “We are born with all of the eggs we will ever have, and they deplete as we age, with all of them disappearing around age 51,” says Dr. Booth. A sharp drop in predominant sex hormones—estrogen, testosterone, progesterone—causes troublesome symptoms for many women (more on that later), but some don’t experience them at all.

3

POST-MENOPAUSE begins immediately after menopause. Per the U.S. Department of Health and Human Aging, because baby boomers are past the midlife point, an unprecedented number of women are currently in this stage.

ERIC TRAORE / TRUNK ARCHIVE

SECOND ACT

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SHIFTING GEARS

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THE SIGNIFICANT DROP IN ESTROGEN DURING PHASES of menopause can manifest both internally and externally. “Like pregnancy, menopause can be a wonderful transition or a complete upheaval of normalcy,” says Dr. Samra-Latif Estafan. “Everyone’s journey is different, so it’s important not to believe everything you read online.” These are the side effects that can arise, and what to do when they throw you out of whack.

SKIN

“The skin on a woman’s face has the second highest concentration of estrogen receptors in her body—the reproductive area has the most—which means that changes in hormone levels directly impact her skin,” says Nashville, TN dermatologist Jill Fichtel, MD. The estrogen decline leads to slower skin cell turnover, which “causes light to reflect off the skin differently, affecting the color and brightness of the skin, and making natural irregularities like wrinkles, oil glands and hair follicles more noticeable as bumps and depressions,” she adds.

One of the most dramatic effects is the acceleration of loss of elasticity and formation of wrinkles. “A study on the decrease of skin collagen in postmenopausal women found a decrease of 2.1 percent per year in the first 15 years after menopause,” says Dr. Booth.

“Thus, on average, from age 50 to 65, more than 30 percent of skin collagen will be lost.”

The collagen plummet then contributes to sagging, “especially around the cheeks, jawline and neck,” notes New York plastic surgeon B. Aviva Preminger, MD. For those wanting to restore a more youthful contour, in-office skin-tightening treatments such as Ultherapy and AccuTite, as well as facelifts and necklifts, can provide long-lasting results.

Dry and dehydrated skin are also concerns: “Moisture levels of the dermis are no longer regulated, and the skin isn’t able to effectively defend itself against oxidative stress,” says Weitzner. “When this is the case, look for products containing hydrating ingredients that also promote collagen production and support skin’s structural integrity, such as niacinamide, peptides and hyaluronic acid.”

Skin-care products made with plant-derived molecules called phytoestrogens—red clover, soy, grape seed—also help reverse signs of ag-

ing in the skin. “They mimic the effects of estrogen, and when applied topically, they activate estrogen receptors in the epidermis, promoting the skin’s ability to hold onto water, as well as increasing collagen and elastin production,” says Dr. Booth, who’s also cofounder of VENeffect, a phytoestrogen-based skin-care line. “Over time, lines and wrinkles become less visible, overall texture improves and skin recovers its glow.”

BODY

Metabolism is effected by estrogen, too, so for many women, menopause triggers weight gain. “The weight seems to settle around the abdomen, hips and thighs, and is very resistant to diet and exercise—the average woman gains between 10 and 15 pounds,” says Dr. Preminger. Breast size can change as well, but whether this is due to weight gain or changes in breast density is not clear, Dr. Hamori says, adding that many of her patients experience this during their 40s and 50s.

“ON AVER AGE, FROM AGE 50 TO 65, MORE THAN 30 PERCENT OF SKIN COLLAGEN WILL BE LOST.”

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“A major side effect many women suffer from but don’t talk about is achiness in the muscles and joints—in some countries, it’s the number-one complaint,” says Mary Jane Minkin, MD, obgyn and clinical professor of obstetrics at Yale School of Medicine. “We really don’t know what brings it on—likely dryness in the joint capsules—but it’s being studied.”

A high rate of osteoporosis is associated with menopause as well: According to the National Center for Biotechnology Information (NCBI), more than 250,000 menopausal and post-menopausal women have this form of bone loss (or decreased bone density) due to estrogen deficiency. “During menopause, women experience an accelerated rate of bone loss of 3 to 5 percent per year for the three to four years after their last period,” Dr. Minkin explains. “We continue to lose bone after that point, but not at such a fast rate.”

Prescription medications such as bisphosphonates and denosumab, and supplementation with calcium and vitamin D, can help minimize symptoms.

HAIR

FEIFAN WANG / EYEEM / GETTY IMAGES

According to Dr. Minkin, hair loss is not an “official” side effect of menopause, but many women experience it, in addition to an increase in the brittleness of their hair and a lack of shine. “The hormonal changes decrease how long anagen—the growth phase of the hair cycle—lasts, leading to thinner, finer, shorter hairs that can even reach the point of being vellus hairs—the barely there hairs you see on your forehead or ears,” Dr. Fichtel says. To strengthen fragile strands, fill your routine with products that promote a healthy scalp and stimulate hair growth, such as essential oils and minoxidil.

VASOMOTOR SYMPTOMS

When we think of menopause, we think of hot flashes and night sweats—known as vasomotor symptoms—which result from constriction and dilation of blood vessels in the body, and affect approximately 75 percent of menopausal women. “Hot flashes last about three to four minutes and can cause discomfort at

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any time of the day,” says Dr. Booth. These, along with night sweats, “occur as hormone levels fluctuate, creating a rush of adrenaline that provokes a surge or drop in body temperature,” says Dr. Samra-Latif Estafan. Migraines are also common, and can generally be managed with OTC pain medication.

Dr. Minkin recommends over-the-counter Remifemin—a German product containing black cohosh, which has been proven to be more effective than soy at relieving menopausal symptoms—and Relizen, a Swedish pollen extract you can find online. “Studies show mixed results, but I’ve found these to be reasonable remedies for my patients,” she says. However, be aware of OTC herbs that make promises to erase symptoms, notes Dr. Samra-Latif Estafan, as some may have benefits, but could interact with other medicines.

Preliminary research is also underway on the positive effects of ingestible and transdermal CBD formulas on vasomotor symptoms, but Dr. Minkin says there’s “very little prospective randomized data,” although some of her patients have been using it and find it helpful.

PSYCHOGENIC SYMPTOMS

Whether it’s a hot flash that wakes you up in the middle of the night or you just can’t doze off, sleep disturbance is a prevalent psychogenic symptom of menopause. “As we age, it has been found that we produce less melatonin, a chemical messenger that is important for sleep,” says Dr. Samra-Latif Estafan.

With lack of sleep, fatigue is very common.

“Exercise has been found to have fantastic benefits for promoting sleep, reducing mood swings and preventing fatigue, and can also help with weight gain that can occur,” she adds. “And a clean diet and cutting down on alcohol will assist in keeping your liver clean, allowing your hormones to function better.”

The imbalance in the estrogen-to-progesterone ratio can cause irritability and difficulty concentrating as well, adds Dr. SamraLatif Estafan. “It is perfectly normal and will eventually subside.” It’s not atypical for feelings of anxiety and depression to escalate, too, but it’s important to discuss them with a doctor.

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MENOPAUSE LARGELY IMPACTS OUR SEX ORGANS AND SEXUALITY, resulting in a variety of urogenital symptoms that affect nearly 60 percent of women, according to NCBI. “The decrease in estrogen, testosterone and progesterone can cause stress urinary incontinence and a decrease in libido,” says Dr. Hamori. “Internally, the vaginal wall becomes significantly drier and thinner due to a loss of collagen and elastin, which can cause women to experience pain during sex and result in a loss of intimacy and self-esteem.”

Dr. Minkin notes that vaginal dryness tends to occur as one gets further into menopause—“hot flashes tend to get better, vaginal dryness gets worse,” so she recommends a moisturizer like Replens, which is available over the counter. Dr. Booth adds that, although OTC options are effective, she explains to patients that “lubrication may help women feel more slippery, but only estrogen inspires elasticity. Therefore, a topical estrogen cream might be a better solution, but it does a require a prescription.”

POWER PLAY

To help tackle these issues and enhance sexual well-being for menopausal women, medical companies have created laser and radio-frequency (RF) devices—based on the science behind existing tightening and

resurfacing technologies for the face and body—which are administered by gynecologists, dermatologists and plastic surgeons.

If the concern is stress urinary incontinence (when you sneeze and a little urine leaks out), Viveve, ThermiVa, Votiva, FormaV and Emsella (electromagnetic energy) can strengthen the pelvic floor, “but they don’t actually tighten the vagina,” says Dr. Hamori. “Vaginal dryness can be reduced with erbium and CO2 laser devices such as Diva, MonaLisa Touch and CO2RE Intima.”

Last year, despite physicians’ advocacy for the devices and heartfelt patient testimonials, the FDA served several manufacturers a warning to revise their claims, which were misleading consumers. The FDA also voiced concerns that the treatments “have serious risks,” but Dr. Preminger says available literature does not demonstrate evidence that these devices are unsafe. “Since the FDA’s warning, the companies involved have adjusted their language accordingly regarding indications for these types of procedures,” she adds. “For example, changing vaginal ‘rejuvenation’ to ‘restoration.’ However, we still need more long-term studies to compare devices and determine their efficacy.” Dr. Hamori says few untoward side effects have been found when the devices are used by trained professionals on appropriate patients.

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SEXUAL HEALING

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THE KIT

SIX ESSENTIALS THAT HELP MAKE MENOPAUSE A LITTLE BIT EASIER

PAUSE WELL-AGING HOT FLASH COOLING MIST

VENEFFECT FIRMING PHYTO-LIFT SERUM

VFIT

Hot flashes may not be avoidable, but they can be tamed with a quick spritz of this ultra-refreshing mist. $39, pausewellaging.com

A wonder worker for skin that’s lost its youthful bounce, this fragrance-free serum restores firmness to the face, neck and décolleté. $195, veneffect.com

Red LED lights, gentle heat and sonic technology combine in this supercharged at-home device to deliver optimal vaginal health and wellness. $495, getvfit.com

THE GOOD PATCH HOT FLASH

EMEPELLE NIGHT CREAM

NUTRAFOL WOMEN’S BALANCE

Wear this tiny, CBD-infused transdermal patch on the inside of your wrist to help keep temperature spikes at bay. $12, thegoodpatch.com

Formulated for estrogendeficient skin, this retinolinfused night cream hydrates, smooths and brightens in one step. $195, lovelyskin.com

Wellness all-stars maca and ashwagandha give this thinning hair supplement an anti-menopause boost. $79 per month, nutrafol.com

THE HORMONE R E P L AC E M E N T THERAPY D E B AT E Hormone Replacement Therapy (HRT) can be a powerful tool in the fight against frustrating menopausal symptoms.

“Contrary to some analysis, recent scientific evidence is basically encouraging women to rethink estrogen therapy and letting them know it’s safe for most,” says Dr. Minkin.

It also may afford women other protections, including positive effects on heart health and the prevention of osteoporosis. “There is also considerable data from Europe showing that natural progesterone is quite safe for the breasts [past studies have linked progesterone to an increased risk of breast cancer],” adds Dr. Minkin.

“If you start taking it within five to six years of your last period, most research suggests the estrogen does have protective cardiovascular effects.” Another option is bioidentical therapy: oral estrogen and progesterone that are exactly the same as the estrogen and progesterone our ovaries make, or used to make. “There’s a new, FDA-approved version called Bijuva that is available at the pharmacy and covered by insurance,” says Dr. Minkin.

“It’s also proven to be quite effective for treating both hot flashes and vaginal dryness.”

( M E N O ) PAU S E B U T TO N As far-fetched as it may sound—it’s still very experimental, and long-term effects, if any, are undetermined—“doctors have figured out a way to delay menopause by up to 20 years by surgically removing a portion of a woman’s ovaries, cryogenically freezing it, and then reimplanting it when the woman reaches perimenopause,” says Weitzner. The reimplanted tissue resets hormones to where they were at the time of the original harvest (similar to when you revert a computer document to a previous version), thereby delaying the onset of menopause—the procedure has been used since the late ’90s to preserve fertility in women undergoing chemotherapy. “While it sounds exciting, to achieve the two-decade delay, women would have to undergo the procedure in their 20s, and may not be prepared to make that decision then,” Weitzner adds.

“It’s definitely interesting technology, and who knows, maybe one day we will be able to delay menopause forever.”

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Say aloha to the real H-Beauty: thoughtful, spiritual, sustainable self care EM I LY D OUGH ERT Y

PAR ADISE MELINDA PODOR / GETTY IMAGES, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

by

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Big Love: Four Seasons O’ahu’s surf guides can match you to your perfect wave, from Waikiki’s good-natured swells to Makaha’s epic breaks.

FOUND J

oan Didion, one of the more famous Honolulu tourists, described Hawaii as a magical place where “winter does not come, and no one fails and the median age is twenty-three.”

This Imaginary Hawaii, captured in the tikikitsch of Elvis and the Brady Bunch or bottled by good-vibe, escapist beauty brands like Hawaiian Tropics and Maui Moisture, has been reclaimed—redefined, gently but powerfully, by an inspiring collective of H-Beauty founders who are tapping into their culture and celebrating their land. “I’m in good company in Hawaii as far as women entrepreneurs go,” says Oahu-based Jennifer Binney, the creator of surf-chic Samudra.

“All of these creative women—wahine—are deeply tied to our natural environment,

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whether through surfing, paddling, hula, lei making, or just being outside and one with nature.” Oahu-born aesthetician Kapua Browning, founder of skin-loving Honua, remembers how her mother and grandmother taught her that ocean water was the ultimate beauty/life fix. “If you have a cut, if you have acne, if you have a broken heart: we were taught to just go jump in the ocean. It cures everything.” And any problem the ocean can’t solve, ‘olena (turmeric from local ginger) or kukui nut oil will. “I think the focus here is function and ease,” says Binney, who notes that makeup takes a backseat to skin care. “Most girls just get their brows and lashes done, and that’s it. That’s all the makeup you need here in Hawaii—you just have to take care of your skin.”

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MIRACLE WORKERS

A

bsorbent and calming, body powders are an island essential to protect skin from the intense heat and ever-present humidity. Mamalani Lohaki ($18, mamalani.com), formulated by Mamalani founder Mele Kalama-Kingma, uses a combination of taro, kaolin and arrowroot plus “gently antifungal” essential oils. “I just love Mele’s energy; her deep roots in Hawaiian culture,” says Binney. Newly reformulated, bestselling Honua Aloha Youth Serum ($92, honuaskincare.com) now packs bakuchiol and vitamin C–rich noni into the original turmeric and kukui nut formula. “It’s the perfect serum-and-moisturizer-in-one for humid days, but it’s also great for layering under your favorite moisturizer in winter months,” says Browning. Papaya and pineapple enzymes combined with hydrating macadamia oil make Pamplemousse Tropical Cleansing Oil, from Kauai-based Leahlani, our current cleanser obsession ($54, leahla niskincare.com). “Once you try Leahlani, you are addicted!” Binney promises. Also from Kauai, buttery Mahalo Skin Care Rare Indigo Beauty Balm calms angry skin with TLC superstars like indigo, marula and kukui.

“OUR DEEP LOYALT Y TO HAWAII MAKES US ALL VERY SUPPORTIV E OF E ACH OTHER. I’M PROUD TO BE HAWAIIAN.” —JENNIFER BINNEY

CLOSE ENCOU N T ER

During an artist residence at Waikiki’s Ritz-Carlton, LA-based perfumer Alia Raza, cofounder of Régime des Fleurs, fell in love with the soporific, quite physical presence of the humid air—she couldn’t tell where her “skin stops and the air begins.” This sense of being cradled, held by the environment—“the natural humidity felt nurturing, instead of oppressive”—inspired Personal/ Space, five mesmerizing, moving fragrances designed for use in your home and on your skin.

Leis, Shells, Vines, Waves, Falls ($175 each, regimedesfleurs.com)

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W H AT TO PAC K

DOCTOR S’ OR DER S

Top derms head to Hawaii each winter for the Winter Clinical and Maui Derm conferences. Here, their must-pack essentials.

“Hawaii has banned sunscreens with oxybenzone or octinoxate starting in 2021: in heavy swim areas, sunscreens are blocking light from the coral reefs. Mineral versions, like EltaMD Pure, with only zinc oxide and/or titanium dioxide, are considered safer.”

—HOLLY GUNN, MD BIRMINGHAM, AL

“Because you’re in paradise, your beauty products need a little tropical touch: Kopari Rose Toner is fun and hydrating for the long plane ride, and Kopari Body Milk is great for post-beach moisture.”

W H E R E TO S TAY

AIMY27FEB/ GETTY IMAGES

FOUR SEASONS O’AHU AT KO OLINA

When developing the innovative Wayfinders Program, this luxury westside resort consulted with Hawaiian alaka’i (leaders) such as kapu Auntie Nettie Tiffany—who still blesses local babies in the waters of the adjacent Aniani Ku (The Looking Glass) beach—to design meaningful experiences for guests desiring to learn more about Hawaiian culture. Change your body language with powerful foundational hula steps taught by acclaimed La’akea Perry, the kuma hula for Ke Kai O Kahiki. Or, visit surf breaks curated by pro surfer/photographer Ha’a Keaulana, the granddaughter of surf legend Buffalo Keaulana. And when the sun goes down, stargaze with the help of a NASA-affiliated astronomer and a massive Orion telescope.

Must try: At the award-winning Naupaka Spa & Wellness Centre, brave the hot and cold plunge pools, then fall asleep during an authentic lomilomi massage.

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—RITU SAINI, MD NEW YORK, NY

Four Seasons O’ahu guests soothe surf-kissed skin with the North Shore–conceived, California-made O’o Hawaii Brilliant Feather Balm.

“Coolibar dresses, Wallaroo hats, Dr. Tony Nuara’s Foundation polypodium supplements, Colorescience Sunforgettable powder sunscreen and SPF 30 tinted lip balm, Baleaf’s long sleeve rash guards and kneelength swim knickers, ISDIN Eryfotona Actinica sunscreen.

Whew! And Sockwell compression stockings for the airplane ride—because no one wants puffy ankles or a pulmonary embolism on vacation!”

—GRETCHEN VANDERBEEK, MD PORTLAND, OR

“Add a little Sally Hansen Airbrush Legs body makeup to your favorite sunscreen to make your own bronzing lotion. And I like to add Skinbetter Science Alto Defense Serum over my facial sunscreen to provide additional free-radical protection” —MARIEL BIRD, MD SCOTTSDALE, AZ

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Secrets o f t he

BOUNCE BAC K by

TATI ANA BIDO

In the movies, makeovers happen in an instant: Meryl Streep drinks Isabella Rossellini’s breast-lifting, wrinklereducing potion in Death Becomes Her and instantly rewinds 20 years of aging. In that moment, when Meryl looks in the mirror to see herself completely remade, we too imagine snapping our fingers for an on-the-spot upgrade.

But in real life, there is no magic potion.

We can’t fast-forward to the end of a transformation. It takes time, and more than a little bit of patience, to see the results of top aesthetic treatments.

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The Rules of RECOVERY No one really talks about the waiting, healing and compliance required between before-and-after photos.

Recovery is where the real magic happens, and what a patient does or doesn’t do can make or break a doctor’s good work. The reality is, good results don’t happen in the operating room—that’s just where they start.

It seems like a no-brainer, but ensuring your doctor is board-certified and specializes in the procedure you are seeking is key. Vero Beach, FL plastic surgeon Alan Durkin, MD says, “How your surgery is performed will define what happens during recovery. You want your doctor to be succinct and crisp in their decision matrix and practiced in the execution of those decisions. You can only do that with training and experience, working with the same team day in and day out. Consistency and predictability are essential.”

2. LIVE SLOW, HEAL FAST All doctors agree, a healthy lifestyle is the foundation for a seamless recovery. “A patient who is active and a nonsmoker can expect less risks or complications during recovery,” explains West Orange, NJ plastic surgeon Mokhtar Asaadi, MD. “Those who smoke and have not taken good care of themselves may have looser, crepier skin and take longer to heal.” Montclair, NJ dermatologist Jeanine Downie, MD adds, “Patients who are sun-damaged from tanning beds, and those who vape also heal slower.” Pre-op blood work will reveal crucial health information to the doctor: “When I order labs, it’s not just for anesthesia. It can also tell me things like whether a patient has elevated liver function tests. If so, I’m going to shorten the procedure time as much as I can because the patient already has stress on their liver.”

3. BE A FOLLOWER “Only use products that your doctor gives you,” advises Beverly Hills, CA dermatologist Rhonda Rand, MD. “One doctor’s laser procedure may be different from another’s. Don’t Google it, don’t use a cream from a facialist and don’t listen to your friend. Follow your post-treatment care sheet to the letter.”

4. STAY OFF THE SCALE Swelling is an inevitable side effect, and even a tiny needle prick can cause tissue to react.

“The procedure time, trauma to the tissue and the amount of IV fluids administered can affect how much swelling there will be,” Louisville, KY plastic surgeon Chet Mays, MD says. Miami, FL plastic surgeon Sean Simon, MD explains: “Fluids are temporarily forced outside of the vascular circulation and then slowly get taken back up and reaccumulated into the vascular tree.” Excess fluid is then eliminated via the kidneys. “Fluid retention is why some patients gain weight right after surgery,” he says. “It will disappear over the coming weeks.” Dr. Downie adds, “This is a good time to decrease salt intake.”

“FOLLOW YOUR POST-TREATMENT CARE SHEET TO THE LETTER.” —DR. RAND

VINCENT BESNAULT / GETTY IMAGES, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

1. CHOOSE YOUR SQUAD CAREFULLY

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5. TAKE YOUR LUMPS Some irregularities are to be expected. For bumps under the skin at injection sites after injectables, ask your doctor what to do. West Palm Beach, FL dermatologist Kenneth Beer, MD explains: “With hyaluronic acid fillers, I advise patients to massage the bump to help smooth and flatten it out. With longerlasting fillers, you can massage for up to a week.” Dr. Downie cautions, “Nodules that flare up months after treatment may need to be dissolved. Consult your doctor.” Hardness under the skin after liposuction is typically caused from maturing scar tissue. “Lumps can be areas where some fat was left behind or is being reabsorbed,” says Dr. Mays. “With massage, they will soften, smooth out and start to feel like surrounding skin.”

6. DON’T SCRATCH “Tingling, burning, aches and pains in the surgical areas can occur for weeks to months and typically represent recovery of sensory nerves of these areas,” says Dr. Simon. “Topical Benadryl and a good Aveeno moisturizer can help subside excessive itching.”

7. DON’T DO WHAT CARDI B DID “Stay active post-surgery,” advises Dr. Mays.

“We want patients up, walking and slowly increasing activity every day.” However, that doesn’t mean it’s OK to go back on tour like Cardi B did just days after lipo. “Patients get frustrated when they start feeling better,” adds Dr. Mays. “We advise not to lift more than a gallon of milk for two to four weeks.”

VIP HEALING

HOTELS AND HOUSE CALLS When Le Petit Ermitage in Beverly Hills opened in the ’70s, plastic surgery was a hush-hush endeavor reserved for the rich and famous. In a town full of notable faces and their surgeons, hiding and healing in a “spa” for the first 48 hours were the norm. Famous faces like Liz Taylor and Michael Jackson were whisked away from ORs by limo and transported through subterranean garages to luxe suites at Le Petit Ermitage or Shanteque in the ’90s (aka “Facelift Hotel”), under the careful watch of a team of nurses, masseuses and private chefs.

AFTER-CARE AFFAIR

Today, private hideaways like Beverly Hills’ Pearl Recovery Retreat, The Carlyle in Manhattan and Dallas’ Rosewood Mansion offer VIP guests gourmet fare and amenities like in-room lymphatic drainage massage and hyperbaric oxygen chamber therapy. “Certain procedures require a higher level of care and monitoring by someone trained to recognize possible but rare post-op complications,” says Beverly Hills, CA plastic surgeon Leslie Stevens, MD. “For facelifts, some tummy tucks

and Mommy Makeovers where a patient may need help with getting out of bed, I prefer they spend one night in a recovery facility.” To preserve anonymity, Dr. Stevens often arranges for a stay at the Peninsula Hotel, where guests are given a key to the hotel’s back door leading directly to his office.

On the Upper East Side in New York, facial plastic surgeon David Rosenberg, MD, who has worked on more than a few famous faces says: “Nearly all of my surgical patients stay overnight in one of several hotels within a few blocks of my surgical center. These patients are cared for around the clock by a privateduty nurse specializing in post-op care.”

AWARDS PREP

Dr. Rand says many of her VIPs prefer the comforts of home, and because of this she often makes house calls, especially when the client is prepping for a high-profile event. “There isn’t much recovery needed with Botox, so I have been called on to inject before a red-carpet event. Unless it requires a particularly large device, I can do pretty much any treatment at their home.” Dr. Rand, who counts some of the biggest stars in Hollywood as her loyal patients, says she’s been known to say no if there isn’t enough time to heal.

“I say 10 days, at least, are required before a big event. If I know they have to be camera-ready, I’ve been known to say ’no’ because there isn’t enough time to heal and look good.”

8. TRUST THE PROCESS “Patients should be patient,” says Dr. Simon.

“You won’t see your final surgical result for three to six months.” Dr. Asaadi adds, “This is why we don’t redo a rhinoplasty after one or two months if the nose doesn’t look good. It takes months for the swelling to resolve and the skin on the nose to reshape.” Dr. Mays notes, “Healing is a physiologic process that takes time—we cannot speed up physiology.”

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Pearl Recovery Retreat’s luxe suites at the Viceroy L’Ermitage range from $5,500 to $75,000 per night.

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PostProcedure TOOLBOX THE FIRST FEW DAYS

1. ARNICA Essentially vitamin K, this homeopathic herb is an industry standard for reducing inflammation, swelling and bruising.

THE FIRST FEW WEEKS

3. COMPRESSION GARMENTS Most procedures—on areas from the chest to the ankles—will benefit from a compression garment. “They help support the tissue and can keep fluid from filling into the surgical sites,” advises Dr. Mays. “Every doctor will recommend a different length of time. I find that most of my patients like how their garment feels and continue to wear it even longer.”

4. LYMPHATIC MASSAGES Some doctors, like Dr. Simon, say massages are important after body contouring with liposuc-

tion: “They aid in the stimulation of blood flow and the reduction of swelling and scar tissue.”

Dr. Durkin agrees. “There’s an emotional component to touching the area that has gone through trauma,” he says. “The faster you recreate that human connection, the better you heal.”

+

“I always recommend using Vaseline on incisions as they heal,” says Dr. Durkin.

ANYTIME AFTER

5. SCARAWAY SILICONE SCAR SHEETS Shrink, flatten and fade new and old scars with these silicone scar sheets. $21, myscaraway.com 6. DOCTOR ROGERS RESTORE FACE LOTION Hypoallergenic and hydrating, this healing lotion boosts moisture levels to restore even the driest skin. $72, doctorrogers.com 7. SKINBETTER SCIENCE SUNBETTER TONE SMART SPF 68 COMPACT Cover and protect scars from damaging UVA/UVB rays in style with this mineral-active tinted sunscreen in a super luxe compact. $55, skinbetter.com

5

6

7

RESULTS TIMELINE

THIS IS WHEN DOCTORS SAY YOU CAN EXPECT TO SEE FINAL, FINAL RESULTS. FACELIFT

Four to six weeks, and sometimes up to six months

EYELID SURGERY

Four to 12 weeks

RHINOPLASTY

Six months to a year

BREAST SURGERY

Three to six months

LIPOSUCTION

Three to six months

TUMMY TUCK

Three to six months

MOMMY MAKEOVER

LASER SKIN RESURFACING

Three to six months

Three to six months

NONSURGICAL BODY CONTOURING

Six to 12 weeks after last session

STUDIO 504 / GETTY IMAGES, RITA HAZAN

2. HEALING OINTMENT “During the first week of surgery, most incisions will benefit from antibiotic ointment to keep a nice moist environment, which allows the skin to restore,” says Dr. Mays.

Seattle dermatologist Heather D. Rogers, MD cautions to be careful with lanolin, although it is a common ingredient. “A recent study looking at allergic reactions in patients with chronic wounds found 11 percent reacted to lanolin. This is not what our skin needs when it is trying to heal!“

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R E A L PAT I E N T T I P S

M Y S TO RY

ABOUT FAC E

C

BY S ANDY LIN TER

elebrity makeup artist and all-around beauty icon Sandy Linter found herself in the back of a New York taxicab , chicly wrapped in a facial bandage on the way to a star-studded memorial at Lincoln Center just one week after a lower facelift. Here, she shares her best tips for a speedy recovery: “I had two very anxious days before my procedure because I didn’t really schedule anything to do. Looking back, that was not the wisest choice. My first tip is to keep yourself busy leading up to your surgery to avoid the pre-procedure jitters.

On the day of surgery, I was so excited to get it over with that I didn’t even read the

Linter, pictured with celebrity colorist Rita Hazan, went public with her post-surgery look just one week after a lower facelift.

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WAITING ROOM WHISPERS

post-care instruction sheet beforehand.

Make sure you read everything and follow it.

It’s your doctor’s blueprint for how to heal the quickest way possible.

I decided to be cared for by nurses at home instead of going to a hotel. I have two cats, and I arranged for them to be fed and cared for, but my surgeon, Dr. Rosenberg, didn’t really want me around pets. Shortly after surgery, a blister formed under my chin.

When I went in for a checkup, it was tested and they found there was bacteria present.

I was quickly put on medication and the blister cleared up easily.

The doctor gave me medication to sleep, and my advice is, don’t refuse it. I have no memory of the first two days after surgery and that was fine with me. I used Aquaphor around my incisions along the sides of my face. I never felt any pain, but I did feel some tightening on the back of my head and my neck, which I expected.

It was just one week after my surgery that I found myself in the back of a taxi with Rita Hazan on my way to our dear friend Oribe Canales’ memorial. Swollen face and all, I wouldn’t have missed it for the world. That day I saw people I haven’t seen in more than 20 years.

I really didn’t take much time off at all. The only time I ever felt slightly uncomfortable during healing was when a client began peering under my neck. I was still sore and just didn’t feel like being inspected. Although I had already shared with her what I had done, it still felt a little invasive. If I want to show you my scars, I will, but please don’t go looking for them without my permission.

Not even a month after my surgery, another client asked to take a photo with me. I said OK even though I knew I’m wasn’t ready for my close-up, but it’s a hard request to refuse.

Of course she posted it on Facebook, and I hated it. Recovery isn’t easy!”

xo,

S ANDY

No one can tell you what to expect better than someone who’s been where you’re going.

ANGELICA, 31

LIPOSUCTION “There was swelling, bruising and some pain. Follow your doctor’s post-op instructions as best you can. After all the money, pain and time you invested, it is not worth spoiling your results for negligence on your own part.”

ELANA, 58

BLEPHAROPLASTY “Don’t hide or lie about your procedure, especially if it’s a visible change. Own up to it.

I found that most women were more inquisitive and less judgmental if I was upfront and honest. There’s no shame in wanting to improve yourself and live your best life.”

CHELSEA, 36

BREAST SURGERY

“My stitches kept opening up, which prevented my wounds from healing. When something like this happens, it usually means you need to take a break. I should have taken a week off from work to lie down and let my body heal properly.”

ANNA, 41

LASER LIPO “An automatic recliner is a life saver! Some patients even sleep in one after surgery because it makes it easier to stand up and sit down—the chair does all the work for you.

Also, you’ll probably be tender, bruised and sore. Invest in a plastic donut for when you need to sit down on any surface that isn’t padded.”

LOLY, 65

FACELIFT “I made sure to massage my scars with arnica gel morning and night. I found that it brought down the swelling and helped my scars heal faster.”

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THE GUIDE : AUTOLO GY

SELF

SERVICE

From Cinderella to Karate Kid, it’s a trope that has made its way into stories for centuries—one where the protagonist learns that you already “have everything you need inside of you.” And while this usually refers to one’s character, it’s also proving true in aesthetics. The storytellers of the past likely never dreamed that we would one day have the ability to use fat, blood or hair from one area of our bodies to enhance another, but what was once science fiction has become an accessible reality. by

MARCI ROBIN

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FLORIAN SOMMET / TRUNK ARCHIVE, DANIELLE VAN DAM / DEBOEKERS, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

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“Autologous” applies to any cells or tissues that are obtained from and then used on the same individual.

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By definition, autologous describes any cells or tissues that are obtained from and then used on the same individual. “It means ‘from yourself ’ or the same tissue composition, as opposed to an allogenic procedure, which would be using something foreign or from others, explains New York plastic surgeon David Rapaport, MD. Before their expansion into cosmetic treatments, autologous procedures were used by oncologists treating cancer with a patient’s own stem cells and orthopedic surgeons utilizing bone grafting to heal and repair broken bones. Aesthetic medicine has been equally ingenious in the category, finding ways to enhance one’s contours with fat harvested from an area of the body that can spare it, improve the results of treatments through the introduction of a patient’s own platelet-rich plasma (PRP), and add hair nearly anywhere it’s desired, from the top of the head to the eyebrows.

One of the most notable advantages of autologous treatments is the high likelihood that the body will accept one’s own tissues and cells with a far lower risk of complications. “Our system was designed to be defensive and have an immune response when it determines something foreign. This is how we react against bacteria, viruses and substances that appear harmful,” says Beverly Hills, CA oculoplastic surgeon Raymond Douglas, MD. “Unfortunately, these reactions can also occur when using foreign substances for repair or cosmetic purposes.”

Dr. Rapaport concurs, saying, “By using one’s own tissues or cells, one need not be concerned about sensitivi-

One of the most notable advantages to autologous treatments is the high likelihood that the body will accept one’s own tissues and cells.

PEAK HARVEST In order to use one’s own fat in an area of the body where more volume is desired, it must first be harvested from elsewhere in the body. Denver plastic surgeon Manish Shah, MD says this is done with mini liposuction, during which a saline solution containing lidocaine and adrenaline is injected into fatty areas of the body— usually the thighs, abdomen or anywhere fat deposits tend to be more stubborn throughout weight fluctuation—and then the fat is then removed by suctioning it out through small metal tubes.

One increasingly popular option for harvesting and prepping fat that’s heading to another part of the body is a system called Revolve. Allergan touts it as “the only allin-one fat-processing device that harvests, filters, actively washes, and removes [collagen] strands,” (these strands can can clog the syringes used for injection). Studies have shown that, in addition to rapidly concentrating adipose tissue, Revolve thoroughly washes it for higher-quality fat.

There are a number of ways harvested fat can be used in the face, many of which echo the way a plastic surgeon or dermatologist might use a hyaluronic acid–based filler to enhance cheek shape or lip size. However, in addition to the harvesting process, the injection process is different as well.

“Typically, fat transfer is injected with a microcannula—not needles—and in a 1:1 ratio, because we know some of the fat will not take,” Dr. Wise explains. There’s also a few days of downtime with fat transfer, whereas fillers have no downtime.

“Patients who get fat transferred for facial contour often get it simultaneously with other procedures, such as

TAMARA SPECHT/THE LICENSING PROJECT

ALL THINGS AUTOLOGOUS

ties, allergic reactions or rejection, and in theory, autologous treatment may save money by not requiring synthetic filler materials.”

However, autologous treatments aren’t without their disadvantages, from stem cells’ lack of clinically proven effectiveness in aesthetic treatments to fat’s unpredictable longevity. “The volume you will get is less and may require repeat treatments,” according to Wayne, NJ facial plastic surgeon Jeffrey Wise, MD. “The take-rate is 25 to 50 percent, which makes it challenging to predict how much volume the patient will see.” That retention, however, will last forever, and fat will also improve the quality of the overlying skin, which does not occur with synthetic fillers.

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30-50 % According to La Jolla, CA plastic surgeon Robert Singer, MD, “generally about 30 to 50 percent of the injected fat lasts permanently.�

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NEWBEAUTY

T OP D OCT ORS Turn to page 125 to find one near you.

T H E E Y E S H AV E I T Fat alone isn’t the only option for transferring tissue in this area.

“When doing a blepharoplasty, I often use a range of autologous procedures to lift and hold up the eyelids in the right place, borrowing tissue from the mouth, which shares many properties with the eyes inside the ocular region,” Dr. Douglas says.

“It is moist, stable, soft and supple, and offers great benefits, including offering contour and holding its shape for many, many years when placed inside the eyelids to reconstruct them.”

a facelift,” says New York plastic surgeon Craig Baldenhofer, MD, who explains that, in these cases, it’s often under local IV sedation or general anesthesia.

“Fat transfer for lip augmentation can work, but fat is happiest in areas that don’t move a lot,” Dr. Shah says.

“Because we move our mouths with talking and chewing, the motion can cause more reabsorption of the fat.

Patients may need touch-up injections to get the right look,” including correction of lumps and bumps, which can be avoided with meticulous technique.

A portion of the fat gets reabsorbed after the first few weeks, but then it stabilizes and becomes permanent— perhaps the biggest difference between fat transfer and nonautologous fillers, which get completely reabsorbed over time.

A larger amount of fat is used when fat is transferred to areas like the breasts—an excellent option for patients who want to make a modest change in bust size. “Implants can give you very dramatic results in a single surgery,” says Dr. Baldenhofer. Fat transfer to the breasts, however, will likely result in one-half to one full cup size, according to Dr. Shah, who notes that fat has a lesser-known advantage over implants: “Fat is not as capable of stretching out the tight skin of small-breasted women.” The two procedures can also be combined for a customized result, according to Dr. Baldenhofer.

The increasingly popular and controversial Brazilian Butt Lift relies on what Dr. Shah refers to macro fat grafting to create fuller buttocks. However, it’s worth noting that this procedure has one of the most difficult—and risky—recovery periods. “You can’t sit or lie down on your buttocks because putting pressure on them can kill the fat cells that were injected,” he explains. “Additionally, fat transfer to the buttocks carries the dubious distinction of having the highest mortality rate of all elective cosmetic surgery procedures.” This is due to the risk of fat making its way into the large veins of the gluteal region, causing fat embolism to the lungs. “It is important that your surgeon follow the guideline for safe fat transfer set by the major cosmetic surgery societies in the world such as ASAPS and ISAPS.” Fat can also be transferred to the backs of the hands, and even the eye area, which requires an intimate understanding of the area’s structure, like the expertise of a plastic surgeon or oculoplastic surgeon such as Dr. Douglas. “Fat transfer in this area is usually a relatively small procedure with rapid recovery and results that are long-lasting with highly desirable improvement in appearance,” he explains. “I most often use micro lipoinjection or autologous fat transfer when I remove some excess fat from specific areas of unneeded or unwanted healthy adipose tissue and place it in and around the tear trough, by injection, to fill the hollows.”

SOPHIA BECK / GALLERY STOCK, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

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THE FUTURE O F FAT: W H AT’S N E XT ?

SCIENCE SUBJECTS

LOCATION, LOCATION, LOCATION HAIR TRANSPLANTS, SKIN-TRANSFORMING TREATMENTS, STEM CELLS AND A WHOLE LOT OF PRP BUZZ MAKE UP THE LIST OF FORWARD-THINKING INNOVATIONS.

1

2 3

HAIR TRANSPLANTS

Hair transplants have come a remarkably long way since their inception.

The two most common versions are follicular unit strip surgery (FUSS) and follicular unit excision and extraction (FUE). “With FUSS, a thin strip of tissue is taken from the back of the head and then slivered and dissected into the individual naturally occurring follicular units,” explains Beverly Hills, CA hair restoration specialist Dr. Craig Ziering. “During an FUE procedure, the follicular units are harvested one graft at a time using either a handheld device or the hair surgery robot,” which will leave tiny individual scars, in contrast with FUSS's thin, linear scar across the back of the head. One of the most exciting autologous developments in restoring hair has come in the form of PRP, or platelet-rich plasma, which involves drawing a patient’s blood and reinjecting the portion of the plasma that’s most rich in platelets and growth factors into the scalp.

SKIN REJUVENATION

In addition to hair growth, PRP is being used to improve skin, too. It is typically added as a topical preparation or injected superficially after a controlled injury is made to the skin, such as laser resurfacing or dermabrasion. “Sometimes it can be combined with filler to improve the longevity of the treatment,” Dr. Wise says. Perhaps the most buzzedabout use of PRP in skin care, despite a lack of valid studies about its safety and efficacy, is the “vampire facial.” Dr. Rapaport says that after the initial part of treatment, which typically includes microneedling, PRP is massaged onto the face. “The one benefit that has been proven is that the skin does heal more quickly after wounding when PRP is applied,” he adds. However, “true rejuvenative effects have yet to be demonstrated scientifically.” PRP as simply a topical preparation without a controlled injury first has no effect.

STEM CELLS

Stem cell treatments are arguably some of the most controversial available, as there is little scientific evidence of their effectiveness for certain uses. That hasn’t dimmed the hopes of plastic surgeons who see enormous potential in them, but currently, the marketing is ahead of the science. “With stem cells, the main issue is that, aside from leukemia, right now there are virtually no approved therapies in the United States.

But, that is likely to change soon, with hundreds of advanced studies taking place all around the world,” says Dr. Rapaport, who has been working with a company called Forever Labs to bank patients’ stem cells for future use.

“I strongly believe that in the not too distant future, techniques will be developed for reinfusing stem cells, whether intravenously or into local tissues, and that this will result in real rejuvenative effects."

DISCLAIMER: As of press time, the FDA is paying particular attention to PRP and stem cell treatments. It is important to note that, aside from potential FDA regulation, state licensing boards may discipline physicians who make claims of outcomes with these products.

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Autologous cosmetic treatments have come leaps and bounds, but it seems that there is room for even more developments in the future, whether it’s new takes on fat grafting—or entirely different types of transfers. San Diego plastic surgeon Joseph Grzeskiewicz, MD is especially excited about one particular development: “We can now create 'nanofat,' which essentially behaves as a liquid, allowing us to inject using the same size needles we use for Botox! This is a huge advance.”

Dr. Baldenhofer says, “I think we will be hearing more about nanofat procedures where emulsified fat is either injected into the skin or used in conjunction with microneedling to improve the appearance, texture and thickness of the skin.”

Dr. Shah echoes the enthusiasm. “I am very excited about the role nanofat injections will have in the future in terms of stem cell treatments on the skin and scars,” he adds.

“Additionally, amniotic membrane-sourced growth factors for hair treatment and wound healing,” while not FDA-approved, “are showing some interesting results.”

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Acne Advanced Treatment System 1 Cleanse BEFORE

2 Treat

3 Hydrate

AFTER

Treats Advanced Acne in 28 Days* I feel so much more conďŹ dent when I look in the mirror. My breakouts are gone and my scars look lighter! — Vanessa T.

For more information about how the Acne Advanced Treatment System works, visit eminenceorganics.com/acneadvanced. *In

vivo clinical study results, based on application of the complete system for 28 days.

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THE

The magician of melanin. The scientist who put the stem cells in your favorite serum. The guru responsible for helping us become smarter about sunscreen. They might not have made a billion on a lip kit, but they’re the driving forces behind how we look at all things beauty today.

TURN FOR MORE



TORKIL GUDNASON / TRUNK ARCHIVE, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

INNOVATORS

NEWBEAUT Y WINTER 2019

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I

n 3000 B.C., Chinese cosmetic chemists were already perfecting nail polish using vegetable dye, ground blossoms, and later, gold and silver dust.

In 2nd century Greece, Galen whipped up the first jar of soothing, hydrating cold cream.

And while the practice of tinting lips red goes back for centuries, what we consider to be “modern” lipstick, easy to apply straight from a tube, has been around for over a hundred years. So it might seem as if All The Things, at least all those that are beauty-related, have already been invented.

However, from a technological perspective, the Golden Age of aesthetic innovation is unfolding right before our eyes. And the great minds behind history’s biggest beauty breakthroughs— from skin-transforming lasers to line-smoothing neurotoxins— walk (and work) among us.

T H E P OW E R D U O

DRS. EUGENE VAN SCOTT + RUEY YU

FOUNDERS, NEOSTRATA AND EXUVIANCE

On every Instagram shelfie, you’ll find a product that owes its potency to Van Scott and Yu, PhD: this dynamic pair looked at organic acids found in apples and oranges to invent alphahydroxy acids. Here, Dr. Van Scott shares his current obsessions.

Favorite beauty trend: I believe daily home skin care is best: peels, polyhydroxy acids, and perhaps the application of other physiologic agents. Proudest moment: Receiving the Lasker Award. Current inspo: Continuing our research on pain control. Wish I would have invented: A way to bring our global society together quickly to implement ways to save our planet.

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T H E S U N S C R E E N A DVO C AT E

DR. PERRY ROBINS

FOUNDER OF THE SKIN CANCER FOUNDATION

As Dr. Robins says in his new memoir, “giving back is the highest level of success”—and that’s exactly what he’s been doing for 40 years with his work at The Skin Cancer Foundation.

Favorite beauty trend: When people not only make the healthy choice not to tan, but also use sun protection as both an anti-aging strategy and to prevent skin cancer. Proudest moment: Being the first in my family to go to college, and then medical school, despite my dyslexia. The first thing I do when I wake up: Put a smile on my face. Career confirmation: When a mentor in the Army told me I would make a great doctor, and that I must try or he would haunt me for the rest of my life.

THE MELANIN WHISPERER

DR. DAVID E. FISHER

CHIEF OF DERMATOLOGY AND DIRECTOR OF CUTANEOUS BIOLOGY RESEARCH CENTER AT MASSACHUSETTS GENERAL HOSPITAL (MGH)

ADÉL BÉKEFI / GETTY IMAGES, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY RALPH A. CLEVENGER / GETTY IMAGES

From UV-released endorphins to a topical drug that turns on skin’s protective melanin production, Dr. Fisher targets the real-world triggers that lead so many to risk tans.

Favorite beauty trend: The increased focus on underlying science in all areas. Proudest moment: Elucidation of pathway for melanin synthesis, and the means of manipulating it.

Current inspo: Our son Sammy, who passed away suddenly at age 24 during a charity triathlon—afterwards, we learned about his efforts at combating homelessness. Wish I would have invented: Fully recyclable plastic. Wise words: Dream broadly, focus closely and persevere.

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T H E C U R ATO R

LORETTA A. MIRAGLIA

CORPORATE SENIOR VICE PRESIDENT PRODUCT DEVELOPMENT & INNOVATION, LA MER

The physicist turned skin-care creator sourced from NASA to create La Mer’s airy loose powder; Buckminster Fuller’s geodesic domes inspired the structure of the brand’s Soft Cream. And bendable glass (only Apple, Samsung and La Mer had access to the tech) led to La Mer’s lifting serum.

Proudest moment: Every time someone tells me—even shows me— how La Mer The Concentrate has healed and changed their life. Career confirmation: After creating my first innovation, I was hooked. There’s nothing better than creating something from nothing. Current inspo: [The television show] Euphoria. Wise words: Live life fearlessly: love keeps you safe, not fear. Lee Ann Womack says it best: “When you get the choice to sit it out or dance, I hope you dance.”

OO%

Perate volupis numqui culparc hilici aut eium nonseque nonserum ipis porepre ptatecae occustin excernatios voluptio. Et ea sinvel ipienisquati omnimen

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THE LIGHT SOURCE

DR. R. ROX ANDERSON

LANCER-ENDOWED CHAIR OF DERMATOLOGY; PROFESSOR OF DERMATOLOGY, HARVARD MEDICAL SCHOOL; DIRECTOR OF WELLMAN CENTER FOR PHOTOMEDICINE, MGH

5,000 The number of retinol launches since 2016, according to P&G. “Taking an old, well-known ingredient and working with the team on how to bring genius new formulations to life is incredibly rewarding,” Dr. Neuser says.

T H E C O N S U M E R A DVO C AT E

DR. FRAUKE NEUSER PRINCIPAL SCIENTIST, OLAY SKIN CARE, P&G

Cosmetic chemist Dr. Neuser’s number-one goal hasn’t changed since she joined P&G almost 20 years ago: to deliver the right information and the right ingredients to women around the world.

Favorite beauty trend: Personalized beauty! We can now analyze peoples’ skin, genes and microbiome, track environmental effects and turn the results into personalized advice, services and products. Current inspo: Working in an industry that is changing all the time. Wish I would have invented: Olay Skin Advisor, the first-ofits-kind application of Artificial Intelligence in Beauty. It’s changed the way women understand their skin, and is now available to millions of women around the world.

FLORIAN SOMMET / TRUNK ARCHIVE, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

Name any of the biggest energy-device launches of the last 20 years—think everything from laser hair removal to CoolSculpting— and chances are, you have Dr. Anderson (colleagues liken him to a modern-day Benjamin Franklin) to thank.

Proudest moment: When one of my very young patients said, “Dr. Anderson, I love you, and I like you.”

The first thing I do when I wake up: Kick my dog off the bed. Career confirmation: When I figured out that it combines all of the stuff I like: science, helping people, inventing. Current inspo: My children. Wish I would have invented: Global cooling. Wise words: Be here now.

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CONGRATULATIONS

DR. R. ROX ANDERSON o n t h i s d i s t i n g u i s h e d h o n o r.

Your esteemed research and groundbreaking developments have revolutionized our industry.

F ro m Yo u r F r i e n d s a t

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THE STEM CELL SCIENTIST

DR. GAIL NAUGHTON

FOUNDER, HISTOGEN, INC.

An inventor, an innovator and the reason your favorite serum—we’re looking at you, SkinMedica TNS—does so much, Dr. Naughton saw a void in the skin-care space and filled it. Today, she has a whole lot of other lines to add to the resume, but it’s her forward thinking on growth factors that has changed the face of beauty.

Favorite beauty trend: Products that stimulate your own cells to help restore youthful functions to naturally rejuvenate and regenerate. Proudest moment: Winning the National Inventor of the Year award. The first thing I do when I wake up: Give thanks for another day and go into the kitchen to feed my rescue dogs and cat who act every morning as though they haven’t eaten in weeks! Career confirmation: I wanted to go into medical research for as long as I can remember (at least 4 years old) to make a difference. Current inspo: Mother Nature. Wish I would have invented: The cell phone. It connects people worldwide!

T H E C H A N G E AG E N T

BALANDA ATIS

To create shades that would work on women in all 150 countries where L’Oréal is found, cosmetic chemist Atis combed through more than 20,000 data points.

Her aha moment: An Yves Klein–esque ultramarine blue pigment added a rich, glowy tone to darker foundations, leading to the development of over 30 additional hues.

Proudest moment: Meeting consumers who are literally moved to tears at finally having found foundation shades that match them.

The first thing I do when I wake up: Meditate. Career confirmation: When I couldn’t find a shade that matched my skin. Current inspo: Both my children and our consumers bring out the best in me. Wise words: Never give up on your dreams, even when “no” is all you keep hearing. One day, the door will open and all you’ll hear is “YES!”

DANIEL SCHROEN, CELL APPLICATIONS INC / SCIENCE PHOTO LIBRARY

DIRECTOR OF THE L’ORÉAL MULTICULTURAL BEAUTY LAB

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CONGRATULATIONS

DR. GAIL NAUGHTON o n t h i s d i s t i n g u i s h e d h o n o r.

Your scientific research continues to fuel innovation and transformative results in skin care.

F ro m Yo u r F r i e n d s a t

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T H E I N J E C TA B L E P I O N E E R

T H E M A K E U P M AV E N

OPHTHALMOLOGIST

PRESIDENT, BAREMINERALS, BUXOM, SHISEIDO MAKEUP AND JWALK, AND CEW CHAIRWOMAN

DR. JEAN CARRUTHERS

For Scalamandre, it was “love at first sight” when it came to a career in beauty. “I started at Revlon in product development, learning the need gaps in lipstick, the science of formulating and the basics behind shade ranges. It combined all of my personal passions.”

Favorite beauty trend: After watching [bareMinerals’ global ambassador] Hailey Bieber do a tutorial on applying foundation with a brush, I decided to give it a try. I was a fingertip girl. Now, there is no going back. Proudest moment: Launching the bareMinerals Power of Good Fund, which was established to help young women realize their potential. Current inspo: Plant-based everything—food, formulas, packaging.

It’s really a passion. Wise words: Check your ego at the door.

LEA KUMAUS / EYEEM / GETTY IMAGES, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

With her husband, Dr. Alastair Carruthers, she pioneered the cosmetic use of botulinum A exotoxin, and remains at the forefront of research and teaching about the popular treatment we know so well today.

Favorite beauty trend: Combination treatments such as IPL and Clear + Brilliant with neurotoxins and fillers. Research shows that combinations are not only more effective, but also last longer and are associated with higher long-term patient satisfaction. Proudest moment: I actually have eight—marrying the love of my life, Alastair, and the birth of our three sons and four grandchildren. Current inspo: Seeing my female colleagues shine and lead. Wish I would have invented: A way to make each day longer. Wise words: Surround yourself with positive people!

JILL SCALAMANDRE

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CONGRATULATIONS

DR. JEAN CARRUTHERS o n t h i s d i s t i n g u i s h e d h o n o r.

Your vision, inspiration, and innovation have forever changed our industry.

F ro m Yo u r F r i e n d s a t

P L E AS E S E E SU M M A RY O F I M P O RTA N T I N FO R M AT I O N A BO U T BOTOX© C OS M ET I C O N N E XT PAG E . ©20 19 Allergan. A l l rights re ser ved. A l l tra dem a rks a re th e pro per ty of th eir re spective own ers.

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Summary of Information About BOTOX® Cosmetic (onabotulinumtoxinA) What Is the Most Important Information I Should Know About BOTOX® Cosmetic?

BOTOX® Cosmetic may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX® Cosmetic: • Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection.

Swallowing problems may last for several months.

• Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing.

There has not been a confirmed serious case of spread of toxin effect when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines, crow’s feet lines, and/or forehead lines.

BOTOX® Cosmetic may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of taking BOTOX® Cosmetic. If this happens, do not drive a car, operate machinery, or do other dangerous activities.

BOTOX® Cosmetic dosing units are not the same as, or comparable to, any other botulinum toxin product.

What is BOTOX® Cosmetic?

BOTOX® Cosmetic is a prescription medicine for adults that is injected into muscles and used for a short period of time (temporary) to improve the look of moderate to severe: · frown lines between the eyebrows · crow’s feet lines · forehead lines Who Should Not Receive BOTOX® Cosmetic?

Do not receive BOTOX® Cosmetic if you are: allergic to any of the ingredients in BOTOX® Cosmetic such as botulinum toxin type A and human serum albumin; had an allergic reaction to another botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); or have a skin infection at the planned injection site.

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What Should I Tell My Doctor Before Treatment?

Tell your doctor about all your muscle or nerve conditions, such as amyotrophic lateral sclerosis (Lou Gehrig’s disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects.

Tell your doctor if you have or have had bleeding issues; plan to or have had surgery; have forehead muscle weakness such as trouble raising your eyebrows; drooping eyelids; or any changes to your face.

Tell your doctor if you are pregnant, plan to become pregnant, are breastfeeding or plan to breastfeed. It is not known if BOTOX® Cosmetic can harm your unborn baby or if BOTOX® Cosmetic passes into breast milk.

What Are Common Side Effects?

Other side effects, while less common, have been reported including dry mouth; tiredness; neck pain; double vision, blurred vision, decreased eyesight, dry eyes; and allergic reactions (itching, rash, red itchy welts, wheezing, asthma symptoms, dizziness or feeling faint).

These are not all of the possible side effects. Call your doctor for medical advice if you experience any side effects after treatment with BOTOX® Cosmetic.

What Should I Tell My Doctor About Medicines and Vitamins I Take?

Using BOTOX® Cosmetic with certain medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® Cosmetic in the past. Tell your doctor if you have received an injection with another botulinum toxin product in the last 4 months, such as Myobloc®, Dysport®, or Xeomin®. Be sure your doctor knows which product you received.

Tell your doctor about all prescription and over-thecounter medicines and supplements you take including: vitamins and herbal products; recent antibiotic injections; anticholinergics; muscle relaxants; allergy or cold medicine; sleep medicine; aspirin-like products; and blood thinners. Ask your doctor if you are not sure whether your medicine is listed above.

To Learn More

If you would like more information, talk to your doctor and/or go to BotoxCosmetic.com for full Product Information.

You may report side effects to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.

Based on PI72714SU10 Rev. 10/2017 BCT70101_v2 1/18

© 2018 Allergan. All rights reserved.

All trademarks are the property of their respective owners.

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T H E B OTA N I S T

BOLDIJARRE KORONCZAY

TORKIL GUDNASON / TRUNK ARCHIVE, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

PRESIDENT OF ÉMINENCE ORGANIC SKIN CARE

An icon in the spa world and just about the best person on earth to get a facial from, Koronczay is passionate about helping others through his magical world of beauty.

Favorite beauty trend: Biodynamic ingredients.

They’re the new organic!

Career confirmation: As a survivor of leukemia, I stayed home most of my childhood watching my mom, an aesthetician, give facials to the neighborhood ladies. I would see her clients come in stressed and anxious, and leave relaxed and happy. As a teen, my mom encouraged me to become one of the first male aestheticians in Hungary, and I thought that would be an amazing way to spread my passion for organic living through skin care while also helping others. Wise words: Reach for the stars, but keep your feet on the ground.

THE EXPLORER

DR. DANIEL STANGL

DIRECTOR OF INNOVATION, LA PRAIRIE

The Indiana Jones of luxury skin care, Dr. Stangl, an avid mountaineer, literally climbs every mountain in search of the most active ingredients.

Favorite beauty trend: The work of Swiss architect Peter Zumthor. Proudest moment: I’m proud to be around wonderful people. Career confirmation: The moment I realized that our skin is as vulnerable as the earth’s atmosphere and serves the same purpose: to allow us to live. Current inspo: The mysterious nature of light. Wish I would have invented: The perfect delivery system for active ingredients. Wise words: Be curious in all you do.

1931 The year Clinique La Prairie was founded by Dr. Paul Niehans in Montreux, Switzerland.

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T H E H A I R A P PA R E N T

ESI EGGLESTON BRACEY EVP & COO, BEAUTY & PERSONAL CARE, UNILEVER

COFOUNDER, MOROCCANOIL

CARMEN TAL

With leadership roles at mega-brands such as CoverGirl, Coty and now Unilever, Eggleston Bracey has changed the laws, literally changing millions of lives with programs like the Crown Act. Favorite beauty trend: Textured hair—from braids and locs to curly fros in all shapes and sizes. The first thing I do when I wake up: Japanese water therapy. I drink a liter of water in about five minutes to cleanse and flush my system to continue my body’s natural cleansing process from sleep. It’s life-changing for my allergies, skin and appetite. Current inspo: My Dad. Watching him stay strong and positive despite his significant physical challenges that prevent him from speaking or moving independently. Wise words: Give yourself grace. Over the years, I’ve learned that I’ve held myself to extremely high standards.

Tal introduced the world to a product that launched the argan oil revolution—and a bunch of good hair days in the process.

Favorite beauty trend: Transparency in everything, from ingredients to packaging.

Proudest moment: In 2007, when the brand attended its very first trade show and we were able to see firsthand the growth the Moroccanoil Treatment experienced and how it was loved by so many. The first thing I do when I wake up: Meditate and thank the universe I am alive and healthy. Career confirmation: After opening my first salon, I realized this was my calling and I had a knack for it. I loved the beauty industry and wanted to do more. Current inspo: Sustainability.

Our brand is consistently working to further our commitment to the planet and to create beauty products in a more sustainable way.

ZUBIN SHROFF / GETTY IMAGES, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

THE BARRIER BREAKER

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T H E S K I N - C A R E S AVA N T

JAN MARINI

FOUNDER, JAN MARINI SKIN RESEARCH, INC.

Before there was Ulta Beauty there was Jan Marini, the pre-millennial answer to all things active and systematic in the skin-care space.

Favorite beauty trend: I really applaud that consumers are trending more toward attaining glowing, healthy-looking skin, as opposed to covering up their flaws with makeup. Proudest moment: Marrying my husband, Reed, and knowing that I had found my forever love.

We’ve been married almost 25 years. The first thing I do when I wake up: My skin-care routine. It’s a ritual that signals the day has begun. If nothing else goes right on any given day, my skin is glowing.

THE ARTIST

TIM QUINN

MAKEUP ARTIST, GIORGIO ARMANI BEAUTY

He’s the force behind why so many celebrities look flawlessly glowing, but for Quinn, his mom is still the “glam” in his life.

Favorite beauty trend: The return of glowing skin! Natural, beautiful skin always adds to your confidence. The first thing I do when I wake up: Wash my face with a gentle exfoliator and follow it with Armani Crema Nera Firming Plumping Essence to make me look like I’m awake! Career confirmation: Back in the late ’90s, I had just come back from Milan, and Lancôme had me stand in as National Makeup Artist at an event in Boston. I loved the energy of helping real women feel empowered.

THE BIOLOGIST

TANYAROW / GETTY IMAGES

DR. ROCIO RIVERA SCIENTIFIC COMMUNICATIONS VICE PRESIDENT, L’ORÉAL PARIS

INSIDE TIP  CELEB MAKEUP ARTIST TIM QUINN SAYS HIS NUMBER-ONE PIECE OF MAKEUP ADVICE IS TO BE KIND TO YOURSELF, ESPECIALLY WHEN IT COMES TO BEAUTY. “APPRECIATE WHO YOU ARE AND YOUR UNIQUENESS,” HE SAYS.

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Merging scientific rigor with an outspoken personality, Dr. Rivera brings her expertise in biology to the world of beauty.

Favorite beauty trend: Historically, skin care was seen as a chore, used on problematic skin, or a seasonal step to use sunscreen. Now, everyone is using skin care as a form of selfcare, while enjoying serums, sheet masks, showing off their bare skin on social media, and really enjoying their skin-care routine.

Career confirmation: At a very young age at my grandfather’s pharmacy back in Spain, watching him create topical unguents for all types of issues. It fascinated me. Wish I would have invented: SPF. Such a critical product.

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T H E M O U T H M AC GY V E R

LUCIA SMIGEL

T H E S K I N B O DYG UA R D

DR. CARL THORNFELDT

FOUNDER, EPIONCE

The marriage of research and botanical ingredients to create effective skin care has always been Dr. Thornfeldt’s passion; his brand, Epionce, his baby.

Favorite beauty trend: Repairing the skin barrier! Since our discovery in the 1990s, I have been writing and lecturing on this topic, in many cases being criticized by “thought leaders” along the way. It is so gratifying that this topic is finally getting the attention it deserves. Proudest moment: Every time a new Epionce product proves more effective and safer than a prescription product, I am most proud. Current inspo: My patients. Having a full-time clinical dermatology practice really helps me stay grounded. Every day I see a patient who is not responding as well as I would like, which reminds me that dermatology still needs more scientific answers. As I like to say, the diseases didn’t read the textbooks.

Married to Dr. Irwin Smigel (“the father of aesthetic dentistry”) for more than 60 years, Lucia Smigel taught everyone from Calvin Klein to Jimmy Fallon how to floss during the day, and then designed products at night.

Proudest moment: Getting my first toothpaste into a store: I took a tube to the pharmacy on Madison Avenue and 60th Street that specialized in makeup, and asked them if they could order me a tube because that one was almost empty. Then I ran back to my office to take the call from the pharmacy.

I told them the minimum order was 12 tubes, $8 a tube, and they had to put them on the checkout counter.

They laughed. Back then toothpaste was 80 cents a tube. I told them I would take it back in five days if they did not sell. In five hours, they called and ordered another two dozen...and off we went.

Wish I would have invented: I am still inventing! When I have an idea, I go after it. My husband always said to me: “If it’s to be, it’s up to thee.” Wise words: I believe that, if you are a creative person, you can bring that to any job you do.

TORKIL GUDNASON / TRUNK ARCHIVE, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

CEO OF SUPERSMILE

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P RO M OT ION

THE TUBE

2.

REPORT

Each issue we round up our editors’ favorite products to help you discover new brands, unique product formulations and key ingredients that you can find all in one place: your TestTube.

1. amika Reset Exfoliating Jelly Shampoo This once-a-week shampoo treatment is infused with sea salt, charcoal and pink clay to provide a deep, soothing clean for hair in need of some TLC. loveamika.com, $25

3.

2. Curology The Cleanser A gentle foaming cleanser with anti-inflammatory oat extract that’s noncomedogenic and ultra-hydrating. curology.com, starting at $19.55 3. ODE Orchard Alchemy Antioxidant Facial Oil A nourishing facial serum blended with skin-loving oils and extracts, including organic, early harvest extra virgin olive oil from McEvoy Ranch. mcevoyranch.com, $65 4. Nuria Defend Skin Shielding Essence A lightweight, vegan essence with ginseng root and carob that shields skin from environmental toxins and stressors. nuriabeauty.com, $48

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1.

4.

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P RO M OT I O N

5. Batiste Dry Shampoo in Wild To get an instant refresh on tired, oily tresses, this dry shampoo is made with a unique rice starch formulation that revives lifeless hair, eliminates odor and extends blowouts. ulta.com, $8.99

7.

6. HydraFacial DermaBuilder An add-on to an in-office HydraFacial treatment that helps smooth the appearance of fine lines and wrinkles, and supports skin’s structural proteins, including collagen. hydrafacialnation.com/ newbeauty, $50 value 7. Probiogen Daily Digestive Balance A high-potency, oncedaily probiotic supplement that helps support the digestive and immune systems, and promotes healthy hair, skin and nails. gnc.com, $24.99

5.

8. Mass Eden Facial Steam A mixture of tea spices that works with steam to create a weekly DIY spa treatment. masseden.com, $16

8.

ARE YOU A MEMBER? NewBeauty’s luxury sampling experience delivers $150+ worth of full- and travel-size products to your door bi-monthly for only $29.95.*

Subscribe today: TestTube.NewBeauty.com *Plus shipping, handling and applicable tax. Prices shown reflect product’s full-size price.

6.

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PROMOTION

MENTOR

TALKS NewBeauty hosted its first-ever Mentor Talks forum this Fall in New York City.

Attendees participated in an interactive evening that uncovered unique stories behind the journey of breast augmentation and reconstruction, as well as facts around implant health and safety. NewBeauty’s Editor-at-Large, Sarah Eggenberger moderated a diverse panel discussion between doctors, patients, and Mentor’s health and safety expert.

Plastic surgeons Emily Clarke-Pearson, MD and Ashley Amalfi, MD provided advice on how to navigate all of the implant options and how important it is to empower other women facing similar circumstances. Dr. Clarke-Pearson said, “I want my patients to think of me as not just their plastic surgeon, but as their lifelong confidante, advisor and doctor.”

Stations were set up for attendees to touch and feel the implants up-close. Many attendees vocalized how picking an implant size can be overwhelming, but Mohamed Shariff, Senior Program Lead for Regulatory Affairs at Johnson & Johnson, shared: “At Mentor, we recognize that every patient is different, so we've developed a wide range of profiles, sizes and styles to ensure women have options.”

Guests left with confidence to make a more educated decision on breast implants. A patient who received Mentor implants after undergoing a mastectomy said: “Through this experience, I have become a vocal advocate for other young women facing a similar genetic circumstance. Finding the right healthcare team is so important.”

Visit breastimplantsbymentor.com to learn more.

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“In aesthetics, safe and sensible prevention and maintenance are more cost-effective than correction.”

—PLASTIC SURGEON ROBERT SINGER, MD LA JOLLA, CA

THE

WELCOME TO THE CLINIC

A comprehensive guide to the most advanced aesthetic procedures and the top doctors who perform them.

108 PAG E

LASERS

110 PAG E

BELLY FAT

116 PAG E

REVISION SURGERIES

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THE CLINIC

LASERS

BEAM ME UP F RO M R E D N E SS TO P O R E S I Z E , “ LU N C H T I M E L AS E RS” A D D R E SS I T A L L B Y E M I LY TAY L O R

T

here used to be something called a lunch break: people would stop working in the middle of the day, leave their desks and go somewhere else to eat.

We know, it sounds crazy! Sarcasm aside, studies show that less than half of U.S. workers take advantage of these moments, and instead, eat at their desks. But thanks to innovations in lasers—new wavelengths, energy sources and devices—doctors can now transform patients’ skin in less time than ever, with minimal or no post-procedure redness, making the case for the comeback of the lunch break. Here, our favorite laserbased skin-fixers, each faster than waiting in line at Panera.

REDNESS

A little rosiness now, for less tomorrow: Pulsed-dye lasers (PDLs)—like Candela’s Vbeam or Cynosure’s Cynergy—treat flushed faces, according to Washing37,849 facial ton, D.C. dermatolo- resurfacing treatments with lasers were gist Tina Alster, MD, performed in 2018—an by “emitting a wave18.7 percent increase from the year prior length of light that SOURCE: The is preferentially abAesthetic Society sorbed by hemoglobin in the blood. Heating the blood vessel causes the body’s repair system to clear the damaged vessel over the coming weeks.”

Typically, the procedure takes “a few minutes to half an hour, depending on the area,” and may require three to five treatments for desired results, says Studio City, CA dermatologist Gene Rubinstein, MD. Downtime is

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minimal, and minor swelling and redness can last for a few hours or a few days. Though for some target vessles, Vbeam results can be long-term, Denver dermatologist Joel L. Cohen, MD mentions that capillary dilators like spicy foods, alcohol and hot beverages could

cause redness to return, especially for rosacea-prone patients.

DULL SKIN

Thulium-based lasers like LaseMD and Clear + Brilliant work similarly to Fraxel,

ALEX SARGINSON / TRUNK ARCHIVE

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THE CLINIC

LASERS

notes Dr. Rubinstein, by “creating microscopic columns in the skin. As the body heals these heated columns, it generates new collagen and results in fresher-looking skin.”

Procedure time is about an hour, which includes the time it takes to prep the skin with numbing cream, explains New York dermatologist Julie Russak, MD. Following the procedure, moderate redness can last up to a day, with minor skin shedding for approximately 10 days. According to Dr. Rubinstein, “People describe the treatment as feeling like a ‘cat’s tongue’ licking your skin.

The skin feels a little rough for a few days because each column produced by the laser creates a column of exfoliation.” Other glowboosting options doctors love? Short-pulsed Q-switched lasers, that can be used as a fullface treatment to address dull skin. One such laser, Lutronic’s Spectra, wields four separate wavelengths: the lower energy works at the surface of skin and the higher heats the deeper layers of skin to trigger a

healing response. Dr. Cohen notes that they usually cause minimal downtime—“you can go out that night”—with swelling lasting a few hours.

MILD PIGMENTATION

In addition to revitalizing dull skin, Q-switched lasers also diminish dark spots, according to Dr. Rubinstein, who notes that they use a specific wavelength to “break up pigment with a very fast pulse. The faster the pulse, the smaller the particles for the body to clear.” Depending on how many spots are treated, and whether the patient needs a 20-minute pre-treatment under a numbing cream, the full procedure can take anywhere from a few minutes to an hour. For certain types of hyperpigmentation, like melasma, Dr. Rubinstein also uses Cynosure’s PicoSure laser, which is FDA-approved for tattoo removal and uses photomechanical waves. (It also works more quickly than the traditional Q-switch). “The PicoSure has a picoseconds

pulse, which is one trillionth of a second!” he says. For more diffuse areas of benign hyperpigmentation and melasma, Dr. Cohen recommends a thulium-driven laser like Lutronic’s LaseMD, which creates microchannels of controlled damage and offers a broader range of treatment settings than Q-switched lasers do, to reach deeper into the skin.

LARGE PORES

Though pore count is genetically determined, their size can be altered, at least in the short-term. Thulium-based lasers minimize pore size by boosting collagen production—something skin loses over time that leads to “sagging” pores—as a result of the controlled damage caused by the laser.

Additionally, the temporary swelling that follows a Clear + Brilliant procedure can render pores almost invisible. Each treatment takes about 45 minutes—this includes the numbing cream; actual time with the laser is about 20 minutes.

BEFOR E & A F T ERS

FO U R D I F F E R E N T L AS E RS O F F E R D R A M AT I C R ESU LTS W I T H M I N I M A L D OW N T I M E AFTER AFTER

BEFORE

AFTER

BEFORE

PICOSURE Miami plastic surgeon SEAN SIMON, MD performed multiple passes of PicoSure laser spaced weeks apart to break up the hyperpigmentation found on the tip of this 40-year-old patient’s nose.

BEFORE

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BEFORE

CLEAR + BRILLIANT Paradise Valley, AZ dermatologist SUSAN VAN DYKE, MD injected filler into this 33-year-old patient’s fine lines and used a single pass of the Clear + Brilliant laser to address “tired-looking” skin.

ND:YAG To treat this 31-year-old patient’s dark reticular vein and rejuvenate the appearance of her skin, Grand Rapids plastic surgeon BRADLEY BENGTSON, MD used an Nd:YAG Nordlys Hybrid Laser.

VBEAM This 21-year-old patient was worried about a vascular birthmark.

Charlotte, NC dermatologist GILLY MUNAVALLI, MD used the Vbeam Perfecta and Prima, and intense pulsed light (IPL) over several sessions.

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For women, a waist measurement of 35 inches or more is cause for concern.

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B E L LY FAT

THE SKINNY ON BELLY FAT MANY OF US NOTICE AN INCREASE IN OUR WAISTLINES AS WE GET OLDER, EVEN IF WE AREN’T GAINING WEIGHT. RESEARCHERS HAVE FOUND THAT WE SHOULD BE PAYING CLOSER ATTENTION TO THE HARD-TO-LOSE FAT AROUND OUR MIDSECTIONS B Y TAT I A N A B I D O

FACTS ON FAT

 Get a group of women together to talk about common health and wellness issues, and the pursuit of a flatter, tighter tummy will surely come up. Whether we’ve had children or just never got rid of that pesky Freshman 15, many of us have had our own personal struggle with hard-to-lose fat. If it seems like a totally relatable issue, it’s because it is: According to the Centers for Disease Control and Prevention (CDC), women’s waist measurements have increased in the last 20 years from an average of 36.3 to 38.6 inches. The CDC also states that more than two in three women in the United States are considered overweight or obese. Those numbers point to an increase in women with tummies that put them at a higher risk for obesity-related diseases. Now, researchers are looking at more than just BMIs to assess health risks— they’re also factoring in our waistlines.

RISKY BUSINESS

ALTAN CAN/EYE EM/GETTY IMAGES

A recent study published in the Journal of the American Medical Association’s Network Open used data from the Women’s Health Initiative to track the health of more than 156,000 post-menopausal women between

the ages of 50 and 79 over the span of 20 years. Assistant professor of epidemiology at the University of Iowa, Wai Bao, MD, PhD, said he and his team linked mortality rates to the respondents’ BMIs, as well as their central obesity, or the excess accumulation of fat around their midsection, which was measured by their waist circumference.

“What we discovered was that women who were considered normal weight with a BMI of 18.4 to 24.9, but who also had central obesity, or a waist circumference of more than 34.6 inches, were a third more likely to die within a 20-year period than normal-weight women without central obesity.” This higher risk was almost identical to the risks observed among women who are considered obese—with a BMI of 30 or higher—who also had central obesity. The takeaway: being what we call “skinny fat” can be deadly.

DEEP AND DANGEROUS

So, why is belly fat so hard to lose? First, not all belly fat is created—nor can it be treated—equally. There are two types of fat found inside our stomachs. “Visceral fat is the fat that is stored within the abdominal cavity, deep into the abdominal muscles and around our organs,” says San Diego

“ Women’s waistlines have increased in the last 20 years, from an average of 36.3 inches to 38.6.”

T H E B R E A K D OW N

ABDOMINAL FAT REDUCTION 101

TREATMENT OPTIONS: Surgical procedures include liposuction and a tummy tuck. Noninvasive options include nonsurgical fat reduction and magnetic muscle stimulation (MMS).

AVERAGE TREATMENT COST: Procedure costs can range from $3,000–$15,000 for liposuction; $5,000–$15,000 for a tummy tuck; $1,000–$2,000 per area for nonsurgical fat reduction; and MMS treatments average $1,000 a session per area.

BEST FOR: Healthy patients who are close to their ideal body weight with a BMI of 30 or lower.

LONGEVITY: For fat-reduction procedures like liposuction and nonsurgical fat reduction, “once we destroy or remove a fat cell, it can never come back,” says La Jolla, CA plastic surgeon Hector Salazar-Reyes, MD.

SOURCE: CDC

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B E L LY FAT plastic surgeon Joseph Grzeskiewicz, MD. Visceral fat, commonly called the dangerous fat, cannot be pinched or felt because it is located behind the abdominal wall. “When we see a large belly, there can be an excess of visceral, or inside fat. The difficult thing about this type of fat is that there really is no way to remove it surgically—the only way to reduce it is through diet and exercise,” he says. We sometimes refer to visceral fat as active fat because it can actively increase the risk of long-term, life-threatening problems like heart attacks, heart disease, cancer, stroke and Type 2 diabetes.

SUBCUTANEOUS BLUES

If you can poke it, pinch it or jiggle it, then it’s the other type of fat found on our bodies called subcutaneous fat. We refer to this fat as outside fat because it accumulates outside the abdominal wall and underneath the skin. Dr. Salazar-Reyes explains, “Subcutaneous fat under the skin is fat you can pinch with your fingers. As it accumulates, we have a tougher time losing it because the fat in our stomachs is not as metabolically active as the fat that we have on our extremities.”

THE SOLUTIONS

 Thankfully, we only have to worry about the fat cells we were born with. “Fat only hypertrophies, meaning the fat cells we have at birth are the only ones we ever get,” says Dr. Salazar-Reyes. “The number of cells remains the same, but the cell size can get bigger.”

When we’ve exhausted every effort to rid our bodies of those fat cells with diet and exercise, we have several options to help us reshape our waistlines by eliminating the fat doctors can actually get to—that soft, jiggly subcutaneous fat.

SUCK IT UP

To remove some of those over-nourished fat cells, surgeons use a cannula during liposuction to suck out the fat in a targeted area.

“Once the fat cells are sucked out and removed from the body, they disappear and never come back,” Dr. Salazar-Reyes says. Today’s liposuction techniques focus on body sculpting to carve and mold the abdomen into a streamlined contour. “After removing the deep fat compartment, we can manipulate the remaining superficial fat to better show the patient’s muscles and give them very nice, well-defined six-pack.”

“There are also modalities such as radio frequency, ultrasound and some laser liposuction devices that claim to also cause more contraction and shrinkage of tissues,” explains Dr. Grzeskiewicz, “but they can add to the risks of the procedure, too, including burns.”

CINCH IT

Liposuction can remove abdominal fat, but it won’t address excess or loose tissue from skin that’s been stretched by an extra fatty layer. A patient in good health who is close to her ideal body weight or fat percentage is a good candidate for a tummy tuck. This entails general anesthesia, removal of excess skin and fat, and at times, surgical tightening of the muscles of the abdominal wall. “Many women who believe they have belly fat may just be loose in their core,” says Las Vegas plastic surgeon Mary C. Herte, MD. “When they stand up, their abdominal contents fall forward, creating a Buddha belly, but when they lie down, their stomachs look flat. This is best treated by a tummy tuck with repair of the separated abdominal muscles to create an internal corset.” However, Eugene, OR plastic surgeon Mark Jewell, MD cautions, “over-tightening of the abdominal muscles in patients with large amounts of visceral fat

“ Once the fat cells are sucked out and removed from the body, they disappear and never come back.”

—DR. SALAZAR-REYES

and only a thin layer of subcutaneous fat can impair breathing.”

FREEZE OR BURN

Nonsurgical fat-reduction treatments, whether using hot or cold energy, work to disrupt fat cells, which are later expelled from the body through the lymphatic system (the dead fat cells slowly leave our bodies through our urine and sweat). The actual death cycle of the fat cell can take several months, making patience a real virtue with cutting-edge treatments like WarmSculpting by SculpSure, UltraShape, Vanquish and CoolSculpting.

Procedures like WarmSculpting and Vanquish use radio frequency to heat up fat cells; UltraShape uses ultrasound energy. The difference between these treatments and CoolSculpting is that they use controlled heat, whereas CoolSculpting uses cryolipolysis, or controlled cooling. “We apply cold to freeze the fat in a targeted area,” Dr. Herte says. “The destroyed fat cells are naturally eliminated over the next few weeks. Typically, multiple applications of the device are required over multiple sessions, but the upside is that there are no restrictions after the procedure. This is perfect for anyone whose schedule does not allow time off for recovery.”

MUSCLE MEMORY

Magnetic muscle stimulation (MMS), a new category in tummy-toning treatments, help to jump-start muscle building faster than we ever can on our own in the gym. Boasting the power to give ab muscles a workout equivalent to 20,000 sit-ups or more in a 30-minute span, these new state-of-the-art devices— Emsculpt was FDA-approved last year, and CoolTone just received FDA-clearance this summer—claim to easily create muscle definition where fat once resided. The end result: a leaner, more toned tummy.

“High-intensity electromagnetic muscle stimulating technology has been in the rehab space for years, it was even used to prep astronauts back in the ’60s,” says Delray Beach, FL dermatologist Dr. Janet Allenby.

“Now we are using the technology for body contouring with devices that build and tone muscle, reshaping problem body areas. Both Emsculpt and CoolTone deliver electromagnetic energy through the skin, directly to the

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STILL IMAGES/GETTY IMAGES

Of the more than 1.8 million cosmetic surgical procedures performed in the U.S. in 2018, liposuction procedures were the second most popular.

SOURCE: American Society of Plastic Surgeons

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B E L LY FAT muscle. The energy is basically talking to the neurons that tell the muscle to contract.”

These muscle-toning options are making it easier for women with a small amount of stubborn fat to fight the battle of the bulge without going under the knife. “Usually, we start with four to six treatments to a targeted muscle group, such as the abs, butt or thighs,” says Dr. Allenby. “Each treatment is telling your body that you’re getting ready for a higher intensity event and is prepping your muscles for a more explosive future response, which creates more muscles. Just like in traditional exercising, it may take several weeks before you see your desired tone develop, but you should feel improvement of your strength far quicker.” Dr. Allenby foresees a future where we look at MMS

treatments as a supplement to, not a replacement for, an active lifestyle: “I recommend one maintenance treatment every six weeks to keep the muscles nice and tight.”

HEALTHY CHOICES

Despite the myriad of options to fight belly fat, the old adage remains true: Six-packs are made in the kitchen. “Someone with undisciplined dietary habits, but an intense exercise routine, will probably still accumulate more fat than someone who performs only modest exercise, but has a very clean, disciplined diet,” says Dr. Grzeskiewicz. “I find that the worst influence for development and retention of belly fat is a high-carbohydrate diet.

For many patients, restricting carbohydrate intake is the only way to lose fat in this area.”

WAIST TR AINER

And while belly-busting treatments continue to grow, researchers have just tapped the surface of studying the link between waist circumference and disease. Dr. Bao says women need to know that their waist sizes are just as important as their BMIs, even if they’re meeting all of the health guidelines on paper. “With our study, we hope to inspire others to replicate our findings and eventually influence changes to the national health guidelines. For a woman with a normal BMI, a doctor may never take her waist circumference into consideration when assessing her overall health. All of these factors should be considered when evaluating a person’s risk for diseases related to increased body fat.”

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AIRET/GETTY IMAGES

According to Harvard Health, 10 percent of our total body fat is the hard-to-treat visceral fat.

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B E L LY FAT

BEFOR E & AF T ERS

WHEN STUBBORN, HARD-TO-LOSE ABDOMINAL FAT CANNOT BE DIETED AND EXERCISED AWAY, THESE FAT-BLASTING PROCEDURES CAN FLATTEN, CINCH, TIGHTEN AND TONE .

AFTER

BEFORE

AFTER

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COOLSCULPTING After one CoolSculpting session by Greenwich, CT dermatologist MITCHELL J. ROSS, MD this patient saw a decrease in stomach fat. Results are shown three months after treatment.

AFTER

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TUMMY TUCK Unhappy with her abdominal contour and loose skin after prior pregnancies, this 55-year-old patient underwent a drainless tummy tuck with San Francisco plastic surgeon ANNE PELED, MD.

TUMMY TUCK New York plastic surgeon DANIEL MAMAN, MD performed a tummy tuck with rectus diastasis and umbilical hernia repair on this 35-year-old mother of two.

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TUMMY TUCK Chicago plastic surgeon NIKI A. CHRISTOPOULOUS, MD gave this healthy, active 60-year-old patient a tummy tuck with tightening to correct diastasis recti, and liposuction of the abdomen and flanks.

TUMMY TUCK To give this 43-year-old patient the tighter and more toned-looking stomach she desired, San Diego plastic surgeon LARRY POLLACK, MD performed an abdominoplasty.

TUMMY TUCK To give this 37-year-old patient a streamlined silhouette and remove abdominal fat she couldn’t lose after pregnancy, New York plastic surgeon JEFFREY S. YAGER, MD performed a tummy tuck.

BEFORE

AFTER

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TUMMY TUCK This 41-year-old patient was unhappy with excess abdominal fat. Sugar Land, TX, plastic surgeon PETER CHANG, MD performed a tummy tuck with liposuction to the stomach and flanks.

COOLTONE This 35-year-old patient wanted to tone and tighten her abdominal area. Delray Beach, FL dermatologist DR. JANET ALLENBY performed four CoolTone treatments to achieve this result.

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In a recent American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) survey, facial plastic surgeons have reported the average number of revision surgeries performed have nearly doubled since 2017.

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REVISIONS

THE ULTIMATE DO-OVER

100/GETTY IMAGES IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

S

F RO M D I SSAT I S FACT I O N W I T H R E SU LTS TO N EC E SSA RY R E- D OS, T H E D E M A N D FO R A S EC O N D, T H I R D O R FO U RT H C H A N C E AT T H E B E ST O U TC O M E C O N T I N U E S TO G ROW

ometimes it takes a little persistence to achieve bliss. And if art imitates life, Michelangelo’s famous Mary (La Pietà) required 20 “revisions” to fix a droopy eyelid, injured during a tragic 1972 assault. In surgical terms, a revision is defined as the second (or third, or fourth) round of the same surgery. “Never would I have imagined that I would need four extra breast surgeries,” says Gwen Roman, a 48year-old mother from South Florida. “If I could’ve gone back in time, I would have not just talked to doctors and flipped through their pictures, but I would have talked to patients who had undergone a similar ordeal.”

Four years ago, Roman was diagnosed with stage-zero ductile carcinoma. After a complicated lumpectomy, her breast surgeon recommended a double mastectomy, which he performed alongside a plastic surgeon, who inserted Roman's implants.

BY CAROLINA BUIA T H E B R E A K D OW N

REVISIONS 101

WHAT IT IS: Revision defines the second, third or fourth round of the same procedure to make a correction or adjustment.

“While I looked awful, I had just cheated cancer, and it made clear to me that a revision surgery would be required in six to eight months,” she says. But after the first revision, Roman was aghast and saw little improvement. “My breasts were still uneven and saggy, and my nipples weren't in the right place.”

Six months later, Roman returned to the same surgeon for a second revision. “When I voiced my concerns, he seemed to brush them off. When I asked him to center my nipples, he said it was not possible.”

Roman was even more crestfallen after the results from her second revision. “Not only did I have these scars near my armpit, but he had done some liposuction on my stomach and left me with a concave swoop above my belly button.” While her plastic surgeon offered to perform a third revision, Roman had had enough. She spoke to friends who had undergone similar experiences, and then interviewed doctors based on their referrals.

“ My breasts were still uneven and saggy, and my nipples weren’t in the right place.”

WHY IT'S DONE: For aesthetic reasons, loss of functionality, unexpected scarring, or even complications such as a hematoma or infection COMMON REVISION PROCEDURES: Abdominoplasty, blepharoplasty, breast surgery, browlift, facelift, liposuction and rhinoplasty POSSIBLE RISKS: Eugene, OR plastic surgeon Mark Jewell, MD says all revision surgeries carry their own set of risks. He notes breast reconstruction surgery can be problematic because of tissue loss, scarring and the effect of radiation, which if used, can compromise the outcome.

Revision rhinoplasty is the most problematic, he explains, as there are many variable factors, “including structural elements and skin thickness, and how it drapes over the reshaped nose.”

KNOW BEFORE YOU GO: “Going to a highly trained, board-certified surgeon who specializes in your procedure will improve your chances of a good outcome the first time,” adds Dr. Jewell.

GINA ROMAN, BREAST SURGERY PATIENT

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REVISIONS

SIZE DOES MAT TER

While revision statistics are scant, the FDA estimates that 40 to 56 percent of all breast revision surgeries relate to a change in implant size. Implants, which are labeled as medical devices, do not last forever, and there is always the possibility of capsular contraction, infection, wrinkling or rupture.

“I see higher revision rates with patients who have a combination procedure, such as breast implants with a breast lift,” says New York plastic surgeon Stephen Greenberg, MD. “It has to do with the way the breast, skin and implants relate to each other.”

Dr. Greenberg finds the increase of medical tourism cases gone wrong to be alarming.

“I’ve treated a number of patients who have returned from having plastic surgery in countries like Costa Rica or the Dominican Republic. Sadly, some return home with

FACE FACTS

Perhaps one of the more challenging revisions of all is the rhinoplasty. A 2016 study published in the Journal of the American Medical Association estimates that between 5 to 15 percent of all nose jobs are revised. “I always take the time to counsel my patients and let them know that this is not a surgery for perfection, but rather improvement,” says New York facial plastic surgeon Alexander Ovchinsky, MD. He says that in some cases, minor imperfections can be improved with fillers, steroid injections or the shaving of a cartilaginous irregularity. Other times, a revision is a medical necessity. “It is not uncommon for the nose to be made smaller during a rhinoplasty surgery; sometimes, the narrowing of the airway interferes with normal breathing.”

Compromised functionality can occur

SHARED HISTORY

“IT'S IMPORTANT TO CONSULT YOUR PRIMARY SURGEON BEFORE CONTEMPLATING A REVISION, AS THEY KNOW YOUR HISTORY BEST,” SAYS DR. OVCHINSKY. “BUT, IT IS EQUALLY IMPORTANT TO SEEK OUT OTHER OPINIONS FROM QUALIFIED SURGEONS. IF A REVISION IS NECESSARY, YOUR PRIMARY SURGEON MAY WANT TO DO IT. AFTERALL, YOU ARE THEIR WALKING BILLBOARD.” immediately or over a long period of time, says Boston facial plastic surgeon Jaimie DeRosa, MD, who adds that our noses continue to change throughout our lifetime.

Donna L. (name changed) from Rhode Island knows that all too well. She had two conservative rhinoplasties in her teens, but at age 20, was finding it increasingly difficult to breathe through her left nostril.

“I returned to the same surgeon to remove the excess scar tissue. As he was putting me under, I asked him to revise the tip a little more. This was a mistake I will forever regret,” says Donna. “He took too much off and ‘Michael Jackson-ed’ me.” After 20 years of living with her Thriller nose job, she decided it was time to interview top surgeons in the Northeast. A few refused to operate on her, but Dr. DeRosa was up for the challenge.

40-56%

of all breast revision surgeries relate to a change in implant size SOURCE: U.S. FOOD AND DRUG ADMINISTRATION

EFENZI/GETTY IMAGES IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

F

inally, Roman felt confident about her decision to entrust West Palm Beach, FL plastic surgeon Luis A. Viñas, MD with her next surgery. “Dr. Viñas took the time to understand what bothered me.” He suggested two more revision surgeries, during which he lifted Roman’s breasts and centered her nipples, a feat her initial plastic surgeon said was impossible. “A part of my practice is fixing surgeries from other surgeons. You have to be willing to listen to your patients. There is always something you can do,” says Dr. Viñas. “My goal is to make the breasts look as they once did, or even better.” He also replaced Roman’s teardrop implants with round ones. “They looked so much better. I was finally happy,” says Roman.

problems, and even life-threating infections, which require hospitalization and corrective surgery.” Huntington Beach, CA plastic surgeon Andrew Smith, MD advises all patients to make sure their doctor is board-certified and has extensive experience with reconstruction procedures. Dr. Smith, who performs his fair share of revision procedures, says the most common tummy tuck complaints are when the scar ends up too high or the belly button looks fake. “If the tissue has loosened over time, it is an easier fix, but if the tissue or skin is too tight, it becomes more difficult.”

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REVISIONS

MENTAL IMAGE-ING

IF YOU DISAGREE WITH THE PROFESSIONAL CONSENSUS TO FORGO MORE SURGERIES, SEEK THE ADVICE OF A TRAINED THERAPIST. REMEMBER, SELF-ESTEEM CAN ALSO BE REVISED. AND, THERE ARE NO DOWNSIDES TO THIS.

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REVISIONS “She took precise measurements, modeled the nose and described a strategy in layperson’s terms,” says Donna. “She felt different than any other surgeon I had consulted with.

I’ve repeatedly thanked her for changing my life. My nose looks normal. Finally.”

Dr. DeRosa says not all patients who are potential candidates choose revision. “It’s a big decision. Every time you operate on the nose, you weaken it,” she says. But, she is comforted that a majority of her patients come in with realistic expectations. Ten years ago, she says, that was not the case.

Patients wanted Angelina Jolie's nose, but in most cases, they lacked her cheekbones, eyes and lips. “Today, patients are self-imaging on photo-editing apps. They’re getting real-time information on how their nose might look after surgery.” Dr. DeRosa says apps cannot replace a surgeon's own imaging, which takes into account aspect ratios and nasal skin thickness.

Unlike rhinoplasties, facelifts rarely require revision. “Time and the progression of the aging process are the most common reasons for a revision,” says Charlotte, NC facial plastic surgeon Joshua Surowitz, MD. His partner, facial plastic surgeon Andrea Garcia, MD, adds that occasionally patients with heavier faces may require a minor touch-up a year after their initial surgery.”

The decision to undergo a revision is not one that should be taken lightly. But, at least in dexterous hands, a rough beginning can be chiseled into a work of art that even Michelangelo would approve. It just might take more than one try.

TAKE A BREAK

CAVEAT EMPTOR

B E FO R E T H E K N I F E , T H E R E’S T H E P E N . H E R E 'S W H AT TO E X P ECT B E FO R E YO U S I G N

1

CONSENT FORMS list the known minor and more serious complications. This list is not meant to scare you before a procedure, but rather to make you a more educated patient and consumer.

2

COMPLICATIONS CAN AND DO HAPPEN, but a capable, boardcertified surgeon who specializes in your procedure should be trained to recognize them and address them during or after surgery.

3

DISCUSS THE REVISION CLAUSE. If a revision surgery is needed, medical malpractice attorney Trisha S. Widowfield says a patient may still be responsible for some associated surgical fees.

4

MANAGE EXPECTATIONS. ”Patients need clear expectations to determine what results the surgeon can assure and what the potential variations can be,” says Widowfield.

5

DON’T GO AWOL. Comply with your surgeon’s postoperative instructions, schedule and show up for followup appointments, and notify your surgeon of any new or unusual concerns that may arise.

SOUTHERN STOCK/GETTY IMAGES, IMAGE USED FOR ILLUSTRATIVE PURPOSE ONLY

DON’T RUSH TO REVISE. ALLOW YOUR BODY TO HEAL. “EVERY TIME WE OPERATE ON THE NOSE, THERE IS A RISK OF COMPROMISING ITS STRUCTURE,” SAYS DR. DEROSA. SOMETIMES, MINOR IMPERFECTIONS LESSEN WITH TIME.

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REVISIONS

BEFOR E & A F T ERS

W H E N T H E F I RST T I M E I S N OT A C H A R M , R E V I S I O N P RO C E D U R ES CA N M A K E SY M M ET RY, BA L A N C E A N D B E AU T I F U L R ESU LTS A R E A L I T Y FO R D I SSAT I S F I E D PAT I E N TS. AFTER AFTER

BREAST LIFT Atlanta plastic surgeon CARMEN KAVALI, MD removed this 55-year-old patient’s breast implants and performed a revision breast lift to give her breasts a new size and shape.

AFTER

BEFORE

AFTER

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BREAST AUGMENTATION This 44-year-old patient sought Voorhees, NJ plastic surgeon WILLIAM FRANCKLE, MD for a revision surgery to give her breasts a softer, more natural look using ”gummy bear” gel implants.

ABDOMINOPLASTY Pasadena, CA plastic surgeon MARTIN O'TOOLE, MD performed an abdominoplasty revision on this 35-year-old patient to correct poor results from a prior surgery and give her a smoother tummy.

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RHINOPLASTY This 30-year-old patient disliked the results of a prior rhinoplasty done elsewhere. New York facial plastic surgeon EDWARD KWAK, MD performed a revision to give her the results she desired.

NECKLIFT Unhappy with the appearance of her neck after a prior facelift, this 59-year-old patient sought New York facial plastic surgeon DILIP MADNANI, MD for a revision necklift with fat transfer.

BEFORE

AFTER

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LIP AUGMENTATION Scottsdale, AZ facial plastic surgeon KELLY BOMER, MD dissolved the excess filler in this 33-year-old patient's lower lip with Vitrase and injected a small amount of Juvéderm for a more natural shape.

BREAST LIFT Kirkland, WA plastic surgeon SARAH MCMILLAN, MD performed a revision breast lift on this 41-year-old patient to reposition her breasts and address concerns about loose skin after a prior surgery.

RHINOPLASTY San Francisco facial plastic surgeon DAVID W. KIM, MD performed a revision rhinoplasty on this 45-year-old patient to give her a more natural-looking, symmetrical nose.

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ADVICE

Q&A

ASK THE

DOCTOR

Q

I’m starting to notice tiny white bumps around my eyes. What are they, should I be concerned and how can I fix them?

“White bumps can be a few things. Milia are the most common, which are basically little white heads. When they occur, they can be extracted by a dermatologist. Good skin care and Retin-A, routine facials and peels are all things that can help prevent them.

Sometimes people have other white bumps around their eyes called syringoma. These tend to be hereditary and can increase with

F RO M A L I G N E RS TO V E I N S, H E R E’S W H AT R E A D E RS WA N T TO K N OW F RO M N E W B E AU T Y’S TO P D O CTO RS B Y E M I LY TAY L O R

time. The best option for removing those are direct excision. Always check in with your doctor if you notice anything concerning— sometimes these white bumps turn out to be cancer.”

JASMINE MOHADJER, MD LARGO, FL OCULOPLASTIC SURGEON

I want a rhinoplasty surgery to reduce the size of my nose, but I’m concerned it will impact the rest of my face.

Will it change any of my facial proportions?

“Rhinoplasty surgery can affect the aesthetics of the whole face. The proportions of the nose affect how everything else on the face appears, especially the eyes and chin.

When the nose has been changed to better aesthetic proportions for a particular face, the nose will disappear when looking at the

face, the eyes will be brighter and the whole face will instantly appear more attractive.

If the nose is tenting the upper lip up due to a large nasal base and this is improved with the surgery, the appearance of the upper lip will improve and have more normal mobility.”

KELLY BOMER, MD SCOTTSDALE, AZ FACIAL PLASTIC SURGEON

I want to get a facelift, but I’m only in my early 40s.

How can I tell if I’m ready or even a candidate for surgery?

“Although the average age of a facelift has remained stable at roughly 57 years old, advances in surgical techniques have opened the door for younger people to get excellent results with very small-scar, mini-facelifts starting as early as their 30s, and have also become safe and viable for people in their

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T OP D OCTORS Turn to page 125 to find one near you.

80s and beyond! For me, the question to any potential patient becomes, ‘Does your desired level of improvement require surgery, or can we approach your goals nonsurgically with lasers, peels, injectables, etc.?’

If surgery is warranted, I make sure they are the right candidate by asking a few important questions. Someone ready for a facelift has realistic expectations—meaning they understand that the best possible facelift restores roughly 10 years; is emotionally stable—facelifts are powerful and can likely trigger lots of emotions, so the right candidate should be supported enough to sail through them; can afford the downtime; and chose our practice because they specifically like what we do and our aesthetic, as we want to be certain that what we deliver satisfies their expectations.”

DAVID HARTMAN, MD DOVER, OH FACIAL PLASTIC SURGEON

I want more youthful-looking eyes, but I’m not ready for major surgery. Are there any good (and safe) nonsurgical treatments to help me not look so tired all the time?

“Aging changes in the eye area can vary from hollowness, fines lines and wrinkles, excess skin and prolapsed fat. It’s important to identify the exact aging changes a person has, and then target those areas. If you’re not ready for surgery, some options include neurotoxins, fillers, lasers and microneedling. However, the newest technology that addresses the upper and lower eyelids, as well as the brows, is AccuTite, which utilizes radio-frequency energy to melt fat, tighten skin and build collagen. This is the latest in nonsurgical rejuvenation around the eye area and can provide good results with minimal downtime.”

KESHINI C. PARBHU, MD WINDERMERE, FL OCULOPLASTIC SURGEON

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I inherited my mother’s blue eyes, but also her varicose veins. Are there any treatments to help get rid of the veins?

“There are multiple causes for varicose vein formation, including pregnancy, obesity, prolonged standing and family genetics.

While varicose veins are unsightly, they can cause significant problems if left untreated.

Chronic swelling, discoloration, pain and ulceration are common long-term effects of dilated abnormal veins in the legs. It is important to determine the underlying cause of the varicose veins to find the best treatment possible. However, there are many treatments to reduce the complications.

Initially, compression stockings help reduce pain, swelling and further issues. More permanent treatments include sclerotherapy injections, endovascular ablation and surgical removal. Addressing the swollen veins early, with the help of a vascular specialist, can eliminate most or all of the longterm complications. Exercise improves blood flow, which can prevent varicose vein formation. Conversely, crossing legs or cutting off circulation can exacerbate it.”

DAVID A. DREYFUSS, MD ORLANDO PARK, IL PLASTIC SURGEON

I’m in my 30s and want to fix my teeth. Do clear aligners work as well as metal braces? And how long before I can expect results?

“I have treated hundreds of patients with Invisalign aligners, and the results are excellent as long as the patient is compliant and wears them continuously, except when eating. Each case is unique, however, the length of treatment and cosmetic results for Invisalign and traditional braces, either metal or clear, are generally the same. For those patients with severe malocclusion,

Invisalign may not be the appropriate course of treatment and traditional braces will be indicated.”

JAN L. ZIEGLER, DDS MIAMI COSMETIC DENTIST

My skin feels “squeaky clean” after I wash my face. That’s a good thing, right?

“It’s a misconception that your skin should feel tight after cleansing. Actually, that ‘squeaky clean’ feeling is a sign that your skin is lacking the necessary oils that help keep it soft and healthy. You may get that feeling after washing if you are using a cleanser or soap that contains ingredients that strip away and break down the acid mantle layer—the protective barrier that shields your skin from external damage.

When this protective barrier is compromised, skin can begin to show signs of inflammation and irritation. Instead, it’s best to use a cleanser that is gentle and hydrating so that the skin feels comforted after a good cleansing.”

DR. QUENBY ERICKSON CHICAGO DERMATOLOGIST

Are there any powerful facial treatments that are best done during winter?

“It is always best to do most facial treatments on skin that has not been exposed to the sun, and best not to have any tan at all.

Treating tan skin can effect the outcome and potentially cause discoloration, burns or scarring. For this reason, I always discourage treatment during the summer months unless my patients are motivated and willing to use lots of sun protection—always broad-spectrum SPF 30, which defends against both UVA and UVB rays.”

SHARON SCHERL, MD TENAFLY, NJ DERMATOLOGIST

10/18/19 9:08 AM

More than 2 people die from skin cancer every hour. See something new, changing or unusual? It could be skin cancer. Check yourself for The Big See today.

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