Has it really been 38 years since Cybill Shepherd won our hearts in "The Last Picture Show"? Cybill is still a most beautiful woman. In an interview with Patricia Sheridan of the Pittsburgh Post-Gazette, she was asked:

Many women of a certain age are having things done to help maintain a youthful appearance. Have you resisted?

Her reply:

"It’s a big issue for me because I feel a responsibility that I should do something. I have fear of doing it. I will do things. I will be doing things. I haven’t yet.

I just cringe at the thought of needles going in my face. I’m not afraid of shots, having almost died of pneumonia when I was 5 and again when I was 7. I had to get shots every day.

I’m just afraid of what might happen to my face. (Laughs.) I have fear of what it’s going to look like afterward."

Cybill can look natural and many years younger without a trip to the operating room. In my office, under local anesthesia I would perform upper eyelid blepharoplasty along with a conservative Fraxel re:pair (fractionated CO2 laser) of her face and neck. This would smooth the skin of her lower lids, and tighten the lax skin of her neck, cheeks, and brows in addition to eliminating wrinkles and "sun damage" brown spots. Once healed from the Fraxel re:pair treatment I would evaluate whether a small amount of hyaluronic filler (Restylane or Juviderm) would help in the lower lid tear trough hollow and cheek area, but usually this is not necessary after the above treatment. She could look 10 to 15 years younger without looking as if she had any plastic surgery. The only Botox that I would use would be in her "crow's feet" area of the lateral eyelid 1 to 2 weeks before the laser treatment as studies have shown that patient's skin heals better from CO2 laser treatments if the muscles are not moving for a short time following the treatment.

Has it really been 37 years since Cybill drove Richard Benjamin crazy in "The Heartbreak Kid"? Should Ms. Shepherd decide to not have any cosmetic treatment at all, she still is a most beautiful woman.

To see picture of Cybill Shepard go to http://inyourface.freedomblogging.com/2008/07/18/cybill-shepherd-fears-botox-but
-says-she%e2%80%99ll-start-using-it/
and also in the slide show here:
http://www.imdb.com/name/nm0001732/

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In an entry on 6/28/08 I wrote, "Health and Beauty correspondent Marta Waller of KTLA, Channel 5 in Los Angeles has documented her Fraxel re:pair experience in a daily video blog available at KTLA.com and at The Chicago Tribune.com.......You can see the first installment at http://ktla.trb.com/news/health/ktla-video-dairy-marta1,0,3083829.htmlstory. Ms. Waller will also be featuring the story on the KTLA evening news, followed by the Morning News. Look for her segment on Channel 5 this week." Well apparently there has been a "managerial change" over at KTLA, so the segment has been postponed. You can still tune in to KTLA, Channel 5 in Los Angeles, evenings at 10-11pm to see the beautiful Ms. Waller covering health and beauty topics. As Jackie Gleason used to say, "Ralph, one of these days" you will be seeing her segment on her experience with Fraxel repair by Reliant (Reliant was bought by Thermage this week in a deal to be finalized later this year. but that's another blog topic). Be well.

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The newest facial filler has been approved in the United States, Evolence. With rumors that traditional bovine (cow hide) collagen will not be available soon, this new product will be used in those patients who are unable to tolerate hyaluronic acid fillers. It is a porcine (pig skin) derived collagen product (we will have to ask the Rabbi if it is Kosher to inject). It is said to last 6 months (we'll see), and unlike previous collagen products will not require allergy skin testing prior to use. It is owned by Johnson and Johnson, so expect to hear about it a lot real soon. I have included their press release below:

Herzliya, Israel and Morris Plains, NJ (June 30, 2008) − The U.S. Food and Drug Administration ("FDA") today announced the approval of EVOLENCE® for the correction of moderate to deep facial wrinkles and folds, such as nasolabial folds. EVOLENCE® is a new advanced collagen-based structural dermal filler, and a first of its kind product. The introduction of EVOLENCE® marks the first dermal filler entry for the Aesthetics Group of OrthoNeutrogena. While new to the United States, EVOLENCE® has been available in other markets such as in Canada, Western and Eastern Europe, Israel, South Korea and Russia since 2004.

"EVOLENCE® represents a new generation of facial fillers, an innovative structural agent providing beautiful, immediate results by replacing the collagen lost with long-lasting, naturally sourced collagen," said Annie Heremans, M.D., Ph.D., Vice President, responsible for the Company's research and development of the Medical and Aesthetic Dermatology franchises. "We are pleased to enter the U.S. aesthetic space with a differentiated dermal filler designed for optimal patient outcomes. Given our rich heritage in skin care and and commitment to science, we anticipate EVOLENCE® will be a welcome addition to current aesthetic treatment options."

EVOLENCE® will be introduced throughout the second half of 2008, in coordination with physician training, to ensure optimal patient satisfaction and outcomes.

EVOLENCE® represents a breakthrough in aesthetics. As one of nature's most fundamental and abundant building blocks, collagen comprises up to 80% of the dermis and it helps maintain skin strength, structure and support. Collagen naturally breaks down as a person ages, leading to the appearance of wrinkles, lines and folds.

EVOLENCE®, and its proprietary GLYMATRIX™ Technology, uses naturally sourced collagen to replace the body's lost collagen, adding volume and structural support in depleted areas, for a more naturally youthful appearance. In addition, no pre-test is needed, and GLYMATRIX™ Technology delivers longer-lasting durability than previous collagen dermal fillers.

Results are visible and immediate at the time of treatment, with minimal to no bruising or swelling, allowing physician and patient to gauge the amount of wrinkle correction with more precision. EVOLENCE® is recommended for the correction of moderate to deep facial wrinkles and folds, such as nasolabial folds, to be injected in the mid-to-deep dermis.

"We now have a collagen filler that does not require a pre-test and delivers immediate, beautiful and
natural-looking results that last with minimal to little downtime for the patient," said Z. Paul " said Z. Paul Lorenc, M.D., F.A.C.S., Assistant Professor of Surgery, New York University School of Medicine and Principal Investigator on the EVOLENCE® U.S. pivotal study. "EVOLENCE® consistent and predictable results for all patients with every treatment."

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At the recent Facial Cosmetic Surgery 2008 Meeting in Las Vegas, Steve Dayan, MD of Chicago, IL spoke on noninvasive methods of facial rejuvenation. His new book, "Instant Beauty" outlines methods to "look your best in one hour or less". Originally wanting to entitle the book "First Impressions", Dr. Dayan emphasized how we all strive to make an excellent first impression in those precious first seconds. One of Dr. Dayan's quotes is, "It is about making people feel better". By using the noninvasive techniques now available, properly trained physicians can truly improve that first impression.

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Dr. Persky is the only facial plastic surgeon in Southern California to offer all three of the currently available Fraxel laser treatments. Fraxel refine provides safe, gentle resurfacing for patients in their 20's and 30's. You can prevent or address the first signs of aging, such as fine lines and mild pigment problems without downtime. Fraxel restore treatment offers patients in their 30’s, 40's and 50's a noninvasive solution to wrinkles around the eyes, acne scars and brown spots, helping your skin to regain its youthful glow. Fraxel repair treatment is designed for patients in their late 30's to 70's looking for a preemptive strike to treat deeper wrinkles and skin laxity without a surgical facelift. If you'd like to find out which treatment best suits your condition, you can e-mail your photo to drpersky@aol.com, or better yet, come to our office for a personal consultation. Be well.

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