Marionette Lines

The lines that extend down from the corners of the mouth toward the chin are known as marionette lines. The marionette lines tend to deepen with age and they give the appearance that one is frowning. Some people have a strong tendency to have marionette lines, even at a young age, whereas some people never develop them. Surgical procedures like facelifts are notoriously ineffective in treating marionette lines.

The most commonly used method to treat marionette lines is to simply fill the lines with a substance known as a "filler". In the past, fillers such as fat, collagen and Cosmoplast were used. Today, fillers such as Restylane and Radiesse are more commonly used, since these fillers last much longer than most of the other fillers previously available. A five minute injection of Restylane can minimize -- or eliminate -- marionette lines. Repeat injections are performed at six to nine months. With Radiesse, repeat injections are necessary at twelve months. Microinjections of silicone, considered controversial by many physicians, is also sometimes done. Finally, permanent implants are sometimes used in this area as well. Implants made of Gor-Tex are sometimes done, but these implants can sometimes be visible or palpable.

I have found that Botox injections can be quite helpful in the treatment of marionette lines. Certain muscles, called the depressor muscles, can pull the corners of the mouth down and contribute to the downward slant to the corners of the mouth, which then leads right into the marionette lines. By injecting Botox into the depressor anguli oris muscle, the corners of the mouth go up slightly, and the n marionette lines are diminished. Typically, with this regimen, the patient will come into the office every three to four months for Botox injections and every six to twelve months for a filler, depending on the type of filler (Restylane v. Radiesse).

There are a few rarely-done surgical options that are designed to address the corners of the mouth directly. A corner lip lift involves cutting a small triangular piece of skin away from the corners of the mouth in an attempt to give an upturn to the corners. However, the scar can be objectionable and the corners can look unnatural. An ever rarer procedure involves cutting the depressor anguli oris muscle in order to deactivate it (like the Botox injections do). But most surgeons feel that the risks out weigh the benefits for this procedure.

Anastasia Oscar Spa

Anastasia hosted her second annual Oscar Spa on Wednesday, March 1 and Thursday, March 2 at her home in Beverly Hills. Anastasia spa is arguably the most private and exclusive of the increasingly popular pre-Oscar spas, because it is held at her secluded home in the hills, unlike most of the spas which are held in public places like hotels. Because of this privacy and exclusivity, Anastasia attracted the likes of Oprah, Nicolette Sheridan, Eva Longoria, Kelly Preston, Debra Messing, Teri Hatcher the very first year she hosted the Oscar Spa. Of course, most of these people are Anastasia's regular clients as well and they were happy to support her new endeavor.

This year, Anastasia expanded the Spa, so that virtually every room in her house her house was devoted to a different service -- hair and makeup, pedicures and manicures and, of course, eyebrow sculpting by Anastasia. A new addition to the Spa this year was Twin Magic. Jimmy and Daniel performed eyelash extensions after Anastasia finished with the guests' eyebrows. Between treatments, guests lounged by the pool and were served lunch. Attendees this year included Lauren Sanchez, Catherine Bell, Amber Valetta, Garcelle Beauvais, Debra Messing, Molly Sims, Angela Bassett and Jessica Alba.

2005 Cosmetic Surgery Statistics

The 2005 American Society for Aesthetic Plastic Surgery (ASAPS) Statistics on Cosmetic Surgery were released on March 2, 2006. The ASAPS consists only of surgeons certified by the American Board of Plastic surgery and these surgeons must have extensive cosmetic surgery experience and must meet certain ethical standards.

Here are some facts:

1. There were 11.5 million surgical and non-surgical procedures performed in the US last year.

2. Since 1997, there has been an increase of 444% in the total number of cosmetic procedures.

3. The top five surgical procedures were:
(a) Liposuction -- 455,489.
(b) Breast augmentation -- 364,610
(c) Blepharoplasty (cosmetic eyelid surgery) -- 231,467
(d) Rhinoplasty -- 200,924
(e) Abdominoplasty (tummy tuck) -- 169,314.

4. The top five non-surgical procedures were:
(a) Botox injections -- 3,294,782
(b) Laser hair removal -- 1,566,909
(c) Hyaluronic acid injections (Restylane) -- 1,194,222
(d) Microdermabrasion -- 1,023,931
(e) Chemical peels -- 556,172

5. Women accounted for 91.4% of the total

6. Eighty percent of patients were Caucasian, 9% Hispanic, 6% black and 4% Asian.

7. For breast augmentation, 83.4% of implants used were saline and 16.6% were silicone.