Her Scene | Head-to-toe guide to pre-Kentucky Derby plastic

The Courier-Journal
April 18, 2014

While we’ve all seen the occasional celebrity show up on a red carpet with expressions eerily frozen or skin looking suspiciously waxen, our local doctors say we’ve gotten much smarter than that. “This whole weird dynamic of patients coming in with completely unrealistic expectations has really diminished,” says Dr. Tami Cassis, a cosmetic dermatologist in Norton Commons. “It’s amazing to me how people have become more educated. Ten years ago, people were coming in the day before Derby asking for Botox. I don’t see that as much anymore.”

To continue the intelligent medical consumer trend, we’ve compiled a list of the most-sought-after procedures and problem-solvers for the pre-Derby season and asked doctors to help set realistic expectations about timing and results.

LIP AND FACE PLUMPERS: A lot of people like to plump up lips and concave areas in the weeks before Derby — to get a younger, firmer, fuller look. “Fillers (like Juverderm Ultra Plus, Restylane, Radiesse, Purlane and Voluma) can be used to plump the face and to fill in folds and wrinkles,” says Dr. Marc Salzman, a cosmetic surgeon at Salzman Institute of Cosmetic Surgery. “They have very little downtime and can have an immediate effect.”

But waiting until a day — or even a week — before is risky. “You want at least two weeks, so your physician can do a followup,” says Dr. Cassis. “It gives any bruising time to heal. You can have a little bruising, swelling, edema, and you want to give it all a little time to go down.” Sometimes, you can even see the injection sites. Instead of spackling them with concealer, our doctors suggest that you schedule the appointments a couple of weeks before the event in question so you get the full benefit without any side effects.

CHEEKS: While the focus used to be more on freezing wrinkles, new fillers have shifted things a bit. The new thinking among doctors and their patients is that restoring volume in the middle of the face can act as a non-surgical face lift, giving the whole face a more youthful look. (It’s often done in combination with Botox so patients can eliminate wrinkles while plumping other areas.) “Injectable fillers are the best prior to any big event. We offer so many different fillers today. Voluma is one new filler and that’s great for quick results,” says Dr. Nana Mizuguchi, a cosmetic surgeon at Calobrace Plastic Surgery Center. “It’s great for cheeks and it’s one of the most popular procedures for addressing volume loss.” That said, potential bruising, injection sites and swelling don’t make it a morning of appointment. “Two weeks is really what you need for injectables to make sure you’re really healed,” says Dr. Cassis.

WRINKLES: While Botox parties and popularity make it seem like you can pop into a doctor’s office on the way to the track, that’s really not the case. “You can do Botox a month before — or at least two weeks before,” says Dr. Cassis. “Always have that little bit of recovery time built in. You may have a little redness. Or bruising. Or you may need a little more. And it takes time for the Botox to kick in.”

COMPLEXION: Sloughing off dead skin, fine lines and surface sun damage can brighten up your complexion and improve the annual Derby photos. “Facials and light peels would be great for the week leading up to Derby events — they give the skin a more radiant appearance,” says Dr. Salzman. It’s one of the late-in-the-game treatments that our doctors recommended most often. “The week of, I think a light chemical peel to give yourself a good glow and a spray tan two to three days before,” says Dr. Cassis. “That’s what’s going to give you the most bang for your buck, not the injectables.”

LEGS: While some firming can possibly be accomplished in a month’s time, unfortunately, according to our experts, removal of veins cannot. “Leg veins really take some time to dissipate — sometimes up to eight weeks,” says Dr. Salzman. “So whether you sclerose (harden) them with an injectable agent … or treat them with a laser, the vein may still be visible and swollen — making it look worse for a couple of weeks.” The smartest move would be to play it safe and schedule vein treatments at least six to eight weeks prior to an event where you plan on showing your legs. (In other words, it’s too late for this Derby.)

THIGHS, HIPS, MID-SECTION: While many of us have had the fantasy of simply sucking out problem areas before slipping into a dress, that’s not the reality. Liposuction may be a lunchtime procedure, but the recovery isn’t at all instantaneous — often requiring a couple of weeks.

That said, there are some potentially faster fixes, if you temper your expectations. Some doctors are reporting fairly quick results from non-invasive body sculpting procedures like Cool Sculpting, Vanquish and Vaser Shape. These treatments are typically offered in packages of multiple treatments because it can take anywhere from three to eight appointments to see optimal results, but visible changes are sometimes seen earlier. “The effect of one or two Vanquish treatments can be seen in as early as two weeks,” says Dr. Salzman. “Since there is no downtime, they can be done even the week of Derby.” (As long as you’re not disappointed if you don’t see a really noticeable reduction until you’ve completed your full set of visits.) “With any of these sculpting treatments that come in a series, one treatment is not going to give you the most bang for your buck,” says Dr. Cassis. “If you start now, you may not be there by Derby, but you’ll be ready for swimsuit season.”

FACE FIRMERS: Once upon a time, the only solution to sagging, lax skin was snipping it with a scalpel. More recently, doctors have been using some of the same technology used in body-contouring treatments to firm and tighten the face. This technology is still new and results are varied. But visible side effects are virtually non-existent: “I think any radiofrequency tightening devices can allow for neck firming and facial toning,” says Dr. Salzman. “This can be performed the morning of Derby and still look great; it can certainly be done the day or week before.”

CAVEATS: Just because it can be done, doesn’t mean that it should. “I would really question anyone who tells you they’ll inject you the day before Derby and you’re going to look youthful tomorrow,” says Dr. Cassis. “You need to do your homework. If someone is making really big promises of instant results with absolutely no side effects, you should think twice.” And no matter when you decide to do a procedure, a consultation should come before it. “My best advice would be to encourage the person, man or woman, to schedule a consultation,” says Dr. Mizuguchi. “Most people are unsure of what they want or need. There are so many options available it can become confusing.” In other words: You may think you’re in a rush and the procedures may be quick, but the decision shouldn’t be. Sleep on it. You don’t want to spend more time choosing the right dress and hat than you did choosing the right doctor or the best strategy for your face.


Other than scheduling a consultation with a reputable doctor and sleeping on your decision, these are the pre-procedure tips Dr. Cassis offers her patients to guarantee the best possible outcome from procedures.

“Discuss your vitamin, medicine and skincare regimen with your doctor to avoid any possible contraindications.”

“Take ibuprofen or aspirin. They help reduce swelling and inflammation.”

“Stop taking vitamin E and ginseng a week or two before. They can thin your blood and increase the chance of bruising.”

“Ice before … and after.”

“Don’t drink the night before. It dehydrates you and increases visible side effects.”

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