by Terry Dubrow, M.D., F.A.C.S.

Terry Dubrow, M.D., recommends
a "leveling up" of treatments.

The Three-Tiered Approach To Facial Surgery

No one advertises their trips to the cosmetic doctor, least of all movie stars. But take it from me: celebrities do come to us, time and time again, and that's one of their biggest beauty secrets. They don't dramatically change from "before" to "after" because they have the resources to do things as needed.

With ready access to plastic surgery, men and women in the limelight handle the small things earlier, so they never really look different -- just better and more refreshed. Early intervention obviates the need for delving into major procedures that would be noticeable in the extreme.

Today all of us have the same opportunities for improvement as the stars. With the cost of cosmetic procedures becoming less expensive due to new technologies and less-invasive surgical techniques, we too can begin to do the small things earlier and be back to work looking "younger than springtime" within a short time.

Here are four secrets of the stars you can use to your advantage.

Skin Care  Skin Care  Skin Care

 I can't say it too often or emphasize it enough. The stars do a lot of skin care, and you should, too. It's crucial. Start with an aggressive treatment program in a doctor's office/salon, then follow up with a strict regimen at home.

Microdermabrasion is today's hot treatment. Before the public heard a whisper, the word was on the lips of celebs. Instead of power lunches, they were hitting the doctor's office for the "lunch-time lift approach" of microdermabrasion. This painless, non-invasive, no-recovery procedure has virtually replaced chemical peels and facials.

A cautionary note: one treatment does nothing. You need a series to smooth the skin, improve discoloration and also help acne dramatically. I recommend one or two treatments a week; typically 10-12 in all. After that, come in once a month for maintenance, and remember: keep up the good skin work at home!

Collagen Injection

 The stars love collagen injections and so will you: they're very beneficial as a quick fix of lines and wrinkles.

Collagen is a naturally occurring fibrous protein. It provides structural support and is the most abundant protein in our body. As we age, our body's collagen begins to weaken and lose its elasticity, eventually wearing down. The result is as plain as the lines and wrinkles on your face.

Collagen is available in certain moisturizers, but it cannot penetrate the surface of the skin in that format. When I inject collagen into the dermis, it temporarily corrects lines, wrinkles and even scars.

The Beauty of Botox.

 I'm sure you've read about the people lining up early in the morning at doctor's offices (not to mention physicians making house calls on the rich and famous) for the miracle of botox. What's all the fuss about? Well, botox is simply incredible!

   Whenever we frown, squint or even smile, we gather tissue between our eyebrows into a fold. In many people, this process causes a chronic furrow, producing a frustrated and angry appearance. Botox can improve frown lines, crow's feet and forehead creases without surgery or scars. Here's how:

   Botox injections block the transmission of impulses from the nerve cells to the muscle, causing a temporary muscle weakening. By selectively interfering with the muscle's ability to contract, existing lines are smoothed out over time and future lines may be prevented. After the procedure, the lines will improve at rest, and facial movements will no longer create as deep a furrow.

Stars rely on botox with great success to help achieve a younger appearance. Although no scientific data exists to support the theory, it even appears that the duration of "muscle relaxation" is cumulative, lasting longer after each successive treatment.

Take care of minor problems before they worsen.

It's a well-known principle that it's easier to fix six minor problems now than to procrastinate your way into a major procedure. Stars follow this principle religiously, which is why you never see a celebrity changing drastically all at once; they never go from having nothing done to undergoing the "full monty" in their sixties. (They also stay within their ideal weight range and avoid the sun and other causes of premature aging.)

 If you have a small double chin, lines around the eyes and mouth, lose skin around the jawline or upper/lower eyelids, you can take care of each concern early on. You'll enjoy: 1) less recovery downtime; 2) a significant but less dramatic change with no trace of surgery; 3) a more natural, longer-lasting look.

 If the amount of lose skin is mild, I can use the laser to give you a mini face lift. If you cannot avoid a face lift, the early mini is more beneficial with less downtime and swelling.

Looking at their bodies from top to bottom, stars know the eyes are the first venue of aging. Upper eyes often need a brow lift, effected through an endoscopic procedure that results in a significant change without the "surprised" look. With little downtime and great results, it's no wonder the stars seek this out like hungry teenagers in search of a super-deluxe pizza.

Moving down the body, breast augmentation (I use a pre-filled PIP implant from France that feels natural like silicone yet is saline -- it's the hottest thing going!), tummy tucks (I will do an endoscopic mini tuck when possible, a less-invasive procedure with smaller incisions), and liposuction are the hot procedures around Hollywood. Instead of the typical lipo machine, I prefer a hand-held Italian syringe/plunger. I like the manual control and my patients love the results -- more precision, less bleeding and fewer contour irregularities.

Before you opt for this new technique, check out your doctor's biceps. As I can tell you from experience, the doctor must be very strong to use it.  To me, it’s ideal:  You get a slim new silhouette and I get a real workout!

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