When it comes to staying young, everyone's got a swear-by technique. Singer Mariah Carey only eats purple foods such as red grapes and beetroot three days a week because of their anti-ageing benefits. Actor Teri Hatcher thinks fake hair and “taping up her boobs” are more than enough. Actor-politician Hema Malini is an Art of Living fanatic, expounding the virtues of deep breathing when it comes to warding off the years. My grandfather insists the secret lies in green tea. And my grandmother simply must rub sardines on her face everyday.

But for people who simply don't have the time to, well, fight time, people such as Bina Kapoor, a freelance fashion coordinator, botox comes as a real shot in the arm. In the last two years, the 54-year-old has spent Rs 50,000 on various skin treatments from botox to fillers to skin lifts.

“I practically live at the Kaya Skin Clinic,” says Bina. Plagued by wrinkles, frown lines and pigmentation, Bina says she was too embarrassed to step out of home without packing on a lot of foundation and make-up. Today, after three sessions of botox and fillers, two sessions of skin lifting (of ten sittings each) and several rounds of pigmentation therapy, Bina says she now looks and feels younger. “With the right skin treatments, you can easily take five to ten years off your age,” says Dr Amee Daxini, a dermatologist at Kaya.

Dr Maya Vedamurthy, a dermatologist in Chennai, says she has seen an increase of about 30 percent in the number of people asking for various forms skin treatment, especially botox. “It isn't because of an increasing awareness,” she says. “People come to me seeking procedures for age control.” Dr Vedamurthy has indulged in botox too, for her forehead.

The market for plastic surgery, or “age control” as it called, has certainly grown tremendously. This year, the Cannes International Film Festival offered its celebrities USD 5,000 free plastic surgery as part of its goody bag. Actor Angelina Jolie's newborn Shiloh has been offered free rhinoplasty by a Namibian plastic surgeon if her nose doesn't turn out as good as her mother's. American Reality TV show Extreme Makeover uses top plastic surgeons, eye surgeons and cosmetic dentists, to completely change the way people look... while you watch.

Plastic surgeons are now calling themselves age management consultants. Spas have started skin treatment centres — Studio D' Image, for instance, at actor Sanjay Khan's The Golden Palms resort in Bangalore has an exclusive healthcare complex, complete with laboratory and X-ray unit and offers services such as a state-of-the-art dental clinic as well as facilities for anything from a nose job to a breast lift and tummy tuck. Clearly, cosmetic surgery has come of age.

Artificial hair implants are possible in which synthetic fibres are injected into the scalp one at a time. Plastic surgery can change the shape of the hairline. A receding hairline for instance, can be corrected.

Botox (where botulinum toxin is injected into the muscle) and dermal fillers (which contain hyaluronic acid, a natural component of the skin, are injected into the skin and can serve as permanent moisturisers) can be used to remove wrinkles. Worry-lines can be removed with a forehead lift.

Sometimes repeated plucking can thin eyebrows and make them unnatural to look at. A new cosmetic procedure — the Eyebrow transplant — takes hair follicles from the back of the head and implants them along the eyebrow line one at a time. The treatment is not yet available in India and costs between USD 4,000 and 8,000.

An eyebrow lift is possible with botox and dermal fillers. In the process, eyebrows can also be shaped, arched and flared. Browplasty, a surgical procedure, is also an option where the skin above the eyebrow is cut and replaced.

Micropigmentation is a surgical procedure where pigment is added to the skin. For instance, when you want a mole on the chin. In the case of eyebrows, micropigmentation can make them appear thicker. Micropigmentation can also be used to make the lip line more defined or make you look like you are always wearing eyeliner.

Dermal fillers also help stretch the skin, making it lighter and fairer. And the skin around can be treated with nonablative radio frequency for rejuvenation.

Blepharoplasty is how the plastic surgery department deals with eyelids. Blepharoplasty removes the loose skin on the upper and lower eyelids and pushes the eyelids back. Texture of the skin is then improved with laser treatment.

As people age, they develop gravity lines and wrinkles. Naso-labial folds or creases form between the nose and mouth. While the folds can be removed with botox as well as fillers, sometimes a facelift or rhytidectomy is performed, where the folds and excess fat are removed and the skin is tightened and stretched back over the face.

Infrared photorejuvenation is another age-fighter entering the market. Chemical peel, microderm abrasion (skin polishing with aluminium oxide crystal, sodium chloride or diamond tip), mesotherapy and mesolift or skin lift can also rejuvenate the face.

As you grow older, you will find that your nose droops. But not to worry, this can be rectified with a little botox injected into the filtrum. The tip of the nose can also be made sharper using dermal fillers. A depressed nose or saddle nose that comes with age can be lifted with rhinoplasty (in simple terms a nose job). The surgery can also sharpen the tip and make the nose bridge narrower.

Lips can develop contours around them but fortunately for Indians they appear only when they get really old. Indians usually only have trouble dealing with gravity lines (the droopiness). You can lift the droop and give your lips contours with fillers and botox, and get rid of any pigmentation you might have noticed with intense pulse light and a chemical peel.

Cheeks can be plumped up and contoured using botox and fillers. And dimpled chins can be smoothened the same way. Drag cheeks need a face lift. Skin can also be lifted using contour thread or suspension treatment, a new and expensive procedure (each thread costs Rs 5,000 and you need a minimum of four for a face). A double chin can be reduced surgically or with liposuction.

Thin atrophic earlobes can be treated using fillers. Earringptosis (where when the ear hole stretches) and earlobe creases can be removed with fillers.

Vertical platysma bands or the turkey neck is taken care of with botox as well as a necklift. Horizontal necklace lines disappear with nonablative radio frequency, fillers and botox. Skin texture is improved with chemical peels and photorejuvenation (light is used to smoothen and soften the skin). Unwanted facial hair can be done away with through diode laser and intense pulse light.

In the armpits, botox is used to reduce sweating, while chemical peels take care of the excess pigmentation. Hair removal is possible too and sagging skin is rejuvenated with nonablative radio frequency. Elbows are smoothened with microderm abrasion and chemical peels.

Hand rejuvenation is very popular these days as people have realised hands are a dead giveaway of how old you really are. You see, they age ten years ahead of the face and neck. Hand mesotherapy is an option, as are fillers.

Skin texture can be improved with an auto fat fill, where fat is taken from parts of the body that can do without it and redistributed to parts that need it.

Sagging breasts can be lifted, bulky ones reshaped, and small ones enlarged. In a breast lift procedure, the skin is opened out, reduced and stitched up, pushing up the breast tissue and the result is a “skin brassiere”.

For men, silicone implants can be used to enlarge the bulk and projection of pectoral muscles. While for men who suffer from a condition known as gynaecomastia that gives them 'breasts', liposuction is possible.

Mesotherapy helps remove excess fat but remember it does not result in weight loss, it only removes inches. A sagging abdomen, which does not have much fat, can be lifted with abdominoplasty, which merely removes the excess skin and tightens the muscle under the stomach. If there is a lot of fat, then liposuction is employed. Bariatric surgery or stomach stapling is another option.

Vaginoplasty is sometimes performed in older women to enhance sexual pleasure as the vaginal muscles get lax with age. A 'labiaplasty' can recontour a sagging vulva to pre-childbirth status. Laser is used to improve tone, stop stress incontinence, and decrease the diameter.

A "butt lift" can be done with microderm abrasion and then a lifting treatment using collagen. Buttock augments are available to plump them. Cellulite can be removed with mesotherapy. Liposuction is performed on those with excess fat.

Although not done in India, ankle liposuction is a rather popular plastic surgery procedure abroad. But as the ankles do not contain deep compartments of fat, it is difficult procedure. Spider veins are removed with intense pulse light.

Collagen injections can be used to give temporary padding to the soles of the feet. For some people, their second toe is a lot longer than their others. Plastic surgery can shorten them making small incisions, cutting a piece of bone out of the joint and reattaching the tendon. But the most common toe surgery is the toe tuck, where the pinky is aligned with the other four. Microderm abrasion smoothes and softens the skin on the feet, rejuvenating them.

Sources: Dr Nirmala Subramaniam, plastic surgeon, Apollo Hospital, Chennai, Dr Maya Vedamurthy, dermatologist, Apollo Hospital, Chennai, and Dr Amee Daxini, dermatologist, Kaya Skin Clinic.

Costs for the non-surgical procedures vary from Rs 1,500 for microderm abrasion to Rs 10,000 for a hair transplant. Plastic surgery costs range from Rs 10,000 for liposuction to Rs 70,000 for calf implants.

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