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The Ass Vs. Face Dilemma


September 7, 2020

“A 30-year-old woman must choose between her bottom and her face,” Catherine Deneuve famously declared.  You’ve heard it before: After a certain age, you have to make a choice between your—ahem—derrière and your visage. Basically, the “theory” assumes the tighter and firmer the former gets, the saggier and sadder the latter. Unfortunately, at not even quite 40, that age-old maxim seems to be holding all kinds of true for me.

First, a little backstory. I recently embarked on a new fitness regime for a magazine story. With the help of trainer Heather Marr, a former model and bodybuilder whose client roster consists almost entirely of models, I was to train and eat like a Victoria’s Secret Angel for two weeks. My workouts included moves like the aptly titled “deathcrawl” (a walking plank thing), boxjumps, and about five different variations on the lunge. At the same time I survived on a low-fat, high-protein, no-refined-sugar, no-wine, no-gluten diet.

I love to exercise, but I also love my wine, bread and cheese. As a food editor, following a restricted diet was difficult, but the results I was seeing with my figure kept me on track. After one week my abs were decidedly more chiseled; after two, my body looked all-over leaner and more toned. Heather continued to send me daily workouts over email and checked in with me about my diet. For example, when I went on vacation in Australia, she gave me some guidelines on how to eat and drink while on the road (there were lots of hard-boiled eggs, steamed fish entrees, and tequila and sodas). In a month, my body looked better than it had since my mid-20s when I got pregnant with the first of my three kids.

Lose ten pounds by gain five years?

The only problem was my face. I had dark circles under my eyes and my nasal labial folds—already bothersome to me—had deepened. I looked tired and haggard, the exact opposite of what I actually felt. But I also loved my new body. The question was: could I have both the body of my dreams and a youthful-looking face?

My first call was to Dr. Robert Anolik, a New York-based cosmetic dermatologist and Charlotte’s Book expert. He’s known for his natural-looking, age-reversing work with lasers and injectables. I told him about my predicament, which he calls a “common concern” among his patients. “A lot of people don’t realize when they are getting their bodies in shape, they are going to be frustrated by the changes they see in their face,” Dr. Anolik said.

The key culprit? The loss of fat or volume in your face, which can lead to a less youthful or gaunt appearance, more skin laxity, and wrinkles. Dr. Anolik likes to tackle the problem with a combination laser-and-filler approach. He adds volume to the lateral malar fat pads (the upper, outer region of the cheek) to lift the skin and replace lost volume. And he uses lasers to tighten the skin.

One of his current favorites is Infini, a relatively new-to-market, nonsurgical fractional energy device that uses microneedles to deliver radiofrequency energy under the skin. “The current can only pass at the very tip of the needles, well below where lasers typically reach. This allows us to remodel and tighten collagen fibers of the skin at a deeper layer,” explains Dr. Anolik. The downtime is minimal; the skin may appear pink and irritated for 2-3 days post treatment. You can see results within five days.

He also advises patients to take a more holistic approach to their skincare, and to lose weight slowly. “If you suddenly starve yourself, it causes stress and inflammation in the body and the skin will not appreciate that. It’s important to eat well, and to get plenty of Omega fatty acids and nutrients to allow your skin to remain looking good.”

Lose ten pounds by gain five years?

Dr. Doris Day, a cosmetic dermatologist in New York and a Charlotte’s Book expert, takes her advice a step further. She counsels patients to lay off their workout routines when she feels they are taking it to the extreme and looking worse for wear because of it. “There is such a thing as ‘runner’s face’ or ‘exercise face,’” says Dr. Day. “It’s a different look than someone who is just skinny. Moderation is the best thing.”

Dr. Day tackles skin laxity issues with neuromodulators (like Botox), fillers, and skin-tightening treatments like Thermage and Ultherapy. She also recommends what she calls a “high-antioxidant, low-crap diet” that includes very little processed foods and lots of fruits and vegetables. “In addition to a healthy lifestyle, combining treatments and devices can make a very big difference,” Dr. Day says.

Looking for a few little improvements of my own, I head to the Upper East Side office of plastic surgeon Dr. Dara Liotta, a Charlotte’s Book expert facial plastic surgeon. Like me, she’s a busy working mom who wants to stay fit, but not at the expense of looking youthful. When I complain to her about my nasal labial folds, she tells me it’s the place most people zero in on after they lose weight. “Thin people problems,” she jokes, before recommending what she’s dubbed “tweakments,” or small cosmetic interventions that will help restore some of the more youthful contour of my face.

Since I have a lot of hyper-pigmentation, the result of a lifetime of running outdoors, in addition to some sagging, she decides I could benefit most from a series of Forever Young BBL treatments. These use different wavelengths of light to address different skin concerns, plus some filler to help with those under-eye circles and the lost volume.

In my first session, Dr. Liotta zaps my sunspots and the little capillaries on my nostrils with two different wavelengths. Neither hurts very much. Then she changes the setting of the laser once again so that it doesn’t zap my skin with concentrated energy but gently heats it to encourage collagen production. Some people feel like they’re sunburned after the treatment but I felt close to zero irritation afterwards.

And as for the results? Within the first few days, the spots on my face darken and then begin to slough off, almost like tiny coffee grains. Two weeks later, my skin looks much more even and clear. I notice an impressive amount of tightening and two friends say I’m glowing when I see them for dinner. I can’t wait for my next treatment. Like my body, it turns out my face is a work in progress, too.

Now the only question that remains is: what to do with the saggy skin on my tummy?

To stay on top of Tatiana’s transformation, follow her on Instagram.

This article was originally published in March 2016.

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