But I must admit I’m intrigued by modern methods of facial rejuvenation. We’ve come a long way from the scarily tight “cut and pull” days (the popularity of face-lifts has been on the decline for the past decade, according to the American Society for Aesthetic Plastic Surgery).
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# Are Microtreatments the New Facelifts? One Writer’s Yearlong Journey to a Fresher Look

January 11, 2017

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The author, in a Brock Collection coat and Anissa Kermiche earrings, in her Brooklyn neighborhood. Photographed by Ward Ivan Rafik. Fashion Editor: Gabriella Karefa-Johnson.WARD IVAN RAFIK

The idea of growing older gracefully is a noble one. But in this day and age, looking fresh and vital is not just a matter of vanity but also professional survival. Luckily, a proliferation of next-generation noninvasive cosmetic procedures—futuristic lasers, nimble fillers, and resurfacing treatments—offer, when done in succession and with restraint, subtle refreshment without the scalpel. The concept is highly appealing to cosmetic surgery virgins like writer Jancee Dunn, who, in the January issue of Vogue, wrestles with turning 50 and embarks on a yearlong rejuvenation journey. Here, in the first installment of a four-part series, Dunn undergoes the first of many microtreatments that promise to redefine what it looks—and feels—like to be happily middle-aged.

“We are always the same age inside.” Of all Gertrude Stein’s quotable remarks, this one resonates with me the most. My interior age has, for longer than I can remember, hovered around 30. On the outside, however, I recently turned 50, a number that still surprises me when I say it aloud. Similarly, when I catch an unexpected glimpse of my face, for a few unreal seconds, I often do not recognize myself—a jarring sensation the French call a coup de vieux.

Gravity finds us all, no matter how many green drinks you tip back or how diligently you hit the gym. My face has sunken in places and drooped in others. One of the many consequences of what I’ll call middle-age resting face is that I’ll look irritated when I’m in a perfectly sunny mood. Research has found that older faces are often rated as appearing more negative, presumably because of age-related changes. I’m constantly reassuring my young daughter that nothing’s wrong—I just have a permanent frown.

And while I have been reasonably devoted to self-care for years, I lived fast and hard in my twenties, industriously and unrepentantly breaking down my collagen with scant sleep, copious alcohol, and hours on the beach broiling my skin, slathered in baby oil. As a result, I look pretty much all of my 50 years. A more scrupulous peek in the mirror reveals broken blood vessels, hooded eyes, incipient jowls—you know you have hit midlife when this odious word enters your vocabulary—and what Amy Schumer has called an “at-risk chin.”

Yet I have long resisted tampering with my face. As a journalist who has interviewed celebrities for a quarter century, I have witnessed, up close, some truly abysmal work: immobile, glassine foreheads; chipmunk cheeks tumescent with filler; lips plumped like inner tubes. (“My patients want to see their money’s worth,” a celebrity injector once told me with a shrug.) I am likewise disturbed by the needlessly overfilled faces of very young Insta stars, whose images are quickly turning into the new beauty standard. With the exception of a DOT laser on my upper eyelids six years ago, documented in this magazine, I have resisted having any procedures done.

Increasingly, however, as I turn up to photo shoots at which I am older than the crew and models by several decades, I sense the gulf between my inner and outer persona. As a stylist friend of mine eager to stay competitive puts it, “I need to get work done in order to get work.”

And who am I kidding here? Vanity plays a big part, too. Recently I was riding the subway, and a leather-jacketed guy with a man bun kept glancing my way. I reflexively frowned at him and returned to my book. A moment later, when I glanced up and saw that he was still gawking, my scowl deepened: Women don’t like to be ogled, friend! Get the message!

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Then I realized that his gaze was actually trained slightly to my left.

I turned to see a 20-year-old sylph with sleeve tattoos and the same Dr. Martens I wore three decades ago, studiously ignoring him but very aware of his presence. I have handbags older than her. Maybe the guy didn’t even know I was scowling, anyway, and simply assumed I had middle-age resting face.

No matter what decision a woman makes, she is in a defensive crouch. We have been mercilessly analyzed and assigned value for our looks since Plutarch picked over Cleopatra’s appearance, writing dismissively that her beauty was “not altogether incomparable, nor such as to strike those who saw her.”

But I must admit I’m intrigued by modern methods of facial rejuvenation. We’ve come a long way from the scarily tight “cut and pull” days (the popularity of face-lifts has been on the decline for the past decade, according to the American Society for Aesthetic Plastic Surgery).

Instead, the newest way to freshen your face is something L.A.–based cosmetic dermatologist Harold Lancer, M.D., refers to as “composite microtreatments,” employing many different nonsurgical procedures—from needle-delivered radio frequency and fractional lasers to fillers and prescription topicals—in conjunction with one another over time. This multipronged approach is gradual, gentle, tailored to each patient, and requires little if any downtime. The goal: not to obliterate your facial expressions, but to subtly introduce tweaks that banish redness, spots, and lines. In 2017, it’s not about looking decades younger, or visibly “done,” which is something that even a skittish treatment-phobe like myself can appreciate.

I book a consultation with several eminent cosmetic dermatologists (we spend hours cross-referencing shoes online; we should be just as diligent about deal-hunting with our doctors). Savvier friends guide me on what to look for when I visit. In the waiting room, they instruct, put your phone away and look around. Watch the faces of those coming in and out: Are they unnaturally taut? Observe the staff, because a derm often treats them to procedures, too. “If they look crazy,” advises one friend, “run.” Oh, and don’t forget: Bring in a photo of yourself from ten or fifteen years ago so the doctor has a visual guide of—here’s a melancholy phrase—the person you used to be.

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After meeting with three doctors, I’m thinking of my mother as I walk up Park Avenue to see my final candidate, Macrene Alexiades, M.D., Ph.D. A former Southern pageant queen and still lovely in her 70s, Mom once issued me a warning: One day, you will be invisible. I tell her repeatedly that she receives admiring glances all the time—she has phenomenal bone structure, and dresses beautifully in simple, tailored clothing—but in my heart, I know what she means. She talks about little indignities, like the time she watched a news segment on fashion for “every age”: that is, the 30s, 40s, and 50s. After that, the producers evidently decided, fashion is a dark, barren universe, its postmenopausal inhabitants creeping around in comfort-waist Capri pants and fleece pullovers.

I take a seat in Alexiades’s orchid-dotted office (no self-respecting cosmetic dermatologist, I have learned, has an orchid-free office, or furnishings that are anything but clinically white). Next to me, a woman in a crisp power suit taps her phone—is she 35? 45? My age? It’s an odd feeling to have no idea whatsoever. Despite the now-familiar environs of a high-end dermatology office, I am still jittery and fight the urge to bolt from the waiting room.

So many things have the potential to go wrong, your humiliating results broadcast to the world. I think of a lunch I had with a friend who is an enthusiastic proponent of Botox. I was telling her about a tough time I was having, and it was the eeriest sensation to relay my tale of woe to a person whose expression was utterly impassive, the only sign of life an occasional nod.

And even if the work I have done is barely detectable, I can’t shake the feeling that it still sends an unwelcome message that I’m shallow, uncomfortable with myself, unable to accept reality.

Another persistent fear is this: What if you start altering your face—a tweak here, a jab there—and are eventually unable to tell that you are becoming unrecognizable? When I see a woman whose visage is rearranged so that she resembles a Cubist painting, my judge-y thoughts begin: I’m not staring because you look good, I’m staring because you look like a freak. But I must also admit to feeling, on some level, a certain recognition: I know why you wanted to change your face. I know what it’s like to hate your reflection some mornings. I’ve been there. I am there now.

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My thoughts are broken by the appearance of Alexiades, known as Dr. Macrene, who ushers me into her office and settles her Pure Yoga–toned frame into a white chair. I tell her my idol for aging beautifully is Meryl Streep, to me the ultimate version of 67. Or maybe the elves from The Lord of the Rings, who have soft, dewy skin, even though they are several centuries old.

She trains her unblinking gaze on my skin. I imagine I hear cyborg bleeps as her mind processes the data flow (she holds three degrees from Harvard). She looks sharply at me, writes rapidly in a notebook; looks again, writes rapidly, then shares her plan of attack. “It’s all coordinated,” she says in her blunt, rapid-fire way. “If all you do is injectables, you’re going to have old skin with fewer wrinkles.”

Her protocol includes lasers to vanquish spots and redness, more lasers to build collagen and tighten the jowls, a fat-dissolving acid called Kybella for the extra bit under my chin, and a radio frequency treatment called the TriPollar for my neck (“basically three Thermages in one”). Garnish with tiny amounts of filler, “used judiciously,” Botox to lift the brow, and topical antiaging agents to build more collagen. All of this will allegedly occur with no downtime. (“Zero. Zero. I’m very fastidious.”)

In the end I pick Dr. Macrene—for her almost-terrifying intellect, the reams of scientific research she has generated, and her resolute conviction that I will remain in possession of my facial expressions.

Before I can hesitate, I book my first treatment: a Genesis laser, which works by gently heating the dermis below the skin’s surface to boost collagen, zap brown spots, and shrink broken capillaries. As she powers up the device and I don protective glasses, she tells me she chose the Genesis over the more popular Fraxel because it can go deeper—up to four millimeters. “You want to have the full thickness of the skin rejuvenated,” she says. “If you want to make an analogy, if the peel of the fruit is smoother, what good is it if there’s no substance inside?”

As she moves the device quickly over my face, it feels like hot August sunshine. Aside from the piquant scent of my own burning flesh, it’s rather relaxing. But I can’t stop the hectoring voice in my head that now there is no turning back. What if my appearance is drastically altered and no one will level with me? I try to reassure myself by remembering the words of one derm I consulted: that those with aggressively pumped-up lips and cheeks are actually a very small percentage of people—they just happen to be a very visible percentage. You don’t notice the person with good results, because they simply look normal.

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Afterward, Dr. Macrene proffers a mirror. My face is slightly pink, as if I’ve gone for a long run. Within two weeks, she tells me, I’ll see fewer wrinkles. The process is not cheap: Lasers start at $900 a shot, fillers at $650, but Alexiades maintains that they are an investment for down the road. “A patient I saw today has built her own collagen around the filler I’ve done, and those lines are not coming back,” she says. “Now she’s in maintenance mode.” For many of her patients in maintenance, she only sees them once or twice a year.

I am in what she terms “activation mode.” I must see her once a month. Dr. Macrene says: “Give me a year. Can you do that? It takes me that long to do all these things, and space them out, without overloading.”

My decision is sealed two weeks later, when I notice that my face is glowing and tighter, as if a real-life Instagram filter has been applied—not the dramatic Amaro, necessarily, but perhaps Rise. I am flooded with emotions, the strongest being elation. It is the most seductively primal feeling to see your own vibrancy restored, and with it the markers of youthful health: fresh pink cheeks, blooming skin. It’s dangerous, delusional, and yet I want more, more, more. I’m already calculating how I can possibly afford the upkeep a year from now.

I’m also hit with the realization of how thoroughly I had buried the disappointment of feeling defeated before I was even out of my pajamas, the bewilderment and sense of betrayal that my unintentionally morose expression was so completely out of sync with the energy and optimism I felt on the inside. Gravity had pulled down my psyche as well as my skin.

My mother is right: It is painful to fade from public view, and it’s a potent hit of the crack pipe to discover that it’s entirely possible to slowly, steadily wind the clock backward. As my eyes range greedily over my face, I feel an almost sickening sense of hope as I begin a cosmic bargaining that rarely ends well in Greek mythology: Please, please, just give me a few years in this hypnotic limbo, and I promise I’ll be more accepting of this whole age thing. I keep thinking of Dr. Macrene’s promise to zap away my jowls. “You’ll have your mandible back!” she said. I would give anything to glance down at my smartphone and not stifle a scream when I see the mocking reflection of my marionette lines.

When I was in my 30s and wrote for Rolling Stone, I regularly interviewed some of the most famous women in music. If any of them happened to be over 50, I was instructed by my editors to ask them how they felt about aging (blithely not realizing at the time how incredibly annoying that unrelenting question is). I received the same succinct answer from Dolly Parton, Cyndi Lauper, and Cher: It sucks. (Or, as Cher recently expanded on Twitter in her inimitable Cher way, it “Sucks the Big 1.”)

The hell with it. I’m taking the plunge. I have no desire to look like a 22-year-old—or at least a simulacrum of one—but the idea of being the best possible version of 50 is a heady one. I speed-dial the doctor and tell her that yes, absolutely, I’ll give her a year of my outer, 50-year-old life. And so it begins.

Hair: Neil Grupp

Makeup: Junko Kioka

Produced by Quinn Buggs at Aces & Vices

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