No Time for Any Wrinkles; Women have more beauty-treatment choices than ever. Is that a good thing?

Byline: Jennifer Barrett, With Mac Margolis in Rio de Janeiro

Alisa Kauffman has been practicing dentistry for nearly two decades, but some new patients still mistake the petite, 44-year-old New Yorker for a dental-school student. "I tell them it's just the Botox," she says, but the popular treatment, which paralyzes the muscles that form wrinkles, is actually just one weapon in Kauffman's anti-aging arsenal. She began applying Retin-A (trans-retinoic acid) daily to wrinkle-prone areas of her face at 28, well before the vitamin-A derivative became widely accepted as a topical treatment for fine lines. At 40, she added more potent products. Besides periodic Botox shots for her forehead and eyes, every few months she gets injections of Restylane to smooth the skin by her mouth. Kauffman also regularly undergoes intense pulse-light (IPL) treatments--laserlike pulses of high-intensity light that penetrate the skin--to get rid of a sprinkle of sun spots on her face. "I am very vigilant," says Kauffman, an attractive redhead. "I try to take care of things before they happen."

That's much easier to do these days. The quest for youth--or, at least, the appearance of it--is ages old. But the range of nonsurgical, anti-aging options has soared in recent years. Most women are wary of going under the knife in their 30s and 40s, but they'll undergo a temporary treatment that can smooth their skin in one lunch break. Less costly and more convenient than surgery, cosmetic injectables, IPL therapy and other wrinkle remedies are booming as more and more women incorporate them into their beauty-maintenance routines. According to the International Society of Aesthetic Plastic Surgery, injections are by far the most common cosmetic surgeries, making up about 14 percent of all procedures.

A few years ago doctors relied on collagen that came from cows and required a skin test. Now there's a range of fillers, from Restylane to CosmoDerm and CosmoPlast--both made from human collagen that require no test--and, of course, Botox. "They're extraordinarily quick to perform and have an extraordinarily rapid recovery--if there is a recovery period at all," says New York surgeon Philip Miller, who performed Kauffman's procedures. He and other practitioners say the uncomplicated nature of the treatments keeps women coming back for more. "I have several female patients who feel that because they are in the workplace and around so many young people, they need to do whatever they can to keep up a more youthful appearance--without using surgery," says Boston dermatologist Lynn Baden. "It makes you look good, so why not do it?" says Robin Rothkopf, 46, a real- estate investor in Newton, Massachusetts, who has had Botox, Restylane and human-collagen injections. "Every single person I know does it. Young and old--everybody."

While the side effects of such treatments appear minimal, few studies have tracked long-term use. The psychological impact on women is also a concern. Clinical psychologist Rita Freedman, author of "Bodylove: Learning to Like Our Looks and Ourselves, A Practical Guide for Women," calls it the "creeping disease." "One woman gets Botox and then her neighbor and relatives look at her and feel relatively unattractive and feel they need to do something, too," she says.

Women in the work force seem particularly susceptible to such pressure. "Working women are judged in a different way than men; they have to be equally productive but also keep their appearance up," says ...