Hot Shots.

Hot Shots

Many adults still harbor a pathological fear of shots. Yet as Fredric Brandt, New York City and Coral Gables dermatologist, says, "No one ever complains about the pinch of the Botox needle." Injectable wrinkle treatments are the fastest-growing cosmetic trend out there. The number of people ages 19 to 34 receiving fillers has more than doubled since 1997, to 166,264. And Botox use has increased 72 percent since 2000, with more than 3 million people trying the muscle-paralyzing wrinkle eraser in 2003. New fillers are remarkably effective at spot-treating small areas of wrinkles such as crow's-feet, smile lines, and undereye hollows. Also, injections aren't surgery. For anyone who is more afraid of the scalpel than the needle, injections offer minimal pain, few risks, and short recovery times. Plus, the results usually aren't permanent. If you don't love the outcome, you only have to live with it for six months or so. That said, there's no magic injection that renews skin elasticity, and only a face- or brow-lift can undo serious sagging. Still, if you're happy to settle for a temporary fix, the needle could be the answer.

BOTOX

BOTOX What It Does: The highly diluted form of botulinum toxin temporarily stops the muscle contractions responsible for lines, thereby softening them. Botox is FDA-approved for use in vertical frown lines in the forehead, but in other areas (crow's-feet, horizontal frown lines, neck cords), it's considered off-label (in other words, legal, but not FDA-approved). No allergy testing is needed. The Procedure: Botox is injected into the muscles that cause the lines. The degree of sting depends on how the physician dilutes the powdered toxin. An anesthetic cream can numb the skin, making the experience almost painless. The Recovery: Doctors immediately ice the area to minimize swelling and bruising. Most doctors suggest the patient spend the next two hours knitting or raising the brow and forcing smiles to help the toxin bind with the nerves controlling the muscles. While doctors commonly tell patients not to lie down for three hours, no study has proved that staying upright is necessary. There is usually some redness or swelling at the injection site for up to a day and occasional bruising and headaches. The Risks: There's a 5 percent chance the toxin will drift into an eyelid muscle and cause it to droop for several weeks. In most cases, over-the-counter eye drops can counteract the droop. The Results: It takes three to seven days to see the full effect, which lasts about four months in the forehead and three months in crow's-feet. The Cost: Treatments for a single area of the face start at about $400.

COLLAGEN

COLLAGEN What It Does: Injections of Zyderm and Zyplast (purified cow collagen) or Cosmoderm and Cosmoplast (purified, laboratory-engineered human collagen) can replace the natural collagen in the face that decreases with age. The injections add fullness in smile lines (which run from the nose to the corners of the mouth), ...