Nadine keeps Father Time at bay thanks to a diligent decade-long anti-aging routine that includes regular rounds of Botox and collagen injections. But when the striking 56-year old Manhattanite wanted to eradicate years of sun damage on her neck and chest, she turned to Fraxel, an FDA-approved resurfacing laser that uses heat to prompt collagen production and even out skin tone over the course of one to three months. "After four painless treatments, the lines between my breasts are gone, and my skin is smoother and more even-looking. It's a dramatic change."
Nadine isn't the only one enamored of the striking results that these zaps of light and energy can provide. Cosmetic lasers have evolved to become one of the hottest modalities in the quest for smooth, younger-looking skin. "They not only treat existing problems, but they can also help prevent the onset or advancement of certain conditions, such as wrinkles, sagging skin, and cellulite," says Tina Alster, M.D. (202-785-8855), director of the Washington Institute of Dermatologic Laser Surgery in Washington D.C.
CHOOSING THE RIGHT TREATMENT: "No one laser can treat every problem," says Mitchel P. Goldman, M.D. (858-459-6868), dermatologist and medical director of La Jolla Spa MD in La Jolla, California. "There are more than 50 cosmetic lasers available in the United States, and each system costs, on average, around $60,000. So if a doctor can afford to buy only one or two systems, he or she may try to sell it for every type of problem," Goldman explains. Which means you could end up spending a lot of money on a treatment that may not be effective. To avoid this, visit the website for the American Academy of Dermatology (aad.org), which allows you to search for board-certified doctors by location and specialty. Call to ask how many laser machines the doctor owns (she should have several) and if she is experienced in laser treatments for your specific condition. "You want someone who uses these systems on a daily basis, not as a side practice," says Kathleen Gilmore, M.D., corporate medical director and VP of American Laser Centers (americanlaser.com). And keep in mind that a laser is a medical device, so it should always be administered in a doctor's office, never by a salon or spa aesthetician.
We consulted some of the top laser experts to find the most effective FDA-approved treatments to handle your biggest concerns.
REDUCE WRINKLES: "The best solutions require some down-time," claims Goldman. The CO2 and erbium:YAG lasers are ablative and the most effective for eliminating wrinkles. For deep furrows and lines, a CO2 is recommended: It vaporizes the top layer of skin while stimulating new collagen. Because it's the most intense of the ablative lasers, it's administered after the patient is given topical or general anesthesia. The skin will be red, irritated, and swollen for one to two weeks afterward and may remain somewhat red for up to six months. For less severe wrinkling, an erbium:YAG may be advised. This laser treatment is generally less invasive than the CO2, so the recovery time is as short as three to five days, with some reness possible for up to three or four months. Both CO2 and erbium:YAG offer a 70 to 90 percent reduction in wrinkles, usually in only one session. Cost: CO2 is $5000 to $8000 (not including anesthesia); erbium:YAG is $2000 to $5000.
At home: Stave off wrinkles and treat existing ones with Prevage ($150), which contains idebenone to repair damaged skin cells. To plump and soften mature skin, try L'Oreal Paris Age Perfect Pro-Calcium Cream ($24.99) with calcium to pull in moisture and to thicken and firm skin.
TIGHTEN AND LIFT SAGGING SKIN: This is one of the newer yet increasingly popular areas for laser treatments. Titan and Thermage are the two nonablative devices designed to firm mildly sagging skin on the face and body by heating the dermis to stimulate collagen and elastin. Thermage uses radio frequency energy to deliver heat to the dermis. Though earlier use of this system was often painful and sometimes caused dimpling and unevenness of skin (because the laser went too deep and damaged the underlying layer of fat), the technology has improved and doctors have now learned how to control the heat to minimize pain and complications. Titan uses infrared light, which is almost painless and carries no risk with the exception of some milk blistering, but it can't go as deep as Thermage's radio frequency. In some doctors' opinion, it delivers less significant results. "The problem with these systems is you can't predict who will respond to them," explains Alster, noting that only one-third of patients get profound results (80 to 90 percent improvement). Upkeep sessions may be required to maintain results. The cost: Titan is $700 to $2500 per session; Thermage is $1000 to $1500. One to three treatments are usually recommended with either system. New to the scene is Aluma; it uses radio-frequency energy and delivers results comparable to those of Titan and Thermage, but because it is able to cover a broader section of skin per zap, it takes as little as five minutes to treat the entire face, according to Goldman. (Thermage and Titan take about an hour to do the same thing.) The cost: $250 to $400 per weekly session for six weeks total.
At home: Boost slack skin with Olay Total Effects Night Firming Cream ($19.99). Its vitamin-rich complex improves elasticity, while wheat protein moisturizes and fills in lines.
To read more on lasers that eliminate sunspots, acne, broken blood vessels, and unwanted hair, see the August issue, on newsstands now.
i just came across this article at cnn , 
i cooked some bacon this morning so the shrinking thing is still fresh in my mind
i mean.......u can pull the skin as much as you like......but you need to tighten the muscles under the skin and add collagen layers or it will never work!
