On the Up

A growing cadre of women are trading their injectables for a more lasting, and somewhat more retro, procedure: the facelift

- Mattie Kahn

Because we both know the limits of even the most diligent retinol routine, an actor famous for her kittenish smile and tailored separates levels with me. For a woman on the rise in this business, there are not just parts to consider, but procedures.

Her face is her instrument, and it will require maintenance, but instead of using fillers-which she calls "the devil" she will stall out the aging process with treatments and lasers like Morpheus8 and Fraxel. And then, before she turns 50, she will invest in a surgical solution. With a grin, she deems it a kind of au naturel aging: It's her same skin, just less of it. As she explains: "It's low intervention until the facelift."

Despite the omnipresence of socalled Instagram face, with its characteristic puffed-up cheeks, button noses, and smoothed-out nasolabial folds, fillers are, in fact, a somewhat recent invention-and the actor is not alone in her scorn for them. It's been about two decades since the FDA approved the first non-animal hyaluronic acid injectable to treat and plump, after which doctors and medi-spa innovators used the aesthetics not just to approximate facial implants, but also to reshape jawlines and foreheads. Filler has made the nonsurgical nose job possible, and thinner formulas can now smooth out the hollows responsible for dark circles. But in 2022, when the American Academy of Facial Plastic and Reconstructive Surgery issued its annual trend report, the findings showed that filler use is on the decline: Doctors were doing 14 percent fewer injections compared to the year before. Filler reversals are on the rise too.