Lately I've noticed a stubborn little crease on my forehead. I lift the skin just a bit, mimicking a facelift - and the crease disappears. During a facelift, the surgeon makes an incision, usually around the hairline, and then pulls the facial skin upward to smooth loose skin and wrinkles, and provide a more youthful appearance.

While a facelift can provide dramatic results, I'm not quite ready for all that. I'd just like something to freshen my face a bit. And yet I'm smart enough to know that some products and procedures billed as facelift alternatives are likely to have more of an effect on my wallet than on my face. But how to separate the facts from the fictions? I turned to an expert for help - and here's what I learned.

Topical Treatments

Dr. Joel Schlessinger, MD, FAAD, FAACS, president of the American Society of Cosmetic Dermatology and Aesthetic Surgery, assured me that creams can be very effective when targeting specific problems. No single cream can do it all, however, and sadly he could not tell me of a cream that is truly "better than Botox." He recommends the Obagi line for pigmentation and age spots, and he has found creams that accomplish such things as increasing eyelash growth and enhancing pouty lips.

Peels are another option, and their level of invasiveness depends on what you'd like. Prices range from low strength AHA peels at $30 - $100 per treatment to very strong phenol peels at $4000 or more. Chemical peels burn off the outer, damaged layers of skin, revealing the younger skin underneath. Babies have such soft skin because their cells are constantly regenerating, but this slows as we age. Chemical peels speed the process up.

There are some nasty stories about what happens if a chemical peel goes too deep, so be careful in your choice of practitioner. Some of the newer options, like blue peels, claim to be safer. At $200 - $1000, these peels may be adjusted to the desired strength. Milder peels can be repeated at regular intervals to achieve a desired result and minimize side effects and healing time. According to the blue peel website, a measured application of blue glycerine is mixed into the traditional peel chemical, trichloracetic acid (TCA), to "improve patient safety by visually indicating the TCA solution strength and facial skin coverage." Anything that helps keep the peel from going too far sounds good to me.

High Tech Salon Treatments

Laser treatments are increasingly popular these days, whether you're trying to remove unwanted hair or get rid of wrinkles. Laser "facelifts" use a carbon dioxide laser to remove outer layers of old skin and tighten muscles. Dr. Schlessinger tells me that the first laser treatments had "a long recovery time and fabulous results. Today's technology produces only about 20-30% of the those early results, but with almost no side effects." The new buzz word, Schlessinger tells me, is "fraxellation." In today's treatments, you can "strafe" an area so that the laser only disrupts pinpoints of skin, leaving enough surface untreated to speed healing time. This one sounded good to me.

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