By Jane Glenn Haas
Orange County Register

The women come in with wrinkles. Loose skin. Brown spots. Signals of aging.

In 30 minutes, their skin pumped with liquid filler, the signs of age or weight loss are erased.

Fillers are the solution for most women who want to combat the signs of aging, says dermatologist Dr. Tony Nakhla. Injected fillers remove, correct or even reverse the skin deterioration – for thousands of dollars less than plastic surgery.

“Don’t try to dial the clock back 15 or 20 years,” he says. “You can look great for your age. Your focus should be on looking your personal best.

“And the cost is thousands of dollars cheaper than surgery, can last two years, and doesn’t require downtime or anesthesia.”

Nakhla is the head of the OC Skin Institute, with offices in Santa Ana, San Clemente and Laguna Niguel, Calif. A board-certified dermatologist, he also is a skin cancer surgeon, cosmetic surgeon and osteopathic physician with training in traditional and holistic medicine as well as nutrition.

He also is the author of “The Skin Commandments: 10 Rules to Healthy, Beautiful Skin,” a guidebook to topics ranging from healthy exercise to how to pick the correct cream for your skin.

Q: “Before” and “after” shots are always dramatic, but are fillers safe?

These are safe and effective treatments and they last two years and beyond. They help boost the skin’s own production of collagen.

If your collagen has dissolved, your elastic fibers have lost their springiness and your subcutaneous fat has atrophied. You can join the 1.8 million individuals who turned to injectable fillers last year to fill in wrinkles, lift jowls, rejuvenate thin lips, erase deep grooves under the eyes, restore volume in deflated cheeks, smooth concave temples, plump up the skin on the back of hands.

Q: What’s the difference between Botox and fillers?

Botox is good for frown lines and other wrinkles in the upper face, like crow’s feet. It irons out existing wrinkles and helps prevent the formation of new ones. Fillers are good for wrinkles where the skin is sinking or sagging.

The best way to look your best probably combines the two.

Q: You’re a dermatologist – will you charge more than a day spa?

A spa is not the place to go – or a hair or nail salon. You need to see a dermatologist with training and experience. No single filler is perfect for every area of the face, for example, and using inexperienced injectors can leave you with a “monkeylike” face with flat contours.

Q: All this sounds wonderful – but pricey. What if I can’t afford them?

You can still improve the looks and condition of your facial skin, as I outline in my book.

I think everyone knows not to use a soap bar on the face. That’s never a good idea. But the ingredients of various cleansers often can be confusing, and I summarize that in the book.

For instance, there are things that shouldn’t be in there – like fragrances loaded with dyes and smells like cucumber. Natural products or products derived from nature are wonderful but must be scientifically proven to have benefit to the skin. A lot of things are natural – like tobacco and marijuana – and that doesn’t mean these natural things belong on the skin.

It’s like the theory that two cucumber slices on the eyes are helpful. They really do nothing.

Q: What about facial moisturizers?

There are a number of great topical moisturizers. But olive oil, peanut oil, shea and cocoa butter, for example, should be reserved for the body, not the face. They could clog pores and create breakouts.

Q: And sunscreen?

Again, this depends on the skin type. If you have oily skin, just use it in the morning, for example. There is not a “one size fits all” answer, as my book points out.

The bottom line is you don’t have to spend a ton of money on products. Frankly, you’re better off saving your dollars for three or four months and seeing a dermatologist for a Botox or filler treatment.

Q: A lot of what you advocate seems to focus on being cost-effective.

I’d like to be thought of as America’s dermatologist, reaching out to people in all economic groups – especially with information on skin cancer.

There’s a lot of skin care “information” out there that’s baloney. The market is saturated with celebrities and nonspecialists, and they spend millions on advertising campaigns.