If you looked in the mirror in 1987 and saw the wrinkles and sags of aging, you might have joined the “new revolution” that was sweeping the country and considered plastic surgery.You didn’t know it at the time, but your options were quite limited.That year, as I completed my plastic surgery residency at the University of Chicago, I could offer you a facelift or eyelid lift for those big sags, a browlift that left scars across the scalp from ear to ear, a deep chemical peel and maybe collagen for those fine wrinkles. And that was about it.QUIZ: How Do You Feel About Your Face?Over the last two decades, facial rejuvenation has undergone a quiet change from a “healing with steel” field to a much less invasive undertaking. The metamorphosis has been gradual but steady, and now the vast majority of people who want to look better and younger can do so without the incisions and long recovery of surgery.Plastic surgeons love to operate. It’s in their DNA. But while cosmetic surgery is more popular than ever, most of the growth has been in those procedures that don’t require a scalpel. And while that may bother some surgeons who are now forced to evolve, it’s good for you. After all, who really wants to feel discomfort during and after a procedure, and hide out for weeks waiting for bruising and swelling to settle?MORE: Will Plastic Surgery Make You Happier?Certainly, if you’ve got a huge turkey gobbler in your neck, or your eyelids are blocking your vision, surgery may well be in your future.  But if you’re like most people—if you have milder changes of aging—then the projects that plastic surgeons and pharmaceutical and engineering scientists are working on might just be for you.The sociomedical movement to eliminate the scalpel can be traced to the 1990s when Botox first became popular. This wildly popular drug paralyzes muscles and stops their pull on the skin. Wrinkles immediately soften and the longer you use the drug the less wrinkles you’ll have.  While the discussion is usually about Botox, there’s actually two other drugs that do the same thing. Dysport has been competing with Botox for a few years and very soon Xeomin will be launching an advertising campaign.Botox has all but eliminated the operations that lifted eyebrows and cut out the muscles responsible for those dreaded vertical lines over the nose. Even with surgery, the body is so good at fixing itself that within a year, scars form and bridge muscle gaps helping to recreate those wrinkles. If only we could tell our cells that we removed the muscle for fun.While Botox improves wrinkles, a good skincare program with creams that contain vitamins A and C can stabilize and even reverse the thinning of the skin that inevitably occurs after age 30. These vitamins really can boost your own collagen, elastin, and hyaluronic acid, and can do so relatively inexpensively.  Wrinkles develop more slowly if you maintain these substances on your skin.MORE: Should You Use Botox?In the 1990s, lasers and light peels replaced those deeper chemical peels that took weeks to heal.  Deep lasers worked, but often caused permanent skin lightening and took weeks to heal.  So, lighter versions of lasers were introduced during the 2000s, sacrificing effectiveness for a much quicker recovery.  Light chemical peels are very effective at decreasing the splotchy brown pigmentation that accumulates on our faces as we age, and they can even help fine wrinkles. You don’t hear as much about these peels, though, since without enormous profits for tech or pharmaceutical companies, there’s no big advertising push.Probably the single most important advance in the noninvasive revolution has been with a new generation of wrinkle fillers. The collagen that was FDA approved in 1981 really never hit it big because it lasted only a few months. And people who received hundreds of injections were at risk for developing allergic reactions or even serious problems like arthritis.In 2004, the FDA approved Restylane, the first wrinkle filler that contained a type of sugar called hyaluronic acid. Hyaluronic acid is responsible for keeping our skin moist and flexible. But, like collagen, it must be injected because the molecule is too big to penetrate the skin. Injected hyaluronic acid does a great job at plumping the skin, has minimal risks and lasts almost a year. It’s no wonder it has become a blockbuster product. Creative and artistic use of this filler can fill wrinkles, lift the corners of the mouth, and plump up lips and eyelids. Nearly two dozen other fillers have been approved over the last 7 years, some of which last two years and some of which have permanent effects.MORE: Your Guide to Filling WrinklesBut with all of these new techniques, big sags like the jowls and crepey skin of the neck have been elusive problems. Recently, space age technology using high intensity sound waves have been commercialized. These new machines can actually lift the skin and tissues and destroy unwanted fat without so much as making the skin red. The first one, called Ulthera, has complemented Botox, fillers, and peels to give a truly noninvasive facial rejuvenation, lifting eyebrows and jowls and smoothing facial and neck skin.With all of these changes, women and men can now achieve substantial facial rejuvenation without ever seeing the inside of an operating room.While plastic surgery cannot make you younger, it is becoming easier and more affordable to look better and younger with a good skincare program coupled with well-timed noninvasive procedures.

RELATED ARTICLESMORE FROM AUTHOR