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Can Nonsurgical Face-Lifts Zap Wrinkles?

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Since birth, twin sisters Kathy and Karen Ritter have been nearly inseparable, doing everything from twirling batons together in elementary school to dating the same guy in high school. But now, at 43, they're sharing something neither of them wanted: wrinkles.

A few months ago Good Morning America began searching the country for twins who wanted a non-invasive makeover, a pain-free way to turn back the hands of time. The Ritter twins -- now Karen Cascadden and Kathy Fitch -- fit the bill perfectly. Each will undergo a different type of nonsurgical face-lift that does not involve scalpels, sutures or scars.

The sisters say they are both ready for a makeover, and they'll do it together.

Dr. Howard Sobel (, a cosmetic dermatologic surgeon based in New York City, will use a cold or "Cool-Touch" laser on Cascadden, while Dr. Michelle Copeland (, another New York-based cosmetic surgeon, will use a "hot" rejuvenation-combination technique for Fitch. The non-ablative therapies, which involve no cutting, are gradually making their way onto the market in major cities.

Unlike traditional treatments, which alter the top layers of skin and require days or weeks of healing, the nonsurgical face-lifts work on the tissue beneath the skin, and can be done in just minutes in the doctor's office. The nonsurgical techniques are aimed at a younger clientele, who are too busy to deal with the days or weeks of healing.

"This is for somebody who doesn't want a lot of down time," Sobel said. "Not for someone who is 70 plus years old and has lots of skin that needs tightening. This is more for people in their 30s to 50s who have fine lines and now have some loosening of skin and find gravity is winning out and don't need to go under the knife."

The Cool Method

The CoolTouch technique takes 20 minutes and stings a little, Sobel said. The patient is awake during the procedure.

"We give a topical agent to numb the skin, or if needed a pill to relax you," Sobel said. "It feels like a light rubber band snapping your face."

A cooling device cools the top layer of the skin with a cryogen mist while a laser heats up the water that is under the skin. That helps stimulates the body's cells to produce more collagen, which helps keep skin younger looking.

"This can be done during lunch, and has only a little pain involved," Sobel said. "It is done in 20 to 30 minutes and you can go back to work. There are no real pre- or post-instructions to follow. It is a laser that causes temporary redness but no scarring."

The "cold" treatment helps make fine and deep lines less visible, works on acne scarring, and helps skin that has become less elastic with time. Patients may see a blush in the treated area for a short period of time following the treatment, but they can apply makeup and resume regular activities right after the treatment.

Each visit costs about $700, and most people require between three and six treatments.

The Hot Method

The "hot rejuvenation-combination" technique works differently, with a combination of procedures. It is ideal for people with mildly to moderately wrinkled and sagging skin. It can also tighten skin around the neck and reduce discoloration, visible scars and fine lines.

First, microdermabrasion is used to remove the top layer of cells

"We spray fine crystal across the skin and vacuum them off along with the dead cells so this smooths the skin," Copeland said. "Then there is a light-touch laser, which removes another top layer of cells and helps thermally tighten the skin."

The last step involves using an intense pulse light on the skin, which stimulates the cells to produce more collagen beneath the skin's surface.

"All these things together make each one more powerful," Copeland said. "You get more tightening. More youth."

Patients typically require six treatments of the "hot" therapy, and that they can be a week or several weeks apart. Patients will see improvement in their skin over time. It costs between $500 and $700 a visit, and patients will need at least three visits.

Repeat Visits Needed

For both the "hot" and "cold" procedures, repeat visits are needed, but there are very few down sides, Copeland said.

"You have to have it done more than once in return visits," she said. "It doesn't do the same as surgery would, if you have a lot of sagging."

Doctors are not sure how long the treatments last, as there have been no long-term studies.

Sobel said he will also use a brand-new type of laser that can help diminish the appearance of dark spots, freckles and broken blood vessels on Cascadden.

For Fitch, Copeland said she will also start doing things every day to her skin, including using glycolic acid.

Skin That Reflects Good Care

When they were little girls growing up in Reading, Mich., Cascadden and Fitch were known as the Ritter twins, and to this day people have trouble telling them apart. When each married and it was time to settle down, they both moved to Bradenton, Fla., to raise their families. Fitch is a teacher and Cascadden is an assistant superintendent at the Manatee County Schools and a Mary Kay beauty consultant.

Even though the Ritter twins maintain diligent nightly skin regimes, they still worry about their skin. Both have wrinkles, acne scars and age spots. They blame the wrinkles and the age spots on lying out in the sun before SPF levels were marked on sunscreen bottles. Both have also had oily skin since they were young.

"I take good care of myself nutritionally and would like my face, my appearance, to reflect how I feel," Cascadden said.

"Ditto," said Fitch. Online Resources: American Academy of Facial Plastic & Reconstructive Surgery: American Association of Plastic Surgeons: American Board of Plastic Surgery: American College of Surgeons: American Society for Aesthetic Plastic Surgery: Note: ABCNEWS' Good Morning America does not endorse the products or services of guests appearing on our air. 

To see more on this story, go to Copyright 2003 All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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