Q. What about using Exercise to get rid of my wrinkles? I've seen ads in magazines and informercials on TV that make sense to me. I'd like to put off having a facelift until I'm 55. S.F. Las Vegas

A. If it sounds too good to be true... Exercising your facial muscles is exactly what caused the wrinkles in the first place. The facial muscles are directly attached to the skin so that when you move them the skin is pulled to make your facial expressions. Every time you pull your skin with those muscles you crease or stretch your skin and eventually the skin loses it's elasticity and you make a wrinkle or sag that stays even when your face is totally relaxed.

There are lots of options besides a facelift to deal with sag and wrinkling of the face and neck. Your best approach is to see your Plastic Surgeon and discuss what bothers you and what s available to minimize that problem. Your skin condition is the issue not your number age.

There are two things you (everyone) can start today to minimize wrinkles: avoid the sun and wear sunscreen daily, and stop smoking (it accelerates the aging process).

Other simple things to minimize wrinkling include: Botox injections to weaken overactive muscles that are making deep wrinkles, collagen injections to fill in the indentation of the wrinkle and give a smoother, plumper look; a medical skin care program to maximize health and flexibility of the skin at any age.

Of course, for the most radical improvement you need the surgical approach: facelift, eyelid enhancement or laser resurfacing. Definitely the ultimate rejuvenation treatment is surgery. having been a patient myself, I can certainly recommend the surgical approach, the rewards are much greater, and I would have another facelift tomorrow if I needed it. Ask to see my "before pictures".

Q. I have been dieting and dieting and I just can't shake that last 10 pounds. Can liposuction get rid of them? F.G. Laughlin

A. Yes and No. Liposuction can be used to remove fat in any volume from just about any area but that doesn't mean it's a good idea. Your health and safety are the most important issue not what the scale says. Liposuction is a safe procedure if used as intended to reshape the body contours and bring troublesome areas into balance with the rest of the figure.

Q. How do I know when I need a facelift? My mirror tells me I look worn and saggy but I'm energetic and only 45. L.O. Summerlin.

A. There is never a "correct" age for having a facelift or any other cosmetic surgery. It's time when you feel you need it. If you look tired and that bothers you, then you are ready. Age numbers are not important: what is 45 really supposed to look like? In my practice, we discuss specifically what you want to change, then identify a "fix" that fits your lifestyle and concerns. That may be a facelift, eyelid lift or even a personalized minilift addressing just the areas that uniquely concern you. We don't believe in "one size fits all". We have seen 35 year olds that ned a facelift and 55 year olds who don't.

A personalized consultation with full discussion of trade-offs and key benefits will be your best approach to looking your personal best.

Q. I'd love to bid farewell to the family curse of heavy thighs but every time I say the word liposuction my mother pretends to have a heart attack! What about safety? D.F.C. Green Valley

A. It's truly a shame that so many people have been frightened away from one of the safest and most frequently performed plastic surgery procedures in America because of unfavorable press coverage. Liposuction is remarkably effective in reducing figure faults caused by lcalized fatty deposits.Anyone whoe has tried to "spot reduce" with exercise knows that it doesn't work.

Extremely fast recovery, remarkable results, tiny incisions and high marks for satisfaction make liposuction one of the greatest Plastic Surgery Advance of the 20th century. While vacuuming out body fats looks like the magical solution to weight loss struggles, it is best for reshaping the body contours, not for weight reduction.

When you consult with us, we seek solutions to your figure problems and balance that with your health capacity, carefully maintaining a clear safety zone. Safety concious, informed choice can allow you to join hundres of thousands of women (and men) who look great and feel great becase they got the figure improvement they wanted through liposuction. P.S. Bring your mum: the safest way to talk to her about liposuction is with a doctor present!

Q. I have 3 beautiful children but lost my figure in the process. I still look five months pregnant but I'm not "fat". Sit ups are not helping! What can I do to get my waistline back?

A. If you are like most women after pregnancy or weight loss, you can do sit ups all day long and not change your protruding belly. The reason is that the muscles get over stretched permanently or even split, and they cannot function normally. This result in a loose abdominal wall that bulges out when you stand upright but falls in considerably when you lie down. Your posture is affected and low back pain is common with this condition.

Exercise and diet are not the answer as you have already discovered. The muscles must be surgically tightened back to their correct position so that exercise can actually do something. This muscle repair is an essential part of abdominoplasty or "tummy tuck". Any excess skin overhang can also be removed at surgery as well as any fatty excess that remains out of proportion with your general figure. Stretch marks are frequently removed. Restoration of flat abdomen with a more defined waistline is a common result. Patients have reported unexpected benefits of "tummy tuck" such a relief of chronic low back pain or even improvement in post pregnancy incontinence.

Many different abdominoplasty procedures are possible in our practice, and the choice is based on what needs to be corrected for each patient. My favorite approach is the limited incision abdominoplasty that we refer to as the "Victoria's Secret" tummy tuck, because the C-section type incision can usually be hidden in even smallish bathing suits and lingerie, and there is no belly button incision.

Body sculpture with liposuction in limited areas can also be combined with abdominoplasty. Some of our happiest and most satisfied patients are abdominoplasty patients. It is a great way to restore you figure after weight loss or pregnancy. We can help solve problems when diet and exercise are not enough.