The Sneaky Girl's Guide To Cosmetic Enhancements

Illustrated by Anna Sudit.
Let's get one thing out of the way first: We're not saying anybody needs plastic surgery, fillers, or any other cosmetic enhancements. Love what you've got — that's our motto. At the same time, we know plenty of people who feel a bit better with their wrinkles softened or their nose straightened. That's okay, too.
Not that it's easy to say who's had a little "help" and who's natural. These days, the frozen-faced Botox look is passé, and breast enhancements are often so subtle that they look untouched. "It's really individual," says Michael C. Edwards, MD,, a plastic surgeon in Las Vegas and the president of the American Society for Aesthetic Plastic Surgery. "Some women have absolutely stunning lips, and they've never had a thing done. Some have thin lips and use a little filler."
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To find out how people are using cosmetic surgery and injectables in stealth mode, we found 10 not-so-obvious treatments that deliver results. Some are quick and temporary, while others are serious surgeries. The point is, you can't always tell — and that's just how many people like it.


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Illustrated by Anna Sudit.
The Eye Enlarger
You can use Botox for much more than reducing frown lines. "A lot of treatments are off-label," says Jeannette Graf, MD, assistant clinical professor of dermatology at Mount Sinai Medical Center in New York. This means they're not officially endorsed — but that a well-trained provider could use the drug to create various cosmetic effects.

One surprising example: You can use Botox to subtly shift the shape of the eyes. "Injecting in the correct areas of the eye muscles can make the eye look larger," Dr. Graf says, "but it's not for beginners." As for "preventative" Botox, she says there's no such thing — it's meant to be used for existing conditions. "I turn some people away," she says. "If you see lines at rest, then you may be a candidate."

While we think there should be no shame around these injections, not everyone wants to share. Hence, this sneaky trick. A while back, a friend of ours met with us, looking fantastic: bright-eyed, relaxed, awake. "Did you just get back from a tropical vacation?" we wondered. "Nope," he said. "Just got a haircut." Except, he later admitted, he'd also recently had Botox. "I schedule my Botox a few days before my haircuts, so everyone thinks I look great because of the haircut," he said gleefully. Fooled us.
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Illustrated by Anna Sudit.
The Jawline Contour
Bubblicious addicts, take note: All that gum-chewing can make the chewing muscle — and, consequently, the face — look heftier. "People who chew a lot of gum can develop thick masseter muscles," Dr. Graf says. To contour and define the jawline, you can use a small amount of Botox.

The result: "It can look more soft and pointed," Dr. Graf notes, adding that it can also help with TMJ disorders. (In that case, the benefits could be more medical than cosmetic, so your insurance may cover it.)
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Illustrated by Anna Sudit.
The Dark-Circle Stopper
We've been hearing a lot of quiet buzz about this sly eye trick lately — and everyone who's done it swears that it keeps their tired "panda eyes" at bay.

Using a hyaluronic-acid filler such as Belotero or Juvéderm, a dermatologist injects the tear troughs (the spots just under the eyes). "Injectable filler in the tear trough makes the circles softer," says Dr. Graf. "They're less obvious, and I've seen it still look good a year later."
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Illustrated by Anna Sudit.
The Anti-Frown
People whose mouths naturally turn downward are often asked why they're not smiling. Bitchy Resting Face is real, and it's really annoying when people are constantly asking why you're upset, or if you're mad about something.

If it's becoming a personal annoyance to you, a bit of Botox can turn that frown upside down, says Dr. Graf. "A small amount of Botox in the depressor anguli oris muscle" — that's a muscle associated with frowning — "can make the lips turn upward." The effect lasts for a few months of smiling (or, at least, not frowning).
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Illustrated by Anna Sudit.
The Mini-Nose Job
Long gone are the days of a one-size-fits-all button nose. Today, people may choose to refine their shapes, but they don't want to lose them completely. "If somebody has a large dorsal hump on the top, they just want to take it down," Dr. Edwards says.

Traditional rhinoplasty is one way to go, but for a temporary fix, some turn to fillers. "If somebody has a bit of a bump, maybe they had a fracture of their nose — it can be wonderful," Dr. Edwards says. "It's a temporary change, but it can help them a lot."

But, it's not the best treatment for an earlier rhinoplasty-gone-wrong, he notes, because the effects only last a few months. In that case, surgery — or, living with it — is the way to go.
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Illustrated by Anna Sudit.
Liposuction
Contrary to popular belief, liposuction isn't about dropping pounds. "The best candidate isn't someone who thinks of it as a way to lose weight," Dr. Edwards says. "It's a body-contouring procedure." Often, it's used to treat hip rolls and weight behind the waist — areas that are weight-loss resistant even if you're a CrossFit trainer, he says.

Dr. Edwards urges people to see only board-certified plastic surgeons if they're considering liposuction. "It's tremendously important to go to a properly trained provider," he says, noting the lumps-and-bumps look of badly done lipo. "I hate the stories in the press that talk about plastic surgeons harming people with liposuction — and then you find out that it was an ophthalmologist performing the procedure."
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Illustrated by Anna Sudit.
The Did-She-Or-Didn't-She Boob Job
Bigger isn't always better, even in the world of plastic surgery. While breast augmentation is consistently one of the most popular cosmetic procedures, the effects look less obvious than they typically used to. The "Brazilian B" — a modest boost — is meant to make the breasts look naturally — but proportionately — full.

"You don't have to go overboard," Dr. Edwards says. "With bigger implants, there are more side effects. For instance, exercise is more difficult. I find myself talking women down sometimes."

He recalls a patient who used a clever trick to keep her surgery secret. "She wanted her breasts augmented, but she didn't want them big," he says. "She had a consultation, picked the implant size she wanted, then slowly padded her bra up to that size over a two-month period." By the time of her appointment, people were used to seeing her with that breast size. "She went on 'vacation,' came back, and people were none the wiser," he says.

Of course, he adds, there's always the classic route: "If [women] want to augment their cleavage, they can also get a push-up bra."
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Illustrated by Anna Sudit.
The Eye Brightener
Crepe-y eyelids and baggy eyes certainly aren't the end of the world. (Actually, they could be signs of an enjoyable Friday night.) But, some women choose blepharoplasty, or eyelid surgery, to look younger and more refreshed.

"Some people have heavy eyebrows that sit low," says Dr. Edwards. "If they put their hands on their forehead and lifted it up a little — we're talking 5 millimeters — they look less tired." A well-done blepharoplasty, he says, can create a rejuvenated look instead of a "done" one. "Friends might ask if you're getting more sleep," he notes. "But, if patients don't tell anybody, they can just say they took a vacation."

As for a less invasive way to create a lifted look, you guessed it: Botox above the brows.
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Illustrated by Anna Sudit.
The New Lip Injection
The era of oversized lips is over. "I had a patient come in asking me to make her lip touch her nose," Dr. Edwards recalls. "I told her, 'Absolutely not.' Thank goodness people have realized that's an unsightly look." These days, lip enhancements use the same fillers as before —usually Juvéderm and Restylane — in smaller doses that create a more believably natural appearance.

Considering a plumper kisser? Dr. Edwards says to keep your original lip size in mind. "Sometimes, people might have a bit of filler in their lips, and two weeks later, they want them just a little bit bigger," he says. "After a while, they forget the starting point, and before you know it, they've gone too far." In addition, he advises researching the practitioner carefully. "Don't go to a strip mall to get your face injected. If the price is ridiculously low, you get what you pay for. You might get a gray-market filler or something that isn't FDA-approved." Safety first, people.
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Illustrated by Anna Sudit.
The Temporary Bust Boost
Last month, The New York Times highlighted an unusual phenomenon: injecting saline solution into the breasts for a temporary enlargement. The procedure, typically done with women who are considering breast augmentation, is relatively rare — but it's piqued some interest. The solution does increase breast size before being absorbed into the body, but Dr. Edwards isn't a fan. "I don't recommend injecting saline into a woman's breast, but there are those who it will appeal to," he says. Not to mention, the procedure can cost almost as much as an actual breast surgery. "They're charging $3,500 for something that will last 24 hours," he points out.
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