Of course, the best solution would be reducing the demand for such procedures—or even replacing them altogether. Scientists do seem to be getting closer to the latter goal. Studies have shown that repeated injections of certain fillers have the ability to increase the body’s natural collagen, leading to longer-lasting results and less frequent injections. And while dozens of antiagers claim to be “Botox in a bottle,” Revance Therapeutics has developed a topical gel form of botulinum toxin type A, to be administered only in a doctor’s office. Early reports are enthusiastic—it’s currently undergoing clinical trials—though some doctors worry that surface application will lead to less precise outcomes.
But until the gel is approved, there’s still a place for bedside manner of the human variety. For every woman so tough she can inject herself, Giles says there are just as many “who come with their shaman and aromatherapy oils.” Because “anxiety is a huge component of pain,” she finds that engaging patients in conversation while she works goes a long way toward reducing discomfort. Says Giles, “I call it talkesthesia.”