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Botox is out. Plasma injections are in. But is L.A.'s 'natural' anti-aging movement any better?

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Botox is out. Plasma injections are in. But is L.A.'s 'natural' anti-aging movement any better?

When Ali Weiss, 30, shares a selfie on Instagram, she often adds a disclaimer: This is a face that hasn’t had any work done.

“The most punk thing you can do in 2024 is not f— with your face,” the New York City-based on-air host and podcaster writes via email. Surrounded by peers who got fillers early and often, she believes her choice puts her in “the minority,” especially for those working in front of the camera. “The fact that people seem to be more shocked by a-30-year old who hasn’t gotten work done than a 30-year-old whose entire face is frozen is bonkers,” she says.

Weiss writes of her filler-less face with pride, but she still cares about her youthful appearance. She has several less-invasive treatments in her arsenal, including a red-light therapy gadget, laser facials and facial massages. In a few years, she hopes to try more invasive laser treatments that cost thousands. Anything before considering injectables.

For the last few decades, the consumer base for neuro-modulators like Botox and dermal fillers like Juvuderm has grown exponentially. In 2010, more than 5.3 million people got Botox and more than 1.7 million received filler in the U.S. In 2022, 8.7 million received Botox and more than 6.2 million received filler, according to the American Society of Plastic Surgeons. Especially in recent years, these procedures have gone from an indulgence for the wealthy and famous to casual and frequent appointments that cost a few hundred dollars.

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“They are incredibly effective, relatively low cost and have become part of an accepted mainstream lexicon for self care,” said Dr. Steven Williams, president of the plastic surgeons’ group.

But now, a number of beauty-conscious consumers are saying “no” to injectables and directing their money toward expensive natural treatments instead.

Marta Freedman, 33, is one of them.

“I grew up in the era of excess injections and the Kardashian era, so for me, it makes sense that the pendulum would swing the other way as people investigate alternatives,” the L.A.-based entrepreneur said.

Weiss and Freedman are among a chorus of anti-injectable sentiment on social media and in beauty publications that has intensified in recent years.

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“The art is in making the work disappear and look like nothing has happened.”

— Dr. Ava Shamban, founder of Skinfive Medical Spa in Pacific Palisades

TikTok and Instagram feature thousands of videos of (mostly) women chronicling the process of dissolving their filler. The sometimes painful process can take multiple sessions and is done by injecting an enzyme called hyalase that can cause facial features like lips to bruise and balloon before settling back into their original shape.

Many Los Angeles-based practitioners are noting filler fatigue among their clientele. They’ve seen more patients who are asking not only for their fillers to be dissolved but also seeking alternative procedures to maintain an enhanced, albeit more technically natural, look.

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“There is a pendulum swing back to the more natural, best version of yourself, similar to the ‘no makeup makeup look,’” said Dr. Ava Shamban, founder of Skinfive Medical Spa in Pacific Palisades. “The art is in making the work disappear and look like nothing has happened.”

So what are the beauty-obsessed, but Botox-averse doing instead? Some will pay top dollar for all-natural ancient practices, while others opt for high-tech, sometimes painful treatments — just so long as they can say they’re toxin-free.

Julie Civiello Polier has amassed more than 120,000 followers on Instagram by espousing noninvasive anti-aging facial massage techniques. Before the pandemic, the Los Angeles-based aesthetician and Chinese medicine practitioner offered in-person facials to her celebrity clientele, including Goldie Hawn, Miranda Kerr and Christy Turlington, but has since moved her practice online, teaching clients massage techniques for facial lifting and sculpting.

Her Instagram videos — with titles like “Support for ovaries and eyebrow lift” and “No Botox needed forehead sculpting” — have built her a dedicated audience . The services she provides range from live-streamed classes on DIY face-lifts (that cost $100 per ticket) to one-on-one coaching packages, priced at more than $2,000.

“I don’t feel aligned with filler or Botox, I prefer myself with a more natural look.”

— Marta Freedman, L.A.-based entrepreneur

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Angela Cravens, a 45-year-old copywriter based in San Diego who prefers chemical-free beauty products and Eastern-inspired natural practices, is one of her followers. Since finding Polier’s free tutorials on Instagram, she’s built a gua sha and facial routine that works for her. She says people often mistake her for being younger than she is — something she posits may be because she avoids injectables, “not the other way around.”

Polier says her clients come for the aesthetic benefits but find unexpected emotional release from her techniques. Inspired by traditional Chinese medicine, she believes inner traumas can affect parts of the face.

“This one client kept getting surgeries on one part of the face and it kept kind of drooping back down or kept kind of being really inconsistent with the other side, until we started looking at her relationship with her father,” Polier said. “That left side of the face is where our relationship to [our] father is stored.”

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In West Hollywood, a three-year-old cosmetic acupuncture practice called the Reset caters to people in their late 20s to 40s who don’t want to try injectables. Owner Toni Weinrit, a board certified and licensed doctor of acupuncture and Chinese medicine, says that although some of her older clients still use injectables, the younger generation is thinking twice.

Freedman, the L.A.-based entrepreneur, found Weinrit on Instagram and did weekly treatments at the Reset for about 10 weeks last year. She plans to resume them there soon. (In the meantime, she’s supplementing with at-home electrocurrent devices, Frownies wrinkle reducing patches and professional facial massages).

“I don’t feel aligned with filler or Botox. I prefer myself with a more natural look,” she said.

Weinrit charges $250 a visit for the service, advising a regimen of 10 sessions across five to 10 weeks (after which she recommends once-a-month maintenance, combined with occasional $500 microneedling, which she said aids in improving skin texture).

The American Institute of Alternative Medicine says cosmetic acupuncture “operates on the belief that the face reflects the body’s internal balance and health.” While the practice is rooted in more than 2,000 years of traditional Chinese medicine, there have been limited scientific studies investigating its benefits on facial skin elasticity.

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Though Weinrit’s services are significantly more expensive and time-consuming than your average Botox or filler treatment, her schedule is booked. She theorizes that that’s because the results are gradual.

“If you get Botox, 24 to 48 hours later, you have a different face,” said Weinrit. “This is not that.”

“If you get Botox, 24 to 48 hours later, you have a different face. This is not that.”

— Toni Weinrit, owner of West Hollywood acupuncture studio The Reset

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Some clinics have begun counseling patients about the changes they want to make, going so far as to refuse requests that won’t look natural.

Cosmetic nurse Vanessa Lee nearly left the industry after being asked to give lip injections to a teenage girl with her mother’s approval. In 2018, she opened The Things We Do, a medspa in downtown’s Arts District (now with locations in Chino Hills and Venice too) that focuses on a moderate approach. Lee, who has more than a decade of experience, says the medspa receives so many requests to dissolve filler done by other practitioners that she has had to begin charging for the once-complimentary service.

The Things We Do has a naturopathic doctor, a licensed healthcare provider on staff who is trained to address skincare through gut health. Lee says she has turned away patients who request excessive work and has referred them to a therapist.

“If somebody comes in and they’re saying things like ‘This guy just broke up with me’ or ‘I’ve been through the hardest year,’ maybe they’re not at a place to be making a big decision about full facial balancing while they’re in this emotional state that needs a bit of support,” she said. “Let’s start somewhere else first.”

Even so, Lee is running a business. For patients who are seeking a youthful refresh, she and her nurses first suggest bio-stimulating treatments like platelet-rich fibrin matrix.

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The treatment, which clinical studies have shown can reduce wrinkles and hyperpigmentation, involves drawing a patient’s blood, extracting the plasma from it and either injecting it in the face for those with volume loss in a specific place or using it with microneedling devices for patients with thin or dull skin.

One session starts at $1,100 for results that can last up to two years when done twice. Yes, needles are used, but no foreign bodies are injected into the face, a technicality that is meaningful to clients who want to avoid chemicals.

The procedure is proof that, though the pendulum may be swinging toward a more natural approach and look, one thing will never go out of style: the willingness to pay — and suffer — for the promise of beauty.

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AI windfall helps California narrow projected $3-billion budget deficit

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AI windfall helps California narrow projected -billion budget deficit
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California and its state-funded programs are heading into a period of volatile fiscal uncertainty, driven largely by events in Washington and on Wall Street.

Gov. Gavin Newsom’s budget chief warned Friday that surging revenues tied to the artificial intelligence boom are being offset by rising costs and federal funding cuts. The result: a projected $3-billion state deficit for the next fiscal year despite no major new spending initiatives.

The Newsom administration on Friday released its proposed $348.9-billion budget for the fiscal year that begins July 1, formally launching negotiations with the Legislature over spending priorities and policy goals.

“This budget reflects both confidence and caution,” Newsom said in a statement. “California’s economy is strong, revenues are outperforming expectations, and our fiscal position is stable because of years of prudent fiscal management — but we remain disciplined and focused on sustaining progress, not overextending it.”

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Newsom’s proposed budget did not include funding to backfill the massive cuts to Medicaid and other public assistance programs by President Trump and the Republican-led Congress, changes expected to lead to millions of low-income Californians losing healthcare coverage and other benefits.

“If the state doesn’t step up, communities across California will crumble,” California State Assn. of Counties Chief Executive Graham Knaus said in a statement.

The governor is expected to revise the plan in May using updated revenue projections after the income tax filing deadline, with lawmakers required to approve a final budget by June 15.

Newsom did not attend the budget presentation Friday, which was out of the ordinary, instead opting to have California Director of Finance Joe Stephenshaw field questions about the governor’s spending plan.

“Without having significant increases of spending, there also are no significant reductions or cuts to programs in the budget,” Stephenshaw said, noting that the proposal is a work in progress.

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California has an unusually volatile revenue system — one that relies heavily on personal income taxes from high-earning residents whose capital gains rise and fall sharply with the stock market.

Entering state budget negotiations, many expected to see significant belt tightening after the nonpartisan Legislative Analyst’s Office warned in November that California faces a nearly $18-billion budget shortfall. The governor’s office and Department of Finance do not always agree, or use the LAO’s estimates.

On Friday, the Newsom administration said it is projecting a much smaller deficit — about $3 billion — after assuming higher revenues over the next three fiscal years than were forecast last year. The gap between the governor’s estimate and the LAO’s projection largely reflects differing assumptions about risk: The LAO factored in the possibility of a major stock market downturn.

“We do not do that,” Stephenshaw said.

Among the key areas in the budget:

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California confirms first measles case for 2026 in San Mateo County as vaccination debates continue

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California confirms first measles case for 2026 in San Mateo County as vaccination debates continue

Barely more than a week into the new year, the California Department of Public Health confirmed its first measles case of 2026.

The diagnosis came from San Mateo County, where an unvaccinated adult likely contracted the virus from recent international travel, according to Preston Merchant, a San Mateo County Health spokesperson.

Measles is one of the most infectious viruses in the world, and can remain in the air for two hours after an infected person leaves, according to the CDPH. Although the U.S. announced it had eliminated measles in 2000, meaning there had been no reported infections of the disease in 12 months, measles have since returned.

Last year, the U.S. reported about 2,000 cases, the highest reported count since 1992, according to CDC data.

“Right now, our best strategy to avoid spread is contact tracing, so reaching out to everybody that came in contact with this person,” Merchant said. “So far, they have no reported symptoms. We’re assuming that this is the first [California] measles case of the year.”

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San Mateo County also reported an unvaccinated child’s death from influenza this week.

Across the country, measles outbreaks are spreading. Today, the South Carolina State Department of Public Health confirmed the state’s outbreak had reached 310 cases. The number has been steadily rising since an initial infection in July spread across the state and is now reported to be connected with infections in North Carolina and Washington.

Similarly to San Mateo’s case, the first reported infection in South Carolina came from an unvaccinated person who was exposed to measles while traveling internationally.

At the border of Utah and Arizona, a separate measles outbreak has reached 390 cases, stemming from schools and pediatric centers, according to the Utah Department of Health and Human Services.

Canada, another long-standing “measles-free” nation, lost ground in its battle with measles in November. The Public Health Agency of Canada announced that the nation is battling a “large, multi-jurisdictional” measles outbreak that began in October 2024.

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If American measles cases follow last year’s pattern, the United States is facing losing its measles elimination status next.

For a country to lose measles-free status, reported outbreaks must be of the same locally spread strain, as was the case in Canada. As many cases in the United States were initially connected to international travel, the U.S. has been able to hold on to the status. However, as outbreaks with American-origin cases continue, this pattern could lead the Pan American Health Organization to change the country’s status.

In the first year of the Trump administration, officials led by Health Secretary Robert F. Kennedy Jr. have promoted lowering vaccine mandates and reducing funding for health research.

In December, Trump’s presidential memorandum led to this week’s reduced recommended childhood vaccines; in June, Kennedy fired an entire CDC vaccine advisory committee, replacing members with multiple vaccine skeptics.

Experts are concerned that recent debates over vaccine mandates in the White House will shake the public’s confidence in the effectiveness of vaccines.

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“Viruses and bacteria that were under control are being set free on our most vulnerable,” Dr. James Alwine, a virologist and member of the nonprofit advocacy group Defend Public Health, said to The Times.

According to the CDPH, the measles vaccine provides 97% protection against measles in two doses.

Common symptoms of measles include cough, runny nose, pink eye and rash. The virus is spread through breathing, coughing or talking, according to the CDPH.

Measles often leads to hospitalization and, for some, can be fatal.

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Trump administration declares ‘war on sugar’ in overhaul of food guidelines

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Trump administration declares ‘war on sugar’ in overhaul of food guidelines

The Trump administration announced a major overhaul of American nutrition guidelines Wednesday, replacing the old, carbohydrate-heavy food pyramid with one that prioritizes protein, healthy fats and whole grains.

“Our government declares war on added sugar,” Health and Human Services Secretary Robert F. Kennedy Jr. said in a White House press conference announcing the changes. “We are ending the war on saturated fats.”

“If a foreign adversary sought to destroy the health of our children, to cripple our economy, to weaken our national security, there would be no better strategy than to addict us to ultra-processed foods,” Kennedy said.

Improving U.S. eating habits and the availability of nutritious foods is an issue with broad bipartisan support, and has been a long-standing goal of Kennedy’s Make America Healthy Again movement.

During the press conference, he acknowledged both the American Medical Association and the American Assn. of Pediatrics for partnering on the new guidelines — two organizations that earlier this week condemned the administration’s decision to slash the number of diseases that U.S. children are vaccinated against.

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“The American Medical Association applauds the administration’s new Dietary Guidelines for spotlighting the highly processed foods, sugar-sweetened beverages, and excess sodium that fuel heart disease, diabetes, obesity, and other chronic illnesses,” AMA president Bobby Mukkamala said in a statement.

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