The first thing that impresses you about Dr. Deborah Longwill is that she walks the walk. A board-certified dermatologist with five children and three grandchildren, she doesn’t look like any grandmother you’ve ever seen. She looks way too young.

And why shouldn’t she? Dr. Longwill understands far better than most the science of youth, which is really about the appearance of your skin, especially the face. “Skin is the number one sign of how old we look,” she says. “You can tell someone’s age by the glow and texture of their skin, and by the volume.”

That idea—that face volume is critical for the appearance of youth—is a new maxim for dermatologists, and one reason they’re giving plastic surgeons a run for their money. Dr. Longwill is of the new school that says smoothness is not the secret to a young-looking face.

Instead it’s about the return of volume, where the face is actually lifted rather than cut and stretched—the traditional method of the plastic surgeon. “As we age we lose volume in the face muscles and bone,” she says. “You get no support and everything starts to sag, so we’re using volume to lift the skin.”

To achieve this Dr. Longwill relies on a palate of injectable fillers such as Juvéderm, Restylane, Radius and Perlane—bio-identical synthetics that can also stimulate the production of collagen, the basic protein of skin.

Dr. Longwill has a reputation among colleagues of being “good with a needle.” This is key to the injectible game, where technique is critical. Replace the volume correctly and not only can you fill wrinkles; you can rebuild young cheeks that naturally tighten a saggy face.

“I like to use fillers in combination with each other, because each has its own strength—some for fine lines, some for deep lines, some for volume replacement,” she says. “Each filler is strategically placed, either superficially or deeply, to camouflage the aging process.”

Dr. Longwill has been practicing in Pinecrest for more than 20 years and has built a loyal following. Her dermatology practice has the notoriety of having the only valet service in Miami-Dade. Dr. Longwill says it’s because parking for her stand-alone building is hard to negotiate; her patients see it as part of an upscale practice that focuses on anti-aging.

To turn back the clock, Dr. Longwill relies on combination therapies, using “whatever works” to achieve best results. Her Ulthera device tightens skin by using ultrasound to heat up and “shrink wraps” the layer beneath the surface. Her fractional laser selectively burns away every other microdot of your skin—causing fresh layers of skin to grow, but without producing the burned look of a complete laser peel. She uses this on the hands as well, to erase age spots and discoloration (see photo).

Dr. Longwill is also obsessive about skin cancer, and insists on screening patients regularly. Even here she is concerned with aesthetic outcomes, which is why she uses the SRT, or Superficial Radiation Therapy. For both basal and squamous cell cancers, this new low-level radiation device burns out cancer without the use of a knife. Hence, no scar. “This gives us an effective removal of skin cancer with a cosmetic result,” she says. Dangerous melanomas, however, still require a cancer surgeon.

Finally there is Botox, the now famous neuro-toxin muscle relaxer that reduces wrinkles caused by muscular contractions—like laugh lines around your eyes, or the “elevens” caused by scrunching your forehead.

“Patients don’t like the word toxin—that you’re putting a toxin in their face. So we say neuromuscular inhibitor,” says Dr. Longwill. “The fillers don’t stop what is perpetuating the lines, so this works synergistically with the fillers to soften the lines.” Whatever works.