A trip on Miami’s MetroRail from Dadeland North to the Civic Center station for retired Kendall school teacher Janis Prospero led to a marriage proposal.

“I have to say I have received one proposal of marriage from a fellow senior citizen while standing on the platform waiting for the southbound train,” Prospero, 73, says.

The gentleman was very mannerly, and began his conversation in the usual mundane way, asking about train schedules. Then he popped the question.

“I would ask you to marry me because I think you are very beautiful,” Prospero remembers the Spanish stranger saying.

One problem: Husband Joe, a professor at the University of Miami, might have something to say about that proposal. But, “He’s too busy with his scientific research to be the least bit concerned,” Prospero says.

Prospero has been seeing Dr. Ivan Camacho, an assistant professor of dermatology at the University of Miami Miller School of Medicine, for the treatment of parapsoriasis, a skin disease that leads to scaly patches and bears a resemblance to psoriasis. In addition, she works with Camacho to treat the usual signs of aging, such as wrinkles, lines around the mouth, bags under the eyes.

“If you’ve enjoyed a good appearance and have maintained a healthy lifestyle in weight and nutrition, you want to feel better about yourself in a youth-oriented society,” she said. “I thought it was time to seek advice on either cosmetic surgery or some other form of skin care.”

Cosmetic care

Today, the options for people like Prospero are vast.

Doctors have soft-tissue fillers to plump sagging faces or to fill in wrinkles. Traditional fractional resurfacing using lasers to slough away the superficial portions of the skin layer can regenerate new skin free of blotchiness and rough areas. Botox injections and topical creams are other popular choices.

Lasers and lights target many different areas of concern, such as port wine stains, broken blood vessels in the nose and cheek and other small blood vessels, rosacea and scars, says Dr. Keyvan Nouri, professor of dermatology at the University of Miami. Lasers are also used in the treatment of skin cancers, often caused by sun exposure.

“Women are staying active until much later in life, so you see women in their 50s to 70s that still have an active role in many fields of society and in high-level occupations who are interested in doing something about how they look,” Camacho says.

Women, and men, too, in today’s stressed economic times turn to cosmetic tweaks to appear fresher and, thus, more competitive at job interviews.

A visit to a doctor’s office often resembles the intro to Ryan Murphy’s recent cosmetic surgery cable drama, Nip/Tuck. That stylized, often over-the-top show always began with the flashy doctor asking the guest star of the week: “Tell me what you don’t like about yourself.”

“They will say, ‘What really bothers me is this line,’ so I start educating them about why they have that line,” Camacho says. “It’s not just a line. It’s a process of losing some of the bone on the cheeks, so the skin is sagging. They are losing some fat on the cheeks so that’s why there are prominent folds. The skin is not as doughy and thick as before. If they want to have a good effect we probably need to use all the different tools we have available.”