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Anti-Aging Treatments of the Face The facial skin consists of the superficial skin (epidermis), deep skin (dermis), SMAS and facial bones. Each one of these layers is affected by aging, and needs to be individually treated for optimal results. Epidermis Treatments: The superficial skin (epidermis) consists of about 100 layers of cells. The top 10-20 layers are dead skin cells which may become scaly or dry and can block prescription creams from building up the deeper living layers of skin (dermis). Microdermabrasion removes the scaly build up of dead cells and allows presription anti-aging (anti-oxidant) creams tobuild up the living dermal layer. A thicker dermis will reduce wrinkling. Photoaging of the epidermis creates age spots and wrinkles. Age spots, freckles, rosacea, dicolored skin and facial hair may be removed by superficial laser resurfacing, laser hair removal and age spot removal with or without chemical peels. Anti-Wrinkle Treatments of the skin consist of either Botox or wrinkle removers. Botox works by paralizing the muscle underneath it. For this reason, Botox is best used for suppressing the active wrinkles of facial expression such as frown lines, crow's feet, laugh lines, etc. Botox Injections are Best for Dynamic Wrinkles! For wrinkle treatment of the upper face, botox gives good temporary results lasting about 4 months. Since botox paralyzes the underlying muscle, it is best used for dynamic or active wrinkles. In the picture shown below, botox injections were given in the forehead. After botox injection, the patient is unable to cause frown lines or forehead lines, no matter how hard she tries, because botox has paralyzed the muscles underneath. Botox is an excellent way to treat frown lines and wrinkle lines around the eyes, forehead and neck. Dermal Fillers are Best for Static Wrinkles! For static wrinkles, such as wrinkles of the lower face, marionett lines, smoker's wrinkles, etc., we use dermal fillers. Fillers may be temporary, permanent or semi-permanent. Temporary Fillers  Temporary fillers include Hylaform, Restylane, Prevelle or Juvederm. Hyalaform lasts about 3 months, Restylane lasts 6 months and Juvederm lasts 6-8 months. ArteFill is the only non-absorbable injectable product FDA-approved for the nasolabial folds. ArteFill candidates need an allergic skin test 28-days prior to injection. Sculptra is injectable poly-lactate approved to restore volume in patients with HIV lipoatrophy. It lasts at leasts 2 years. No skin testing is needed for sculptra. For permanent fillers, we use ArteFill, Surgiform, Sculptra, Zyderm, Zyplast collagen, AlloDerm, Autologen, Dermalogen, Gore-Tex and SoftForm. Microliposuction & Sculpting of Face Microliposuction of the face can sculpt the face by removing fat from unwanted areas, and transferring it to thinned or wrinkled areas.
Fat transfer is longer lasting than botox or hyalaform injections, with fewer side effects! Chemical Peels  Photoaging spots and wrinkles pmay affect the face at various depths. Chemical peels remove the superficial skin layers and, in this way, reduce wrinkling and photoaging spots. Chemical peels work at different depths: 1. Superficial skin peels, such as glycolic acid, salicylic aid and Jessner's peels are superficial skin peels which reach through the epidermis and into the papillary dermis. 2. Medium penetration peels, such as trichloroacetic acid (TCA) reach the deep papillary dermis. 3. Deep chemical peels, such as phenol peels, reach the mid reticular dermis. Generally, deeper peels remove the most wrinkles and photoaging spots, but may also cause skin discoloration. Patients with Fitzpatrick I/II skin types are unlikely to experience permanent discoloration. Patients with skin types V/VI are at high risk for permanent skin discoloration, especially with deep chemical peels. Patients at risk for discoloration may be skin tested at an innocuous site before a chemical peel is administered. Patients with a history of oral herpes are given prophylcatic medicine before chemical peeling. Patients with acne or suboptimal skin are optimized before chemical peeling. Patients who have used accutane, need to be off accutane for at least 6 months before chemical peel therapy. One advantage of chemical peels of the face, over laser resurfacing, is that they do not require general anesthesia and may be performed quickly, within 30 minutes. Laser Resurfacing Light exposure causes brown "age" spots of the face, neck, hands, feet or any region exposed to sunlight. Besides "age spots" photoaging creates a variety of skin colors which may be treated with laser resurfacing. 
 Skin care does not have to be exotic or expensive to be effective. Exotic products like salmon eggs, coccoons, or expensive creams like StriVectin ($135 per tube) or La Prairie Cellulite lotion ($335) are no more effective than simple products. For basic skin care we recommend washing your face with distilled water. Distilled water has no chlorine (which damages skin cells), salts or pesticides. It is cheap ($1 per gallon) and is sprayed on the face with a plant sprayer bottle. For cleaning the face, we recommend Cetaphyl ($12) not soap. It can be purchased at any pharmacy, Target, etc. Once the skin is cleaned, we recommend a product like Neutrogena Healthy-Skin Anti-Wrinkle cream to be used instead of moisturizer. This product is not only a moisturizer, but has UVA/UVB protection and provides nutrients for healthy skin. |
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