As early as your mid- to late-20s and into your 30s, you may start to notice the very first signs of aging, which are usually subtle but still bothersome. What was once a smooth complexion may now be home to small sunspots, crow’s-feet, dark under-eye circles and uneven texture. Instead of letting the signs of aging get the best of you, take matters into your own hands and correct the changes that you’re seeing—you may even be able to prevent them from progressing as you get older with the proper plan of attack.
CROW’S FEET These small fine lines are easy to prevent and even easier to correct. Regular use of a highly moisturizing eye cream helps keep the delicate eye area supple and less prone to lines and wrinkles. To reduce their appearance and prevent new ones from forming, Dr. Tanne can inject the area with Dysport, Botox or Xeomin.
UNDER-EYE BAGS, DARKNESS AND PUFFINESS With age, the area under the eyes becomes dark and puffy. Makeup can help camouflage bags and circles, but injectables and proper skin care can reverse them. Hyaluronic acid fillers, such as Restylane, Restylane Silk and Belotero, can fill in hollows to give the illusion of fewer bags. You’ll also want to use retinol and a product with growth factors to thicken thinning skin around the eyes. Another method of treating dark circles is with conservative use of hydroquinone, which may be irritating to some. Chemical peels, Intense Pulsed Light (IPL)/FotoFacial,fractional CO2 lasers and eMatrix Sublative Rejuvantion can also help tighten the under-eye area.
HYPERPIGMENTATION Discolored skin can result from a variety of factors. Protecting your skin from the sun with a mineral based sunscreen is important, but in-office procedures and prescription-strength ingredients can make a difference, too. When treating sun spots, the first line of defense is almost always hydroquinone, which stops the production of pigment in its tracks. If your skin is still discolored, your doctor may choose to use a light laser, like IPL/FotoFacial, or a fractional laser, such as CO2RE fractional CO2, for more severe spots.
NASOLABIAL FOLDS If you’re starting to notice lines around your mouth that start at the corner of your nose and extend downwards, those are nasolabial folds, which, if not addressed, may worsen with time. Hylauronic acid fillers like Restylane and Restylane Lyft (previously known as Perlane) are best for filling in these lines, especially among women in their late 20s and early 30s. The next best thing to injectables that doesn’t necessitate the use of a needle are topical products containing hyaluronic acid that temporarily add some volume.
One reason why our facial features lose shape and become less defined is because of fat changes. Fat is essential for fullness but over time it starts to descend in some areas and shift position. Adding your fat or synthetic dermal fillers into your face, restoring volume especially to the mid-face, is a big breakthrough in cosmetic medicine.
The “Liquid Facelift”Restores Lost Definition Surgery is often the go-to for turning back the hands of time, but in the right patient with the right anatomy and realistic expectations, fillers and injectables can work wonders. For those who have lost volume in the face but are not experiencing the looseness that often comes with it, a “Liquid Facelift” may be what you need. Using a variety of fillers and injectables with a mix-and-match approach, Dr. Tanne can re-volumize areas that have become sunken or hollow, namely the temples, cheeks, lips and the jowls. The idea is to restore fullness to the areas that have lost it, not create a tight unnatural look.
Fill Out Thin Lips With Injectables Aging lips means thinning of the lips, which is a common concern among many women. Lips tend to flatten out, lose their Cupid’s bow and become longer. When using filler in the lips, it’s about restoring a youthful, natural looking shape and, if necessary, adding size. Fillers such as Restylane are the best choice for this. For vertical lines in the upper lip, Belotero and Restylane Silk help plump out those lines without adding volume to the lips. To treat deeper wrinkles around the mouth, Dr. Tanne often recommends fractional resurfacing with either eMatrix Sublative treatments or CO2RE fractional CO2 laser treatment, which can act like an eraser.
Plump Up Saggy Cheeks With Fillers Sagging cheeks, which is caused by a loss of fat and changes to the underlying bone structure, can lead to deep lines around the mouth. When the cheeks start to fall, so does the rest of the face. Adding volume conservatively to the cheeks can produce a natural appearance to smooth out the area and add lost fullness. If you are trying to achieve a lift in the cheek, Radiesse injected high in the outer cheek often gives excellent results.
Treat Sun Damage with FotoFacial RF The natural aging process takes its toll on your skin over time. When combined with the effects of hormones, sun exposure and stress, it leaves you looking far from your best. FotoFacial RFsafely and comfortably treats age spots (also known as freckles, brown spots or sun spots) Rosacea, spider veins, sun damage, as well as uneven skin tone created by brown and red spots. With its bipolar radiofrequency, FotoFacial RF will simultaneously stimulate collagen production leading to softer wrinkles and tighter pores.
Refresh Your Skin With Fractional Laser Resurfacing As skin starts to lose its natural healthy glow and the signs of time become more evident, it can cause the face to appear aged and weathered. An effective way to reverse the look of dull, aged skin is with a fractional laser treatment. Whether we use CO2RE fractional CO2 laser (which usually requires only one treatment, but some downtime) or eMatrix Sublative Rejuvenation (which has no downtime but requires a series of about 3 treatments) both accomplish controlled fractional resurfacing, forcing the skin to heal and create new, healthy collagen and a smoother, more even surface.
Get Radiant Skin with CO2RE CO2 Fractional Resurfacing
Wouldn’t you love to see radiant skin when you look in the mirror? If so, CO2RE CO2 fractional resurfacing is a procedure that you may want to consider trying. This procedure involves using a state-of-the-art carbon dioxide laser treatment to remove layers of skin in order to reduce the appearance of things like fine lines, wrinkles, brown spots, hyperpigmentation and scarring. This laser creates small wounds inside the skin, which helps induce healing. CO2RE CO2 fractional resurfacing only targets specific areas of the skin, and the surrounding skin is not damaged.
At Cosmetic Laser MD in Livingston, NJ, we help restore a more youthful appearance and give you radiant, glowing skin with fractional resurfacing. This non-invasive treatment can help give you back your glow in as little as one treatment. Our medical team, led by Susan Stevens Tanne, MD, can help customize a treatment plan that is tailored to your needs. To schedule your consultation, contact Cosmetic Laser MD today.
How Many Treatments Are Needed? The number of treatments can vary depending on the patient. However, many patients are able to get amazing results with just one treatment. For some patients we recommend follow-up treatments in order to maintain their results. It is important to note that the results of CO2 fractional laser resurfacing are not permanent. Most people will need to get another treatment within a few years.
Is This Procedure Painful? Most people do not find this procedure to be uncomfortable. A topical anesthetic is applied before this procedure in order to minimize the discomfort. We can work with you to ensure maximum comfort is sustained throughout the procedure.
Is This Treatment Right For Me? The only way to determine whether CO2 fractional laser resurfacing is right for you is to schedule a consultation with Dr. Tanne. The best candidates are people who have realistic expectations and are healthy. However, this treatment is not right for pregnant women. It is also not right if you have a history of cold sores.
Side Effects and Recovery It takes several days for the skin to heal. For the first 3 – 5 days, you will need to wear an ointment on your skin which we will provide you with. During this time, you may experience some oozing, bleeding, crusting and dryness. Once your skin peels, you no longer need to use the thick ointment, however diligent use of mineral based sunscreen is essential. We recommend sunscreen from ELTA MD. Your skin will still be pink, however you may wear mineral based foundation at this point. We recommend Oxygenetix. Even though the skin will usually heal within two weeks, it is important to note that some redness may persist for two to three months after the procedure. You will notice a significant improvement in your skin after you have healed completely.
Aftercare To properly recover, it is vital that you to follow all of the instructions recommended by Dr. Tanne. We always recommend that you limit sun exposure in order to help your skin heal faster. You will also need to follow a strict skin care regimen. The net results will be RADIANT SKIN!
We have all seen women with those dreaded “smoker’s lines” around the mouth – those tell-tale signs of aging that are impossible to hide with any type of makeup – THE BARCODE! So what are they, and how can we make them disappear?
Well, smoking and sun damage are the top two reasons for these dreaded lines, but aging causes thinning of the lips in most women, resulting in too much skin above those shrunken lips with no place to go except to causes pleats and folds.
While mineral based sunscreen is the best anti-aging product to prevent damage in the first place, once these lines have etched themselves in, it is time for more aggressive measures.
CO2RE fractional laser skin resurfacing or a series of eMatrix Sublative resurfacing treatments will turn back the clock and erase the deep and shallow lines.
For the still present volume loss due to shrinkage of the underlying fat, injectable fillers restore a youthful fullness to this area.
The third component is to soften the puckering movement that continues to create lines with a small amount of Xeomin or Dysport.
The end result is a smooth, youthful mouth with no sign of that dreaded BARCODE!
If you have deep lines on and around the eyes, fairly good skin elasticity, are over the age of 40,laser resurfacing is the best option to reduce the appearance of fine lines and wrinkles around the upper eyelids.
What it can’t do: Get rid of loose skin, or lift like surgery would.
What it can do: Stimulate collagen production to give a tightening effect; improve tone & texture
CO2fractional lasers, such as our CO2RE laser,work to stimulate collagen from within to decrease fine lines and also address crepey (not excess) skin around the eyes. Unlike injectables, which can’t be used on the eyelid but just on the outer corners of the eyes, fractional CO2 lasers—they combine the resurfacing power of more traditional CO2lasers with the healing and anti-demarcation benefits of a fractional laser—can be used on both areas to rejuvenate skin that’s laden with both lines and wrinkles.
When used properly and on the right patient, lasers can smooth out some of the lines around the eyes, but not correct significant laxity, hollows or bulging fat pads.
Fractional CO2lasers will also help even out any discoloration around the eyes, like age spots, which may accompany the type of skin that is suitable for this treatment. Lasers work best on surface irregularities from sun damage.
This article is based on a recent one in US News and World Report.
Battling the clock No one likes looking older…which is why we spend billions of dollars every year on over-the-counter products, prescription creams and fillers, and, most drastically, cosmetic surgery. Do any of these actually work to reduce the signs of aging? In many cases, yes – at least temporarily. But given the not-inconsiderable costs, it’s important to be smart in your choices.
Aesthetic physicians can prescribe skin creams and perform laser skin-resurfacing and chemical peels, and they can administer injections. Surgical procedures, meantime, can be performed by cosmetic and plastic surgeons. When you pick a doctor, ask how often and how frequently he or she performs the procedure that you’re having (weekly is better than monthly.
Here is a quick guide to some of the most popular treatments and procedures.
1.Retinoid creams A host of over-the-counter products claim to help fight wrinkles. One option: topical retinoid (derived from vitamin A) creams; look for retinol in the ingredient list. They are proven to get rid of wrinkles that you already have. We love our Night Defense Cream, which comes in 3 strengths, suitable for all skin types. A stronger prescription strength version is Retin-A.
2. Over-the-counter peptide creams Creams containing peptides—short snippets of linked amino acids—can be useful for reducing the appearance of wrinkles and fine lines, but they haven’t been shown to work as well as retinoids. As skin ages, it loses collagen and becomes wrinkled and thin; creams containing peptides are supposed to encourage the skin to make new collagen. Our favorite peptide boost is Daily Cocktail, which gives a one-two punch!
3. Microdermabrasion Microdermabrasion uses a very hard diamond-tipped wand to slough off cells from the top layer of the skin and encourage new skin growth. The procedure is usually quite comfortable, doesn’t require an anesthetic or recovery period, and the skin heals quickly. But you may require multiple procedures spaced a few weeks apart. A recent study found that a rougher buffing of the skin is better than a lighter touch. You will be left with ultra-smooth, polished and glowing skin.
4. Laser Skin Resurfacing Laser resurfacing uses high-intensity light to zap and improve the look of wrinkles and scars, and to tighten loose skin. The effect of your treatment and recovery time vary. We use either the eMatrix system which uses fractionated Radio Frequency, and requires little to no downtime and 3 – 4 treatments, and also the CO2RE fractional CO2 laser, which requires 3 – 5 days of downtime, but only one treatment.
These treatments can be tailored to specific needs and can be superficial or intermediate and deep. Depending on which treatment and how aggressive, you may see redness from one day to two weeks. The benefits of laser resurfacing usually last between two and five years, however, if you smoke or don’t use sunscreen, it’s likely to be on the shorter end of that spectrum.
5. Chemical Peels Used to address mild acne scars, age spots, dull skin texture, skin discoloration, or wrinkles around the eyes or mouth, chemical peels remove the outer layers of the skin and encourage the growth of new, smoother, more evenly colored skin. Depending on the peel’s intensity—which can range from superficial to medium to deep—it may cause reddening and peeling that can last up to several weeks. Our favorite peel, the Apeele, is a blended mix of several ingredients that safely and effectively addresses many skin concerns. This peel comes in 3 strengths, depending on the specific needs and concerns of each patient. The benefits of superficial and medium depth peels last up to a few months.
6. Botox or Dysport Injections of the now familiar Botox or of Dysport (our favorite) can relax tiny facial muscles, smoothing out the appearance of lines or wrinkles. The cost of Dysport or Botox will vary depending on how many units are needed. The effects of injections may last three to four months, depending on whether you’re a repeat customer. The more injections you’ve previously had, the longer the results last.
7. Filler Injections Injections of fillers containing hyaluronic acid (Restylane, Perlane, Belotero and Juvederm) and the longer lasting Radiesse, can fill in lines and wrinkles and add volume to skin. Hyaluronic acid is a naturally occurring sugar which is significantly reduced as we age. Radiesse, a longer lasting filler, acts by stimulating your own collagen formation around tiny synthetic microspheres. Injecting these fillers into wrinkles and hollows plumps them up and restores lost volume. The effects generally last between six months (hyaluronic acid fillers) and one year (Radiesse).
8. CosmeticSurgery Lifting the skin on the face, neck, eyelids, and forehead can give a tighter appearance. The effects of cosmetic surgery are somewhat permanent. With this type of surgery you are turning the clock back, but we’re not stopping the clock.
9. Try Prevention If all this sounds extreme (and expensive), remember that you can start immediately to prevent any further damage: Start wearing sunscreen every day. Lifetime exposure to the sun can wreak serious havoc. When many of our patients were younger, they didn’t think that the sun caused any harm. Now, 30 years later, they are really seeing the effects of all that exposure. We advise our patients that without diligent use of mineral based sunscreen daily, our treatments will not be an effective solution for the long term.
4 Types of Skin Discoloration and How to Stop Them
As aggravating as hyperpigmentation can be, understanding why it’s happening and how you can stop it (yes, it can be done) is rule number-one on the path to clear, even skin.
What is Hyperpigmentation? Brown, red or pink, small or large, clustered or diffuse, hyperpigmentation is a darkening of the skin due to higher than normal levels of melanin. Any part of the skin that is darker than the rest is hyperpigmented, no matter where it occurs. The most important thing to do is wear sunscreen – even if you don’t see discoloration on your skin, you should protect it from the sun to lessen your chances in the future.
Two Types of Melanin Melanocyte cells make pigment by creating one of two types of melanin: eumelanin or pheomelanin. Both are found in the skin and each creates different shades of pigment. Eumelanin is brown to black in color and is more common in those with tan or darker skin. It also absorbs UV rays, acting as a skin protector. Pheomelanin is yellow to red in color and is found in concentrated amounts in the lips and in people with lighter skin tones. Pheomelanin cannot absorb UV rays and makes the skin more sensitive to UV rays.
Types of Discoloration and How to Treat Them Melasma Light to medium brown in color, this pigmentation occurs on the cheeks, sides of the face, upper part of the nose, forehead and above the lip. It appears as splotchy patches that are inconcsistent in shape and size, and is caused by a surge in hormones, usually from pregnancy or birth control coupled with sun exposure. Melasma can be treated with: hydroquinone and Retinol; salicylic,lactic or glycolic acid peels; Intense Pulsed Light (IPL)/FotoFacial plus vitamin C; or chemical peels containing hydroquinone. (Melasma is hard to treat because of its potential to reoccur.)
Sunspots (AKA Age or Liver Spots) Light to dark brown in color, sunspots can appear on the face, chest and hands; and look like small, flat, dark spots. As their name indicates, they are caused by the sun and can be treated with Retinol plus IPL/FotoFacial or CO2RE fractional laser resurfacing.
Post-Inflammatory Hyperpigmentation (PIH) Pink, red or brown in color, PIH can show up anywhere on the face. It appears as flat spots and is caused caused by inflammatory acne. PIH can be treated with light salicylic acid chemical peels or red light and blue light treatments(if there is active acne).
Freckles Caused by the sun, freckles are light to dark brown or even red or black in color. They occur on the face, chest and arms in the form of small, concentrated spots. For treatment try IPL/Fotofacial or CO2RE fractional laser resurfacing.
Crow’s feet are those tiny lines that usually extend out from the sides of the eyes, up toward the temples and/or down toward the top of the cheek. Sun exposure is enemy number-one in the formation of crow’s-feet, but smoke, pollution, squinting and smiling all cause the structure deep within the skin to breakdown. Less collagen means less support, making the skin more susceptible to fine lines.
Your at-home plan of attack should consist of a mild exfoliator to help turnover skin, a daily mineral based sunscreen to prevent collagen and elastin breakdown and intensive hydrators that contain hyaluronic acid, to soften dry skin and fill-in and smooth out wrinkles. In addition to these topical problem-solving ingredients, a large pair of sunglasses will also help preventing against squinting and blocking
Dysport, Xeomin or Botoxcan treat crow’s-feet, and can even be used to prevent them from forming. They are considered to be the gold standard for preserving youthful-looking eyes because they halt movement of the muscles that lead to these lines and wrinkles. Keep in mind that these injectable neuromodulators only temporarily smooth out wrinkles—they don’t address discoloration, sun damage or incite collagen production.
To reduce lines, another options is to resurface the skin with lasers. Ablative fractional and CO2 lasers such as CO2RE, and eMatrix are commonly used to address textural changes around the eye. These modalities ablate the top layer of damaged skin, prompting the body to make new, better collagen—the new skin grows in plumper and less laden with lines. These types of treatments also help to give the area a tightening effect.
When you want to look and feel younger, your face is the front and center battleground of that fight. And while there are a few ways to surgically make the face look years younger (facelift, neck lift, even a nose job), many women might not be ready for the commitment or cost of a surgical procedure. If not, there are “best practices” for rejuvenating the face without reaching for the scalpel. Here are some of the best treatments to get a younger face without surgery.
SKINCARE – First and foremost, start with a good skin-care routine. Routine skin care by trained, experienced estheticians is invaluable in producing, improving and monitoring the skin. Let’s face it – beautiful skin always creates a more youthful look. A comprehensive skin-care program that may include professional products and treatments (like microdermabrasion and facial peels) can minimize sun damage, soften fine lines, reduce acne, rehydrate dry skin and brighten dull, aging skin.
INJECTABLES – If you want to take it one step further, a cosmetic physician has more options available to make the face look younger. Before finding the best method for facial rejuvenation, your doctor has to take into account your age. When you are younger, we’re getting rid of wrinkles with products like Dysport, Botox and hyaluronic acid fillers such as Restylane, Juvéderm and Belotero. For restoring more volume in an aging face my choice filler is Radiesse.
LASERS – Noninvasive radio-frequency treatments, on the right patient, can work wonders. I am a big fan of eMatrix Sublative Rejuvenation and Sublime Skin Tightening (the eTwo duo). I also love to treat with FotoFacial RF for color correction and eMatrix for texture improvement with my FotoMatrix combo. For a more significant result CO2RE Fractional CO2 Resurfacing is my go-to treatment. It is an ablative laser, but it’s not as invasive as making incisions. It is a very effective tool in treating fine lines, irregularities and brown spots. With one treatment, a major improvement can be obtained.
While sun damage doesn’t happen overnight, it can seem like it visibly affects the skin in a rather short period of time. The more the skin is exposed to the sun, the more the collagen and elastin in the deeper layers is broken down, giving less support to the underlying muscles and the skin’s surface. As a response mechanism, the skin tries to protect itself from the damage, in turn thickening as a means of regeneration.
Treat sun-damaged skin at home:
Peptides and vitamin A need to be used consistently to help strengthen the skin and improve its texture. Retinol is key since it sheds the top layer of skin and strengthens it from inside out. Dr. Tanne’s favorite daytime skincare – Daily Cocktail – is bursting with peptides, antioxidants and other key repair ingredients. Her Tanne MD Medical Skin CareNight Defense is her go-to nighttime anti-aging must-have – a retinol serum blended with hydrating hyaluronic acid.
Free radical-fighting ingredients like green tea and vitamins C and E will help safeguard the skin from future damage. Check out Tanne MD Medical Skin CareT-Power Pads and CE Ferulic Infusion.
Protection and maintenance are vital-once sun-damaged skin has been transformed, you don’t want it to regress. It is recommended to wear a sunscreen with ingredients that contain primarily physical blockers, which provide protection from all UV rays. Check out our absolute favorite, TIZO(titanium/zinc oxide).
Treat sun-damaged skin professionally:
Before starting any in-office treatment for sun damage, Dr. Tanne recommends all patients begin a 3 product at home regimen to pre-treat their skin, including:
Night Defense – to help shed these unwanted pigment cells
TIZO – to protect your beautiful rejuvenated skin
Laser and light-based treatments, like FotoFacial RF (which combines Intense Pulsed Light with bi-polar Radiofrequency) and both ablative and nonablative resurfacing procedures, work to reinstate the skin. FotoFacial can help eliminate brown and red spots on the face and body. A downtime-free treatment, although several sessions are required, FotoFacial helps to rejuvenate the skin so that it looks younger and fresher.
Treatments that tackle sun-damaged skin, including chemical peels – our hands down favorite is Apeele – can improve the skin, too. Acid-based peels buffer the skin, making it more sensitive to the sun. We also love DiamondTip™ Microdermabrasionto gently buff away the top layer of dead skin cells, leaving you polished and glowing.
Our new fractional CO2 resurfacing laser, CO2RE, reverses years of sun damage. Unlike older versions of the laser, which used a solid beam, this revolutionary device uses a fractionated beam so there are zones of normal skin, allowing for a shorter recovery period – less than one week, as opposed to two or three. It’s excellent for restoring skin to its natural state without all of the sun damage. CO2RE gets rid of discoloration while improving the skin’s texture. Instead of employing light, fractional resurfacing lasers create microscopic wounds in the skin-as the skin heals, the sun-damaged areas flake off, and collagen is increased – all in ONE treatment!
Call us at 973.716.9000 to schedule a complimentary consultation or click the button below. We will discuss your concerns and establish a treatment plan to achieve your aesthetic goals.