Just because you have lines and wrinkles (and are bothered by them), doesn’t mean you have to live with them. Here are 3 treatments that help reduce their appearance:
Fillers The depth and severity of your lines and wrinkles will dictate what type of filler Dr. Tanne will use. When there is a loss of volume from shrinking of the bone or fat pads, the skin loses its scaffolding and signs of aging such as sagging skin and wrinkles are created. By using volumizing fillers, Dr. Tanne can help slow down the aging process and maintain a natural, youthful appearance for you. Hyaluronic acid fillers, such as Restylane, Perlane, Restylane Lyft and Belotero stimulate collagen and add volume to plump wrinkles.Collagen stiimulating fillers, such as Radiesse, work on thick folds and wrinkles and stimulate collagen to fill from the inside out. Volumizing fillers are the key ingredient in maintaining a youthful appearance.
Fractional Lasers Fractional resurfacing lasers, such as our CO2RE fractional CO2 laser, can be used on wrinkled skin that’s the result of sun damage. These lasers work to help lessen the appearance of wrinkles and lines by plumping skin, increasing collagen production and removing the rough, aged outer layer to create a more youthful appearance.
Neuromodulators Injectable toxins (also referred to as “neuromodulators”), like Botox, Dysport, and Xeomin work to smooth out the skin’s surface by temporarily stopping the contraction of the muscles that are responsible for creating wrinkles. Neuromodulators reduce the muscle movement that creates the fold and, over time, often reverse the lines that may already be present in the skin. We recommend Botox or Dysport, Xeomin or Botox when patients start to see a trace of a wrinkle when the face is at rest. This helps prevent etched lines that are more difficult to treat.
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!
Now that 2015 is finally here, it’s time to put your best foot forward and kick it into high gear so that you look your absolute best.
GET ENOUGH SLEEP Sleep does a body good. Not only will you feel better, a good night’s rest will leave you with less darkness and puffiness under your eyes and more evenly toned skin that looks fresh come morning. A good night’s sleep can also prevent unnecessary eating. Try to establish a set bedtime every night and never fall asleep with the television on.
EXFOLIATE ON A REGULAR BASIS Dead skin does nothing for your complexion. In fact, it makes your skin look lackluster and dull and can even make your makeup look muddy. The easiest way to get rid of pore-clogging dead skin is by exfoliating regularly with an exfoliator that’s compatible with your skin type. Treat your skin to the professional version, such as a microdermabrasion or light chemical peel, every four to six weeks.
HYDRATE INSIDE AND OUT When your body is void of water, your skin lacks the moisture it needs to look plump and healthy. Hydration is one of the easiest ways to look instantly younger and better—and it’s simple to do. To properly hydrate your body, make sure you drink at least eight glasses of water per day. To keep your skin looking healthy and full, apply moisturizer both day and night.
TAKE A TRIP TO THE DOCTOR For stubborn lines and wrinkles that require a little extra help, nothing does the job quite like injectables. Botox, Dysport and Xeomin work wonders on getting rid of hard-to-erase lines and wrinkles caused by smiling, laughing and squinting (think those that live around your eyes, between your brows and on your forehead), whereas hyaluronic acid fillers like Restylane, Perlane and Belotero can fill in hollows, wrinkles and folds for a more rejuvenated look. Collagen stimulating fillers such as Radiesse are excellent for restoring volume to the cheeks and also last longer than the hyaluronic acid fillers (about one year). Platelet rich plasma (PRP) such as Selphyl, uses your own platelets to “fertilize” the skin with your own growth factors. This “all-natural” treatment restores elasticity and makes you glow! For a long lasting result, fat transfer is an excellent, all natural way to restore youthful volume.
Post from Skin Procedure News- American Society for Aesthetic Plastic Surgery
The genes you inherit from your mother have an impact on your skin quality.
Have you ever wondered why some people get wrinkles at a young age and others don’t? There are many answers to this question – smoking can cause wrinkles to form sooner, and if you don’t wear sunscreen when you’re young, you can expect signs of aging to surface earlier rather than later. But a new study finds another potential cause of early facial lines – the genes we get from our mothers.
What your mama gave you For some time now, it’s been known that the mitochondria, often referred to as the “powerhouses” of the cells that make up our bodies, have a lot to do with aging. As these mitochondria sustain damage, they mutate and lose their ability to produce energy, resulting in the breakdown of the cells that leads to signs of aging.
The new study, published in the journal Nature, finds that the mitochondrial DNA passed down to us from our mothers also influences our own rate of aging. In other words, if your mother had wrinkles at a young age, you might be more likely to see fine lines on your own face in your early years. On the flip side, if your mother had smooth, blemish-free skin well into her 40s or 50s, you could be in for the same luck.
Looking to the future This study focused solely on cell aging and genetics, but researchers hope that it may help future development of therapeutic interventions that could focus on mitochondrial function, thus slowing the aging process. Unfortunately, such developments probably won’t be available for some time until more research can be conducted.
However, there are certain cosmetic procedures available today that can help people who show signs of premature aging. No matter whether you want long-term results that target deep facial lines or something less invasive that treats fine lines, you can likely benefit from a visit to a cosmetic physicians office.
For example, Botox (Dysport/Xeomin) injections, which have become immensely popular over the past few years, offer results that last for several months. This means you won’t have to make a big commitment like you would if you chose to undergo facelift surgery, but on the downside, you’ll need to continue to get injections of the substance to keep wrinkles at bay.
Sunday Review MARCH 21, 2014 Gray Matter By RICHARD A. FRIEDMAN
FEELING down? Smile. Cheer up. Put on a happy face. No doubt you’ve dismissed these bromides from friends and loved ones because everyone knows that you can’t feel better just by aping a happy look.
Or perhaps you can. New research suggests that it is possible to treat depression by paralyzing key facial muscles with Botox, which prevents patients from frowning and having unhappy-looking faces.
In a study forthcoming in the Journal of Psychiatric Research, Eric Finzi, a cosmetic dermatologist, and Norman Rosenthal, a professor of psychiatry at Georgetown Medical School, randomly assigned a group of 74 patients with majordepression to receive either Botox or saline injections in the forehead muscles whose contraction makes it possible to frown. Six weeks after the injection, 52 percent of the subjects who got Botox showed relief from depression, compared with only 15 percent of those who received the saline placebo.
(You might think that patients would easily be able to tell whether they got the placebo or Botox. Actually, it wasn’t so obvious: Only about half of the subjects getting Botox guessed correctly. More important, knowing which treatment was received had no significant effect on treatment response.)
Other studies over the past several years have found similar effects of Botox on mood. Michael Lewis at Cardiff University reported that nondepressed patients at a cosmetic dermatology clinic receiving Botox injection above the eyes frowned less and felt better than those who did not receive this injection. And M. Axel Wollmer at the University of Basel found that Botox injection was superior to a placebo in a group of depressed patients.
Is paralyzing the muscles involved in frowning truly enough to make depressed patients feel better? The notion that your expression can exert a powerful influence on your mood turns our sense of psychological causality on its head. After all, we smile because we feel happy, and cry because we feel sad, not the other way around, right?
Not necessarily. The idea that facial expressions may feed information back to our brain and influence our feelings goes back to a theory of emotion first proposed by Charles Darwin. In “The Expression of the Emotions in Man and Animals,” Darwin posited that the control of facial expression causes a like effect on subjective emotions. William James took the idea further and proposed that emotions were the result, not the cause, of various bodily sensations, suggesting that “we feel sorry because we cry, angry because we strike, afraid because we tremble, and not that we cry, strike, or tremble, because we are sorry, angry, or fearful, as the case may be.”
We are used to thinking of the brain, not the body, as the prime mover of our emotional states. Consider the field of so-called psychosomatic medicine, which emphasizes a mischievous flow of information from brain to body: hence, the psychosomatic stomachache, headache and the like. You can literally worry yourself sick.
The Botox studies, by contrast, suggest a circuit between the brain and the muscles of facial expression in which the brain monitors the emotional valence of the face and responds by generating the appropriate feeling. (Obviously, information flows in both directions, as you can think yourself into practically any emotional state and then have the face to match it.)
There are other treatments for depression that appear to use facial feedback in a similar way. Light therapy stimulates the retina and excites the optic nerve, which sends signals directly to the brain and effectively treats seasonal depression. And direct electrical stimulation of the brain’s vagal nerve has antidepressant effects.
Botox for depression is part of a long tradition of “outside-in” somatic therapies — many of dubious efficacy — that manipulate the body with the aim of altering the brain and mind, for instance by using cold wet sheet packs to treat severe agitation or acupuncture for anxiety.
In a broad sense, these Botox studies underscore one of the biggest challenges in treating people with depression. They might think that the reason they are depressed is that they have little interest in the world or their friends — a mistaken notion that is the result, not the cause, of their depression. They insist that only once they feel better will it make sense for them to rejoin the world, socialize and start smiling. Their therapists would be well advised to challenge their inverted sense of causality and insist that they will start feeling better after they re-engage with the world.
Whether Botox will prove to be an effective and useful antidepressant is as yet unclear. If it does prove effective, however, it will raise the intriguing epidemiological question of whether in administering Botox to vast numbers of people for cosmetic reasons, we might have serendipitously treated or prevented depression in a large number of them.
Richard A. Friedman is a professor of clinical psychiatry at Weill Cornell Medical College.
Certain areas of the face are prone to fat loss—others are not. The cheeks and eyes frequently fall victim to the effects of volume loss first; the lips, eyes and temples eventually catch up.
Around the Upper + Lower Eye Sockets The majority of fat in the face is in the cheeks, and as these pockets deflate, a depression forms from the inner corner of the eyes straight downward (called a tear trough or hollow). The appearance of hollows is related to loss of fat and bone expansion. Since the same amount of tissue is occupying a larger volume, the result is that the eyes look hollow. Sometimes, the fat protrudes, creating a bag. Adding a hyaluronic acid filler or fat restores volume, making the eyes the focus of the face.
Around the Brows A loss of fat and fullness in the brows coupled with lines and wrinkles between the brows and on the forehead can create a saggy brow and hooding on the upper lids. Fillers and fat are the most common ways to fix the problem. Just a little bit of volume (using a filler like Restylane) helps, and it is even more dramatic when combined with a neuromodulator (Dysport, Botox or Xeomin) for an overall rejuvenating effect. The combination of fillers (injectables or fat micro-grafts) plus a neuromodulator produces a better result than either one alone.
At the Temples You wouldn’t think of the temples as an area of concern but they are. As fat diminishes from the temples, they become sunken and appear narrow. Hollow temples can call unwanted attention to the cheeks. Filler such as Restylane, Perlane and Radiesse, used to gently, soften the area for a more youthful look. Fat micrografts are a good alternative and give a more permanent result.
In the Cheeks The cheek area is one of the first parts of the face where a loss of volume is noticeable. As the fat in the cheeks begins to descend, it creates nasolabial folds (smile lines) around the mouth and a flattened look in the cheeks, making you look “tired”. To correct the folds and the cheeks, the natural volume needs to be restored, using either injectable fillers or fat micro-grafts, for a refreshed, natural look.
In the Lips The lips are made of collagen, oil and tissue—not fat—but they too experience the effects of volume loss as they start to thin out. While fillers or fat can help to reinstate plumpness in the lips, the surrounding lines need to be softened with either laser resurfacing or a combination of Botox, Dysport or Xeomin and fillers (I prefer Restylane and Belotero).
At The Corners of the NoseDown Toward the Mouth As the fat in the cheeks begins to fall, there is less support for the skin around the mouth, causing folds to develop in the area where the end of the nose and the lips meet.
On the Jawline The jaw area loses definition with time and the natural contours become boxy and saggy. Volume loss in the jaw area usually comes along with a lack of structure in the cheeks. Injections of hyaluronic acids, Radiesse or fat can all help reshape and revolumize the area.
The Skin Smoother Crystal free DiamondTip™ Microdermabrasion removes the topmost layer of skin, delivering optimum exfoliation for softer, smoother, supple and vibrant skin. This is accomplished by gently abrading the skin with a variety of stainless steel tips imbedded with laser cut diamond chips, while using suction to remove the dead skin cells and stimulate collagen production.
Similar to microdermabrasion, the SilkPeel™ Dermalinfusion™ System combines non–invasive exfoliation with deep delivery of patient–specific solutions directly to the skin without the use of crystal or other chemical exfoliants. These serums are infused deep into the skin where they are most effective, deeply delivering the vitamins, antioxidants, and other therapeutic ingredients that your skin needs most.
As early as your mid- to late-20’s and into your 30’s, 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, I like to inject this area with Dysport, Xeomin or Botox.
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, Juvéderm or Belotero, can fill in hollows to give the illusion of fewer bags. You will also want to use a topical Retinol product 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,FotoFacial RF (Intense Pulsed Light-IPL) or fractional CO2 lasers can also help tighten the under-eye area.
Hyperpigmentation Discolored skin can result from a variety of factors. Protecting your skin from the sun 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, or a fractional laser 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 Perlane, or Radiesse, are best for filling in these lines, especially among women in their late 20s and early 30s. In reality, these lines are due to loss some loss or shrinking of the cheek fat, which makes the skin sag, creating the fold from your nose downward. A bit of filler just below the cheekbone starts lifting the fold, then some filler in the fold completes the rejuvenation.
Sunscreen Although all of the above tips will correct what time has achieved, the single most important way to prevent the signs of aging is with the diligent daily use of mineral based sunscreen! This should be a dedicated layer which is not part of you moisturizer or makeup. We prefer products with a high percentage of zinc oxide. Wear this as your last layer, over any other skin care, but under makeup. Using a mineral based sunscreen every day, rain or shine, will give you the maximum benefits from these fantastic anti-aging treatments.
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.
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.
Think fillers and injectables serve the purpose of just erasing lines and filling wrinkles? Guess again. While these “liquid miracles” may have originally made their mark as wrinkle eliminators, they are now just as well-known for their sheer ability to lift and contour ill-defined and aging features.
When injectables and fillers were first introduced, they pretty much served one purpose: to fill wrinkles. Over time, and with safe off-label experimentation, their use has became more widespread as the effects of volume loss is a constant complaint. In different compartments of our face there is a shifting of the fat pads and re-absorption. Reconstructing the face with filler allows the architecture of the framework of the face to be lifted and restores the youthful contours. With only a handful of product options available, the main difference between filling and lifting comes down to where the filler is placed and how deep.
1. Straight Lifting With Some Volume Perlane: Fills in deeper, thicker lines and folds. Because of its denser nature and thickness, it provides good lift to areas of the face like the cheeks and lower part of the face. Radiesse: Lasts about 1 year. Immediately smoothes out folds around the mouth, lifts the cheeks and the area between the cheeks and the eyes and the jowls. In terms of the longer-lasting fillers, this is said to give more lift.
2. More Volume, Some Lifting Restylane, Juvéderm and Belotero: Lift and contour but on a more superficial level for those that don’t need as much structural improvement for areas like under the eyes, marionette lines and for lip augmentation.