By SUZANNE BRUCE, M.D. from the Fall 2013 issue
Recent research into how the face ages has helped cosmetic dermatologists improve their techniques in using BOTOX® Cosmetic, fillers, lasers and other energy devices to treat facial aging and restore a younger look. Today we now use treatments that are less invasive than the knife to improve our appearance as we age. Some prefer these nonsurgical options because they don’t have time for the downtime, they want a more natural look and/or they are concerned about the potential side effects of general anesthesia.
One analogy that illustrates how the face ages is to describe the skin as the tablecloth and the underlying support structures, such as fat, muscle, and bone, as the table. Aging and sun exposure causes the tablecloth to get thinner and more lax due to a loss of collagen. Aging also causes the table underneath to recede. We lose fat, muscle and bone as the years go by. As a result, the face loses volume and sagging skin develops around the eyes and jawline. Sunken areas begin to appear in the temples, under the eyes and on the cheeks. So in essence, the table cloth loses its smooth, fresh appearance.
In order to tighten the lax, sagging skin we have a number of skin tightening procedures such as Ultherapy®, Thermage®, and Exilis®. They work by heating the skin to the temperature that causes the collagen in the skin to contract and that triggers the production of new collagen helping plump up and further tighten the skin.
Along with tightening, fillers are used to build up the underlying facial structure that has diminished with aging. Fillers, like JUVÉDERM®, Radiesse®, Sculptra® and the new JUVÉDERM Voluma™ XC (see related article) help replace the missing volume. Ultimately, we are trying to recreate the better fit between tablecloth and table that we had when we were younger and restore that smooth look.
To carry our analogy one step further, over time our tablecloth can get a little dingy. Brown sun spots and red blood vessels due primarily to sun exposure can mar our skin as we age. Procedures like intense pulsed light (FotoFacial) and fractionated resurfacing can remove the brown spots and shrink blood vessels rejuvenating the skin and giving you a fresher look. Once we get the fabric of your skin back to an even color, we can recommend a protective sunscreen and a customized skin care regimen with active ingredients like antioxidants, growth factors, peptides and retinoids to maintain your results.
No treatment or regimen can stop the clock. So to keep up with the aging process, we recommend periodic tightening, FotoFacial and laser procedures and filler treatments. Many of our patients choose these less invasive therapies as a good way to restore natural beauty and avoid more drastic surgical solutions. If you would like an anti-aging consultation with one of our dermatologists, please call us at (713) 850-0240.