Hair Loss Archives | The Aesthetic Clinique

The 5 Most Popular Instagram Cosmetic Procedures That Don’t Work

Instagram is being used as a marketing tool for all types of industries. Unfortunately, you can’t believe everything you see touted. This is especially true for aesthetic procedures. As with any, make sure you do your research, the before and after pictures are actually comparable and aren’t using lighting “tricks”, and the provider is experienced and reputable.

Lip flip with Botox – This procedure claims that the lip will turn up and make the lip fuller for very little money. If you weaken the muscles around the lips with Botox, there is no way this can end up lifting the lip. It also risks changing the smile, having difficulty with sipping and whistling.
Thread Lifts – The procedure consists of placing barbed sutures just deep to the dermis. The barbs engage into the skin and by pulling laterally and upward, they are supposed to lift and tighten. The posts on Instagram mainly show providers pulling on the sutures and watching the skin move. The problem is the sutures aren’t anchored in most cases and are attached to mobile skin. It’s impossible to lift when the entire are desiring lift is move. In addition, the barbs pull through their attachments very quickly, much sooner than collagen can be created to help anchor the suture. The side effects – visible threads, redness, puckering, pain – are as high as 34% in one study. In the same study, visible improvements were not apparent at 12 months. The noticeable changes in the author’s opinion are extremely mild and can be achieved with fillers in a more predictable and longer lasting correction.
Low Density PRP – PRP is short for platelet rich plasma. Unfortunately, there is no standard and the concentration for PRP is all over the map. In the majority of cases, 10-12cc of blood is being drawn to get 5-6cc of PRP. In these cases, the concentration is only about 2x (2 times the normal blood concentration) and all that has been done is the red blood cells have been removed by centrifugation. The benefits of PRP have been studied and optimal concentration levels to promote angiogenesis (new blood vessel growth) have been shown to be about 6X. If you are getting only a small test tube of blood drawn, you probably aren’t getting much benefit from the PRP.
MicroBotox for Necklace (“Tech Neck”) Lines: Horizontal neck lines are often called “Tech Neck” because some people believe they are caused by look down at your phone or computer. Providers are reporting improvements with injecting Botox in the lines in very small but multiple injections. In the author’s opinion, this is not the correct solution and these require filler +/- RFM (Genius) for optimal results. Static lines are not responsive to Botox. Dynamic wrinkles are what respond to Botox.
Using Radiofrequency That Doesn’t Penetrate Skin for Tightening: When an RF device is used to stimulate skin tightening, it must achieve 65-70 C to achieve coagulation. Anything short of coagulation causes temporary collagen contraction and denaturing but very minimal long-term effects. The epidermis needs to be kept at 42C or lower to avoid burns or hyperpigmentation. It is impossible to achieve coagulation in the dermis and still keep the skin surface at 42C or lower. So all the no downtime skin surface RF devices will need to be performed multiple times, have extremely variable results, and often very poor tightening effects. Optimal RF results require the energy to be introduced beneath the skin surface such as RF microneedling (Infini, Genius) or FaceTite/Accutite.

Remember, it all boils down to science whether a procedure works. If the science doesn’t make sense, the procedure probably doesn’t work.

Deceptive Practices Used in Before and After Photos

“A picture is worth a thousand words”. It’s true, seeing a great before and after speaks volumes for a certain physician’s or practitioner’s abilities. Unfortunately, there are some deceptive practices that can trick the eyes into believing results are better than they are really are. Instagram is a showcase for the aesthetic industry, but there is no oversight as to the claims made on the photos displayed. The bullet points below will help one to develop a critical eye to discern the truth from the “fictional results”.

Lightening must be the same in both pictures. A common misleading practice is to have a dark before picture and a light after picture. In the lighter picture, wrinkles and shadows are going to be less, and fool the observing into thinking these were related to the procedure.
Angle of the neck/head must be the same in both pictures. Take a look at the nose and jaw to see if the head is in the exact same position. If the head is tilted more upward in the after picture, the neck will appear to have less fullness, less wrinkles, and be firmer. This is particularly popular in the Kybella before and after photos.
The expression must be the same in both pictures. If a patients is partially smiling in the before and not in the after, the wrinkles around the mouth and cheek will appear falsely improved.
Sculptra pictures should have at least a 3-6 month interval. Sculptra is always mixed with water or saline for reconstitution. The immediate results after injection reflect merely the effects of the water/saline and not that of Sculptra. The collagen stimulation from Sculptra will take at least 3 months to appreciate, with 6-9 months being even a better gauge of results.
Using company photos or other physician’s photos without noting this or giving the appropriate credit on their websites or posts is also a common practice.
If make-up is used, it must be similar in both photos. Too often the before has none and the after has make-up.

Perfect before and after photos are very challenging. Even when results are extraordinaire, there are often difficulties trying to capture these changes with the camera. However, purposely trying to “enhance” photos with the practices above must be pointed out to the practitioners.

Hair and Eyebrow Restoration Completely NonSurgical using PRP and ACell

PRP was injected for hair regeneration, from Prime Journal article

PRP was injected for hair restoration, from Prime Journal article, one treatment

PRP was injected for alopecia areata. From Prime Journal, one treatment

[youtube=http://youtu.be/ni_DaXNPaqY]

PRP is “Platelet Rich Plasma”, a portion of whole blood that is separated from the red blood cells through centrifuging. It should contain concentrations of platelets that are at least 4 times that of what is found in whole blood to get the maximum benefits. Its use in medical conditions started in the 1990’s mainly by Orthopedic Surgeons, Dentists, and Oral Surgeons, but has recently been expanded to the Cosmetic Surgery arena.

(Please note: Not all PRP is the same! Most PRP systems don’t get the concentration of the platelets above the 4x level needed to get the full benefits from PRP. The system that has proven to have consistent 4-7x concentrations is the Magellan “TruPRP” system. It cost much more that the other systems, but the results will be superior to all other PRP systems available on the market. In a recent lecture that Dr. Weiner attended in Paris at IMCAS 2014, 13 different PRP machines were evaluated. Some systems didn’t even result in platelets that had higher concentrations than whole blood!)

When an injury occurs in the body, platelets are the “first responders”. Platelets have been found to contain the following growth factors and cytokines:

Platelet derived growth factors
Transforming growth factor beta
Fibroblast growth factor
Insulin-like growth factor 1
Insulin-like growth factor 2
Vascular endothelial growth factor
Epidermal growth factor
Interleukin 8
Keratinocyte growth factor
Connective tissue growth factor

PRP use in hair restoration began during hair transplantation 5-7 years ago. Surgeons found that bathing the harvested hair follicles led to improvements in the “take” of the transplanted follicle as well as more hair growth, and denser hair growth. Injecting PRP in the harvested area led to improved healing of the scar. It was then discovered that when PRP was then injected into areas of hair loss without transplanting hair, that there was new hair growth. Adding ACell (a derivative of porcine bladder) and Vitamin D3 and B complex gave even further improvements. In a study published in “Prime” Journal, patients were found to have improvements in their hair growth from 12-63%, and notably, there was improvements in all the patients studied. Growth seems to start at about 4 months, and starts to fade at about 11 months. Improvements are more dramatic in females than in males.

The mechanism proposed for the improvements seen is that the PRP leads to increased vascularization of the hair follicles, leading to a “waking up” of previously poorly perfused hair follicles. The growth factors also stimulate the hair follicles to produce hair.

Interesting findings have been thickening of hairs that have been growing but have miniturized (become thin). It will not cause hair to grow in areas of scarring or in areas where there was never hair. It’s also been found that new hair growth is sometimes pigmented in areas where hair had turned gray, representing a “youthful” follicle.

Recommendations are for at least one treatment yearly for females, and 2 for males. Topicals such as Rogaine or Propecia should be continued.

The process starts by drawing blood, 60-120cc. It is put in the Magellan processor to separate the PRP, which takes about 15 minutes per 60cc of blood. During this time, the scalp in numbed up with both topical creams as well as injections. When numb, the scalp in injected with the vitamin and mineral mixture as well as with the ACell solution. The PRP injection in then performed. The final process is using the Dermapen microneedling device to create very fine holes in the scalp. A by product of the Magellan PRP system is “PPP” which is platelet poor plasma. PPP has growth factors, but to a lesser degree than PRP. This solution is spread on top of the scalp and will be left there overnight. Washing the hair can be done the following morning. Sometimes extra PPP will be given to the patient to apply to the scalp at home. The total in office time is about an hour or an hour and 15 minutes. A second treatment (for men) is scheduled at 2-3 months.

Dr. Weiner is a Facial Plastic Surgeon who laid down his scalpel in 2005 and concentrates solely on noninvasive and minimally invasive Cosmetic Procedures. He is Johns Hopkins trained and Board Certified.

Website: http://www.theclinique.net

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Facebook: https://www.facebook.com/TheAestheticClinique

PRP and it’s Uses in Cosmetic Procedures: Facial Rejuvenation and Hair Growth Restoration

[youtube=http://youtu.be/a63rF6Gb8kY]

[youtube=http://youtu.be/ni_DaXNPaqY]

PRP is “Platelet Rich Plasma”, a portion of whole blood that is separated from the blood through centrifuging. It should contain concentrations of platelets that are at least 4 times that of what is found in ordinary blood to get the maximal benefits. Its use in medical conditions started in the 1990’s mainly by Orthopedic Surgeons and Oral Surgeons but has recently been expanded to the Cosmetic Surgery arena.

(Not all PRP is the same! Most PRP systems don’t get the concentration of the platelets above the 4x level needed to get the full benefits from PRP. The system that has proven to have consistent 4-7x concentration is the Magellan “TruPRP” system. It costs the most but the results will be superior to all other PRP systems available on the market. In a recent lecture Dr. Weiner attending in Paris at IMCAS, 13 different PRP machines were evaluated. Some systems didn’t even result in platelets which were higher concentrations than whole blood!)

When an injury occurs, platelets are the “first responders”. Platelets have been found to contain the following growth factors and cytokines:

The end result of the combination of these growth factors is increasing the vascularity to the injured area, decreasing the inflamation, laying down new collagen, healing the injured tissue and generation of new tissue.

Studies have shown the benefits of these growth factors in multiple different areas of medicine:

Improved healing in orthopedic injuries
Faster and better integration of bone grafts
Improvements in healing of chronic wounds such as diabetic foot ulcers
Improved outcomes with hair transplants

About 3 years ago, Dr. Charles Runels, devised a new PRP procedure which he called, “The Vampire Facelift”, for facial rejuvenation. The procedure involves injecting dermal fillers, Juvederm, and combining it with injections PRP into the face. The theory is that the PRP will release all the above mentioned growth factors and cytokines and turn on “the healing process” in the aging face. The benefits of the “Vampire Facelift” are:

Collagen stimulation
Neovascularization (new blood supply to the skin)
Collagen remodeling (for scars)
Dermal thickening
Stimulation of fat growth leading to volumization of areas where fat has been lost

PRP has been used in conjunction with hair transplants for at least the last 5-7 years. Studies have shown that there is improved “take” of the grafts, faster growth of the transplanted follicles, as well as more plentiful hair growth. The PRP is bathed over the follicles prior to their transplanting as well as injected into the recipient and donor site areas. In the past few years, PRP with ACell (a membrane from pig bladder) has been injected into areas of hair loss WITHOUT TRANSPLANTS and results have been very promising. In a study published in the peer reviewed journal “Prime”, hair growth was seen in ALL patients, and ranged from 12-63% improvement. Women seem to have greater improvements than men for this treatment. It is recommended that men get 2 treatments, about 2-4 months apart, but women only need one. Once a year touch ups are needed.

The use of PRP is entering a new frontier in the area of cosmetic enhancements. Its benefits continue to be discovered in different applications and areas. It has no side effects because you are using one’s own tissue to heal and enhance your own body. It also is in nearly limitless supply. It seems only a matter of time when PRP will be mainstream for anti-aging treatments.