rejuvenation Archives | The Aesthetic Clinique

The Latest Trend “Prejuvenation” – Preventative Rejuvenation

It’s been touted for years by the aesthetic physicians – “Prejuvenation” – starting maintenance treatments in one’s late teens or early twenties. The Kardashians have popularized these minor cosmetic tweaks to stay youthful and refreshed with visits to their Beverly Hills physician, documented regularly on “Keeping Up with the Kardashians”. There is increasing pressure to get that perfect selfie for Instagram or to look cool and attractive on a “Snap”. Unfortunately filters don’t work well with videos unless you want to look like a cute puppy. Doctors are in agreement (for any disease process) that it is much easier to treat problems in their early stages than to reverse them after they have spiraled out of control. Small preventative treatments early on, can maintain and even enhance one’s looks for many years and avoid invasive surgical procedures in the future. The question is, which procedures should be considered for Prejuevenation?

Neuromodulators: These wrinkle improving injections take less than 5 minutes and have no downtime. Millions of these procedures are done each year and it is the most popular cosmetic procedure performed worldwide. Most often these are used in the younger population in the frown lines (glabella), forehead lines, and crows feet. Treating these areas before the lines set in at rest, known as “etched in” lines, is one of the fundamental concepts of Prejuvenation. (Suggestions: Dysport, Botox)

Dermal Fillers: Dermal fillers made from hyaluronic acid (HA) are used to improve the minor volume loss which occurs with age. In the more athletic patients, fat loss can be appreciated in the face as well as throughout the body. Supple enhancements can be added to the mid cheek and around the eye to stave off this premature volume loss. HA fillers are also used to plump up the lips to create a youthful appearance. (Suggestions: Restylane Refyne, Restylane L, Restylane Lyft, Sculptra)

Chemical Peels: To keep the skin in top notch shape and to reverse early sun damage, chemical peels can exfoliate the superficial layers of skin. This renews the texture and pigmentation and leaves a youthful and glowing quality to the skin. (Suggestions: Illuminize, Vitalize, ZO 3 Step Peel)

Skin care: Great skin care is the basis for good looking skin. Most would agree that some type of Retin A or Retinol is essential for maintaining youthful skin. These products lead to increased turnover of the skin cells, improve dyspigmentation (pigmentation problems), thicken the skin, and create a more hydrated skin. Sun protection with an SPF should be part of one’s daily regime. It is also highly recommended to apply growth factors to the skin to reverse the aging process. (Suggestions: ZO Skin Health, Lifeline Stem Cell Skincare)

Prejuvenation is a trend that is here to stay. Preventative maintenance will prolong the need for more aggressive corrections in the later years. With short, no downtime procedures such as neuromodulators, chemical peels, fillers, and a good skin care regime, youthful, natural appearances will persist for years. Stay ahead of the curve with Prejuvenation.

The Temples Shouldn’t be Ignored When Filling the Face

The ideal facial shaped has been described as “heart shaped”, “V shaped”, or “Upside Down Egg”. A youthful face draws attention to the upper face and eyes. With aging, the lower face becomes “heavier” and more dominant, as laxity and volume loss set it. Instead of round or oval, the shape of the face becomes closer to square. The underlying cause for these changes is primarily loss of fat, muscle, and bone.

The upper face’s width is determined primary by the temples. Fat pads in this area are particularly susceptible to atrophy associated with aging and exercise. To reestablish the youthful facial shape, it is essential to reflate the temples. There is a contiguous fat pad in the preauricular area which follows similar volume loss as the temples and should be volumized simultaneously. When the lateral cheeks are given filler, the temporal deficits become exaggerated and more obvious. Patients must be counseled on their temples whenever cheeks injected.

Besides the overall facial shape change, the benefits of filling the temples are the lift given to the surrounding tissues. The brow, and upper eyelid will be elevated with temporal filler. Placement of filler along the orbital rim and lower forehead further enhances this effect. The ideal temple should be convex in a women and slightly concave in the male.

The filling of the temples is reserved for the experienced injector. Dr. Weiner’s choice for this area is Sculptra because of its safety and natural appearance. The only downside to Sculptra is that when placed along the bone in the deepest aspect of the temporal fossa, a large volume of product is needed for complete correction. To finish corrections after the deep Sculptra placement, a superficial layer of HA filler (Restylane, Juvederm) can be safely placed using large bore cannulas. The filler is placed immediately below the dermis in the subcutaneous layer or just below the superficial layer of the temporalis fascia.

To reverse the signs of aging and restore the upper face dominance, temple volumization is required. It must be considered for patients that have brow and eyelid heaviness as well. This is an area that is difficult to treat with higher than average safety risks, and should be reserved for the most experienced injectors.

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ThermiVa Rejuvenates the “Va”

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It’s okay to talk about these things now. Women are discussing this subject at bars and parties. Restoring and enhancing the vaginal area is now popular, the “in” thing. The industry has gotten onboard with no less than 6 devices that have entered the market in the last 12 months for treating this area cosmetically. A colleague has called 2016, “The Year of the Vagina”. The only one that is different is ThermiVa and here’s why.

ThermiVa is completely non invasive with no healing required
There is no downtime – physical and even sexual activity can resume immediately
ThermiVa can tighten vaginal laxity
ThermiVa can improve “leaky bladders”
ThermiVa can enhance the appearance of the labia
ThemiVa improves lubrication associated with atrophy
There is no topical or blocks needed for pain
Improve sexual gratification, orgasmic function

ThermiVa works by gently heating the tissues up to the desired preset temperature using radiofrequency (RF). The heat causes release of factors with result in increased vascularity to the area, increased collagen production, and tissue tightening. The temperature is not too hot, but tolerable, and has been described as similar to heat from a hot stone massage. There is immediate tightening that patients recognize as well as an improved cosmetic appearance. Full results take about 3 months to fully appreciate.

It is recommended to have 3 treatments spaced about 1 month apart. Results should last about 12 months and touch ups will keep the results up at that time. There are essentially no risks or major side effects. Treatment times are about 30-40 minutes and regular activities can begin immediately afterwards.

There are several anecdotal stories of the partners of women who received the ThermiVa enjoying the results as much as the patient. It’s a procedure both will benefit from.

It is no longer taboo to discuss female sexuality or functional problems in the vaginal area. ThermiVa allows for a quick, no downtime procedure that addresses several areas for which improvement is desired. Please call our office to discuss further, 850.622.1214.

Are superficial chemical peels obsolete? The Spectra Laser Peel (“Hollywood Peel”) might make that happen.

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Chemical peels have been a staple for skin care for decades. There are dozens of different types treating various skin conditions. This blog will be directed at the superficial chemical peels used to treat: fines lines, pigmentation, sun damage, acne, large pores, and to rejuvenate the skin. These peels are usually placed by an aesthetician in a spa or physician’s office. After about 2-3 days, the peeling starts and lasts for a couple of days and sometimes up to 5 days. During the peeling phase, there’s various amounts of flaky skin, treated with moisturizer. The skin eventually looks great, 3-7 days after the initial placement of the peel.

Let’s turn to the Spectra Laser Peel. The Spectra Laser is a Q switched 1064 laser that has a tremendous affinity to pigment. It is designed for (and state of the art for) tattoo removal and treating various pigmented lesions (freckles, seborrheic keratosis, lentigos, cafe au lait, nevi, post inflammatory hyperpigmenation, and melasma). The laser peel begins by placing a carbon liquid on the skin for about 10-15 minutes. The carbon is absorb superficially in the skin. This liquid is essentially tricking the laser into thinking its attacking pigment when it is applied to the face. As the laser is first passed over the skin, the carbon absorbs some heat which is passed to the underlying skin. The next several passes cause vaporization of the carbon as well as a very superficial layer of the skin – 15-30 microns. What’s better is that there is no discomfort during the procedure!

The end result is a glowing and radiant skin tone with NO associated peeling or recovery time.

I believe the effectiveness for the various skin condition (acne, pores size, fine lines, pigmentation, melasma) is marked better with the Spectra Peel than with traditional chemical peels. Active acne outbreaks seem to resolve within days. Just like other laser procedures, the Spectra Peel can’t be performed on tan or recently sun exposed skin, or people on Accutane. It can not be done on darker skin types as well.

If you’re looking for a quick skin rejuvenation with essentially no downtime, do what they are doing in Hollywood just before they hit the red carpet, The Spectra Laser Peel.

Dr. Steven Weiner is a Board Certified Facial Plastic Surgeon practicing in Santa Rosa Beach, Florida, between Destin and Panama City Beach, Florida. After laying down his scalpel in 2005 he has devoted his practice to Lasers and Injectables.

Blog: http://stevenfweinermd.wordpress.com/

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

Website: http://www.theclinique.net

Don’t Forget The Hands and Decolletage When Thinking About Your Cosmetic Refinements!

Before and after hand volumization with Radiesse.

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Most of the procedures advertised and touted have to do with rejuvenating and beautifying the aging face and neck. This blog is to bring attention to the often ignored areas: The Decolletage (chest) and The Hands. There are some simple, quick, and little to no downtime procedures that can be performed to bring these areas up to speed with your face and neck cosmetic improvements.

Just as the other parts of the body, the hands and chest lose volume from fat loss, and thinning of the skin. In the hands, the vessels and tendons become more apparent, and in the decollete, wrinkles form the “cleavage” area. The easiest way to improve this problem is with filler. Using micro blunt cannulas, the procedure becomes nearly painless and without any downtime. Filler of choice for the hands would be Radiesse, and for the chest, Sculptra. For the Sculptra treatment, it will take 2-3 sessions, but this will give 2 or more years of improvement. It thickens the skin by stimulating the skin to produce collagen.

Most people these days protect their face from the sun, but the chest and hands are neglected. Sunscreen is important fo r these areas as well. Sun damage on these areas presents as:

Hyperpigmentation, “sun spots”, lentigos
Wrinkles
Thinning of the skin
Skin cancers and pre cancerous lesions

Hyperpigmentation is treated with skin care, peels, and lasers. Proper skin care can include: Sunscreen, Retin A or Retinol (for the chest), Growth factors like TNS Essential Serum (for the chest), and body skin care like Environ which exfoliates and hydrates. For more extensive damage chemical peels can be done, or laser procedures. If just wanting a few spots removed, the Spectra Q-Switched Laser is state of the art to remove individual spots. They will darken and then flake off over 2-3 weeks. If the skin is covered with pigmented lesions, the Fraxel Dual 1927 is required. This will require 2-3 treatments and is a nice laser peel that rejuvenates the underlying skin as well and thickens the dermis. Peeling from the 1927 takes about 2 weeks to resolve. Subsequent treatments can be done after 1 month. The Fraxel Dual is also a great tool to remove and prevent pre cancerous skin lesions called actinic keratosis. It is FDA approved for this purpose and is equal in efficacy to the topicals used for this like: Aldera, Efudex, and Carac.

There are 2 technologies which have yet to be used extensively in the chest and hands but offer promise. Ulthera (Ultherapy) and Infini. These devices create small injuries in the dermis which lead to the body tightening the overlying skin, laying down collagen, and thickening the skin. There are already FDA trials of the Ulthera on the chest. Infini is a very new technology and Dr. Weiner is one of the first in the country to have it. Soon hands will be done with the Infini at The Aesthetic Clinique and results will be posted.

Often people who look much younger than their stated age, the truth is seen in their hands. Don’t ignore this area, as well as the chest! There are several easy ways to get them to match your youthful facial appearance.