Archive for April, 2015
Décolletage is what we call the neckline, or more specifically the area made up of the neck, chest and cleavage. If we neglect this area between our face and breasts, it is sure to age us. Although we can cover up our décolletage, we would certainly be limiting our style and where is the fun in that.
The décolletage is a special concern, because it tends to suffer more sun damage than other areas and women also tend to develop lines between the breast while sleeping on their side. Luckily, there are plenty of options to improve this area, but we have to be patient as correction for non-facial skin is much slower than it is when treating the face. When we treat the décolletage or any non-facial area, we need to treat more conservatively and thus, more often. The skin cell turn over for non-facial skin tends to be slower, so this means the recovery process will take longer, which will require more time spaced between treatments. When treating the décolletage you should treat early and often. Slow and steady wins the race.
When it comes to skin care and anti-aging, the best approach is a comprehensive one. One treatment does not necessarily replace the other. Your skincare provider should work to help you understand which treatments are best for you and the time line that treatments may be done. When budget is a concern, you will need to decide which concerns are a priority for you.
Topical Skin Care
The first step is to use effective skin care products on your neck and chest, every morning and every night, just as you would your face. Most of the skin care products that are used on the face, can also be used on the chest. Some topicals, such as hydroquinone and retinoids need to be used less frequently on non-facial skin to avoid irritation. Some products should be used daily, such as topical antioxidants and an SPF 30 or higher. There are some great products formulated specifically for the neck and chest. Revision skin care formulated Nectifirm for firming the neck and décolletage. NIA 24 Sun Damage Repair for Décolletage and Hands, is formulated with patented Pro-Niacin to repair damaged skin. Consult with your Esthetician, to determine the appropriate protocol for you.
Treatments that use Intense Pulsed Light work to treat brown spots and redness. There is also research to suggest that ongoing treatments will positively effected gene expression in the skin to mimic that of a younger person. Generally a series of 3-5 treatments are recommended, scheduled 3-4 weeks apart. For enhanced results Levulan may be applied prior, this is known as PhotoDynamic Therapy.
Medium depth chemical peels that reach the papillary dermis or upper reticular dermis, such as the Obagi Blue Peel or ZO controlled depth peel will improve skin discolorations, improve texture, laxity, lines and stretchable wrinkles. A medium depth peel on the chest, may take up to 14 days for peeling to be complete. On the up side, peels on the face generally do not look bad during the peeling phase and are easy to tolerate. These peels can be done as often as 4 times a year, however I find that once a year is optimal when combined with other treatments.
Ultherapy is the treatment of choice for the lines that develop between the breasts. Ultherapy works at a deeper level than any other non-surgical treatment, to lift and tighten skin. Ultherapy uses focused ultrasound to target deep into the dermis and even the top of the muscle. Like many other aesthetic treatments, Ultherapy works by creating a wound healing response, but because the targeted areas are at a deeper level we see more tightening and lifting. The increased collagen production in the treated area, can be seen a year post treatment. Most people should plan on repeating this treatment once a year, although younger patients may be able to stretch it out to every two years. Those with advanced photo damage, or who desire more improvement may choose to repeat the treatment in six months. Pain medication may be prescribed, in which case you will need to arrange for someone to bring you in to your appointment and take you home.
Non facial skin does not respond well to “full coverage” ablative laser resurfacing. Non-ablative or sublative fractional resurfacing treatments, such as E-Matrix or Fraxel are more appropriate for treating non-facial skin. These treatments reduce lines, wrinkles and smooth skin texture. Like many other aesthetic treatments, fractional lasers work by creating a wound healing response in the skin, that stimulates the fibroblast in the skin to up regulate the production of collagen. Because laser treatments create heat, we appreciate a different type of wound healing response than we do with other treatments such as chemical peels, micro needling, which is why we see the up regulation of collagen for longer periods of time post treatment.
Fractional lasers generally work in the deeper layers of the skins dermis, an area which is not effected by chemical peels or IPL treatments. The frequency and number of treatments will depend on the level of treatment performed, level of correction desired and condition of skin.
Micro-Needling Collagen Induction Therapy
Aesthetic professionals use micro-needling pens such as the Eclipse or Dermapen, to deliver tiny needles into the epidermal and dermal layers of the skin creating micro-injuries. This begins a natural wound healing or renewal process that will stimulate collagen production in the treated area. There is little to no down-time, and it is surprisingly comfortable. Although, micro needling treatments do not deliver the same level of correction to skin texture as fractional lasers, they are the treatment of choice for scars and stretch marks. Micro-needling is also a good option for early intervention or in between other aesthetic treatments.
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“Does CoolSculpting REALLY work”, this is a question people ask me all the time. I think the idea of removing fat permanently, without surgery seems hard to believe. Some people notice great results, while others may not see desireable results. So…why does CoolSculpting work for some and not others.
How CoolSculpting works
CoolSculpting is a non-surgical device that works by cooling selected areas of fat to a tempeture the causes the fat cells to go into apoptosis. Apoptosis is a programed cell death, it’s like your fat cells commit sucide. With each treatment cycle we expect 20% of the fat cells to die. You may see improvement 8 weeks after your first treatment, but the fat cells will continue to die up to 4 months post treatment.
You may see a noticeable reduction of fat in the treated area after one visit, but you may appreciate even more fat reduction with additional treatments. Most people should expect to do two treatment cycles on each area treated. Occasionally, more than two treatment cycles are needed to achieve your personal desired results.
Coolsculpting uses something we call applicators that pull the fat bulge in and hold it in place during treatment. It usually take multiple applicators to treat a specific area. For example a stomach may require 3 applicators to treat the desired area, and the sides may require 4 applicators. The exact number of applicators needed to treat an area will vary by individual.
What CoolSculpting will not improve
– CoolSculpting and other procedures like liposuction only treat adipose fat, which is the fat above your muscle. Cosmetic procedures do not treat visceral fat, which is the dangerous fat that surrounds your internal organs. The visceral fat needs to be reduced via diet.
– CoolSculpting will not reduce loose or excess skin, it is not an alternative to a tummy-tuck or body lifting procedures.
– CoolSculpting is not used to treat cellulite. Treatments like VelaShape that us RF to reduce the size of fat cells and improve skin quality are better for cellulite treatment.
Why it does not work for some people
Occasinally, someone will tell me that they have a friend who had CoolSculpting and it didn’t work. The truth is, it most probably DID work, but it may not have worked enough or was not the best treatmentfor actual concern. If someone is confusing skin for fat, they will be disappointed with results. If they have a large amount of visceral fat, reducing the adipose fat will not make enough of an impact. While there are those who were not good candidates, the most likely reason someone may feel like it didn’t work is because they didn’t have enough treatment. They probably needed more applicators to treat the area of concern and may have needed an additional treatment to make an impact that is appreciated.
When I had fat transfer, the doctor used liposuction to remove fat from my abdomen to inject into my face. Now, I know for a fact that the fat was removed from my body, but I did not have any improvement in body conturing. To conture my shape he would have needed to suction out more fat. This does not mean that the liposuction didn’t work at removing fat, it means that MORE fat removal would have been needed to improve my shape. This is usually the case with CoolSculpting, it worked, but more treatment is needed for the desired results.
It is important to keep realistic results, make sure that you understand the amount of area that is being treated. Do not assume that you are the exception, and will only need one treatment. If you have had a treatment and were not satisfied with the results, follow up with your provider to see if further treatments are needs or if perhaps another procedure would be better.
YES, CoolSculpting does work and well.
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