Archive for the ‘Anti-aging’ Category
Copper Tripeptide-1 has been shown to play a role in stimulating the production of collagen, aid in wound healing and tissue remodeling. It also has Antioxidant, Anti-Inflammatory, Anti Microbial and Anti-Tumor Effects.
What is Copper Tripeptide-1
Copper Tripeptide-1 is naturally occurring in the body, it is composed of the amino acids Glycyl-histidyl-lysine, which spontaneously binds to copper, also known as GHK-CU. Copper Tripeptide-1 has many benefits within the human body, however levels decrease with age. Given the benefits that it has for renewing, repairing and protecting the skin, it makes sense that this would be used in cosmeceutical skin care products.
Copper Tripeptide-1 is used topically for anti-aging and firming of the skin. As we age our skin becomes progressively thinner, this is due in part to the declining production of collagen in the dermis and keratinocytes in the epidermis. As we age the skins ability to protect and repair itself also declines and this contributes to the degradation or breakdown of collagen. Copper Tripeptide-1 plays a role in stimulating collagen production and in the proliferation of keratinocytes. This is very promising for anti-aging skin care
Wound Healing and Tissue Remodeling
Copper Tripeptide-1 is seen to play a role in accelerating wound healing and improved tissue remodeling. Studies done on diabetic wounds, showed that wounds healed up to three times faster and had a lower incidence of infection, in the presence of Copper Tripeptide-1. This is relevant to anti-aging, because as we age the levels of GHK-CU decrease, which can affect the ability for skin to repair and renew it’s self. Further more, many of the treatments used to improve skin appearance, take advantage of the skins wound healing ability to increase the production of collagen, elastin and hyaluronic acid. The more effective the skins wound healing ability is, the more effective the treatment may be.
Anti-Tumor and Protective Ability
Radiation from sun exposure and cancer treatments have damaging effects on DNA and induce aging. Copper Tri-petide-1 (GHK-CU) helps to protect DNA from these damaging effects. Tumor cell lines died in the presence of Copper Tri-peptide, however healthy cell lines were protected. Skin fibroblasts, are “master cells” responsible for producing collagen, elastin and hyaluronic acid. Fibroblast exposed to radiation have been shown to restore their function when in the presence of (GHK-CU).
Antioxidant, Anti-Inflammatory and Anti-Microbial Effects
Intrinsic antioxidants, are antioxidants that the body makes, they can not be obtained with diet. With age, the production of these intrinsic antioxidants declines. Some of these intrinsic antioxidants are induced by Copper Tripeptide-1. It also has anti-inflammatory and anti-microbial effects during wound healing and tissue remodeling stages.
Skin Care Products with Copper Tripeptide-1
Topical products with Copper Tripeptide-1 may be useful for post procedure skin care to enhance results. They definitely look to be a promising as part of an anti-aging skin care regimen, especially when used with other power house products such as retinoids, anti-oxidants and most importantly broad spectrum sun protection.
Innovative Skin Care has added Copper Tripeptide-1 to many of their iS Clinical line of skin care products, including the most recent “Youth Serum” which is quickly becoming an A-list favorite. It is also found in Super Serum Advance +, Reparative Moisture Emulsion, Youth Intensive Cream, Youth Complex and Youth Eye Complex.
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If you have not yet heard of Ultherapy it is a non-invasive procedure that is intended to lift and tighten the skin. It sounds almost to good to be true, right. So, the question is, does it really work?
The short answer is, yes it does work, but before you make any decisions, you need to know what kind of results can be expected. First, non-surgical treatments will always give a non-surgical result. If you are hoping for a cheeper alternative to a facelift, mini-facelift or even lifestyle lift, you will be disappointed with Ultherapy or ANY non-surgical treatment. During a traditional facelift the surgeon address lax facial muscle, fat and repositions the skin. Ultherapy is not a facelift and a facelift is not a skin treatment. One procedure does not replace the need for the other.
As we age collagen production progressively declines, which leads to wrinkles and thinning skin. Not to confuse facial volume (fat) loss, with skin (dermal/ epidermal) thinning, they are different concerns requiring different procedures. Like many of the treatments used in the world of medical aesthetic, Ultherapy is used to stimulate collagen. What makes Ulthera so unique is the way it stimulates collagen, where it stimulates collagen, the amount of increased collagen and the duration that collagen production is up regulated. Initially the targeted tissue will contract causing a tightening effect. As the renewal process continues collagen production is up regulated, improving skin density and giving a modest lift. The increased collagen is seen at multiple levels of the dermis, most prominent in the deeper dermal tissue. This up regulation of collagen continues, on average of a year.
An average of 69.5% improvement in dermal thickness is seen after Ultherapy
Although, Ultherapy is currently the only non-invasive treatment that can claim to lift skin, there are other treatments that can tighten the skin. Skin tightening is generally seen when aesthetic treatments target the dermal layer of the skin and stimulate collagen production. Ulthera works by targeting deep into the dermal tissue and also to the top of the facial muscle, leaving the surface intact. This is important because other non-surgical treatments, like RadioFrequency (RF) and laser do not treat at the same depth. Although, RF treatments can target fairly deep into the dermal area, the targeted area is only heated to a tempeture that will cause tissue contraction, this helps to tighten the skin. The difference is that RadioFrequency (RF) treatments do not heat the targeted area to the needed tempeture to achieve optimal collagen synthesis. Laser resurfacing and fractional resurfacing treatments, do heat the target area to optimal tempeture and will definitely generate significant collagen synthesis in the upper-mid dermis, which is ideal for treating lines, scars and skin texture. The difference is that we can not treat as deeply into the dermis with laser resurfacing as we do with Ultherapy. Most importantly, RadioFrequency (RF) and laser do not target the top of facial muscle, where Ultherapy does. Ultherapy does work, very well actually. Ultherapy is most appreciated when it is part of a comprehensive approach to anti-aging.
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I can not tell you how many times I have been in the mall or a beauty store and heard a sales person give a shopper horrible advice on skin care. To the defense of the sales person, they probably are unaware they are giving poor advice, they are likely not trained skin professionals. Often the product they recommend cost just as much, if not more than the more effective cosmeceutical products used by skin professionals.
An in-depth consultation with an licensed Esthetician should be your first step to addressing aesthetic skin concerns such as aging. Even if you are just looking for professional advise on appropriate skin care to maintain your skin, a skin consultation is needed. Standing in the front office and talking to the office staff or even an Esthetician between appointments, does not cut it. Not everyone is qualified to give skin care advice, even the Esthetician can not give you the attention you need in 5 minutes. A full consultation is always the best way to go. We have put together a list of tips to help you get the most out of your skin consultation.
Select your Esthetician
An Esthetician is a skin care specialist, that has been educated and trained on skin health and beauty. They do not diagnose or treat medical skin conditions such as eczema, psoriasis, allergies or skin cancers. An Esthetician may work in a day spa, salon, med-spa or within a medical practice such as dermatology or plastic surgery. When selecting an Esthetician, be sure to ask about experience and training. Some Estheticians may have additional training or certifications to work in medical aesthetics. You should look for an Esthetician that fits your personal goals.
Be Prepared to Discuss Your Concerns
If you can help your Esthetician understand what you see, and what concerns you most, then they can better help you. We recommend you make a list of concerns and what you hope to improve. It may help to look in a mirror while creating your list. If you simply want to maintain your skin, we can help with that too. The more clear you are about your concerns, the more likely they will be addressed. You may have skin issues or signs of aging that do not bother you, your Esthetician does not want to offend you by suggesting that you improve something that you are content with. Estheticians understands that most people have a budget and we want to respect your money, so be sure to communicate the priority of your concerns.
What to consider:
Pigmentation Concerns Is your skin color even or do you notice irregular pigmentation such as Melasma, dark patches, freckles, age-spots, sun spots or pigmented scars.
Acne / clogged pores Do you have any cysts, pimples, black heads, white heads or clogged pores. Do breakouts correlate with menstral cyle or hair removal. How often do you break out.
Texture Is your skin smooth and even or does it feel rough or flakey. Does your skin look creapy, have fine lines or scars that are raised or depressed.
Vascular Issues Do you have Rosacea, broken capillaries, diffused redness or red spots. Do you flush easily?
Oil and Moisture Is your skin normal, oily, shiny, dry, tight and dry?
Aging concerns Do you have any lines, wrinkles, folds? Is your skin that lax or thinning. Is your facial volume plump and cohesive or do you see separation of the fat pads, hollowness of the face or under eyes, flat cheeks, or jowls? Do you have droopy or hooded brows?
Hair Even if you are only seeking skin treatments, let your Esthetician know if you experience unwanted hair, specifically facial hair and how you address it. Hair growth and hair removal methods may provide clues to skin issues. ( This applies to men and women) Some hair removal methods my be contraindicated to potential treatments or products. Estheticians specialize in hair removal methods, so they can provide you with or suggest the most appropriate hair removal methods.
Tell us what products you are using
Be prepared to talk to your Esthetician about the skin care products you have used in the past and are currently using. When filling out your consultation form, it is not enough to list a brand name or only including a couple products. We need a detailed list of the products you are using and it is even better if you bring the products in with you, so that we can read the ingredient list.
Not all skin care products or ingredients play well together, for example products with Benzoyl Peroxide can oxidize your topical antioxidants. Acne and anti-aging products usually active ingredients and if we mix too many, the skin may become very irritated. You may already be using something similar to what we would recommend and we do not want you to purchase something, if you already have it or something like it. Your Esthetician will try to work with your current products, when possible. Sometimes, however it may be necessary to start from scratch.
Tell us what you have done already
Think back to any cosmetic procedures or skin care treatments you may have had and make a list. Your Esthetician will need to know what procedures / treatments you have done. Some things should not be repeated too soon, while others my be contraindicated to each other. For example if you have had deep (full coverage) resurfacing procedures, your Esthetician will want to know because they can not be repeated too frequently. If you have recently had certain injectables, you may need to wait before having some procedures. If you have ever had any silicone injections or have you been on accutane, you need to alert your Esthetician.
Tell your Esthetician what you liked or did not like about the things that you have already done. If you had a good experience with something, that will provides a clue to how you respond to treatment. If you feel something did not work or you had a bad experience, we do not want to repeat that for you. Sometimes, your Esthetician may want to spend some time educating you on why you had that experience. Never assume anything is irrelevant.
Tell us a little more about you
Your Esthetician will want to know a little about your medical background and medications. Some medications may increase chance of bruising or cause photosensitivity. Do not forget to list any supplements or herbal treatments you may use. Remember to list any allergies, including food allergies, as some skin care products contain natural ingredients like pumpkin, papaya and pineapple. Medical conditions can effect how your bodies wound healing ability and how your skin responds to treatment. When listing medical conditions be sure to include any hormone therapy.
Your lifestyle and habits are important too. How do you exercise, are you on a restrictive diet, do you smoke, drink or use any other substance. We are not here to judge you, we need to take into consideration the variables that may influence how you will respond to treatment. If you have any special scheduling concerns, be sure to discuss them during your consultation.
Be clear on expectations
As you are discussing treatment options, be sure to clarify what you should expect. Often clients do not understand that they should expect some reaction with treatment or even some skin care products. Be sure you have an idea of what is normal and when you should be concerned. If you are having a treatment that involves any “down time”, your Esthetician will give you an idea of how long it will take to recover. Keep in mind, that this is just an estimated time frame. There are far too many variables that effect healing, it is impossible to predict exactly. It is also relative to what you consider to be “down time” and when it comes to your appearance being acceptable to return to work or social activities, everyone has different standards.
Before scheduling treatments, be sure you understand what typical results are. Often clients hear what they want to believe, expecting too much. Its tempting to hope that even if your Esthetician recommends a series of treatments, that you will be the exception. Sometimes we convince ourself that a non-surgical treatment will deliver a surgical result. We want to believe that one treatment can replace the need for others or that what we do at home isn’t that important. Try to keep your expectations realistic.
Be sure to find out about your consultation fee, often the consultation fee may be credited toward your first treatment. As a courtesy, many Estheticians offer a free consultation. This likely means they are not getting paid, so if you can not make your appointment, call to cancel or reschedule as soon as possible. A minimum of 48 hours prior to scheduled appointment is standard, this allows time to fill the space.
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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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Stars like Angelina Jolie and Kim Kardashian are rumored to be fans of Collagen Induction Therapy, also known as micro-needling. Collagen Induction Therapy is a minimally-invasive skin rejuvenation treatment designed to improve the appearance of fine lines, wrinkles, scars, and even stretch marks of the face and body by improving collagen production in the skin.
About Collagen in The Skin
Collagen is the main structural protein of the skin, it is produced by a cell in the dermis called fibroblast. Collagen works with elastin and keratin to provide tensile strength, firmness, elasticity, resilience, and skin density. Throughout life the activity of the fibroblast slows and the genes that degrade collagen become more active, as a result collagen levels continuously and progressively decline. Adding insult to injury, the quality of collagen is also degraded and less organized. There are a variety of influences that can further accelerate the decline of collagen, such as genetics, hormones, and sun damage. Collagen begins to decline in our 20’s, and by the time we are in our 40’s, it’s about half of what it was at 18.
Scar tissue is also composed of collagen, but the organization of the collagen is different. In scar tissue, the collagen is aligned in a single direction, instead of a random basket weave formation.
How it Works
Micro-needling delivers tiny needles into the epidermal and dermal layers of the skin creating micro-injuries. These micro-injuries to the skin break up old collagen strands which cause the skin to begin a natural wound healing or renewal process. During the renewal process, skin releases growth factor which triggers fibroblast proliferation, matrix production, followed by the deposition of collagen, elastin, proteoglycans, and GAGs. This tissue remodeling results in an increase of collagen production that is better organized. This collagen induction process can improve lines, wrinkles, scars, and stretch marks. Micro-needling is an exciting anti-aging option to induce collagen, even at an early stage.
The best part is, there is little to no down time, and, with topical anesthetic, it is very comfortable.
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Can you imagine that in 10 years from now, that you could look 2 years younger than you do today? A recent study may have discovered the fountain of youth in a popular skin treatment that utilizes BBL technology, also known as IPL.
PhotoFacial is a popular skin treatment that utilizes IPL (Intense Pulsed Light) technology also known as BBL (Broad Band Light). Traditionally, IPL/BBL technology has been used to treat reds (vascular) and browns (pigmented spots),but new research shows impressive anti aging benefits.The study looked at the effects that BBL treatments had on the skin over a period of nine years. They found that with continued treatments over the nine years, skin looked two years younger than it did before treatment.
Why Does Skin Look Younger
Many of the treatments that we use in aesthetics, benefit from skins wound healing ability to produce collagen. Although IPL/BBL treatments do cause a wound healing response that will stimulate collagen production for the first 3 weeks post treatment, it isn’t exactly long enough to account the level of anti aging results observed. So, then, why did the skin look younger?
The study revealed that ongoing BBL/IPL treatments positively effected gene expression in the skin to mimic that of a younger person. Gene expression is the process by which information from a gene is used in the synthesis or form a functional gene product, usually a protein. Aging is associated with changes in gene expression, which is most evident in the skin.
The study indicates “that patients who maintained a regular annual or biannual regimen of BBL treatments over 5 to 11 years can reduce and delay the long-term signs of skin aging such as photo damage, telangiectases, fine lines and wrinkles, and skin laxity in a natural way.”
BBL has been shown to change the expression of genes associated with aging, longevity, and increased lifespan.
Before Treatment: 43 Years Old | After Treatment: 55 Years Old
After 12 Years of Forever Young BBL treatments, the skin looks younger…
How To Stay Forever Young with BBL/IPL
The protocol that we use for this treatment is more advanced and differs slightly from traditional “Photofacials”. IPL/BBL devices use something we call “cut-off” filters, which are used and changed to target specific chromophores in the skin, for example the color in melanin (browns) or hemoglobin (reds). The best IPL/BBL devices are equipped with several “cut-off filters” that the technician can switch between during a treatment. With a traditional “photofacial” treatment we use these “cut-off filters” to specifically treat brown spots and reds such as broken blood vessels and we work only until we reach what we call a “clinical end point”, which basically means we have treated the targeted lesions. With this new approach we treat with multiple “cut-off filters” and make more passes over the skin than we do with a traditional IPL/BBL treatment. We are not focused solely on treating reds and browns, but also on rejuvenating the skin to act more youthful.
To delay aging, I generally recommend a series of 3-5 treatments, spaced 3-4 weeks a part. A treatment series should be repeated annually or biannually depending on level of improvement desired. I would like to emphasize the importance of a comprehensive approach to aging, as the aging process is multi-faceted and ongoing. Regardless of how great any treatment is, it will never replace the need for treatments that address the other aspects of aging. – One treatment does not necessarily replace the need for another. Consult with your skin care professional to determine which treatments are best for you.
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Ultherapy has become a popular anti-aging treatment for those looking to tighten, lift and avoid the thin skin associated with aging. The common question with any aesthetic treatment is “how long the effects will last” and with Ultherapy, the answer is a long time.
How Does Ultherapy Work?
Ultherapy is the only device that is cleared for skin tightening and lifting. It uses focused ultrasound to precisely target and treat tissue at three levels, the Superficial Dermis, Deep Dermis and most importantly the SMAS which is at the top of the muscle, all while leaving the surrounding tissue intact. We are not able to treat all these areas with chemical peels, micro-needling or even other devices such as lasers or Radio Frequency. So basically…. this is as good as it gets with the exception of surgery.
As we age the processes within the skin begin to slow, our skins fibroblast are more sluggish and we produce less hylauronic acid, elastin fibers become weak, we produce less collagen and our collagen becomes un-organized. This all results in lax skin that is less firm and thinning.
Many of the treatments we use in aesthetics, benefit from the skins wound healing ability. By creating a wound healing response in the skin we stimulate the fibroblast to produce more collagen. The type and length of the wound healing benefits can vary, depending on how and where the “wound” was created. For example a scratch or something like microdermabrasion may only be 14 days of increased collagen production, an IPL / BBL treatment is about 3 weeks, and RF treatments around 6 months. Ultherapy leads to an inflammatory wound healing response which stimulates long-term tissue remodeling and leads to further lifting and tightening. Increases collagen production is seen in skin biopsies 12 months after treatment.
Clinical tightening and lifting can be seen as early as 3-6 weeks,but the most appreciable results are seen at 3 months. The duration of response after a single treatment can be up to 2 years.
Anti-Aging Benefits of Ultherapy Observed in Study
– Increased dermal collagen by over 23.7%, new collagen is organized
– Increased over all dermal thickness
– Increased New collagen Type I (21%-30%) and collagen Type III (48%-68%)
– Increased amount of elastin, elastin fibers are more parallel and straighter
Repeating Ultherapy Treatments
The aging process is continues and regardless of which procedure you choose, maintenance is always necessary. The exact longevity of results with any treatment depends on your body’s ability to produce, maintain and breakdown collagen. The frequency of treatments will depend on age, health, lifestyle, condition of skin, other anti-aging measures taken and desired results. Although one year between treatments is most common, many opt for a second treatment as early as 6 months to boost results.Those who are younger may go as long as 2-3 years between treatments. Ultherapy works best as part of a comprehensive approach to aging, your skin care professional can work to customize a plan for your specific needs.
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The eyes are the focal pointe of the face and one of the first places we start to age. A professional chemical peel to treat the skin around the eyes, may be just what the doctor ordered.
A Medium Depth Peel will..
– Treat skin laxity, fine lines, “stretchable” wrinkles and scars.
– Improve skin texture, reducing roughness
– Treat hyper-pigmentation Brown spots and Melasma
– Tighten large pores
– Increase collagen and skin density
The skin around the eyes is thin and with age begins to show fine lines and take on a crepey texture. Treating the delicate skin around the eye can be tricky. Lasers can damage the eye, so this limits how we treat this area. Laser resurfacing can be done, if special laser eye shields are placed inside the eye. Chemical peels are another option for treating the skin around the eye, and when done by a skilled professional can be done up to the lash line.
Chemical peels that penetrate to the appropriate depth in the skin, can improve texture and tighten skin. A TCA peel that penetrates beyond the papillary dermis, just to the Immediate Reticular Dermis (IRD) will provide skin tightening effect, this is called a Medium Depth Peel. I am choosing not to mention the strength of TCA used, because I read too many horror stories online about people who attempted to do a professional peel at home. Skin care professionals are trained on how to determine where we are working in the skin, this is a medical grade peel and should be done by an experienced professional.
Aging Skin and Chemical Peel Intervention
Skin care professionals often talk about “skin cell turn over”. Skin cell turnover is the process of a new skin cell being produced, working it’s way up to the surface and replacing old skin cells which have been sloughed away. In young healthy skin this process takes about 6 weeks, however aging and sun damage slow this process. Chemical peels increase skin cell turnover, which in turn improves skin texture.
The production of growth factors, collagen, elastin and hylaraunic acid all slow with age, so the goal in anti-aging is to preserve and increase the production all of these things. Collagen is a protein that gives skin it’s volume strength and structure, while elastin is what gives skin it’s elasticity or ability to snap back. Hyaluronic acid is a key molecule involved in skin moisture, as it binds and retains water. Hyaluronic acid is also needed to bind collagen to elastin. When we do chemical peels and laser treatments that penetrate beyond the skins epidermis, we are benefitting from the skins own wound healing ability to up regulate growth factors and stimulate the production of collagen, elastin and hyluranic acid. The result is a thicker dermis, smoother surface and skin tightening.
What to expect
The day of the peel is considered day 1. On days 1 and 2 your skin looks okay, but it may look dry and slightly older. By day 3 skin begins to look dark or bronze, this will vary depending on your natural skin color, skin discolorations and depth of peel. Skin usually begins to peel on day 4 and is usually done by day 5. After the skin has peeled of it may be pink for a couple days. The healing process does vary for each person. Healthy skin will always recover more quickly with less inflammation.
During the peeling process you will need to follow the post peel instructions given to you by your skin care professional. This usually includes using a gentle cleanser, a hydrocortisone cream and mild moisturizer. An occlusive ointment such as Vasoline or Aquaphor may be recommended. It is VERY important to not pick or pull off the skin, let it peel in its own time! (seriously… don’t do it) You should also avoid sweating during the pealing phase, because it will create sweat beads under the skin that will cause it to peel of prematurely and thats bad. The skin should be protected with a totally physical sunscreen, I like Physical Eye UV Defense SPF 50 by Skin Ceuticals.
After the old skin has peeled off, it instantly looks and feels smother. The collagen production will continue to increase and the skin will continue to feel tighter. To keep the skin renewal process un regulated and functioning more similar to young skin, I usually recommend having around 4 TCA chemical peels around the eye area per year. Treatments should be scheduled over 6 weeks apart.
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Pay attention! I am about to share the ultimate beauty secret, the secret to anti-aging.
The desire to stay young and beautiful is a natural part of the human psyche and we are apparently willing to pay big bucks to achieve it. Americans spend billions of dollars each year on anti-aging products and services in a desperate search of the fountain of youth. Each new product we try offers a new opportunity to look younger, but they often prove to be nothing more than disappointment in a bottle. So… how can we avoid disappointment and achieve real results? The answer lies with a comprehensive approach. To understand the benefits of a comprehensive approach you should first try to grasp some of the basics of the aging face. After all, if we do not understand the aging process how can we know how to prevent or correct it?
What is a comprehensive approach to aesthetics in relation to the aging face?
Comprehensive Aesthetics uses a variety of treatments and products to cover a large scope of issues associated with the aging face. Aging occurs on many levels of the face, including the bone structure, muscular level, fat or volume distribution and finally the dermal and epidermal levels of the skin. To achieve the most ideal results it is necessary to address the affects of aging at each level, in order to do this a variety of treatments are needed. We also can not ignore the effects of lifestyle and general health, as both play a major factor in aging.
Aesthetic Professionals and Interdisciplinary Collaboration
Aesthetics is a branch of philosophy or science pertaining to the nature of art and beauty. Aesthetic professionals are those whom are specially trained in the art of beauty. Utilizing a full team of medical aesthetic professionals, including a Plastic Surgeon, Dermatologist, Nurse Injector, Estheticians and Certified Laser Technicians, we are able to take advantage of an interdisciplinary collaboration. Each professional possess a special set of skills that contributes to a truly comprehensive approach toward an attractive, youthful face.
Bone adds to the volume of the face and provides structural support to the other layers of facial tissue and skin. As we age there is a significant loss of facial bone which contributes to biometric volume loss. The bones that define your nose, and upper jaw and brow bone recede and the bones of the eye socket gradually widen. The jawbone also recedes and becomes less defined, reducing the angle of the lower jaw. Even the skull shrinks with age, further adding to excess facial skin. The loss of structural support creates noticeable changes in the other layers of tissue, simply put – when the bones that define your face recede your skin begins to droop.
Bad news ladies, we begin to see bone loss as early as our 40’s, where men may not notice bone loss until their mid 60’s. Hormones can play a factor in bone density. As we age bone density can decrease, leading to diseases such as osteoporosis. Your doctor can help you monitor and address issues of bone density loss. Maintaining a healthy diet with enough calcium vitamin D and magnesium can also help prevent bone density loss.
Once bone loss has occurred you can take action with aesthetic treatments. Injectable fillers such as Sculptra can add volume and support for a more youthful and defined face. Sculptra is injected below the skin to correct the effects of fat loss and natural age-related bone loss. A plastic surgeon can also strategically place fat into the face or use facial implants to make up for bone loss.
Below the facial skin and fat, is muscle. The muscle and connective tissue add support to the overlying fat and skin of the face. As our face ages the ligaments stretch and the supporting system begins to elongate causing the face to droop or sag. When the face is sagging due to muscle, this is usually the time for surgical intervention. During a facelift the underlining muscles and tissues are lifted. If you are not ready for surgery, you may consider Ultherapy which does work at the top of the muscle (SMAS) and gives a modest non surgical lift. Keeping in mind that a non-surgical treatment will always provide a non-surgical result. Ultherapy will not remove excess skin or reposition fat pads, but it will tighten skin and provide a modest lift. Ultherapy is perfect for early intervention and probably as good as it gets without surgery.
Muscle contraction can also cause lines and wrinkles. The muscles we use to make expressions become etched in our face over time, this is most noticeable with the vertical lines between our brows commonly referred to as frown lines, as well as crows feet around the eyes and the lines across our forehead. At first these lines are only noticeable with facial movement, but with out preventative action they are constantly visible even without movement (this is referred to as wrinkles at rest). Botox or Dysport injections are used to treat the lines and wrinkles caused by muscle contraction. It is a good idea to consider these types of treatments early on to prevent the lines from becoming “permanent”. Once the lines and wrinkles have become permanently etched into the skin, fillers may be used to lift the area along with laser resurfacing to smooth the skin or in some more severe cases surgery may be recommended.
Fat and Volume Distribution
A youthful face has the right amount of fat in the right places. As we age some areas of the face loose fat while others gain fat. The areas of fat also become farther apart and the fat pads appear as separate structures rather than a smooth continuous layer.
Fat provides support and volume in the face, as we age this valuable fat begins to decrees. Fat loss creates overall volume loss which contributes to folds, lines and wrinkles. The signs of volume loss can be noticed as early as our 30’s and becomes more significant in our 50’s. As we lose fat in our mid face, we begin to notice things like sunken or flat cheeks, heavy lines and folds around the mouth. Volume loss can also be seen around the temples, near the brow bone and under the eyes. When volume is lost under the eyes, it creates a hollow look and dark circles. Injectables such as Sculptra, Juvederm and Restylane can be used to replace volume to the face. Fat injections can also be used as a more long term approach to replace or add volume. Fat transfer or fat injections is a process in which a plastic surgeon removes fat from one area of the body and places it in another. ( How wonderful is that?! )
Fat accumulation is often seen under the chin and along the jawline creating an undefined jawline and the dreaded jowls. Bags under the eyes are also the result of fat accumulating in the wrong area. A plastic surgeon can perform a blepharoplasty to remove the fat bags under the eyes. The jowls and fat along the jawline can be corrected with a facelift as fat pads are repositioned, but if you are not ready for surgery fillers can be strategically injected to help contour the jawline. If you opt for fillers over surgery you may consider adding Ultherapy prior for a modest lift. Again…. a non-surgical treatment will never give a surgical result.
During a facelift the underlining muscles and tissues are lifted, fat pads are repositioned, fat bags may be removed from under the eyes and volume may be added with fat injections as needed and excess skin is removed.
The surface layer of the skin is generally the first place we begin to notice the effects of aging, most of us begin to notice the effects of aging on our skin in our 30’s. As we age our skin has a reduction in collagen production, elastin, hyaluronic acid and skin cell turnover begins to slow. Uneven melanin production and distribution causes dark spots and skin discolorations. We begin to notice more broken capillaries, changes in skin texture, thickness, elasticity and moisture. When we are treating these issues in the skin we must first consider what skin functions are involve and what layer of the skin the problem begins.
The skin can be divided up into three basic layers Epidermis, Dermis and the Subcutaneous Layer (fat). When we talk about skin we are generally referring to the Epidermis and Dermis. The Epidermis is the top layer of the skin and the Dermis is the deeper layer.
Skin cell turnover in the Epidermis
The skin is constantly in a cycle of growth. The cycle of a skin cell is about six weeks, this is the time it takes for a new skin cell to rise to the surface of the skin and naturally slough off. As we age this process slows down and the dead skin cells begin to accumulate at the surface. When this happens the skin will have a dull appearance, rough texture, dark spots will become more dense and appear darker, and lines and wrinkles become more prominent. In addition to all of this, accumulation of skin cells can clog pores causing them to appear larger and lead to acne blemishes. The slowing of skin cell turnover begins in our 30’s, which is a good time to consider a medical based skin care regimen. Tretinoin (Retin-A), Laser and Chemical peels can stimulate skin cell turn over.
As the skin cell turn over rate slows so does wound healing. After an injury the skin takes longer to reepithelialize, meaning the top most layer of skin (Stratum Corneum) is not quickly replaced. This is why many Doctors and Estheticians recommend preconditioning your skin before surgery or skin treatments.
Collagen is important to youthful skin, but as we age collagen production slows down. Loss of collagen causes the dermal layer of skin to thin and reduces the skins ability to retain elasticity (from elastin) and moisture (from hyaluronic acid). This leads to the domino effect, as loss of elastin causes laxity in the skin and reduced hyaluronic acid which cause skin to be dryer, less supple and thinner.
Professional chemical peels, laser and IPL treatments can help to stimulate collagen production. some treatments offer short term improvement in increased collagen production, treatments such as laser resurfacing and Ultherapy offer longer lasting effects. Beyond professional treatments, a skin care program that includes continuous use of Tretinoin (Retin-A), topical vitamin -C and full spectrum sunscreen will help with collagen production. Tretinoin (Retin-A) is an effective way to stimulate collagen synthesis. Vitamin C is nessacerry to produce collagen and it protects skin from both UVA and UVB, by neutralizing the UV rays. Sun exposure degrades collagen so it is essential to use a good sunblock daily. Another tip to prevent collagen loss add a topical Resveratrol to your night time skin regimen.
A melanocyte is the cell that produces melanin (pigment), the melanin dispersed to keratinocytes, giving skin it’s color. As we age the cycle of melanin production and distribution becomes irregular.
As we age there is a reduction in the number of melanocytes. After age 30 the number of melanocytes decline about 6-8% every ten years. As the number of melanocytes decrease skin will become lighter, less even and white spots or patches (hypopigmentation) can be seen.
Browns spots and patches such as melasma, sunspots, age spots and freckles are known as hyperpigmentation. When a melanocyte produces more than normal amounts of melanin the result is hyperpigmentation. Furthermore the melanocyte doesn’t disperse the melanin evenly, so it is presented as dark spots or patches. Hormones and sun exposure are factors in even skin color.
There are many professional skin treatments that address hyperpigmentation, including chemical peels and Photofacial (IPL) treatments, however daily skin care is most important. Daily sun protection is necessary, this is not optional! Products containing hydroquinone suppresses tyrosinase, the enzyme involved in creating melanin. Botanical (plant based) lighteners can also help to suppresses tyrosinase, however alone are less effective than hydroquinone. Tretinoin (Retin-A) is also important, as it will help with even distribution of melanin.
As we age the structural wall of the capillaries (tiny blood vessels) break down which results in broken capillaries. Flushing, redness and broken capillaries are treated with Photofacial (IPL / BBL) and laser treatments. Vitamin C can also help to strengthen capillary walls, I recommend a healthy diet with enough vitamin-C and a daily topical vitamin -C serum. A sunblock with Zinc oxide can further help by blocking some of the heat that causes blood vessels to dilate.
Lifestyle and Health
Our skin is a direct reflection of our health. All the skin care products and treatments in the world can only do so much, it is up to you to be proactive in maintaining your health.
– Work with your physician to maintain your health.
– Maintain a healthy diet with plenty of fruits and vegetables.
– Exercise contributes to a healthy body and hormone levels.
– Sun protection will go a long way to save your skin.
– If you smoke, quit!
– Limit alcohol consumption
– Drink plenty of water
– Get enough sleep
– Try to reduce stress (get a massage, take up yoga, relax)
– Hormones play a role in the aging process. Ask your doctor to monitor your hormone levels and discuss treatment options.
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Ultherapy is a new type of non-surgical, non-invasive procedure for the face that uses ultrasound and the body’s own natural healing process to lift, tone, and tighten loose skin. Ultherapy is the latest buzz in beauty, it has been featured on shows like 20/20 with Barbara Walters, Dr OZ, The Doctors, Today Show, Rachel Ray, Good Morning America and The View.
Whats The Big Deal?
Ultherapy is a very exciting advancement to those of us in the world of aesthetics for several reasons. First, we are talking about LIFTING and TIGHTENING, not just tightening. An Ultherapy treatment tightens the skin and gives the face a vertical lift. Just incase you missed that, I said “LIFT”! Ultherapy uses ultrasound imaging and ultrasound energy. The ultrasound imaging allows us to see exactly where we are treating. We are able to be very specific in where the ultrasound “energy” or Thermal Coagulation Points are delivered in the skin. The most exciting thing is the depth we are able to treat. Ultherapy is the only non-invasive treatment that can specifically target the deep foundation below the skin that is addressed in cosmetic surgery without cutting or disrupting the surface of the skin. I can’t forget to mention that there is NO down time, which is very convient for those who can’t spare the time to recover from surgery.
Where does it go?
To achieve skin tightening you need to target the skin at a fairly deep level, the dermis and superficial muscle. Procedures that treat the epidermis will not tighten or lift the skin. The Ulthera works at three separate levels, the upper dermis, lower dermis and the SMAS/ Platisma. The area where the facial muscles are connected to the dermis is refered to as the (SMAS). This superficial muscle is something that would be addressed by a facial plastic surgeon during a facelift to reduce the appearance of sagging jowls, cheeks and neck skin. With the Ulthera we are able to address this area without surgery.
Why so specific?
With the Ulthera the “energy” is delivered in a very specific way. This is important because in the past if we wanted to tighten the skin we were mostly limited to devices that use Radiofrequency (RF). Radiofrequency works by delivering heat ( volumetric heating ) deep into the skin to stimulate collagen production and tighten skin. The challenge with RF devices is that they are not very specific. Unlike lasers, RF devices do not precisely reach targeted areas and they are not absorbed by a specific chromophore. Simply put, radiofrequency does not know where to go on it’s own, so it is not as precise as Ulthera or laser treatments. Lasers on the other hand are very precise, they use a single wavelength to target specific chromophores at specific depths of the skin (selective heating). Lasers however do not reach the necessary depth in the skin to achieve skin tightening or lifting. Lasers are not used specifically for tightening, they are more appropriate for treating skin discoloration, vascular lesions, unwanted hair, tattoo removal, acne treatments, peeling and resurfacing treatments to treat scars, lines and wrinkles. Ulthera is in a class all it’s own, it uses (focused ultrasound heating) to precisely target the deep structural support layers of the skin.
Radiofrequenc / Volumetric heating / No Precision
Lasers/ Selective heating / No depth
Ulthera / Focused Ultrasound Heating / Precision & Depth
Tightens and tones the deepest tissues of the skin
Stimulates new collagen production for lasting skin tightening effects
Lifts and brightens the brows and eyes; achieving a non-surgical brow-lift
Defines and contours the neck and jowls
Adds volume to the surface of the skin; reducing the appearance of fine lines and wrinkles
What to expect
Ultherapy will addresses mild to moderate loose or sagging skin, by tightening and gradually lifting the skin. After your treatment there are not any special post treatment instructions or down time. The results will unfold over the course of 2-3 months and some patients have reported continued improvement for up to 6 months. As impressive as the results are, you should always have realistic expectations. You will not achieve surgical results with a non-surgical treatment .
If you are interested in learning more about Ultherapy call Shapiro Aesthetic Plastic Surgery and Skin Klinic to schedule a consultation.
Shapiro Aesthetic Plastic Surgery and Skin Klinic
5410 N. Scottsdale Rd., Ste F-100
Paradise Valley, AZ 85253
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