Anti-Aging Procedures

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     This is the third of a three-part series on anti-aging. For the other parts read the intro, Anti-Aging: Tips and Advice for Younger Looking Skin, and the second article, Anti-Aging Products.
Anti-aging procedures are where the real action can happen to make a significant difference in the way your skin looks within weeks.  Lasers and energy-based devices are the primary skin procedures used today to reverse sun damage. But neurotoxins, fillers and chemical peels of varying strengths are also important tools for both texture and color.
     Young skin reflects light, is smooth and one color.  Photoaging, or skin aging caused by sun damage, results in dyschromia (multiple colors in the skin: reds and browns of multiples shades), prominent vessels, and a rough texture with enlarged oil glands and folds in the skin.   Overall, the skin is dull, and crinkles from smiling and frowning (motion) leave permanent lines.

Anti-Aging and Collagen Production
     The underlying problems are that collagen and blood vessel walls are damaged by sun and free radicals. In addition, repeated sun exposure encourages the creation of protective pigmentation that eventually cannot be totally removed because the processes that remove it are tired and worn out from age.
     As noted in the New York Times, collagen production is proven to be stimulated in three ways:  habitual tretinoin usage (see step 4 in anti-aging products), fillers such as Restylane®, Juvederm®, Radiesse®, and Sculptra®, and laser resurfacing which gets energy into the dermis were the bulk of damaged collagen is found.
Collagen production is not the same as skin tightening.  Skin tightening is best done by plastic surgery!  If you expect to consider doing plastic surgery at some point, the plastic surgeons recommend that you do it earlier rather than waiting until you really need it, as it will have a more natural look and last longer.  We can help you maintain the results.  If plastic surgery is out of the question, some skin tightening can be achieved through various procedures but they are never a substitute for surgery.
     CO2 laser resurfacing is the most effective way to change your skin quickly.  We do not offer it because it has potential for scarring and permanent color changes.  I believe it needs to be done by physicians who do it frequently, so that their staff is well versed in how to care for the skin following the procedure. It typically only is done on the face.

Anti-Aging Procedures
     We offer several procedures which will improve the way your skin looks, decrease dyschromia, and stimulate collagen.  They have very little risk of side effects but may take time to show results, which are not as dramatic as with the CO2.
     Fraxel Restore was the first fractionated, nonablative laser, and I love it.  I have done it six times to my own face.  It resurfaces 20 percent of your skin at a time so there is very little down time but you have to do it five times to see results.  I also recommend an annual touch up.  It can be used off the face, and we frequently use it on the chest and neck.
     Fraxel Dualwave is a unique laser that targets brown spots and generalized dyschromia (though it does very little for vessels and redness).  It is housed in the Restore machine and both can be done at the same time to target color and resurfacing.  I have done it and love the results which show in about 10 days but it has “explain” time.  After the treatment you will have to explain why your face is red/brown and greasy for about a week.
It can be done on chest, neck, arms and legs though it takes multiple procedures to help the legs and arms which have notoriously difficult brown spots and texture changes.
     Fillers including Restylane®, Juvederm®, Radiesse®, and Perlane® are used to fill lines.  They offer instant gratification. Sculptra® adds volume and results take up to 2 months to show.  Bruising is the most common side effect and there may be some swelling in the first 24 hours.
     Gentlewaves is a flashing, yellow light that supports collagen production.  Studies have shown the level of an enzyme which breaks down collagen is significantly reduced after exposure to the Gentlewaves treatment.  We use it before and after Fraxel and Exilis.  Like microdermabrasion, regular, repeated use of Gentlewaves seems to brighten the skin.  It takes about a minute for the treatment on clean, non-made up skin.

Anti-Aging: Fighting Dyschromia
     Brown spots and reddish discolorations start early.  Rosacea and sun damage contribute to their development.  Melasma, the most frustrating dyschromia, is stimulated by hormones and sun.  Numerous treatments exist to help these conditions.
     IPL or intense pulsed light is a multiple wavelength light device, not a laser.  We use our IPL for brown spots and redness.  We treat the whole face and it typically takes multiple treatments to reduce the dyschromia.
VBeam Perfecta is a pulsed dye laser which is designed to treat individual red lines, bumps or areas of redness.  It also can be used to treat individual brown spots.  Multiple treatments may be necessary.
Peels using various chemicals are using to help even out skin tone and color.  Some of the stronger peels exfoliate and may remove mild surface imperfections.  A series of peels is usually needed to make a significant difference in melasma and irregular pigment.
     Microdermabrasion gives a temporary improvement in skin texture.  It stimulates circulation and is like an exercise class for your skin.  The more you do it, the more fit the skin will look.

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Atlanta Dermatologic Surgeon