Cutis Medical Laser’s Weblog

As we age, our face loses volume, our cheeks begin to sag, and the skin loses collagen and elasticity.  In our youth, our faces have full cheeks whereas the aging face has a deflated and fallen appearance.  Deep wrinkles may form such as those between the nose and cheeks- known as “naso-labial folds”.

Placing fillers can reduce the appearance of lines and wrinkles, fill in under-eye circles, define or enlarge the lips, and restore volume to areas that appear flattened such as the cheeks.  It can even be used to improve the appearance of your nose- the so-called “5 minute nose job”.  In these and many other ways, you can achieve a natural youthful appearance non-surgically with injectable fillers.

There are many different types of fillers and at Cutis Medical Laser Clinics, we choose the filler that is appropriate for you. Placement of the fillers can result in a pleasing appearance with limited or no downtime.  Fillers can improve:

• Forehead and frown lines- with or without the use of Botox (Botulinum Toxin A)
• Crow’s feet or laughter lines- the fine lines that radiate away from the eyes, again with or without the use of Botox in combination
• Naso-labial lines- deep furrows running between the nose and the cheeks
• Marionette lines- lines running down from the corners of the mouth
• Lips- by creating a fuller, more defined shape in a natural manner
• Facial scars
• Nose- correcting a bump, or improving the shape of the nose
• Chin- making the chin more balanced with the rest of the face
• Cheeks- by restoring the youthful fullness and lift of the cheeks

Visit us at 81 Club Street or call 6327 9700 for an appointment and find out whether fillers are right for you.

Cutis Medical Laser Clinics

81 Club Street

Tel: 6327 9700

www.cutislaser.com

info@cutislaser.com

Most of us worry about growing old. Some may focus on our waists getting thicker over time, others may worry about a receding hairline, or on one’s wrinkles. Especially in these times of economic uncertainty, as we grow older, doubts about our ability to remain competitive with younger colleagues may come up.

In a study by Johnson¹, it was shown that attractive people, even among the elderly are perceived to be “youthful”, and are thought to be more successful in work and in life. In fact, his study concluded that attractiveness is largely determined by the appearance of youth and vigor in an individual. Such an improvement in one’s perception of attractiveness has been shown to directly translate in improving self-esteem, lifting a low mood, and making it easier to interact with others. What does it mean for our day to day lives? These findings suggest that there is nothing wrong with trying to look our best. Regardless of our age, this is a natural desire that allows us to feel better about ourselves and for others to perceive us as full of energy and youthful. In fact, clinical studies show that patients who have undergone aesthetic treatments have an improved sense of well-being², felt more confident in social situations³ and reported improved quality of life⁴.

Now with the latest developments in health, we are able to make graceful and more natural improvements in our appearance even as we age. In an earlier article, I discussed the importance of exercise, nutrition and lifestyle habits in health aging. In this article, I will focus on non-invasive treatments that allow us to optimize our appearance as we grow older.

Aging changes the face in several ways. The three most common changes are shown below. An overview of possible treatment options to address these most common concerns is also presented.

1. The skin becomes lax due to loss of collagen, and a normally oval face becomes rectangular or pear-shaped. The cheeks drop resulting in an exaggeration of the nasolabial fold and development of two lines on the sides of the mouth. These lines may make a person appear sad, and is a common complaint among Asian patients. Lack of collagen also results in our pores becoming more prominent.

There are several treatments that can improve skin laxity by building collagen in the dermis. These include the Titan, an infrared device that is also known as the “non-surgical facelift”. A photo of the Titan treatment is shown below. Titan has been demonstrated on skin biopsy to increase the amount of collagen in the skin⁵. Another collagen building device is Thermage, which in contrast to the Titan, is a radiofrequency treatment.

Treatments to reduce pores include laser rejuvenation treatments that stimulate collagen formation to close the pores. An example is Laser Genesis, which has been shown to result in building of collagen over the course of several treatments⁶.

Nasolabial lines or deep lines around the nose can also be temporarily addressed by injectable fillers. These dermal fillers, so-called because they “fill a line” come in various forms with varying duration of their effects.

1. Expression lines become deeper and more prominent. These lines which form due to facial expression and muscle contraction are the lines on our forehead (“frown lines”), next to our eyes (“smile lines”), around our lips (“lipstick lines”) and others. Over time, these lines that form due to muscle contraction become fixed, and can make us look “always angry” even when we are not using the muscles of expression.

A simple way to temporarily reduce these expression lines is injection with botulinum toxin A (popularly known as Botox, but includes another brand known as Dysport). Botulinum toxin A works by temporarily weakening the muscles that form the lines of expression.

1. Accumulation of sun damage resulting in changes in skin texture including development of fine and coarse wrinkles, formation of tiny blood vessels on the face (spider veins, telangiectasia), and sun-induced pigments including freckles, age spots or liver spots.

There are several treatments that can reduce the effects of sun damage. Some of these treatments may require a series of sessions, such as pigment removal by IPL. Other treatments may only need one or two treatments such as resurfacing devices (for example the Pearl), so-called because the damaged surface of the skin is gently removed, while stimulating the formation of new “baby” skin.

As we age, including these difficult economic times, we may seek quick fixes especially those with no downtime and are less expensive. When these treatments are performed for the right reason, it may make you feel more positive and empowered. In considering these treatments, talk to your doctor about whether these are right for you.

References:

1. Johnson DF. Appearance and the elderly. In: The Psychology of Cosmetic Treatments Overview of Psychology of Cosmetics., New York: Prager Publishers, 1085:1127-43
2. Edgerton MET, et al. Surgical results and psychosocial changes following rhytidectomy. Plast Reconstr Surg 1363; 33: 503-21.
3. Marcus P. Psychological aspects of cosmetic rhinoplasty. Br J Plast Surg 1984; 37: 313-18.
4. Rankin M, et al. Quality of life outcomes after cosmetic surgery. Plast Reconstr Surg 1998; 102: 2139-47.
5. Goldberg DJ, et al. Treatment of skin laxity of the lower face and neck in older individuals with a broad-spectrum infrared light device. J Cosmet Laser Ther 2007; 9: 35-40.
6. Schmults CD, et al. Nonablative Facial Remodeling. Erythema reduction and histologic evidence of new collagen formation using a 300—microsecond 1064-nm Nd:Yag Laser. Arch Dermatol 2004; 140: 1373-1376.

I’ve found this interesting article and thought it would also fit on our blog as we are focusing on “healthy aging”. The article was first posted on the American Academy of Anti-Aging Medicine.

Researchers at Brigham Young University and Harvard School of Public Health have released a study suggesting that a reduction in air pollutants in 51 U.S. cities between 1980 and 2000 has added an average of five months to life expectancy. Moreover, residents in cities that made the most significant improvements in air quality, such as Pittsburgh, PA, can expect to live almost 10 months longer.

The research compared changes in air pollution from 1980 to 2000 with residents’ life expectancies during those years. Other factors that can affect average life expectancy, such as changes in population, income, education and cigarette smoking, were taken into account. After adjusting for these and other factors, the researchers determined that for every microgram per cubic meter decrease in fine-particulate air pollution, life expectancies rose by more than seven months. “There is an important positive message here that the efforts to reduce particulate air pollution concentrations in the United States over the past 20 years have led to substantial and measurable improvements in life expectancy,” says study co-author Douglas Dockery, Chair, Department of Environmental Health at Harvard School of Public Health.

It is widely accepted that fine-particulate air pollution is known to contribute to cardiovascular and lung disease. The particulate matter is inhaled much like a gas and is believed to increase blood pressure, the risk of heart attack and the possibility of a heart disease-related death.

News releases: Drop in U.S. air pollution linked to longer lifespans cnn.com/health January 21, 2009; Americans owe five months of their lives to cleaner air Newswise January 16, 2009

Cutera’s Pearl laser was prominently featured on The Doctors on January 8, 2009 to an audience of 200 million viewers across North America.  Dr. Ordon performed a Pearl treatment on Stephanie’s face to remove discoloration, fine lines, wrinkles and rejuvenate her complexion. Stephanie reports her impressive results were noticeable within just three days. Before-and-after photos, taken by the Visia camera, show dramatic improvement of both visible and “invisible” sun damage.

We here at Cutis Medical Laser Clinics also use the Pearl and had very good results with this technology. Patients just love the look and feel of their skin after the treatment.

Enjoy the video.

Maybe you finally have the experience and confidence to be at the top of your career game.  But if you’re like many men over 40, you might feel like you’re starting to lose some ground.   A man’s fear of being edged out because he doesn’t look as young as his colleagues is very real.  More than ever, there is competition with the younger guys, and a lot of men are feeling it.  And the focus is not on changing one’s appearance, rather it is on looking well-rested, like you have the energy to go the distance.  

Most procedures work for both men and women, but there are specific characteristics that should be considered in treatment of men’s skin concerns. Typical male concerns include forehead wrinkles, crow’s feet, broken blood vessels on the face, lentigines (freckles and brown spots), acne scars, perioral lines, as well as jowls and laxity of the neck and brow.  In addition, men usually consult for permanent hair removal. 

Common Rejuvenation Treatment Options for Men include:

1.Multi-dimensional (3-D) Rejuvenation for Men- This combines multiple technologies to address the most frequent concerns including skin laxity, fine lines, acne scars and pigment.  These treatment options can be tailored depending on specific findings and concerns of the individual.  For example, one can begin with a treatment known as Titan – which uses infrared light to tighten jowls, sagging eyelids, facial laxity, neck laxity, and even abdominal laxity, this treatment not only tightens loose skin but stimulates the production of your own collagen even months after the treatment has been completed.  A second popular treatment that can be done at the same treatment session as the Titan is Laser Genesis- which utilizes a laser to soften fine lines and wrinkles, shrink pores and acne scars.  Laser Genesis has also been proven to stimulate the creation of new collagen, giving your face a more youthful appearance.  Finally, pigment lasers or Limelight using Cutera’s Intelligent Pulse light can be used to address problems right at the skin surface- mottled complexion, freckles and sun damage.   Together, these treatments address all of the most common conditions of aging- age spots, sun damage, fine lines, wrinkles and lax skin.  Alternatively, a person may only seek facial tightening or even an eyelid lift using non-surgical procedures.  As shown in the picture below, the Titan can be used to naturally lift one’s eyelids to give an alert and well-rested look.  

2.The Pearl Laser- Using a novel YSGG wavelength, this laser by Cutera is FDA approved for addressing fine lines, sun damage and pigments, enlarged pores, and superficial acne scars in only one treatment session.  The Pearl ablates the top damaged layer of the skin, while providing deeper heating and coagulation so that the treated skin is easy to manage after the treatment, and while ensuring that new collagen is created under the skin.  Unlike other fractional devices that require up to 5 treatments to cover the entire surface of the face, the Pearl can provide results in only one to two treatments.  The example below shows the results after a Pearl treatment where lines around the eyes and sun damage have been significantly improved.

3.Permanent Hair Removal- Men and women alike are making unwanted facial and body hair a thing of the past. Permanent hair removal systems come either as an IPL or Laser, with the laser systems allowing for a safe and effective treatment of even the darkest skin types without complications.   

4.Vein Removal-  Newer lasers can now treat a broad range of vessels without the need for surgery or injections.   The laser delivers pulses of light energy which cause the blood within the vein to coagulate, eventually destroying the vessels, which is later reabsorbed by your body.  These lasers can treat a broad range of vessels from tiny spider veins on the face to deep reticular veins (blue veins) on the legs.

5.Botox-  Botox treatment has a high level of patient satisfaction and is among the easiest and safest minimally invasive procedures.  In men, it is most commonly used to treat frown lines, horizontal forehead lines and crow’s feet.  In 3-5 days, you can achieve a fresher, more relaxed look.  Botox is also frequently used to contour the face giving a sharper, more angular look.  In terms of technique, men can be treated similarly to women with Botox.  Men, however, need higher doses of botulinum toxin in almost all treatment areas, because of the greater muscle mass of men compared to women.  

6.HairMax Laser Comb Premium- We all know that men (and women) consider their hair as a symbol of style.  Having a full head of hair is also a source of self-esteem for both men and women, and having thick , luscious hair is another marker for youth and vigor.  Instead of taking expensive tablets, or applying equally expensive topical lotions such as minoxidil, consider this US FDA approved home device for hair growth.  Clinical Studies in both men and women of the HairMax Laser Comb Premium demonstrate an average increase of 78.9% in hair tensile strength and an average increase of 93.5% increase in hair counts.  Results were based on a 12 week study, with the use of the comb for 10 minutes every other day.  HairMax works by doing three things- 1) directly stimulating the hair follicles to form new hair shafts, 2) increase in ATP production, which is the energy source for new hair formation and 3) increase in blood flow to the hair root allowing the delivery of nutrients that are important for hair formation.  

In summary, while diet and exercise can help, you can also help level the playing field with skin treatments- non-surgical medical procedures designed to give you a rested, relaxed look.  Unlike women who want treatments that help them look as young as possible, men typically want a look that is “rested, relaxed, and comfortable”.  In the US, more than 1 million men sought skin treatments in 2005.   Men who have had such treatments often report feeling more confident, more energetic, more optimistic, and less stressed in their daily interactions.  Talk to your doctor about these and other treatment options appropriate for you.