Patricia Perry, M.D., BeWell Expert
Anti-Aging Treatments Without Surgery
Injectables, fractional lasers, or Vbeam light therapy might seem like future space-age treatments, but today, they are common methods for treating aging or damaged skin. Millions of women opt for these less-invasive, non-surgical cosmetic procedures. A survey conducted by the American Academy of Cosmetic Surgery says more than 17 million cosmetic surgery procedures were performed in the United States in 2009, an 8% increase from 2008.
Cosmetic treatments are less extensive than plastic surgery and carry fewer risks. Before having any procedure do your research and be sure you find a qualified, board-certified doctor who has regularly performed the treatment you're seeking.
Light Therapy
Today's technology for reducing redness and age spots is less aggressive than previous techniques, but requires a series of treatments and, in some cases, maintenance treatments may be needed. Special consideration and expertise is needed for the effective use of lasers on African-Americans, Asians and Hispanics to prevent potential permanent discoloration and/or scarring.
The newer LED (light-emitting diode) therapy is used to reduce redness and inflammation from acne, rosacea or from chemical peels. Light emitted from this laser occurs in the wavelength spectrum which can enhance stimulation of cells to produce collagen and elastin. The LED works in a series of six to eight treatments, spaced six weeks apart.
IPL (intense pulsed light) therapy is used to fade age spots or discoloration on the face, hands, or chest. Pulses of broad-spectrum light (UV filtered out) zap discolorations without harming tissues, so there is little to no skin irritation. This process also boosts collagen production and smoothes out the skin. Three to six sessions every four to six weeks are needed to see results.
Vbeam laser uses long, intense light pulses directed into the blood vessels that gently shrink broken capillaries or spider veins. Vbeam doesn't damage your top skin layer, but to minimize discomfort during treatment, a coolant is used on your skin to prevent pain and burning between pulses. One or two sessions may be required, depending on the number and size of spider veins.
I would recommend that patients ask the physician to perform a small test area, when possible, to assess how the skin will react to a particular laser (and its setting) before treatment of an entire area.
Injectables
Slightly more invasive than light therapy are injections designed to fill in wrinkles, plump up deep grooves, smooth out fine lines and even lift sagging skin.
Hyaluronic acid is a common line filler and plumper available in different densities, depending on the depth of lines or wrinkles. These injections are temporary and most patients require a series of two to four injections for results that last up to 10 months. Side effects might include redness, swelling or bruising. The most common brands are Restylane and Juvederm.
Non-hyaluronic acid fillers, made from either natural or synthetic substances, are for deeper wrinkles or to plump up larger sections of your face. Because these boost your own body's collagen production, these injectables can last for two or three years. These may require one extra treatment from six to eight weeks after your initial injection. Radiesse is a widely used brand.
Botulinum toxin, called Botox, is used for wrinkles in the upper third of the face--around the eyes, between the brows, and across the forehead. This toxin works by disrupting the signal from the nerves that normally tell facial muscles to contract. When you smile or make other facial expressions after a Botox treatment, the facial muscles remain relaxed and the skin does not wrinkle. The injection takes only a few seconds and can last from three to six months. Pregnant women and anyone with neuromuscular disease such as Myasthenia Gravis or Eaton-Lambert should avoid Botox.
Cow collagen or human collagen fillers are used for laugh lines and lip lines caused by skin thinning and gravity as opposed to muscle movement. The injections pump up facial lines and depressions and later, the collagen is absorbed into the body. Treatments last for three to six months. Allergy testing is required prior to bovine collagen injections, and it should be performed twice, two weeks apart. If there are no reactions, injections can proceed. Common brands are Zyderm, Zyplast and Cosmoderm.
Autologous fat transfers may benefit women over the age 35, whose skin is thinner than younger women's. The treatment uses the patient's own body fat from the abdomen, hip or buttocks to fill in wrinkles on the lower half of the face, or on the back of hands. Fat transfers take more time than collagen, but last longer--from six months to a few years. Bruising and swelling may occur.
Please don't think that just because injections don't involve surgery the procedures are quick, easy and harmless. There are potential side effects including local tissue swelling, skin infection, joint and/or muscle pain, bleeding, fever and bruising. Applications may be uneven, which could last for weeks. There can be numbness, irritation and tenderness at the injection site.
Fractional Laser
The rejuvenating results from laser treatments are more pronounced than any other office treatments outside of cosmetic surgery.
Fraxel laser is broken into separate points so it is able to zero- in very precisely on mottled skin or age spots. Microscopic wounds in the skin from the laser jump-start healing, which then stimulates collagen production. Recovery time is minimal, but if sun damage is extensive, you may need one to four more treatments, with results lasting up to a year.
Pearl Laser and Portrait Plasma Skin Regeneration are used for dull, rough complexions that are starting to lose elasticity. Pearl targets the top skin layer, causing a rejuvenating process through collagen growth and resurfacing. You may be quite red or flaky for several days, but the physical discomfort is manageable. Only one treatment should be needed with results lasting up to three years. Portrait Plasma uses heat from nitrogen plasma to cause the skin to shed its outer layer and stimulate collagen building deeper in the skin. The result is a new, fresh skin layer. Healing takes about a week and the results should last up to two years.
Thermage uses radio frequency and Titan treatments use infrared rays to stimulate collagen, resulting in lifting and tightening the skin--almost immediately. These deep heat treatments can be used on the neck and hands too. You will probably need two or three treatments for the best results and the effects can last up to four years.
SmartLipo is a treatment to get rid of a loose, saggy jowl line below the chin. A tiny laser fiber is inserted in the neck through a small incision. The laser heats up and breaks up the fat, tightening loose tissue. Once you zap the fat cells, they are gone for good, so this treatment is permanent.
Options for rejuvenating your skin abound. Be diligent in checking for sources through the American Academy of Dermatology or the American Academy of Cosmetic Surgery.