Cosmetic Dermatology<title> <HEAD> <TITLE>Cosmetic Dermatology

How Cosmetic Dermatology Can Enhance the Appearance of Your Skin

by Lois W. Stern

In his chapter in Tick Tock, Stop the Clock ~ Getting Pretty on Your Lunch Hour, Dr. Vic Narurkar states:
"The trend less is more is nowhere more prevalent than in patients seeking alternatives to going under the knife."

He speaks in terms of the five R’s of facial rejuvenation: Resurfacing with lasers, Relaxing with botulinum toxin, Refilling with dermal fillers, Retaining with skin care and Redraping with surgical options. The first four R’s, the ones which do not involve surgical procedures, are the work of the cosmetic dermatologist. The fifth R of facial rejuvenation, Redraping, falls within the domain of the plastic surgeon. So let's review the four R’s that do not involve surgical procedures, known as TNSR or Total Non-Surgical Rejuvenation.

Although we have little control over our inherited genes and their contribution to the rate at which our skin ages, we do have control over environmental and behavioral factors that contribute to aging skin. Our genes to large degree dictate loss of facial volume, bone regression and skin redundancy, but we can control our sun exposure, smoking, diet, skin care products and medications.

Traditional surgery has mostly addressed lax skin, but has done little for the surface of the skin, hyperactive muscles and facial volume loss, all of which are best addressed with non-surgical approaches. Moreover, if some of these issues are addressed in a preventive fashion, it is theoretically possible to delay going under the knife.

The Art of Combination Therapy

The cosmetic dermatologist approaches the patient's facial canvas using several different techniques. This total non-surgical rejuvenation (TNSR) approach uses laser and light based devices for resurfacing the skin, Botox® (Botox Cosmetic) to relax muscles of facial expression, dermal fillers to refill volume loss and skin care/sunscreens to retain the effects of cosmetic procedures. Timing and synergy are critical in order for combination therapies to be effective.

Skin begins to age from the day you are born. It is imperative to start preventive measures such as sunscreen and skin care early on. Photoaging refers to the effects of sun damage, which results in blotchy irregular skin with brown spots, broken capillaries, skin dullness and an uneven skin surface. As patients continue to show signs of aging, their skin continues to show facial canvas blotchiness, frown lines, and volume loss. Photofacials, Botox®, dermal fillers, fractional resurfacing and non-surgical tissue tightening are the multidimensional approaches to non-surgical rejuvenation.

Skin care and sunscreens help retain a youthful appearance and slow the aging process. Botox® relaxes muscles of facial expression and creates a positive expression for the upper third of the face. Dermal fillers add volume and can be synergistically with Botox®. Facial resurfacing addresses a dull and uneven facial canvas and radio frequency tightens skin laxity. With a combination of these non-invasive procedures, the cosmetic dermatologist can offer several options to the patient who is not quite ready or not appropriate for surgical intervention.

The Future of Cosmetic Dermatology

Dr. Narurkar predicts that we will see greater advances in non-surgical approaches in the near future, Inclucing:
  • Topical botulinum toxin applications, which may be an answer for needle phobic patients
  • Advances in skin care with the ability to deliver stronger topical creams effectively to the dermis and beyond for collagen stimulation
  • Some very person specific devices with the ability to scan the skin, detect abnormalities and create an algorithm specific to that patient - a kind of a personal computer for the skin.

The twenty-first century is indeed a time when going beyond the knife for rejuvenation is becoming more of a reality.

Further Resources

Want to learn more about dermal filler (and which one might be the best choice to meet your specific needs)? Read this article.

Want to tighten skin laxity and resurface the skin? Read this article about Energy Driven Devices.

Want to learn about Fractional Lasers, how they work and what results you can expect from these treatments? Read this article.

Afraid of Botox? Here are the facts.

© 2011, 2013 by Lois W. Stern

Lois W. Stern is the author of Sex, Lies and Cosmetic Surgery and Tick Tock, Stop the Clock ~ Getting Pretty on Your Lunch Hour as well as numerous magazine articles. Her Professional Edition DVD is a popular aid to office staff while interacting with their patients.

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