Defy age: Re­gain your youth­ful look with the lat­est anti-ag­ing treat­ments.

To­day’s anti-ag­ing in­dus­try can shave years, if not decades, off your ap­pear­ance. And there are more op­tions avail­able than ever be­fore.

Milwaukee Health - - DEPARTMENTS - By SUZANNE GER­BER

Cos­metic pro­ce­dures have come a long way since the days of in­ject­ing paraf­fin and sil­i­cone into fa­cial creases, only to have one’s face “melt” or de­velop lumps. To­day, more than 17 mil­lion cos­metic pro­ce­dures are per­formed an­nu­ally in the U.S., at a to­tal cost of about $16 bil­lion. With rel­a­tively few ex­cep­tions, these treat­ments are con­sid­ered safe and ef­fec­tive. Some take a few months for the full re­sults to show, while oth­ers shave off five or 10 years al­most in­stan­ta­neously.

Bo­tox was the first game-changer, when it re­ceived FDA ap­proval for cos­metic use in 2002. (For decades it had been used med­i­cally to treat neu­ro­log­i­cal and oc­u­lar con­di­tions.) Then the aes­thetic flood­gates blew open when the FDA ap­proved the first fillers made of hyaluronic acid (which oc­curs nat­u­rally in the body), Resty­lane and Ju­vé­derm. New prod­ucts and treat­ments con­tinue to emerge, while doc­tors re­fine tech­niques to help pa­tients achieve more nat­u­ral-look­ing re­sults. Here’s an over­view of what’s avail­able lo­cally.

Bo­tox and Fillers

Ac­cord­ing to the Amer­i­can So­ci­ety of Plas­tic Sur­geons, Bo­tox and fillers alone ac­count for more than half of all cos­metic pro­ce­dures per­formed. To­day, most folks seek­ing cos­metic en­hance­ment opt for a “combo plat­ter” of these in­jecta­bles. Bo­tox, which is de­rived from the bo­tulin bac­terium, is con­sid­ered the “up­per-face gold stan­dard,” since its par­a­lyz­ing ef­fect slows the cre­ation

of new wrin­kles and min­i­mizes the ap­pear­ance of ex­ist­ing ones in the fore­head, at the out­side edges of the eyes (“crow’s feet”) and the “frown lines” be­tween the eye­brows.

For the rest of the face – and the back of the hands – there’s a host of fillers to choose from. “In­jecta­bles have evolved quite a bit in the past decade,” says reg­is­tered nurse Rachael Mullen, direc­tor at the 40-year-old Clinic of Cos­metic Surgery in Mil­wau­kee. “Rather than tak­ing a one-size-fits-all ap­proach, we now work with dif­fer­ent fillers to ad­dress dif­fer­ent con­cerns in spe­cific ar­eas of the face.”

To com­pen­sate for the vol­ume loss and sag­ging in the mid-face and cheek, which is a re­sult of the nat­u­ral de­crease in col­la­gen pro­duc­tion, Mullen recommends Ju­vé­derm Voluma and Resty­lane Lyft. “Ju­vé­derm Vol­lure and Resty­lane De­fyne are the new go-to’s for soft­en­ing na­solabial folds and ‘mar­i­onette lines’ below the mouth, and defin­ing the jawline. Ju­vé­derm Vol­bella and Resty­lane Silk are specif­i­cally de­signed for sub­tle lip en­hance­ment and smooth­ing wrin­kles around the mouth,” says Mullen. Be­cause these prod­ucts have smaller, smoother par­ti­cles, they’re eas­ier to work with, in­te­grate well into the tis­sue and pro­duce a more nat­u­ral and flex­i­ble re­sult. The ef­fects are im­me­di­ate and can last six months to a year, but re­sults vary greatly from pa­tient to pa­tient.

Beyond fill­ing in creases, some fillers are ef­fec­tive at chang­ing the over­all struc­tural ap­pear­ance of the face. Sculp­tra is like a mold­ing agent that can add vol­ume to the cheek­bones, lower face, tem­ples and jaw lines. Mul­ti­ple treat­ments spaced six weeks apart have a cu­mu­la­tive, longer-last­ing ef­fect – two to five years – thus re­quir­ing touch-ups far less fre­quently.

While these pro­ce­dures are very com­mon and rel­a­tively low-risk, there are things to be aware of. (There’s a rea­son for the dis­claimers ab­solv­ing the clinic or spa of all li­a­bil­ity for a raft of po­ten­tial side ef­fects, in­clud­ing swelling, bruis­ing and bleed­ing; skin erup­tions or lumps; in­fec­tion; asym­me­try; scar­ring; droop­ing eyes; and even blind­ness.) In Wis­con­sin, you need a medical li­cense (doc­tor, nurse, physi­cian as­sis­tant) to in­ject neu­ro­tox­ins and der­mal fillers.

Non-Sur­gi­cal Lifts

Mi­croneedling, or skin needling, uses a de­vice cov­ered with tiny, shal­low nee­dles to poke holes (“mi­cro-in­juries”) in the skin that stim­u­late col­la­gen pro­duc­tion, which will nat­u­rally plump the skin and fill in fine lines. This “stand-alone” ver­sion is ef­fec­tive for wrin­kles, dis­col­oration, stretch marks and sunken ar­eas caused by acne scars. It can also be done on the arms, neck, legs, ab­domen, back and hands.

For max­i­mum re­sults, how­ever, clin­i­cians rec­om­mend the scar­ily named “vam­pire facelift.” This non­sur­gi­cal pro­ce­dure, which is tech­ni­cally called platelet-rich plasma (PRP) re­ju­ve­na­tion, gets its nick­name from the pro­ce­dure it­self. A doc­tor draws blood from your face, sep­a­rates out the liq­uid and plasma, then remixes the plasma with hyaluronic acid (e.g., Ju­vé­derm) and in­jects that back into the skin. “The pro­ce­dure takes 45 min­utes and leaves you with im­proved tex­ture and firm­ness and a smooth, glow­ing com­plex­ion. To get the full ef­fect – which can last up to two years – we usu­ally rec­om­mend a

“Rather than tak­ing a one-size-fit­sall ap­proach, we now work with dif­fer­ent fillers to ad­dress dif­fer­ent con­cerns in spe­cific ar­eas of the face.”

— RACHAEL MULLEN, Direc­tor of Clinic of Cos­metic Surgery, Mil­wau­kee

pack­age of four treat­ments,” says Chris Za­jdel, medical aes­theti­cian and co-owner of Skiin anti-ag­ing lounge in Wauke­sha.

An­other ex­plod­ing trend is the use of lasers to tighten skin, stim­u­late the skin’s nat­u­ral pro­duc­tion of col­la­gen and treat blotch­i­ness, scars and sun dam­age. The gen­tler, “non-ab­la­tive” lasers like Fraxel are ap­pro­pri­ate for peo­ple un­der 50 with fine wrin­kles. (Fraxel can also be per­formed on the eye­lids.)

The fractional CO2 (car­bon diox­ide) laser is rec­om­mended for older pa­tients with deeper wrin­kles, sag­ging skin and/or scars on the face, neck and chest and some­times the arms and legs. These work on a deeper level and as a re­sult re­quire more down­time. Fractional lasers pro­duce a ping­ing or sting­ing sen­sa­tion, and leave the pa­tient with a grid of tiny spots, which are vis­i­ble for up to a week.

In­tense pulsed light (IPL) is rec­om­mended for light­en­ing the skin and re­mov­ing spots on the face, neck, chest and hands caused by ag­ing and sun exposure. This low-risk pro­ce­dure is ef­fec­tive for treat­ing rosacea and bro­ken blood ves­sels. It typ­i­cally in­volves a se­ries of three to six treat­ments per­formed three to six weeks apart. Some pa­tients re­port mild dis­com­fort, not­ing that the first treat­ment is usu­ally felt the most strongly.

Non­sur­gi­cal pro­ce­dures aren’t just for the face. Li­po­suc­tion to re­move fat from a tar­geted area of the body has been around since the 1970s but is still ex­pen­sive, re­quires anes­the­sia and in­volves days if not weeks of down­time. Over the past sev­eral years a pro­ce­dure called CoolSculpt­ing, which freezes fat cells and then al­lows them to be nat­u­rally elim­i­nated from the body, has stepped up to re­place it. Like li­po­suc­tion, the re­sults are per­ma­nent, but there’s vir­tu­ally no down time.

“Not ev­ery­one is the right can­di­date, though,” notes Za­jdel. “For one thing, the skin needs to be in good con­di­tion. And CoolSculpt­ing works best on stub­born fat in prob­lem ar­eas like the thighs, but­tocks, hips and ‘bra fat.’ We can de­ter­mine this in a con­sul­ta­tion, but the pa­tient still needs to have re­al­is­tic ex­pec­ta­tions.” Not all the fat is re­moved from any given area, and it can take four to six months for the re­sults to fully show.

With so many op­tions, the best ap­proach is to find a doc­tor or medical spa you trust. Be sure to ed­u­cate your­self with re­gard to risks as well as re­sults, ex­er­cise healthy skep­ti­cism and check the prac­ti­tion­ers’ cre­den­tials. Ask for a con­sul­ta­tion, in which clin­i­cians will ex­plain how many treat­ments and what pro­ce­dures are most likely to give you the re­sults you seek (since it’s so dif­fer­ent for ev­ery­one), and help you come up with a re­al­is­tic, af­ford­able treat­ment pro­gram.

Platelet-rich plasma (PRP) re­ju­ve­na­tion – shown above be­fore (left) and af­ter – is a 45-minute non­sur­gi­cal pro­ce­dure that im­proves fa­cial skin firm­ness and com­plex­ion.

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