It’s Almost as if it happens overnight. One morning you look in the mirror and find that your face seems to have lost its youthful look. You pull your skin back toward your ears and your eyebrows toward your temple area as you reminisce on how things use to be. Alas! You begin to contemplate surgery, but soon realize that you’re not ready to go under the knife just yet. Here are some nonsurgical alternatives that can take years off your face so you can get back to looking and feeling young again.
Nasolabial folds. Or, “parentheses” are the deep folds that run from the side of your nose to the corner of your mouth. These folds develop as we age and can be one of the first visible signs of facial aging. This is due to the decrease in the production of collagen and hyaluronic acid, and of course gravity begins to take over as a result.
Fillers: The most common and effective treatments for nasolabial fold correction are injectable fillers. These basically work by pushing the folds outward. Popular options include HYALURONIC ACID FILLERS, such as Juvederm, Restylane, and Perlane. Hyaluronic acid is a component of connective tissue whose function is to cushion and lubricate. This tends to decrease as we age, which is why Hyaluronic Acid has been nicknamed as the “key to the fountain of youth” Restylane, Juvederm, and Perlane contain Hyaluronic Acid. Almost all people are suitable for Hyaluronic Acid. Because Hyaluronic Acid is chemically identical to the acid in the human body, allergy is very rare. Hyaluronic Acid injections have been approved “safe” by the FDA for many years.
WHICH INJECTION TO CHOOSE: Plastic Surgeons use all three of the above mentioned injectables to increase the volume in the Nasolabial fold. PERLANE: The major difference between Perlane and Restylane is that Perlane is a larger molecule, because it contains more Hyaluronic Acid molecules. Therefore Perlane may be used for deeper folds. Restylane can be treated for finer lines and also works well for fair skinned people. Both of these fillers will last up to six to eight months. JUVEDERM: This filler more recently approved by the FDA has a consistency, which will instantly restore your skin’s volume and smooth away facial wrinkles and folds. This filler has the highest concentration of Hyaluronic Acid, therefore giving the patient more lasting power. Results can last a little over a year. In addition Juvederm injectable Gel is the first FDA approved Hyaluronic Acid dermal filler that is proven to be safe and effective for persons of color. A patient will see immediate results right after any of the three mentioned Hyaluronic Acids are injected.
In summary, all of the above mentioned fillers are FDA approved and are considered safe, according to the “Journal of Drugs in Dermatology” in March of 2004. Restylane and Perlane can last between six to eight months, while Juvederm can last a little over one year.
LIPS: The border between the skin and lips better known as the vermilion border, tend to lose volume with age. Restylane or Juvederm work well in rejuvenating lips, as long as you don’t overdo it.
Lip Augmentation is a non-surgical cosmetic procedure, most Plastic Surgeons agree that Restylane or Juvederm are “safe” fillers to achieve lip enhancement. The intention for lip enhancement should be to restore what has been lost due to the aging process, or to enhance lips that are very thin, giving the face a more facially balanced appearance. I see a lot of women making the mistake of “overdoing” it. For example, lips should enhance one’s face compliment it, not “overwhelm” it. If too much filler is injected one can get that platypus look and defeat the purpose. Most times with anything, less is more. Lips can be very sensual and when injected properly one can achieve this subtle but sensual look. It should also be age appropriate; most women in their mid to late forties do not have thick full lips. A defined edge to the vermilion border should be the first step in achieving your goal. By defining this area, you are able to fill in the upper and lower portions of the center of the lips accordingly. A face as a whole should be balanced; this is a sign of a job well done. If too much filler is injected, one’s face can look unbalanced, and distorted.
If you were born with thin lips, it is wise to stay within the realm of your features by defining their shape. Once the vermilion border is defined, (Cupid’s bow) it can be very flattering to the face as a whole. And it will give you a clear understanding of how much filler should be used in both the upper and lower cushion part of the lips. Once again Hyaluronic Acid based fillers are best and safer than collagen (bovine- derived collagen) which is extracted from the tissue of cows. Since there is a three percent chance of an allergic reaction to this filler, why take a chance? Hyaluronic fillers are clear, biodegradable substances that occurs in the body’s joints and skin. Once you make the decision of “natural looking lips” Restylane or Juvederm are good safe options according to the FDA. Restylane is a clear gel that is injected in small increments to restore volume and structure. It is based once again on Hyaluronic Acid. Restylane is non-animal, which means that no skin test is required, and there is minimal risk of an allergic or hyper sensitive reactions. The result of Restylane will generally last up to six to nine months, and with a re-treatment has been shown to last up to eighteen months, “American Journal Of Dermatology”. When Restylane is injected properly it can give a smooth natural fuller looking lip, which will give the face a more youthful appearance. A patient will immediately see the results of Restylane or Perlane after either is injected, however the down time is minimal since the Hyaluronic molecule is not as large as Juvederm. A patient will see immediate results after either treatment.
JUVEDERM: According to the experts in “The Journal Of Dermatology” when Juvederm is injected properly into the lips, because of its highly dense Hyaluronic Acid, it can last a little over one year with one visit. There can be more swelling using Juvederm since it is a densely concentrated form of Hyaluronic Acid, therefore it is imperative that it is injected by a “Board Certified Plastic Surgeon” One who is Certified by the “The American Board Of Medical Specialties” (ABMS) to certify Physicians in the full range of Plastic and reconstructive procedures. And because the Hyaluronic molecule is larger, and more concentrated, the down time (swelling) can sometimes last for approximately a week.
CHEEKBONES AND JAW LINE: You might notice that your face is becoming narrower as the years go by. The malar region or “cheekbones” lose volume and eventually sag while your jaw line might become less prominent. Fillers like Sculptra can be injected in the hollow portion of your face, below your cheekbones or along the jaw line. This treatment can last up to two years. Sculptra is a synthetic biodegradable simple lactic acid based sugar that is injected into the face or hands to increase thickness and volume of the skin by stimulating new collagen production. This compound has been widely used in dissolvable sutures for more than forty years and does not require skin testing. Sculptra has been FDA approved to “restore and/or correct facial fat lose” and hollowness that occurs in aging. Patients with loss of facial and hand volume contour as a consequence of normal aging have noticed significant improvement in the quality of life with the rejuvenation and benefits achieved by Sculptra. Unlike temporary “fillers” such as collagen and Hyaluronic Acid, Sculptra stimulates your skins own fibroblast to actually generate new collagen. Contour and volume loss in cheekbones, temple area, and jaw line are restored gradually over a few weeks to months as the body forms new collagen. At least four to several treatment sessions are usually required to achieve the desired effect which occurs gradually and usually last up to two years.
THE TEAR TROUGH: (Is the groove at the juncture between where the lower eyelid and the cheek) As we age, one of the changes which is commonly noticed and commented on is the appearance and gradual worsening of dark circles, or a hollowness under the eyelids. This occurs due to the thinning of the overlying skin and soft tissue over the bony orbital rim. An increasing popular treatment is the use of injectable fillers, especially in patients in their late 30′s or 40′s to essentially fill out the trough. Over the past decade injectable fillers such as Restylane and Perlane which again are Hyaluronic Acid- a natural tissue component produced by the body have been used with excellent safety and effectiveness. Minor bruising is uncommon with this procedure, but it can occur and will usually disappear over 10 days. Most bruising is superficial and light and is easily concealed with makeup.
A first course treatment consist of an office visit for treatment, then a follow up office visit two weeks later to reassess and top up if necessary. Patients may undergo a repeat course of top retreatment if desired to replace any filler which has slowly dissolved overtime which is usually 12-18 months later.
NOTE: It’s also important to know if for some reason you are dissatisfied or unhappy with your result, it is reversible. This is a major advantage; a small injection of hyalase into the injected area can be used quickly to dissolve the filler.
URROWS: The lines between your eyebrows can look rejuvenated with Botox, which relaxes frown lines. Most brow furrow lines are formed by excessive contraction of the two major muscles in the forehead, the “Corrugation” and the “Procerus” muscles. Botox works to relax these muscles by blocking nerve impulses that trigger wrinkle- causing muscle contractions, creating a smooth and improved appearance between the brows. Administered in a few tiny injections of purified protein, this minimally invasive treatment is simple and quick and delivers dramatic results with minimally invasive treatment. Results can be seen within 24-48 hours and the effect can last up to 4-8 months. A Botox lift, (brow lift) makes the muscle weak. That is how it relaxes facial lines, especially around the peri-orbital area (crow’s feet.) If Botox is placed around the eye below the level of the brow it will relax those muscles. If those muscles are relaxed they can’t pull down on the brow. Thus you get a mild brow lift. It opens up the eyes, making it appear as though you got a temporal lift. It arches and elevates the eyebrows. It can even be injected by a skilled Plastic Surgeon on vertical lines; “smokers” lip lines, and elevate drooping corners of the mouth. The FDA’S approval is an important Corporate Accomplishment. Clinical studies show that Botox is “safe” and effective for aesthetic use, commented “Lester J Kaplan PHD”, Allergans President of research and development. Botox does not stop the clock from aging, but it does return a rejuvenated appearance to the face. There is NO downtime with Botox. After this 10 minute procedure, you are able to continue regular activity. Botulinum toxin is a neurotoxin protein produced by bacterium Clostridium Botulinum. Though it can be highly toxic, it is used in minute doses both to treat painful muscle spasm, and as a cosmetic treatment in some parts of the world.
Do Not Use Botox if you have an infection where Botox will be injected, allergic to any ingredient in Botox Cosmetic, Or if you are Pregnant.
Botox should not be used to erase every line or crevasse on your face. This would be “overdoing” it. You should remain with some expression and movement on your face. Unfortunately an example of this can be seen on many “Hollywood” actresses today. Their foreheads appear frozen, expressionless, this SHOULD NOT be you goal. You simply want to soften the edges of aging, not completely wipe out all expression, this is a HUGE mistake many women make, and some men as well. It takes away from who from whom they were, “esthetically.” The KEY to all fillers is to not let anyone know you’ve had any work done at all! You should just look rejuvenated and refreshed.
Until Next time, be well.
Laurie Lombardi