Cosmetic Procedures Women Want and Should Want
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Women make up the largest percentage of patients visiting dermatologists’ offices to seek cosmetic treatments and procedures. Dermatologists can provide a variety of options with immediate results for some of women’s most common skin concerns, and even advise patients about treatments which can optimize skin health and that they may not have yet considered.
Speaking today at ACADEMY ‘06, the American Academy of Dermatology’s (Academy) summer scientific meeting, dermatologist Marian E. Northington, M.D., F.A.A.D., of Birmingham, Ala., discussed the most frequent requests women make in the dermatologist’s office and the procedures dermatologists regularly recommend.
“Women want dermatologic procedures that are safe, effective and create the appearance of youth and vitality,” said Dr. Northington. “Dermatologists can help women achieve these goals by listening to the patient’s specific concerns, evaluating the patient’s skin type and recommending treatments that result in the desired appearance.”
Women most often request treatment for wrinkles, but this can cover a wide variety of aging skin on the face and the body. When discussing treatment options for the face, Dr. Northington recommends that when talking to a dermatologist about wrinkles women talk about texture abnormalities of the skin, such as roughness or a loose, crinkled paper-like appearance. She also recommends that women ask about uneven skin tone, redness and volume loss, which leads to prominent nasolabial lines and marionette lines.
The face is not the only area of the body where cosmetic procedures should be considered. It is important to discuss rejuvenating the hands, neck and chest, because these areas can show signs of aging due to their constant exposure to the sun. “By rejuvenating the face and not the other extremities, patients may find that their new, revitalized skin tone does not match the appearance of their other sun-exposed body parts,” stated Dr. Northington, “thereby limiting the appearance of vitality and youth which they were hoping to achieve.”
According to Dr. Northington, there are three cosmetic procedures that women should want and should ask about when considering treatment for aging skin. “As always, and with any cosmetic procedure, patient safety is the top priority for any dermatologist,” stated Dr. Northington. “A well-informed patient and a skilled dermatologist are always the best prescription for a successful outcome.”
Botulinum Toxin
Today, cosmetic uses for botulinum toxin include treating the vertical lines between the eyebrows and on the bridge of the nose, squint lines or crow’s feet at the corners of the eyes, forehead horizontal lines, and the muscle bands often visible on the neck, commonly known as “turkey neck.”
During the procedure, which takes only minutes, small doses of botulinum toxin are injected into affected muscles. The toxin binds to the nerve endings, blocking the release of the chemical acetylcholine, which would otherwise signal the muscle to contract. The toxin then relaxes the injected muscle.
After injection, the muscle relaxes, creating a smooth surface that lasts about three to four months before the muscle recovers its original strength. Even after the actual effects of botulinum toxin are gone, the lines that are left behind are not as deep and don’t return to their original severity.
“Facial wrinkles can be classified into two types, those resulting from sun damage and the natural aging process of the skin, and those wrinkles produced by lifelong contraction of facial muscles, also called muscular lines,” said Dr. Northington. “Muscular lines disappear when the muscle that produces them is rendered inactive or weakened by a muscular blocking agent like botulinum toxin - which typically occurs a few days following the procedure. By eliminating the excessive muscular pull, the surface of the skin stretches out and the wrinkle disappears.”
Wrinkle Fillers
Fillers are commonly used to treat facial lines and wrinkles, hollow cheeks, receding chins, thinning lips and wrinkles between the eyes. There are many types of wrinkle fillers, including the following that are approved by the U.S. Food and Drug Administration (FDA) and that are widely available:
- Purified collagen from cattle and humans is most often used to treat very fine wrinkles around the eyes and mouth, deep lines and creases, depressed scars such as those from acne or chicken pox, and to add volume to thin lips. Results last three to nine months.
- Hyaluronic acid gel may be used to treat lines around the mouth and to plump lips. Results last three to six months.
- Poly-L-lactic acid beads are commonly used to replace lost facial fat, especially around the eyes and in the cheeks. Results last up to two years.
- Self-donated fat, or fat transfer, is most often used to treat deep lines, deep scars, and hollow cheeks and restore contour to a face. Results last one to three years.
Despite the ease of use and minimal risk, Dr. Northington stressed that wrinkle fillers need to be injected by an experienced and well-trained physician, such as a dermatologist, in order to reduce the risk of side effects.
Fractional Resurfacing
Fractional rejuvenation uses a non-ablative (non-invasive) laser assisted by a computer that precisely reads the contours of the face and body and rejuvenates the skin without breaking the skin surface. It can be used to improve wrinkles, pigment irregularities and texture abnormalities. Since it only treats a fraction of the skin surface at a time, it may take several treatments to see results.
“The best place for women to find answers to their questions about aging skin is from their dermatologist, since we are the experts in the diagnosis and medical, surgical and cosmetic treatment of aging skin,” stated Dr. Northington. “As the number of cosmetic procedures and treatments continues to increase and more technologically advanced treatments becoming available every year, a dermatologist’s recommendations can help consumers make informed decisions about what is best for their skin.”
American Academy of Dermatology
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