Welcome to Plastic Surgery Talk with Dr. Stephen Mulholland, brought to you by SpaMedica. Hello and welcome, Dr. Steve Mulholland here in Toronto, Canada. Welcome to Plastic Surgery Talk and our podcast series. Today’s podcast is on skincare and anti-aging, two very, very fundamental elements to some of the most popular things we do, which is keep the skin looking young, keep it looking attractive, and turn back the clock on older skin.
So, what is preventive skincare, preventative anti-aging, or another term rather than rejuvenation, what is pre-juvenation, and when’s a good time to start? Really, there’s two groups of patients that are good for preventative care, young patients, patients in their late teens and 20s, just starting with healthy skincare, a good approach to eating and internal nutrients, beautiful skin from the inside out, using a good regime of a cleanser, a toner and a moisturizer, it can even be non-medical, something that doesn’t react to their skin. And of course, the most important thing, sun protection, using ultraviolet light protection, sunblock SPF 30, 40, 60, staying out of the sun and wearing a hat. That is the most important part of prevention.
Now, as you get a little older, let’s say late 20s to early 30s, preventative skincare can start to incorporate some more medical therapeutics, things like the injectables and energy-based devices. So by injectables I mean using small, really small, baby amounts of Botox in preventing the frown lines, the crow’s feet and the worry lines that may occur with age. If you start young, the lines you see your mother have or your parents have, you’ll never form them. So using Botox in very small amounts to prevent the lines that will eventually would have come.
Using energy-based devices, lasers, radiofrequency energy systems, ultrasound systems, to pretreat early rosacea, if you have a hereditary tendency to red discoloration, pretreating to prevent that rosacea from getting any worse and stopping it in its tracks. Using other image-based devices for discoloration that’s brown, the pigmentation disorders such as hyperpigmentation and melasma, and starting that before you get it using devices that stimulate collagen, things like radiofrequency devices and fractional lasers, to treat textures and pores, or acne scars, before they form or before they start. Using other injectable elements like stem cell simulation with PRP, Platelet-Rich Plasma, or the vampire lift, again, in your youth, before or as you’re starting to see the early signs of aging, so halt those changes in their path. If you start young enough, lines you would’ve formed, the frown lines, the worry lines, the crow’s feet, the loss of volume, t-zone pores, can all be stopped and permanently delayed before they form.
Of course, then there’s the group that has gotten old, they start getting enthusiastically involved in plastic surgery, noninvasive, invasive treatments, and we do a procedure or some procedures, maybe some cosmetic facial surgery, blepharoplasty, brow lift, neck lift, cheek lift, and we do some fractional lasers on the skin, some Botox, some fillers, and they look great. Then they want to protect their investment and prevent aging from the more youthful position that we created, and again, it’s the same hierarchy of options, skincare, now probably medical skincare, things with growth factors and peptides and prescriptives for pigmentation, energy-based devices, microdermabrasion, red and brown discoloration prevention, neural modular such as Botox and fillers, and the soft tissue filler or volumizers. We can use all those devices after an antiaging surgical procedure to protect your investment and to prevent the aging process from further deteriorating what you invested in.
So those are the two large groups, young before it starts and a little older after you’ve created that youthful look and protecting your investment.
Okay, so now what, you’re committed to the anti-aging process, you’re younger, middle-aged or older, what devices, what weapons do we have to treat the aging process? You can divide them into skincare and topicals, energy-based devices, and injectables, and suture suspension support. And so by having different products and services we can really attack the aging process, which is really divided into the three D’s of growing old, deflation, descent and deterioration.
So deflation is the loss of volume. Air out of the balloon. Without air in the balloon, the balloon sags and gets wrinkly, and so with sun damage and time you get discoloration. So you get deterioration, descent and deflation. Of course, when we look at then at our treatment tools, our weapons against this 3D, we need 3-D therapy, and so we can divide our assault into topical elements such as medical grade skincare, such as Universe Skin, or SkinCeuticals. Their products have active ingredients over and above the strength you get over-the-counter at a Walgreens or in a shoppers drug mart, and will actually give you something you can use at home.
Then, we introduce the injectables, the Botox type products that minimize animation in the muscles that create the creases. And then soft tissue fillers like Juvederm or Restylane where we can create volume and support for the air that’s gone out of the balloon, and by integrating those two we can really create a very youthful look to the face.
We can layer on top of that, again, energy-based devices, lasers, light devices, intense pulse light photo facials, fractional devices, skin tightening devices that are either RF laser light, or ultrasound, and we can make tighter, firmer skin and skin that has less discoloration, less red and less brown. So we put all that together, we can do 3D therapy with a number of energy-based devices, injectables and skincare, and without even using a scalpel, crate significant youth. We can often turn back the a 50-year-old face 5 or 10 years, a 60 or 70-year-old face turn to 15 years without any scalpel.
The last element of my anti-aging preventative, non-excisional option is suture suspension using biabsorbable threads to take the volumize neuro-modulated energy, a device reduced aging and lift it without excision with sutures that support threads that tend to dissolve then over 60 days once the lift has firmly taken. And so we’ve got tremendous options now for the antiaging, non-excisional restoration of youth and beauty, you just need to decide where you’re going to be on that entry level, get a good consultation from a plastic surgeon or dermatologist and begin, being the antiaging process.
So skincare and anti-aging is really treating intrinsic aging, which the signs of aging of your face that would occur without any sun damage, and that’s loss of volume, wrinkles from over-animated movement and the intrinsic loss of support of the elastin and collagen as the tissue sags. What it doesn’t include then, is the extrinsic causes of aging. The extrinsic causes would be things that you do to yourself, environmental factors, weight loss, weight gain, multiple parity, smoking is a big one, ultraviolet light damage. And generally, we tend to use more energy-based devices for these extrinsic causes, the photo damage, the solar elastosis, rhe wrinkles, the fine lines, and the discoloration from sun damage or from underlying inflammatory conditions like rosacea. We use photofacials and lasers to smoothen out pigment, even out tone and tighten skin.
For the intrinsic aging, which is usually volume loss and laxity, we’ll usually use devices like internal heating devices and volumization to bring back youth and then Botox to soften the intrinsic aging from animation.
So you can think of your preventative and your therapeutic skincare non-excisional treatments as addressing aging from extrinsic causes and the internal biological clock aging. And most patients that we do see, most viewers, have a little bit of both that needs to be treated.
So, how do you purchase these services? Let’s say a clinic like mine has all kinds of things we offer, skincare, for Botox, we offer soft tissue fillers, we offer multiple energy-based devices under different categories, radiofrequency, laser, fractional laser, intense pulse light, ultrasound devices, suction coupled devices, and we also offer then suture suspension and volumizing products.
How do we integrate that? Well, you can buy and pay as you play each individual item. Some people come in just for a little Botox, they might come in just for some soft tissue fillers, they might come in just for some skin clarity and laser treatments. In other ways, we very commonly bundle things together in the best possible package that addresses all of your concerns. We tailor and customize in a very bespoke fashion, a unique blend of energy-based devices, skincare, neuro-modulators, i.e. Botox, soft tissue fillers to customize that treatment program to the needs of your aging elements and face for a very unique and rejuvenative procedure that’s different for everybody.
So, how do you select the right physician for you for this antiaging quest, this journey? Probably a specialist like a plastic surgeon, a dermatologist, a facial plastic surgeon, a committed core specialist to beauty in the skin. Now, sometimes there are good specialists family physicians who have specialized in cosmetic medicine who are also very good, a non-typical specialist like gynecologists and other surgeons that will have ventured into cosmetic plastic surgery, but typically plastic surgeon, dermatologist, facial plastic surgeon. So you want to make sure they have a wide array of weapons against aging, so they want to have a full nonsurgical center that includes all the things we’ve talked about, skincare, energy-based devices, injectables, soft tissue fillers, suture suspension techniques and then also, if you’re fortunate, you’ve got a surgeon, a plastic surgeon or a facial plastic surgeon, or derm surgeon, that can offer small excisional procedures to compliment the nonsurgical. Or as you age and progress, and the nonsurgical is not enough to create the rejuvenation you want, you can add a blepharoplasty, a brow repositioning, a cheek lift, a neck lift as you age in different decades, different tools, including finally, scalpel-based rejuvenation.
So look for someone with experience, look for someone with a good reputation online, look on reputation sites such as RealSelf, Yelp, Citysearch, Facebook, Google Plus, Rate, M.D., search out the board certification, the college, and if they’re certified what’s their specialty, any complaints, any malpractice suits, do they have lots of testimonials of patients’ great before-and-afters, and do you have good word-of-mouth referral systems, either online, from people you don’t know that say great things about them, are they in the media and do they have great before-and-afters when they do those kinds of health-based shows? And when you do your consultation, do you have a wide array of options that you can select from and is there a discussion of the risks and benefits? Affordability obviously becomes part of the equation, generally the better physicians that are in demand will tend to be a bit more costly, but sometimes you get what you pay for.
So there’s a lot of elements that you should search out when doing your research. With the Internet now I think there’s lots of opportunity to research your physicians long before you present for a consultation. So most of the barriers to a successful relationship are eliminated by research online and then a live consultation with the physician to get feedback specifically on what your needs and solutions may be.
When you’ve taken a skincare preventative approach or a energy-based device, injectable approach, generally it’s common to be asked, well, what are the costs of these technologies and treatments? I think relatively they’re quite affordable compared to the surgical options. They’re certainly risk-reduced and recovery-reduced. Most of the treatments allow you to go right back to work that day or the next day. There’s a small risk of swelling, redness or bruising, but generally camouflageable. Most of your skincare products are sold by physicians at physician strength, are usually going to cost you about $250 for a good medical skincare program about every four months or three times a year. When you look at how much you spend on your nails, pedicure, manicure, skincare with aestheticians, and hair care products, spending that amount on your skin to look significantly more youthful is generally money well spent.
Once you start layering Botox and soft tissue fillers, the ranges can be several hundred a year to several thousand a year depending on the volume and the needs of those injectable elements. Energy-based devices, usually a good antiaging program is in the 2,000 or $3000 range once a year. Suture suspension techniques usually like thread lifting will be half the price of the surgical options. They’re generally quite affordable. If you’re committed to the best possible rejuvenation that you can achieve, it’s going to involve some of those elements and stepping up your game over and above what you get at a Walgreens, or a drugstore and an over-the-counter experience. Usually affordable and the return on investment is the youth and the beauty that you purchase, that you achieve through those physician interventions.
So thank you again for joining me, Dr. Stephen Mulholland, here in Toronto, Canada on Plastic Surgery Talk for our latest podcast installment on skincare and preventative nonsurgical treatments for pre and rejuvenation and looking great and youthful forever. If you found this to be informative, entertaining and interesting, please share this on all your social media channels and we look forward to seeing you again here on Plastic Surgery Talk. Thank you.