Category: Skin Care/Medi Spa

It’s amazing how often patients suggest… “If I exercise more my loose skin will get tighter right?”  Boy don’t we all wish it was as simple as that.  Unfortunately it doesn’t work that way.  Without getting to scientific about it all let’s discuss skin changes with weight, child birth, sun damage, and other aspects of mother nature.

Exercise is a great thing, most of us could use more of it and it’s great in assisting weight control, muscle tone, maintaining bone density, and keeping our heart strong and our blood pressure down.  Exercise cannot tone your skin your skin however.  Good muscle tone will show nicely “under the skin” but the skin itself doesn’t change as much as we’d like with fitness alone; some just not much.

In fact, if your fitness means being outside swimming, hiking, biking, running, gardening, playing tennis, or golfing the fact is the Arizona sun may be aging your skin significantly while you’re getting more fit everywhere else.

Don’t get me wrong; I’m an Arizona boy and I love my time outdoors in the sun.  It is why we all choose to live here.  Just make sure you are vigilant with quality sunblock, consistent with hydration and try to do the outdoor activity when the sun isn’t beating you down with noontime intensity.  Quality sunscreen contains ingredients that are physical blockers i.e.; titanium dioxide and or zinc oxide.

Moderate exercise does improve blood flow to tissues balances our blood sugar lowers our blood pressure and can smooth out our hormone/endocrine physiology.  Some of these physiologic parameters are good for the skin physiology, but again watch the sun damage.  A significant component of skin aging is genetically driven and exercise can’t compensate for your genes.  Excessive exercise is not necessarily good for you either.  Remember your parent’s adage “everything in moderation.”  Excessive exercise can lead to low grade inflammation in the body, the joints, the organ systems and that’s not a good thing.  So be smart and be consistent with steady moderate exercise and in the long run you’ll be better for it.

Unfortunately if there is stretching of the skin from pregnancy, weight changes, whatever the cause you may need the tricks of our trade with surgery, lasers, truSculpt or other skin tightening procedures to accomplish your goal.  Don’t stop exercising; jsu don’t think you can exercise your “skin” back to youth.

There are many choice for facial fillers to correct fine lines, deeper wrinkles or to add real volume to the face. Juve’derm Voluma XC is the new kid on the block as a true volume filler for the midface and cheeks. The FDA approved Voluma XC for midface filling in early 2014, which makes it a fairly new product. Voluma is still a hyaluronic acid product like Juve’derm Ultra plus XC , Restylane-L, Perylane, or Belotero to name a few. Each new product even if made of Hyaluronic acid (H.A.), like many established products, still has to go through FDA guidelines to get approved so expect to see many different spin offs of hyaluronic acid over the next few years to fit specific needs for types of filling. Hyaluronic acid (H.A.) is a fancy chemical name for something your skin is naturally made of. Hyaluronic acid (H.A.) is a form of gel (think of jello) that our collagen and cells, blood vessels and nerves travel through as part of our skin. Hyaluronic acid is also known as hyaluronan. Oddly enough, back when I was a youthful general surgery resident much of my research related to collagen and hyaluronan. Little did I realize that many years later I’d be using these hyaluronan products all the time for cosmetic improvement for my patients.

So if hyaluronan is a regular part of our skin why are there so many product options. Of course one reason is pure competition by different medical product companies for parts of the market. Competition to make better products is always a good thing. More important for you the patient is to realize that each product is slightly different to fit different purposes. Voluma, to keep the concept simple, is a thicker denser form of hyaluronan than the other Juve’derm products so it can last up to 2 years, but is also designed to be placed deeper into the tissues to create a true volumizing of the face. Voluma is not meant to be used close to the surface under an individual wrinkle like Restylane or Juve’derm might. The differing densities of the hyaluronic acid products lets one be better for a real fine line and one be better for a deeper groove, and Voluma to be better for cheek augmentation as an example. There are other products like Voluma, Radiesse as an example, that can similarly be used for cheek augmentation. Both are great products, both work well, but any given patient might want one or the other for various reason, or any surgeon may prefer using one or the other. At my office I use both routinely and like both products a great deal. For the purpose of this blog we’ll focus on the H.A. product however.

Hyaluronic acid is a hydrophilic molecule. This means H.A. wants to attract water so depending on the density of the H.A. in the gel it pulls water toward it and holds on to water while the body slowly breaks down the product over a long period of time. This hydrophilic effect is what creates some of the extra volume creation by the product. It’s all pretty cool when you really think about it. We are using a natural occurring molecule that our skin looses with aging and we put it back in specific places and with specific products to get the youthful plumpness back into the skin; pretty awesome really. By changing the cross linking of the hyaluronan and the density of the product we get different degrees of water absorption (like a sponge holding water) and different rates of breakdown of the product. That’s why Juve’derm or Restylane might be great for lip lines, the Voluma would be a bit stiffer and denser and might not feel as smooth in that location. Voluma XC is an excellent midface filler and it’s great to have another option for patients. The XC designation just relates to the product having a little lidocaine anesthetic mixed in with it so the injections are less painful and the area injected gets a little numb quickly so it doesn’t feel achy after the injection. Most injectables we use in our office already has lidocaine in the product or we add it to the product prior to injection. Another nice touch is to use a topical anesthetic before injection that also makes it a more pleasant experience than a straight injection without topical anesthesia. The price of Voluma XC varies greatly from one office to another so it’s often wise to check with a given office what they are charging so you don’t pay a great deal more than you need to. Of course, balance this against the experience of the injector and office.

So may Aesthetic options so little time (and of course money).  Plastic Surgery has many terrific options to keep us looking healthy vital and refreshed.  Some of these are completely noninvasive and can take years off your appearance for very little cost.  One such option is Intense Pulse Light or what we call “IPL” therapy.  While patients sometimes think of IPL as a type of laser; it’s not a laser but does use light energy to improve the appearance of your skin.  True lasers use one specific wave length of energy to do its job.  Intense Pulse Light uses a narrow range of wave lengths from the light spectrum for specific purposes.
My IPL system has multiple special energy delivery heads that serve different purposes.  Each head or hand piece has a band of wave lengths that are a part of the light spectrum.  The device has a red, green, yellow & purple hand piece to deliver different methods of laser or light source to the skin.  One head is good for brownish pigment of the skin another for reddish tones another for hair removal as examples.  If you have heard the term photofacials; IPL is that type of treatment.  What has been shown is that patients who do perhaps five photofacials each year over five or more years have skin that is much brighter, healthier and younger appearing after those five years than it was before they were ever treated.  Not only do the color tones improve but the texture, fine lines, wrinkles and general appearance of the skin is improved.
IPL treatments have a nominal cost to our patients and there is no downtime.  Photofacials or IPL  treatments are great first steps in keeping your skin looking refreshed when blended with quality skin care. Come see us for a skin care consult and start turning back the clock.

If there is one thing I can say with a clear conscience is that we all can benefit from skin care.  Living here in Tucson with our endless clear sunny days and very dry climate can be tough on our skin.  You can hydrate all you want, with drinking water; a dry sunny climate is still going to steal some of the vitality from your skin.  This is as important for men as it is for women.  Granted men need a tailored approach that will work for them, but we all need to look after our skin.  In fact we have recently introduced the Turo Skin ™ care line specifically for our male patients.  With specific cleansers, skin care rejuvenators, exfoliants and shave conditioners.  This group of products is tailored for men and doesn’t overwhelm them with too many steps or products.  One advantage of male skin is it’s hearty and usually not unduly sensitive so men respond well over time with consistent use.  I’ve been consistent with my own skin care and close up photos show my skin to be much improved over 10 years ago.  I’ve seen the same effects in many male patients who are committed to mixing healthy skin with their active life styles.

Women routinely have been more accepting of skin care.  Women are more accustomed to cleaning their skin and applying products since it’s not more involved than applying makeup.  It’s just part of the process of feeling good about yourself for my female patients.  Men occasionally need a bit more of a nudge but the benefits can be huge when we look after our most important organ our skin.