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Before & After
You may have noticed that this week and next, we’re having Open House sessions about Coolsculpting®. Coolsculpting has been featured in the national news (the Today Show, Good Morning America, the CBS Early Show, the Dr. Oz show, the Rachel Ray show, Extra, Nightline, and more) and in fashion and beauty magazines ranging from O to Elle, Marie Claire to Allure. Maybe this has piqued your curiosity! Coolsculpting is a relatively new procedure that offers a non-surgical way to deal with those love handles, fat bulges, tummy rolls—all the trouble spots that the gym isn’t fixing for you because the fat is under your skin, not under your muscle.
How good is it? It gets a 4 out of 5 star rating, 75% “worth it” rating on RealSelf.com. That’s an encouraging number, but what about the other 25% of people? Patient selection is key to attaining good results.
There seems to be a lot of confusion on the web about how it works—along with some misunderstandings about what’s normal before, during, and after your procedure, and what it can (and can’t) do for you. These are the types of questions we’ll be addressing in our open house seminar, and we’d love you to come learn more about it if you’re curious or considering it. You get to ask national expert Carolyn Cassling and our excellent staff about any questions that you may have.. And, if you want to know what it will FEEL like, we will even have live demonstrations going on—you can ask someone for yourself what they’re experiencing! This is a really good opportunity to find out more.
“I kind of overdid it this summer.” “I didn’t mean to get such a bad sunburn.” “But I was wearing sunscreen!” “It was cloudy!” I hear these comments from my patients frequently, and they often want to know what they can do to minimize sun damage after a little too much fun-in-the-sun. In these last few days of summer, we are often tempted to cram in a little extra R&R, a little more sunshine, before the back-to-school season signals the end of summer fun.
Immediately after prolonged sun exposure, your skin is stressed. One of the best things that you can do to take immediate steps to reduce your skin’s stress level is to apply a lotion or serum containing antioxidants. I would recommend both Phloretin CF® and CE Ferulic® from Skinceuticals. If your dermatologist happens to have GentleWaves™, early treatment (within the first 24-48 hours) can reduce the amount of redness and inflammation that you experience and can improve healing time and quality. Over the next few days, remember that your burned skin will lose moisture faster—so drink extra water to help rehydrate, and continue to apply antioxidants and broad-spectrum sunscreen!
Too late for immediate first aid? Even weeks after a sunburn, GentleWaves LED treatments can help reduce visible signs of sun damage (fine lines, wrinkles, freckles, and redness) and improve skin’s texture and appearance. If the damage is extensive or you have a history of too much sun, you should consult with your dermatologist for a skin safety check and additional treatment options.
Stretch marks are clinically called striae distensae. Until recently, very little could be done for stretch marks. Historically, the only reliable way to eliminate stretch marks was to surgically remove them (for example, with a tummy tuck), which left scars of its own. Then, in 1996, Dr.McDaniel reported that a pulsed-dye laser (PDL) could successfully treat stretch marks1. The PDL became the gold standard treatment, but time marches on and science continues to advance.
In May of 2011, medical researchers reported finding a new laser that was surprisingly effective against stretch marks in people with medium-toned skin (Fitzpatrick types II-IV) 2.
This particular study was impressive because it tested the laser on over 50 people, in many different areas of the body, and on stretch marks that were up to 40 years old! Most of the stretch marks treated in this particular study were 3-20 years old, so it’s not too late to do something about them. Improvements do take some time to become visible, but this study showed that this laser treatment helped stimulate production of new collagen and elastin to help improve the appearance of in the stretch marks, sometimes in as little as 3 months. The Palomar Lux1540™ non-ablative laser has received the first fractional clearance by the United States Food and Drug Administration (FDA) for the treatment of striae (stretch marks).
The best news for you is that this is a service that we offer! And if you’re still interested in the studies, you can find links below to the summaries of the original articles.
2. de Angelis, F., L. Kolesnikova, F. Renato, and G. Liguori, Fractional nonablative 1540-nm laser treatment of striae distensae in Fitzpatrick skin types II to IV: clinical and histological results. Aesthet Surg J 2011; 31:411-9.
The quest for maintaining or restoring health and beauty impacts each of us in different ways. If you are sitting in a doctor’s office as you read this article, then you are likely involved in some aspect of this quest. Much of American (and western) medicine is focused on treating disease and hopefully restoring health, sadly with much less emphasis on maintaining wellness and health. Ideally, each of us would have as one of our life’s goals to pursue not just a long lifespan, but rather the goal of achieving “healthy longevity”. Having a lifetime of good health inside and out requires some planning and education. There are many articles and books devoted to these pursuits so I will simply try to summarize a few key points and highlight some practical tips that are easily adoptable even for people with limited time or limited budgets.
While a healthy body does not guarantee healthy skin, the old adage that “inner beauty of spirit shines through” also applies to a healthy body – our skin tends to reflect our inner health and well-being. Problems such as chronic physical illness, chronic stress, poor nutrition, lack of exercise and many other factors certainly take a toll on the skin.
In particular, environmental damage to your body – whether from the inside or the outside – really impacts not only your health and longevity, but also how long you maintain a youthful appearance. While we all experience chronological aging (the clock ticks onward for each of us), lifestyle decisions can significantly impact biological aging. We all know people who do not look or feel their age. We also know those who seem much older than their birthday. Even identical twins typically die many years apart in age! There are studies showing dramatic differences in aging of skin in identical twins who have had different environmental exposures (oxidative stress from free radicals and inflammation are two major causes of premature aging that we can impact).
Twin studies show us that while some aspects of aging are due to genetic inheritance, others are clearly due to differences in lifestyle. While we cannot change our genetics (or genes or DNA) and we cannot completely control our environments, our lifestyle choices can significantly impact how our bodies (and our skin) cope with daily life. So please choose wisely and choose health! Here are some helpful tips:
Anti-Aging Tips for Healthier Body & More Youthful Skin
- Eat a “Rainbow” diet with brightly colored fruits and vegetables rich in antioxidants
- Decrease sugar as much as possible (and I prefer to avoid most substitutes as well)
- Eat cruciferous veggies (yes, this means broccoli, cauliflower and brussels sprouts!)
- Omega 3 fish oil supplements (or natural if you can accomplish that)
- Avoid high glycemic index foods and include good natural fiber
- Eat as close to the farm as you can (less processing is generally better)
- Check vital nutritional values such as vitamin D and other critical ones
2. Protect your skin
- SPF with “Broad Spectrum” label per new FDA labeling guidelines
- Consider topical super-potent antioxidants
- Rx topical retinoids are still among the best products for many people
3. Exercise & Sleep
Get enough of both and don’t overdo either one
4. Be proactive (and not reactive) about your health
Read, learn and become your own advocate
5. Keep your mind active…not just your body.
Stay engaged, pursue something you love, enjoy fellowship with other people, help someone else, and never, never stop learning and thinking!
LaVív™ by Fibrocell® is a very innovative new anti-aging therapy which uses your body’s own skin cells to rejuvenate your skin. The Fibrocell process takes a small sample of your skin from behind one ear and then isolates the cells that produce collagen, elastic fibers and hyaluronic acid (which you might know better as the active ingredient in popular fillers such as Juvéderm or Restylane) and then multiplies these cells (called “fibroblast cells”) creating tens of millions of new cells. The cells are then frozen and stored at Fibrocell until you are ready to have your cells injected back into your skin. The unused cells can be stored for years for possible future use, so as aging progresses you will be able to be treated with your own younger cells!
Originally approved for wrinkles and furrows or smile lines (the lines from your nose to the corner of your mouth), LaVív can also be used off-label to inject fine lines and wrinkles on most areas of your face and potentially other areas such as chest/décolleté and the back of your hands, etc. may be treated. LaVív has been used very successfully to treat various types of facial acne scarring and it is being studied for other types of scars. Results are natural and long lasting. Unlike some other skin rejuvenation procedures, LaVív can be used on skin of any color. LaVív is not a volume filler, so results occur over time and produce a natural, youthful appearance, but it also does not require the continual maintenance that current fillers which need repeat injections at periodic intervals.
A new anti-aging cream made from an extract produced by your own cells during their growth and multiplication is expected to become available this summer so that you can apply a personalized cream to complement your treatment with LaVív.
One of the many exciting things about LaVív is that you are using your body’s own cells to heal and rejuvenate your skin. I have specialized for most of my career in providing treatments which produce a natural appearance and youthful beauty to your skin with minimal or no downtime and I was privileged to help with 4 of the clinical studies before the FDA approval of LaVív. We were one of the first few centers in the country (and the first in Virginia) to offer LaVív after its FDA approval. We are also helping to train physicians around the country for the injection techniques for LaVív. Please call if you would like to discuss if LaVív might benefit you – we would be happy to teach you more about this exciting new product.
Remember the saying: “An apple a day keeps the doctor away”? Well, there is more truth in that as we learn more about genomics and how fruit-derived antioxidants and other beneficial compounds from food or Nature may keep us healthier. There have been a number of research studies in recent years demonstrating benefits of apples and there are now apple derived plant stem cells appearing in some anti-aging creams. In fact, the Phloretin CF® antioxidant lotion from SkinCeuticals which we often recommend has some derivation from apples.
This new research study, though, demonstrated rather convincingly that eating white-fleshed fruit such as apples and pears (and also things like cauliflower, bananas and others) may significantly reduce the risk of stroke. The study from Dutch researchers looked at data from over 20,000 people from age 20 to 65 years old and examined their diet for an entire year. None of these people had known heart disease or stroke when this study began. They found that for EACH 25 gram daily ingestion of these white fruits and vegetables there was a 9% decrease in the risk of stroke.
FYI, a whole apple is about 120 grams or nearly 5 times this 25 gram dose – so truly even “an apple…” that is one apple per day may have very profound impact on this type of health risk. So while the study relied on people’s memory of their diet and those kinds of studies can have problems, the results of this study are still pretty compelling.
Personally, I usually eat about half an apple per day, and I now think that I will try to increase that a bit. So for those of you who have attended some of my lectures, you will know that I usually advise to have a daily intake of “brightly colored fruits, berries and vegetables”, and now you should add the “white fruits and veggies” to that list!
Note: this study was published online before print in the medical journal Stroke, DOI:10.1161/STROKEAHA.110.611152
Greetings from the 5 Continent Congress on cosmetic and laser surgery. This meeting was held in Cannes this year, where I had the pleasure of seeing a lot of old friends as well as many new luminary cosmetic surgeons. Exchanging the European viewpoint on cosmetics with American ideas is a great way for us to all benefit. I have some new ideas and tips and can’t wait to share them with our staff and our patients. Since Europe is “ahead” of the USA on many new treatments and products due to our slower regulatory system here with the FDA, it was really nice to preview things soon to come to America. Dr. Zein Obagi, creater of the Obagi® product line, was a speaker there and he and I were able to speak afterwards. He invited me to visit him in Beverly Hills sometime, but in the meantime we discussed some of his his new ideas on skin care. FYI- he still thinks “active vitamin A” is one of the cornerstones of anti-aging and skin rejuvenation. I also strongly believe this as many of you know. Dr. Obagi has a new non-prescription skin care line now called ZO Skin Health (which is between over the counter and the original medical prescription Obagi® line). I also had dinner one evening with my friend Dr. Ghislaine Beilin who is a cosmetic dermatologist to the stars in Paris. She had just returned from China after opening a new spa there (she consults for spas around the world) and I learned some fascinating new ideas from her as well, a few of which I will try to incorporate here. Overall, the 5 Continent Congress was a very successful and insightful meeting. I would also note that the Mediterranean diet really is a lot healthier than the typical American diet! I look forward to the next meeting in two years and to sharing all of this insightful new information.
Now that fall is here and suntans are fading, many people resort to tanning beds to maintain that golden glow of summer. So, just a friendly reminder that the golden glow turns into wrinkles, unsightly age spots, and sometimes skin cancer!
Estimates are that 10 minutes in a tanning bed (for fairer skin) have about the same cancer-causing effects as 10 minutes in the midsummer Mediterranean sun (and I might add without enjoying the beautiful scenery and water).
Studies show that indoor tanners are about 75% more likely to develop melanoma–the deadliest form of skin cancer–than those who didn’t use tanning beds. They are also 2.5 times more likely to develop basal cell carcinoma-not to mention the increased probability of wrinkles and saggy, leathery skin. So be safe and please avoid using tanning beds!
If you are determined to keep that summer glow, self-tanning lotions are now available in many forms and spray tan is an option (FYI, I suggest not inhaling spray tan mist!).
Posted in Laser and Cosmetic
Recently, the FDA issued long-awaited new sunscreen labeling rules. For the first time, the label terms which had no official or scientific basis (such as “waterproof” or “sweatproof” or “sunblock”) will be replaced by meaningful terms supported by valid testing and clear rules. The rules take effect in June 2012.
What does this mean to you?
Well, beginning in June, if you see the words “Broad Spectrum”, you can be confident that you have both UVB (burning ray) and UVA (aging ray) protection–which is what I recommend for both skin cancer prevention and anti-aging. Even skin of color patients will benefit from the broad spectrum sunscreen.
Sunscreens which have some water resistance will be labelled “water-resistant” and specify resistance to either 40 or 80 minutes o f swimming or sweating. Also, sunscreen companies must prove if their product provides sun protection more than two hours without reapplying.
Does keeping your skin covered with a high SPF or with clothing (or if you have darkly pigmented skin of color) prevent receiving “enough” light to produce the Vitamin D your body needs?
That is a common question I receive these days and there is a lot of misinformation about this subject. While there is debate about what is the optimal level of Vitamin D (recall that some guidelines recommend levels to prevent disease rather than levels needed to produce optimal health… two different goals!) there is general agreement I believe on some basic issues. Research suggests that 2-8 minutes of summer sunlight daily (at the latitude where I practice) to unprotected skin is generally sufficient and also should carry most people through the winter when the sun is less intense or clothing covers your skin (recall that Vitamin D is stored by your body).
It is possible that some people are not, for various reasons, producing enough Vitamin D from sunlight for their body’s needs. However, that does NOT mean you need to top wearing SPF or buy a tanning bed membership! It just means that you need either dietary source or dietary supplement (typically this would be D3… good dietary sources of Vitamin D include such foods as salmon, sardines (I know, but they are great for your health in many ways), eggs, and fortified foods like some juices and breakfast cereals… so check out these and other dietary sources to help you achieve your desired Vitamin D levels. And check with your family doctor about whether you need to have your Vitamin D levels checked and also the number of units to take daily if you need a supplement-but please do not overexpose yourself to sunlight or tanning beds to get your Vitamin D-this will accelerate aging of your skin as well as possibly increasing your risk of skin cancer.
Posted in Laser and Cosmetic