Health Features

Health: Tweaking the Body

You know what they say about supply and demand and necessity being the mother of invention ? Well, these days there’s increasing demand for less-invasive procedures, and that has given rise to an ever-growing supply of innovative technologies. Not surprising, when it comes to improving appearance, there is a solution for just about every problem area.

[crow’s feet & forehead fixes]
Your eyes and forehead may be aging you, without you even knowing it. Forehead lines, crow’s feet along the outside of the eye, and vertical lines between eyebrows are common signs of aging. They’re also the areas most likely to be treated with Botox.

eek! where did that come from?
The most significant causes of wrinkles in the forehead and at the edge of the eyes are repetitive actions by the muscles of expression, says Dr. Brock Ridenour, a facial plastic surgeon at Ridenour Plastic Surgery. “Over time, these repetitive movements break down the collagen and elastin fibers in the skin, leading to wrinkles. Age-related loss of fat around the eye, as well as excessive rubbing and squinting, also contribute to the appearance of aged eyelid skin,” he says.

And let’s not forget the sun. Damage to the skin caused by exposure to ultraviolet radiation also can accelerate the aging process, says Dr. Joe Muccini, a dermatologist at Midamerica Skin, Health & Vitality.

fight back
If started early, wrinkles in the forehead and eye areas can be treated without surgery. “The fastest and most effective way to soften wrinkles is with Botox,” Ridenour says. “Botox eliminates harmful muscle movements and diminishes the resting muscle tone that underlies wrinkles in the forehead and edges of the eye, also known as ‘crow’s feet.’” Botox is relatively affordable, but you’ll need injections every three to six months to maintain the effects.

Results depend on the expertise of the provider, Muccini says. If the provider is careless, it can leave the brow feeling heavy and eyelids looking droopy. To plump out especially deep forehead lines, fillers like Juvederm may be needed. “Dermal fillers are made of naturally occurring substances such as polysaccharides (sugar molecules) that can smooth skin and correct hollows.

opt weapons
Over-the-counter and prescription creams generally are not effective on established lines and wrinkles. However, they can improve surface texture and pigment, Muccini says. “Moisturized skin has more volume and it’s better hydrated, making fine lines and wrinkles less prominent,” he says. “These creams won’t have lingering effects, though.”

What about those expensive, specialty eye creams? “Eye creams are difficult to navigate,” says Ridenour. “You don’t necessarily need a separate product labeled eye cream if you’re already using a well-formulated facial moisturizer or serum. However, if you have puffiness, dark pigment, or sensitive skin, there are products that contain anti-inflammatory agents, brightening agents, antioxidants and ingredients that tone and reduce swelling.”

au naturel
Proper eating can delay skin aging, Ridenour says. Foods that contain the antioxidants lycopene (tomatoes and other red fruits and vegetables) and beta-carotene (carrots, sweet potatoes, pumpkin and spinach) offer protection from the sun and may help repair cells after sun damage. Also, polyphenols appear to have anti-aging effects, he says, and may diminish wrinkling.

[noninvasive contouring – too good to be true?]
Even those with healthy weight and body size ca n struggle with problem areas. Pockets of stubborn fa t in the midriff, waist and back are the most common complaints. But as with all things, there are tradeoffs if you choose to go the noninvasive route.

hype or consequences?
There are literally dozens of different noninvasive body contouring devices on the market, including mechanical, radiofrequency, ultrasound, cryolipolysis (fat freezing) and low-level laser therapy devices, according to Dr. Michele Koo, plastic surgeon with Aesthetic & Hand Surgery Institute. “The noninvasive devices all rely on the use of an externally applied energy to cause fat cell death or disruption (causing liquid fat to leak out of the cell).”

There’s not one machine that will do it all, though. Typically, these tools target fat, loose skin or cellulite—not all of the above, says Dr. Terry Myckatyn, plastic surgeon at Washington University School of Medicine. Fat-freezing devices like CoolSculpting are the most effective at targeting unwanted fat, he says. “Fat cells are more sensitive to cold than other cells. Cells die over several weeks, and the immune system clears them out,” he explains.

Myckatyn says while Lipodissolve received poor reviews, there’s a promising new FDA-approved injection, Kybella, designed to melt away fat below the chin. Most other devices focus on tightening skin. Ulthera, for example, is a popular choice for tightening skin around the neck. It’s often used in conjunction with CoolSculpting, Myckatyn notes.

As for cellulite, simply removing fat will not take care of the problem, he says. A new device, Cellifina, has been cleared by the FDA for long-term improvement of cellulite. It’s a manual tool that flattens dimples by snipping the clusters of tissues in the fat under the skin, that connect the skin to muscle. Still, Myckatyn says none of these devices works as well as liposuction. Koo agrees. and says patients often complain about the results and how uneven they appear.

[penny-wise & pound foolish]
Patients like these procedures because they are noninvasive and do not require much downtime. However, you can target only small, well-defined areas, and you’ll likely need multiple treatments to get the desired result, Koo says. A typical protocol is six sessions over two weeks or one a week for six to eight weeks.

Multiple treatments not only take time, but also are costly. Liposuction, on the other hand, can remove more fat over larger areas and tighten skin immediately, Koo says. The results also are more predictable. “For very small areas, external devices may be effective, but there is no data on the long-term results with truly good scientific studies,” she says.

Noninvasive procedures are not entirely pain-free, Myckatyn points out. For example, CoolSculpting can be uncomfortably cold at first and leaves the treated area feeling sore and numb. If you are considering a procedure, Myckatyn says to see a board-certified physician who can offer a variety of options. “Be very careful to ask what type of device is being used, and about the long-term results,” adds Koo. “Ask to talk to previous patients, and ask about adverse complications that can occur and what can be done about them. And start with very small areas to see if the result is acceptable.

[kiss aging lips goodbye]
Have you noticed that your lipstick just doesn’t look as good as it used to? Unfortunately, it may not be the product but what you’re trying to apply it to. As we get older, lips naturally lose some of their volume and definition, making them look thin and not as appealing as they once did. Don’t despair; there’s a fix for that!

the sad reality
As we get older, the dermal layer naturally loses fat and muscle, causing lips to appear thinner. Additionally, the lipline can flatten and blur, causing a loss of definition (and running lipstick!). What to do?

For starters, apply a good lip balm frequently, says Dr. Dee Anna Glaser, SLUCare dermatologist. Dry, flaky lips, which are more common as we age, make your lips appear thinner. She recommends inexpensive drugstore brands like Vaseline and Aquaphor. It’s also important to drink plenty of water and avoid things that dry your lips, like long-lasting lipstick and licking the lips. A good lip liner also might prevent lip color from running.

Fillers are an easy and relatively safe way to add volume, Glaser says. “There is a brand new filler that recently hit the market, Restylane Silk, that is approved for lips and fine lines around the lips,” she says. “Another new filler, Volbella, has a very soft look and can erase wrinkles and lines without making the lips bigger.” Juvederm and Restylane remain popular choices, too, she reports.

the beauty of fillers
Today’s fillers are made from a natural compound called hyaluronic acid, which is safer and lasts longer than collagen and fat injections. Another benefit is that it is naturally broken down by enzymes in your body, so it can be reversed within 24 hours if the patient is not happy with the result, she adds.

“Don’t be afraid of fillers,” she adds. “You probably don’t recognize all of the good lips that have been injected. It can look very natural. People are afraid of looking over-treated, but it can be done in a beautiful and artistic way.”

lines & wrinkles
Most people associate fine lines around the mouth with smoking. In reality, that’s just one of the possible causes. Sun exposure, genetics and repetitive movements like drinking from a straw, chewing on a pencil or even the way we annunciate words also can cause wrinkles over time, the experts say.

Over-the-counter and prescription creams probably do more for you before you develop these issues, says Glaser. Look for creams with an SPF of 30, vitamin C and retinol, which helps force collagen production, she advises.

As for treating fine lines and wrinkles once they appear, options include chemical peels, dermabrasion, laser skin resurfacing and fractional laser skin resurfacing, says Dr. William Hart, a plastic surgeon at Hart Cosmetic & Reconstructive Surgery Institutes. Deeper wrinkles require more aggressive treatments. One downside to these treatment options, though, is that they can affect your lip pigmentation.

the latest for lips
A newer treatment option treats the dermal level directly without affecting the upper epidermal level where pigmentation is made. Radio frequency treatments such as Pellevé have been around for a couple years and are growing in popularity, Hart says. “The results seem to be more consistent and less obvious. It is also comparable in price to other options.” While radio frequency treatments cause no damage to the cells, they still trigger an ‘injury response’ that causes the body to create large amounts of collagen fibers to fill in the wrinkles and leave the face looking younger.

Botox in small doses along the border of the lip can limit crease lines, too, Hart says. The best solution, however, is prevention, and that starts with not smoking and limiting sun exposure, Hart says.

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