The winter season can turn our thoughts to self-improvement, especially as we recover from holiday meals and celebrations. Health care professionals say it’s an ideal time to consider skin and body treatments that can help us face warmer months with confidence.
cellulite solutions
There’s a new treatment option, Cellfina, for St. Louis-area women hoping to make cellulite a thing of the past. Imagine getting rid of that unsightly subcutaneous fat that causes dimpling of the skin on your thighs and buttocks!
meet cellfina
Dr. Richard Moore, owner of The Lifestyle Center in Ladue, has begun offering the cellulite-reducing system intended to improve on treatments of the past. “Older procedures would stretch the fibrous bands under the skin or shrink the fat cells that contribute to cellulite,” Moore says. “Cellfina actually releases those bands, so the results are longer-lasting.”
First, Moore says, prospective patients have to be screened to see if they are candidates; very loose or thick skin may not be appropriate for the procedure. “This treatment is for true cellulite ‘dents,’ not the orange-peel skin laxity that comes with age,” says Racquel Frisella, a nurse practitioner at Nayak Plastic Surgery, which has been offering Cellfina for about a year.
the process
During the procedure, a local anesthetic is injected into the area being targeted, then a suction device is placed on the skin to deliver the treatment. Moore says a small pin goes into the anesthetized area, moving back and forth to release the tissue bands under the skin. “After-effects are minimal, but may include a small amount of soreness or bruising that usually resolves in five to 10 days,” he notes. “We treated one of our employees here at the office, for example, and she continued working immediately afterward.”
Cellfina may take as little as 20 minutes in the doctor’s office if the patient needs only about 10 sites treated; those with 40 or 50 sites may spend an hour or so. “There’s usually no significant downtime afterward,” Moore says. “We have patients wear a compressive garment such as bike shorts or Spanx for a couple of weeks to give the skin a chance to readhere to the soft tissue underneath. And routine exercise is fine, but anything strenuous such as hard running or squats should not be done for 30 days.”
long-term solution?
Moore says clinical study results are showing that Cellfina continues to be effective three to four years after treatment. “The manufacturer is seeing patient satisfaction ratings of 96 percent at two to three years out,” he says. “This may be a permanent cure for cellulite; only time will tell.”
Frisella adds, “Our patients say they feel much more comfortable in workout clothes and yoga pants after the treatment. They like the way it makes their thighs and buttocks look smoother. It makes them feel better about themselves.” Technologies of this kind are continually evolving, too, she notes—so even more improvements may be on the horizon.
unsightly leg veins
Health care providers agree that winter is an ideal time to treat unsightly spider veins and varicose veins common in the legs. A little advance planning will have you ready for swimsuit weather.
varicose vs. spider
“Both women and men come to our office at this time of year for treatment of symptomatic varicose veins and spider veins,” says Maria Bein, R.N., clinical director at Vein Specialties in Creve Coeur.
Varicose veins are visibly twisting, bulging blood vessels caused by the failure of one-way valves inside the vessel. Blood leaks backward and collects in spots, causing the vein to swell. Symptoms include tiredness, leg pain and cramping, and feelings of ‘heaviness,’ pressure, throbbing or tingling in the legs. Treatment can be delivered via radiofrequency ablation (removal) such as the ClosureFast procedure, which uses heat to shrink veins; laser ablation to resurface the skin; and microincision venectomy, which removes vein clusters through small incisions, explains Dr. Patrick Geraghty, professor of surgery and radiology at Washington University School of Medicine.
Spider veins also are visible through the skin and caused by the backup of blood, but they’re smaller and red or purple in color. They can be treated with injection sclerotherapy, which involves injecting a saline solution that narrows the vessels, Geraghty says.
plan ahead
“Some people come to my office wanting varicose and spider vein treatment right before summer, but it can take four to six weeks for post-procedure bruising to resolve,” Geraghty notes. “You want to plan farther ahead than that.” Bein adds that a series of treatments may be required, and patients may need time to meet health insurance prerequisites before receiving care. So scheduling a wintertime doctor visit makes sense.
Another reason to seek treatment in colder months is that patients are wearing long pants anyway, so there’s time for any bruising or small scars to heal unseen before shorter pants and skirts come in season. Dr. Norman Bein of Vein Specialties notes that some patients also seek varicose vein treatment at the end of the year to meet health insurance deductibles.
easier than ever
Geraghty describes today’s treatments as “walk in, walk out.” Most can be done on an outpatient basis, often with simple injectable agents and minimal incisions. He says it’s common for a patient to spend about an hour at the doctor’s office, then return to work in a day or two. “Usually there’s no pain that requires anything more than ibuprofen,” he says. “It’s a nice change from older surgical procedures in terms of discomfort, appearance and recovery time.”
“Twenty years ago, you would have an operating-room procedure for varicose veins,” Dr. Bein explains. “Now, in-office treatments can be done with local anesthesia.” He says varicose vein procedures normally are covered by health insurance, while spider vein therapies typically are not because they’re considered more cosmetic than medically necessary.
“It’s very satisfying to see people get dramatic improvement from simple procedures,” Geraghty says. He notes that varicose vein patients often say they’ve suffered for years without treatment because they didn’t know today’s options are quicker and easier than surgeries of the past. “Now people are astounded when they see the results,” he says. “The most common thing they say is, ‘I can’t believe how long I waited to have this done!’”
face time
Beauty may be only skin deep, but most of us would kill for lovely skin. Fortunately, help is on the way: Health experts say there are options to improve facial skin quality, especially during winter months.
common concerns
“People are interested in their skin year-round in terms of health and appearance, but as warmer weather approaches, they focus on what’s bothering them most,” says Dr. Joseph Muccini of MidAmerica Skin Health & Vitality Center in Chesterfield. “And they’re living longer, which allows them more time to be discontented with signs of aging and skin damage that don’t fit their self-perceived images of youth and vigor.”
Carol Anderson, BCRN, BSN, CANS, a registered nurse and owner of Nouveau MedSpa in Kirkwood, says the main facial skin issues she sees in winter are discoloration, hyperpigmentation from previous sun exposure, broken capillaries in the skin, and ‘crepey’ lines and wrinkles. “Patients have just come through the holidays and are thinking, ‘I don’t have a lot of social activities going on now, and I’m not outdoors and exposed as much, so now
is a good time to improve my skin for the spring,’” she says.
Anderson points out that as people age, their skin loses collagen and becomes thinner. “Collagen protein is like the ‘mortar between the bricks,’” she notes. “When patients come in asking to ‘fill this spot in’ and ‘plump this area out,’ I tell them we need to improve their skin quality first by boosting its collagen so it will be thicker, stronger and more resilient. It will need less in the way of fillers, and it will look better.”
the toolbox
Anderson cites multiple therapies to improve skin quality. One is the Sciton Forever Young BBL laser system, which helps tighten skin and treat broken capillaries, sun damage and brown pigmentation. “It actually ‘turns off’ aging genes that cause collagen breakdown and ‘turns on’ youthful genes that rev it up,” she says. “The technology involves BroadBand Light, or BBL, which applies color wavelength to improve skin at the cellular level.” Anderson says this technology requires no post-procedure downtime. If your skin has a lot of hyperpigmentation, it may take a few days for dead skin cells to slough, but you still can apply makeup and observe your normal daily routine, she notes.
According to Anderson, patients also are asking for new facial procedures such as fractionated radiofrequency (RF) technology and platelet-rich plasma (PRP) treatment under the brand name Infini. “These can be used together or independently,” she says. “RF is good for tightening and lifting skin, and PRP rejuvenates skin cells. When they’re used together, you often see faster healing and less downtime. You could have the procedures on a Wednesday, and be ready for work Monday.”
Once skin quality has improved, Anderson says patients often consider injectable treatments such as Botox, Juvederm and Restylane for wrinkles and lines, and Radiesse to plump the jawline. Sculptra, a biostimulator, helps the body generate more of its own collagen to restore facial areas that need filling, she says.
Muccini adds, “For wintertime, I recommend Pearl or Pearl Fractional treatments, or any more aggressive laser or ablative treatment (to treat lines, uneven skin texture and sun damage). Recovery from this type of treatment is something patients feel more comfortable with in non-summer months.”
