| Botox, Restylane and Obagi
Non-Invasive Procedures To Treat Facial Aging There are three main
signs of aging in the face: the development of lines and wrinkles,
sagging and relaxation of the tissues of the face, and changes in the
quality of the skin (increased pore size, increased thickness,
pigmentary changes, flaking, etc.). We can pull on the skin as in a
rhytidectomy; we can correct the muscles causing the wrinkle if it is
a dynamic wrinkle, or we can fill up the groove, thereby making the
If the forces causing the wrinkles are due to underlying muscle
contraction, then paralysis or weakening of that muscle results in
fading or lessening of the wrinkle. This can be accomplished by Botox
injections. Botox is produced from the fermentation of a strain of
bacteria. It works by blocking the release of acethylcholine from the
end of the nerve which is the chemical released from the nerve to
produce muscle contraction. Botox is very successful in the glabellar
area (frown lines between the eyebrows) in crow's feet area; sometimes
in the forehead. Botox is occasionally used for neck bands and for the
corners of the mouth.
If the wrinkle is not entirely due to muscle contraction, or if
complete paralysis of the underlying muscle(s) is contraindicated, a
variety of substances can be used to fill the wrinkle. The materials
used for filling wrinkles can include human collagen (injection or
sheets) or synthetic substances. Some are manufactured substances
similar to tissues normally present in the body (Restylane, Radiance)
some are substances that are completely foreign to the human body
(Silicone, Acrylic beads).
As the skin loses volume and wrinkles start to appear due to the
loss of the ability to produce enough of a naturally occurring
substance called hyaluronic acid (HA) we can replace that substance
with Restylane which is made of molecules of the same chemical
attached together (polymerized)
The treatments are quick and easy and they are cost effective.
Allergy testing is not required and the side-effects are minimal.
Restylane is a clear non-animal biodegradable hyaluronic acid gel (HA)
with an excellent safety profile. The gel is injected into the skin
with a very fine needle to minimize discomfort. The effect of
Restylane generally lasts about six months, but this varies depending
on the area injected. It will last longest in an area which has very
little motion and little circulation.
Another option for tissue replacement is Radiance, made of calcium
hydroxyapatite, a molecule found in bone and coral, the particles are
small enough to be injected. I reserve the use of Radiance to defects
over bony areas and the naso-labial folds.
Although one may want filler that will be permanent in nature, the
disadvantage of such filler is that, if any irregularity were to
occur, it would be very difficult to correct. Any long- lasting filler
will induce scar tissue formation and the amount of scar tissue and
the quality of the scar tissue will vary according to the patient and,
therefore, is not a controllable variable. The other advantage of
using non permanent filler is that, since the aging will vary over
time and over the areas of the face, adjustments are possible with
subsequent treatments as the changes of aging are occurring.
If the changes are mainly in the form of pigmentary changes and in
the quality of the skin I recommend the Nu-Derm program.It will
replenish the collagen, correct the pigmentation and get rid of the
pre-malignant cells. Nu-Derm is a series of products applied by the
patient morning and evening and adjustments with regards to individual
needs are made. It is useful in the treatment as well as maintenance
for healthy skin.