The typical areas treated are the nasolabial folds (lines from the end of the nose to the end of the lips), perioral area (wrinkles around the lips), lips, wrinkles of the cheeks, marionette lines (lines from the corners of the mouth to the jawline, accentuating the downturn of the lip leading to a look of sadness). Other areas include filling in acne scars and the "tear-trough deformity" (hollow under-eye circles). Injectable fillers work by putting volume into an area that has lost volume. When this is done artfully, the appearance of lines and areas of concavity are erased, and a much more natural, youthful appearance is created. Results: The results are very gratifying for the majority of people. Filling in lost volume and wrinkles can often transform one's appearance in a very profound but natural way. Most of the time one's family and friends know something has changed but they are not sure what it is. Results for Restylane™ generally last around 4-9 months.
Obagi Nu-Derm System: For Skin That Looks and Acts Younger & Healthier
The Obagi Blue Peel is effective for all skin colors and thickness for many conditions including laxity, wrinkles, brown spot/age spots, large pores, and acne. Obagi Blue Peel can also be used on the neck, chest, hands, arms, and even legs. The Blue Peel is a quick, relatively simple procedure that usually requires approximately 20 minutes, depending on the number of coats your doctor has determined necessary to achieve your goals. The Obagi-C™ Rx System:
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Skin resurfacing procedures
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Click here for Before & After pictures of the Ogagi-C Rx System |
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COUPON: Print this coupon and receive 3 Free Glycolic Skin Peels with the purchase of the Obagi NuDerm System from CCENT |
More information from Obagi
Click Here for Before & After Pictures of the Obagi Nu-Derm® System
Click here for Before & After Pictures of the Obagi Blue Peel System
Click here for Before & After pictures of the Ogagi-C Rx System
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Cellex-C
Cellex-C Core Formulations are designed to help your skin look, act and feel like younger skin. After eight to twelve weeks of topical application, your skin will begin to feel firm, smooth and toned with deep wrinkles looking less pronounced. |
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With regular use, Cellex-C will improve the overall texture, color and look of your skin and help reduce the visible signs if aging.
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Glominerals™ Makeup
CCENT offers the Glominerals™ Makeup line. Our micronized mineral bases combine powerful antioxidants and UV protection in a delivery system that provides flawless coverage. It's skin-nurturing makeup for beauty with a higher purpose. Glominerals™ is safe for camouflage and sun protection following microdermabrasion, chemical peel, cosmetic surgery, laser resurfacing and waxing. |
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Physicians Complex Skin Care ProductsPhysician's Complex is a medically oriented skin rejuvenation system which, with continued use, will improve the quality and appearance of your skin. This skin care system is available only through a physician or physician-owned website. The products contain only the highest pharmaceutical grade, anti-aging ingredients. |
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Benefits Include
• Softer, smoother skin
• Firmer, retexturized, younger-looking skin
• Improvement in the appearance of hyperpigmentaion
• Improvement in uneven skin tone
• Improvement in fine lines and wrinkles
• Promotion of healthy cell renewal
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Glycolic Acid Peel Glycolic peel is a safe process that removes a micro thin top layer of skin. Removal of these damaged cells stimulates cell division that results in plumper, healthier, newer cells. The glycolic peel procedure smoothes and softens the skin, diminishes fine lines, decreases acne, even out discolorations and increases moisture retention. |
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The result is a wonderful appearance of glowing, healthier and more youthful skin!
Most people notice a change in skin appearance right away. Improvement continues over the course of the treatments revealing fresher, younger skin. Peels are done in a series of 6 at 2 week intervals and usually take about 20 minutes, making the procedure convenient and accessible at any time of the day, even the lunch hour!
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COUPON: Print this coupon and receive 3 Free Glycolic Skin Peels with the purchase of the Obagi NuDerm System from CCENT |
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TCA Peel- Trichloroacetic Acid Peel
Trichloroacetic Acid (TCA) Peels, often called "freshening peels", are chemical peels that have been used for many years to remove the buildup of dead skin cells. TCA (Trichloroacetic acid) Peels also help with age spots, acne, wrinkles, poor lusterless complexion, freckles, sun-damaged and weathered looking skin, shallow scars, pre-cancerous skin growths and skin pigmentation.
Trichloroacetic acid peels not only help to remove the buildup of dead skin cells but also promotes the growth of new cells. As your skin heals, new elastin and collagen tissues are formed and this will help tighten the skin, leaving it brighter and giving you a younger appearance. For optimal results, peels are performed in a series of 6 at 2-week intervals.
Related Newsletter Article - Skin Resurfacing Treatment January 2007
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OBAGI CLENZIderm™
Breakthrough Acne solution from OBAGI
CLENZIderm M.D. is clinically proven to treat the three main causes of acne:
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OBAGI ELASTIderm™
The missing piece of the anit-aging puzzle
Clinical studies of OBAGI ELASIderm show:
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Skin Resurfacing
Scars are an inevitable part of life. Unless you’ve never fallen or cut yourself, all of us have undergone the healing process that can lead to scars. Any surgery that involves a cut in the skin leads to scars. This article discusses some of the things that can be done to minimize excess scar formation.
After surgery or repair of a cut in the skin, keep the wound clean and out of the sun for at least a year. Cover the wound with a physical barrier (hats, clothes, tape) and apply sunblock over the wound. Sometimes an occlusive or semi-occlusive dressing is useful right after surgery to maintain some moisture over the wound but you don’t want the wound to be too moist and breed infection. Having a good nutritional status is also important for effective wound healing.
Some occlusive or semi-occlusive dressings are available over-the-counter. Silicone gels have been shown to decrease the redness, vascularity, pain, height, and itchiness of a wound and works well with all skin types. Studies have shown these to be helpful when applied twice a day beginning two weeks after surgery through three months with minimal side effects. Silicone sheets have been shown to help reduce excess scar formation. The mechanism of action is not clear but has been attributed to keeping the wound moisturized but not excessively. The best length of use is unknown but most recommend starting two days after injury and continuing up to 6 months. The sheets should be changed daily and the wound cleaned and washed daily. Another product is MEBO (moist exposed burn ointment) which has been shown to decrease redness and hyperpigmentation although some patients had a skin hypersensitivity reaction. Mederma skin care gel has shown potential but no studies have proven it to be more beneficial than other products. The active ingredient is Allium cepa whose derivative quercetin (a bioflavinoid) has shown anti-proliferative and anti-inflammatory effects. Quercetin is also found in apples, red wine, and gingko biloba. In laboratory studies, quercetin has resulted in inhibition of the cells that promote scar formation. Rretin A, Rrenova or other vitamin A derivatives have been shown to be especially helpful for reducing acne scars and other scars.
Pressure garments have been shown in the burn literature to promote better organized wound healing. In the face, this is often difficult to apply except on the ear. Magnetic ear rings are often a useful and aesthetic pressure device for excess scar formation at the site of ear piercing that tend to recur (keloids).
Despite our best efforts with the above treatments, excess scars still form. Vvarious treatments exist and vary in their successes, applicability to certain skin types, and effectiveness.
A common treatment is with topical or injection of steroids. Usually several treatments are necessary (at one month intervals). Pain is minimal (just the pain of the needle injection) and there is a risk of skin atrophy.
lasers are very useful for scars that are vascular or raised. They have been shown to shrink keloids as well. Keloids are excess scars that extend beyond the original incision or site of injury and tend to recur. A laser treatment can be started six weeks after the initial wound formation and often requires more than one treatment. Some darker skinned individuals have a higher risk of pigmentary changes with treatment and overaggressive treatment can lead to worsening of the scar.
Dermabrasion is another popular treatment of scars. The skin is superficially abraded and results in a smooth texture and helps blend the scar into the surrounding tissue. This can be started six to twelve weeks after the initial wound formation. Over aggressive treatment can result in scar depression and pigmentary changes.
Botox injections (also discussed in the newsletter for the treatment of wrinkles) can help reduce wound tension by immobilizing muscle. These injections are temporary but can be helpful especially in the initial wound healing processes.
Several other treatments exist for severe scars such as keloids which are too large to be resected or reasonably treated with a laser. These include radiotherapy and injection of chemotherapeutic agents such as 5-Fluorouracil. Both contain a risk of promoting cancer formation at the treatment site.
After a scar has matured (your body is continually remodeling and fine-tuning a scar months and even years after the initial wound is formed), your surgeon may recommend removing the scar and reclosing the wound. This is especially helpful for scars that wide from the initial injury (after a large cut on the face from trauma) or for scars which are oriented in a very noticeable direction. For example, a scar which runs parallel to natural wrinkle lines is less noticeable that a scar which runs perpendicular and right through them.
What about herbal treatments?
vitamin E in the body has been shown to inhibit inflammatory responses and formation of collagen (involved in wound healing). However, studies on topical vitamin E have been scant. One study showed that in 90% of patients, topical vitamin E had no effect or actually worsened scars.
Allo vera is another popular topical treatment which has been shown to improve healing in frostbite and electrical injuries. Studies on human wounds are lacking but it is otherwise safe to use. Centella asiatica (gotu kola) has been documented to aid in wound healing but again, human clinical trials are lacking but it is otherwise also safe to use.
There are many exciting studies involving herbs, barks or roots found in Africa and India with suspected wound healing properties. Curcumin, an antioxidant, has been found to help wounds heal faster, leaving smaller scars.
Conclusions:
There are many varied treatments of scars but all involve long term care and diligence on your part but can be guided along by your physician or surgeon.
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Blepharoplasty (eyelid surgery)
Focus On: Eyelid Surgery
This Article is presented in our January 2007 Newsletter
Eyes are one of the first areas to show aging. Some people refer to the eyes as the “windows of the soul.” They are certainly the focal point of the face and increased laxity of skin can portray a tired, sad, or melancholy appearance when in actuality we feel otherwise. Blepharoplasty surgery, or the eyelid tuck as it is sometimes called in layman’s language primarily gives us a more rested appearance by reducing the excess skin and fatty tissue which can develop in both the upper and lower eyelids with aging.
ANATOMY
The entire eyeball is surrounded by fatty tissue which medically we call adipose tissue. A thin membrane called the orbital septum holds this fatty tissue into position. With aging, the fatty tissue can bulge forward, especially in the lower eyelid, and form a hernia, just like in any other part of the body. The dark circles that people complain of are many times not due to pigmentation in the lower eyelids, although that can occur in rare instances, but is usually due to a shadow effect caused by this excess fatty tissue. This results in a convexed bulging to the lower eyelid with a resultant concavity which causes the shadowing effect. This is the reason the condition may appear more severe in various kinds of light.
The condition may be worsened during a woman’s menstrual cycle, or when one is
eating or drinking an increased sodium intake. Both of these conditions result in an
increased fluid retention by the body. The fatty tissue attracts this fluid which results
in an increase in bulging in this area. If the condition is detected early, the fatty tissue
can be removed simply by using a laser on the interior part of the lower eyelid and
removing the fat without any external incision. This is called a transconjunctival
blepharoplasty. The fatty tissue is removed and the skin redrapes into its normal
position. However, if the condition has persisted too long or the skin laxity has
markedly increased, then both skin and fatty tissue need to be removed. This would be
the traditional blepharoplasty or eyelid tuck.
The appearance of our eyes is an individual
characteristic and is due in part to the shape of the
bony cavity (the orbit). Some people have a very
prominent superior orbital rim which affects the
shape of the periorbital area. little can be done
to alter bone structure of this area. In some cases
the depth of our eyelid crease is determined by the
amount of cartilage in the eyelid area. This is an
inherited characteristic and there is a limit to how
much can be modified. For example, an individual
with small eyelid fissures may be able to obtain
significant improvement in the appearance of their
eyes and a well rested look, but may never be able
to obtain a large deep set upper eyelid fold due to
their anatomy.
Individuals show changes in the eyes at varying
ages. The average person as early as age 25 may
have enough laxity in the upper eyelid that they can
obtain significant improvement and at approximately
25-30 for the lower eyelid. However, our individual
anatomy in this area varies so greatly that a good
rule of thumb on the time to seek eyelid surgery
is, for women when it becomes difficult to place
eye shadow on the upper eyelids, and for men and
women when a good night’s sleep doesn’t get rid of
puffiness in the lower eyelids.
SURGICAL PROCEDURE
Eyelid surgery is usually performed in our office
surgical suite under twilight anesthesia on an
outpatient basis. A special marking pencil is used to
mark the upper eyelid crease and calipers are used
to engage the amount of excess skin contained
in the upper eyelid in a method called a pinch
technique. The skin is then removed and excess
fatty tissue from the middle (medial) most portion
of the eyelid is also removed. In some cases the
upper eyelid muscle may be contoured. The incision
is closed with dissolvable sutures and/or sutures
that run underneath the skin and can be painlessly
removed after several days. Within approximately
one week the incision conforms to the natural
contour of the eye and is hidden in the eyelid fold.
laterally it blends in to the fine eyelid creases in the
outer part of our eye.
In the lower eyelid an incision is made several
millimeters below the eyelash line and is carried
laterally into the skin crease. The skin and muscle
are reflected down and three fatty tissue pockets
in the lower eyelid are opened and excess fatty
tissue is removed. The skin and muscle are then
repositioned and excess skin is removed. The
incisions are closed with interrupted dissolvable
sutures. Frequently special tape is used to support
the lower eyelid area for a week after surgery. This
helps to reduce the amount of swelling and bruising
and allows and increased amount of extra skin to be
removed more safely.
If the only problem in the lower eyelids is bagging secondary to excess fatty tissue no external incision is needed. In this case the incision and removal of the fatty tissue is performed from inside the eyelid with no incision on the outside of the eyelid. If excess fatty tissue has resulted in stretching of the lower eyelid skin, then both fatty tissue and skin need to be removed in the traditional blepharoplasty with an external incision.
Patients commonly will ask how long eyelid surgery
lasts. Because the tissue is removed, one will
always look better than they would have had they
not had the surgery. Unfortunately we continue to
age, so there will always be changes in this area.
We are fortunate that eyelid changes do not occur
as rapidly after surgery as changes in other areas.
While some individuals may require repeat surgery,
we find that most people, whether they have
surgery done at age 30, or at age 50, rarely have
to have this procedure repeated. This appears to
be due to the fact that the fatty tissues does not
recur and that the eye is located within the bony
structure and appears to be protected somewhat
by the gravitational and environmental effects of
aging as contrasted with the cheeks, jowl and neck
area which may need tuck up procedures after a
facelift.
Various types of chemical peels can be used to remove wrinkling in the eyelid area and provide an additional tightening effect to the skin. These are usually performed 3-4 months after the eyelid surgery. various types of chemical peels can be used. Each type of peel varies in the degree of wrinkle removal and tightening that is obtained. Some provide an increased lightening effect to the skin in the eyelid area. A new development in recent years has been the use of laser abrasions to resurface or rejuvenate eyelid skin.
RECOVERY
Following eyelid surgery an individual needs to sleep with their head elevated approximately 30º for the first two weeks following surgery. They need to refrain from lifting over 5-10 pounds or activities which result in heart rate elevation for the first 7 to 10 days following surgery. This will help to minimize the amount of swelling and bruising.
Eyelid incisions are cleansed with hydrogen peroxide soaked Q-tips 4-5 times a day during the first week. The patient can wash over these areas or get in the shower, as long as the shower spray does not directly hit the face. In fact this is encouraged in order to accelerate the wound healing. Makeup can be applied after 7 days. Applying makeup sooner could result in irritation to the incision lines and should be avoided. Ice water soaked compresses are applied to the eyelid area, every 10 minutes, for the first 48-72 hours following surgery. This is critical in helping to reduce swelling and bruising, decrease discomfort and accelerate wound healing. Ice packs work well, but do not contour into all areas of the eyelid and therefore increased swelling and bruising can result. This problem is eliminated with wash clothes soaked in ice water.
One needs to limit eyelid movement for the first 48 hours after surgery. This means they should keep their eyes closed as much as possible and use the cold compresses.
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