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Family Health Magazine
WOMEN'S HEALTH

Put Your Best Face Forward
Five Common Cosmetic Procedures

The quest for clear, smooth, youthful skin is not new. For thousands of years we have used products to improve our skin. Still, compare Cleopatra and her sour milk baths to the current multi-billion dollar skincare industry. We are exposed daily to magazine ads, billboards, commercials, and now extreme makeover television promoting a youthful appearance.

Why all this interest? Baby boomers are getting older. However, they take better care of their bodies than previous generations did. They exercise, eat well, and are staying active and vital as they approach their senior years. Of course, they want to look as good as they feel.

Effective and affordable non-invasive procedures are now available. These methods involve very little or no down time. They soften the signs of aging, creating a natural, more youthful look without the noticeable tightness of a facelift.

According to the American Society of Aesthetic Plastic Surgery, the number of cosmetic procedures being done has increased over 400 per cent since 1997. Over 80 per cent involve non-surgical treatments. It is often not just one, but a combination of procedures that offers the best results. Both surface and deep layers of the skin, as well as underlying muscle are affected. So what are these treatments and how do they work?

Botox

Botox is the most popular cosmetic procedure done in North America. Over 3.2 million injections were done in the United States alone last year. Despite the popularity of Botox, many mistaken ideas about it still exist.

Botox is not bacteria, but rather a protein that comes from the bacteria Clostridium botulinum. This protein is extracted, purified and sterilized before being injected in tiny amounts into a specific muscle. This protein blocks the signal from the nerve, relaxing the muscle.

Botox is not really new. It is a well-established medical procedure. It has been used for many years to correct medical problems such as eye twitches and overactive eye muscles. It can relax spastic muscles in children with cerebral palsy, and is the treatment of choice to reduce excess sweating. However, it only gained media attention once it was approved for cosmetic use in 2001.

Wrinkles such as frown lines, smile lines and forehead lines are caused by skin folding as the underlying muscles contract. When specific muscles are injected with Botox, they relax along with the overlying skin. Wrinkles are softened or eliminated, an effect lasting three or four months. Botox can also lift the brow to create a less tired look around the eyes. It can eliminate bunny lines on the nose, lighten down-turned corners of the mouth and prominent neck bands.

The procedure itself is very quick. The only discomfort is the prick of a small needle. No recovery time is necessary. Results appear gradually over a week or two, and last about three months.
Although Botox is safe, it should not be used if certain conditions are present. These include pregnancy and rare nervous system conditions such as myasthenia gravis, Lou Gehrig disease and Eaton Lambert syndrome.

The risks associated with Botox injections are quite minimal. There may be a small, temporary bruise or redness at an injection site. Temporary tightness or headaches after injections in the forehead are also possible. With frown injections, there is a very small risk of a temporary droop of the upper eyelid. However, this rarely happens.

Although the procedure seems simple, most problems with it involve poor injection technique and lack of understanding by the injector. Make sure that a doctor trained in this procedure does your injections. To find a qualified practitioner in your area, check the Botox website (www.botoxcosmetic.com).

The cost of Botox treatment varies greatly depending on the area of the face being treated and how deep the muscles and wrinkles extend. The botox is measured in units, so a common procedure such as for frown lines on the forehead might need 20 to 40 units, costing from $200 to $500 in total. ‘Crow’s feet’ at the corners of the eyes would be $120 to $150 but for the best outcome, might be combined with the use of ‘fillers’.

Cosmetic fillers

Even when the underlying muscles are relaxed, some wrinkles remain. These static wrinkles are caused by collagen loss and age-related changes to skin structure. However, we can replace lost volume by injecting filler substances into the skin.

Fillers are typically used to lighten the lines stretching from the base of the nose to the corners of the mouth (nasolabial folds) and to lift the corners of the mouth. Puppet lines around the mouth are softened. Fillers can plump up lips and reduce lipstick lines around the mouth. They work well with Botox to eliminate permanent creases formed by repeated folding of the skin due to muscle activity. For instance, frowning for years can cause a permanent groove between the brows that remains even after the muscles relax. Fillers can fill the groove, eliminating the line.

Collagen, the original filler substance, has been available since 1981. Newer fillers made from hyaluronic acid have become very popular, and include Restylane™, Perlane™ and Juvederm™. Hyaluronic acid is a sugar molecule normally part of skin and cartilage structure. It can be synthetically produced as a gel, which is injected as a cosmetic filler.

Such fillers are temporary and usually last from six to 12 months. Many new filler agents on the market boast more lasting results. Permanent fillers include small plastic beads coated with collagen or hyaluronic acid. They can be injected to leave permanent substance fillers in the skin.
During the procedure, a topical freezing agent is used to numb the skin. A dental freezing injection can be done for lip augmentations. The procedure usually takes less than 30 minutes and results are seen instantly. Although this is non-invasive, two to three days of swelling and some bruising in the injected areas may result. True allergy to the newer hyaluronic acid fillers is rare. However, there is a small risk of hypersensitivity causing persistent redness and reaction in the area. Instead of using synthetic fillers, fat can now be removed from one part of the body and injected elsewhere to replace lost volume. With development of these many filler substances, true facial sculpting is now possible.

The cost of cosmetic filler treatment will also depend on the area of the face and the depth of the ‘wrinkles’, as well as the type of filler used. The treatment of one of these areas, such as ‘crow’s feet’ at the corners of the eyes, would cost from $250 to $500.

Intense pulsed light

Commonly called IPL, photofacials or photorejuvenation, intense pulsed light treatments use light energy to remove unwanted blood vessels or pigmentation from the skin. Here, specific wavelengths of light focus on a problem area within the skin. The area absorbs enough heat energy to eliminate blemishes, while leaving overlying and surrounding skin intact.

Such treatments are ideal for removing broken capillaries within the skin caused by aging and pigmentation spots due to sun damage. It is also very effective in reducing redness in the skin due to rosacea, a condition involving flushing or broken capillaries. Although there is often visible improvement from one treatment, four to eight treatments are often necessary for best results.

Microdermabrasion and chemical peels

Here, the dull layer of dead cells that gather on skin surface over the years are removed. Skin has a fresher look and an added glow. This also helps to smooth rough texture and soften fine lines that occur with aging.

Microdermabrasion is a mechanical peel. It is best described as a gentle sandblasting of the skin. At the skin’s surface, a fine, pressurized spray of crystals lifts off dead skin cells. A gentle suction is delivered almost at the same time, removing the crystals and dead cells.

Alternatively, chemical peels can achieve the same result. Alpha hydroxy acids (glycolic acid) or beta hydroxy acids (salicylic acid) are used. They dissolve the dead surface cells and unclog blocked pores to freshen the skin surface and clear up acne. This is ideal for those fighting pimples and wrinkles at the same time!

Before you proceed

Anyone interested in cosmetic procedures should ask many questions before proceeding to have a clear idea of the type of procedure best suited to their needs, the expected results, the potential dangers, and the cost. Choosing a reputable medical practitioner or medical spa and understanding what you really hope to achieve are the best ways to prevent disappointment or complications.

Prevention is always the best approach

We cannot stop the clock and the normal aging that it brings. However, we can control many changes we associate with aging of the skin, including sun exposure and smoking. Wearing sunscreen, not smoking, eating a healthy diet and drinking enough water make a difference to skin health. However, once the effects of aging do appear, non-invasive cosmetic treatments may be an option for those who choose them.

FAMILY HEALTH is written
with the assistance of
College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2012, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6    [WH_FHd06]
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