Prejuvenation Part 2: Minimally-Invasive Cosmetic Procedures
Beyond a topical skincare routine, the other key component to prejuvenation is a series of thoughtfully planned minimally-invasive cosmetic procedures. These treatments should be safe and convenient, have minimal to no downtime, and produce natural results.
Determining which procedure to start with is dictated by an individual’s anatomy, genetics, prior history of sun exposure, and particular cosmetic concerns. By mixing and matching a combination of the following treatments, it can lead to aging gracefully and a natural, elegant aesthetic without appearing ‘overdone’ or having others know that you are getting cosmetic treatments performed.
1. Botox: Botulinumtoxin (Botox) injections are the most effective treatment for lines on the upper face (forehead, crow’s feet, and “eleven lines” / glabella). Botox can be used preemptively to prevent the formation of expression lines by reducing the number of times and how hard the muscles are crunching. This prolongs the formation of deeper, etched in lines. Young patients will also appreciate the natural, refreshed appearance of Botox, and how this treatment can be used to reshape the brow and open the eyes, providing a more relaxed, awake appearance. Regular treatments can help maintain a smooth, youthful appearance; even doing Botox 1-2 times per year will slow the formation of lines at rest. If lines are getting deeper or more noticeable, then more regular treatments are advised to prevent them from worsening.
2. Dermal Fillers: Fillers like hyaluronic acid can restore volume and contour to the face, addressing early signs of aging such as nasolabial folds and hollow cheeks. They provide a non-surgical option to maintain facial symmetry and volume. Some of the most popular areas for ‘prejuvenation’ including the midface (cheeks, nasolabial folds) and under the eyes (tear troughs) to address dark circles caused by volume loss. Hyaluronic acid dermal fillers are temporary, but with each treatment it stimulates some of your own endogenous collagen production to further slow down signs of aging.
3. Laser Treatments: Non-ablative lasers, such as Fraxel, target deeper layers of the skin to stimulate collagen production without damaging the surface. Regular sessions can improve skin texture, tone, and elasticity, preventing the onset of more visible aging signs. This is helpful to reduce acne scars, enlarged pores, and fine lines and wrinkles. Other lasers can be used to target pigment (Q-switched and picosecond lasers) or target broken blood vessels and capillaries (e.g. pulsed dye laser) to remove red and brown spots. Restoring more even skin tone and complexion can take years off one’s appearance with minimal downtime. This is a good place to start for individuals leery about injectable treatment options.
Importantly, I published a study during my fellowship at Harvard University showing that these laser treatments not only make the skin appear more youthful, but it also behaves like younger skin more resistant to sun damage. When we induce a controlled wound in the skin with these lasers to stimulate collagen production, we are also selectively removing pre-cancerous cells. Notably, my study found that patients treated with a non-ablative fractional laser (Fraxel) had 50% fewer facial skin cancers compared against a matched group of patients who never underwent this facial laser treatment. This represents a paradigm shift: that these laser treatments once considered solely for cosmetic and aesthetic purposes may in fact provide a significant medical benefit.
4. Tissue Tightening Treatments: Ultrasound and radiofrequency treatments can be used to stimulate deeper collagen production, resulting in lifting and tightening of the skin. These treatments are especially popular among those who have recently lost weight or are noticing early signs of skin laxity. However, these treatments are only treating the deeper layers in the skin and they do not do anything for the quality of the overlying skin (differentiating them from laser treatments). The advantage of these treatments is that they have essentially no downtime, but it can take a three months for neocollagenesis (new collagen production), and the results typically continue to build during the first year after treatment. Regular, annual maintenance treatments are typically advised to combat the continual collagen loss and decrease in the skins elasticity. These are a nice treatment for those who are on the fence about dermal fillers to restore volume, or those who have already had fillers and want to avoid looking ‘overdone.’I also recommend them for patients who already have good skin tone and little to no sun-damage; otherwise, we will often start with laser treatments to improve the surface quality of the skin.
5. Chemical Peels: These are great for freshening up the skin and giving a nice glow. They can be used to treat acne and residual discolored marks from a recent acne outbreak, as well as to remove brown spots and excess pigmentation from conditions including melasma. They can be tailored to your skin type and particular skin concerns, and range from superficial to medium depth with little downtime and noticeable results.
Conclusion
Prejuvenation represents a forward-thinking approach to skincare, focusing on prevention rather than correction. By incorporating effective topical treatments and minimally-invasive procedures, individuals can maintain a youthful appearance and reduce the need for more aggressive treatments as they age. There is synergy between injectables (Botox, fillers), lasers, peels, and energy-based devices to maintain a natural, elegant aesthetic.
Contact us to develop a comprehensive prejuvenation plan that suits your individual needs!