Ask a Dermatologist - Cosmetic Treatments: Your Questions Answered

By Pacific Derm on August 25 2016

Dr. Ulmer addresses some of the most common questions from patients about cosmetic dermatology and aesthetic enhancements.

Dr. Ulmer

When should one start considering looking after their skin?

It can literally begin in childhood. Why do I say this? Sun protection including a good sunscreen will protect against sunburn and the development of skin cancer. It will also help to reduce the damage caused by the sun on the skin. In my opinion, a sunscreen is an integral part of not only healthy skin but in preventing signs of aging caused by the sun.

How do I know what type of aesthetic treatment I need?

Each person’s needs are unique and therefore it is important that they consult an experienced aesthetic physician with their concerns before pursuing a specific treatment. Almost everyone can benefit from some type of treatment – whether it is to improve the clarity or quality of the skin, reduce the appearance of frown lines, or improve the volume of the face when there has been development of skin laxity or sagging.

Advanced training and an understanding of dermatology help an aesthetic physician determine the best course of treatment, which commonly involves combination therapy to achieve the best results.

What is “combination therapy”?

“Combination therapy” refers to using two or more cosmetic treatments to achieve a desired outcome. Of course every device or procedure may be used on their own, but we often use a combination of therapies to enhance the benefits of each one.

For example, the combination of laser resurfacing with a neuromodulator (e.g. Botox Cosmetic® treatments) may help the skin to remodel itself with better results. Fillers are often combined with neuromodulators in different areas of the face to address multiple issues simultaneously. By so doing, a more harmonious and balanced outcome can be achieved.

What is the difference between an injection with ‘filler’ and one with a ‘neuromodulator’?

Fillers are used to replace volume loss in the skin and deeper tissues and can be used for multiple indications. In Canada we have many different types of filler products and each has its own specific characteristics that allows the physician to tailor the treatment to the individual. As such, fillers can be used to reduce a number of problems including: sunken cheeks, the deep folds between the nose and lips, “marionette” lines, hollow temples, and jowls.   Further, fillers can be used to correct depressed facial scars, improve neck lines and to rejuvenate the hands.

In aesthetics, neuromodulators are most often used to temporarily relax facial muscles that cause lines and wrinkles. So they treat ‘dynamic’ wrinkles versus the static ones, which are addressed with filler.

Neuromodulators are indicated for a number of reasons, ranging from the reduction and softening of lines that occur during facial expression – for example, frown lines, forehead lines and “crow’s feet” around the eyes. However, neuromodulators can also be used to shape the eyebrows, lift the brow, reduce gummy smiles, and re-contour the lower face.

Although neuromodulators are used most often for people with established facial lines, they are also used in younger individuals (at a lower dose) to prevent the onset of lines that inevitably develop with time.

What are the current trends in cosmetic medicine?

The current trend is for a move to more non-invasive procedures with minimal downtime. This is evidenced by the fact that traditional procedures such as facelifts and liposuction are decreasing, while the use of fillers (the “liquid facelift”) and non-invasive body contouring devices (high intensity ultrasound, radiofrequency and cooling to break down fat) are steadily growing in popularity.

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