“Saving Face” is the name we give to our efforts to assist our patients in protecting, improving and reclaiming the health and beauty of their faces.
Each of us is born with a beautiful God-given face with smooth luminous and bright and perfect skin. Over time our faces change. Not only time and genetics take their toll but environmental factors such as excessive sun, cigarette smoke, stress, acne, poor nutrition and other factors begin to take their toll. Add gravity and the physicality of living life, and each year can bring more unwanted changes.
We emphasize the importance of basic health habits first of all: proper diet, regular activity, adequate sleep, the value of family and friendships, a spiritual belief, and other core values that make living positive. Then since everyone has skin, the appearance and health must be valued.
This begins with adequate protection from excessive sun (or tanning bed rays). We emphasize the importance of daily skin maintenance. Using a couple of properly selected topical skin care products, one in the A.M. and another in the P.M., is important, just like eating your fruits and vegetables. While there are many “fluffy” but ineffectual skin products advertised everywhere, our focus remains on recommending only high quality medical grade products that are based on science and results.
Our aesthetician, Tara, is knowledgeable about skin, and skin care products. Many of our patients benefit from a session with her, and this may include a therapeutic facial. We utilize both a water- based SkinMaster ultrasonic system, combined with light peeling agents specifically selected for your skin. Or we may use the MultiDerm™ exfoliating system uses mechanical energy and gentle paddles to smooth and exfoliate skin prior to the topical peels. These facials are custom designed for each individual patient, whether the need is for increased hydration, improvement of acne prone skin, lightening of discoloration or removal of thickened rough skin. These are brisk but pleasing and no downtime is required following a therapeutic facial.
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NEXT STEPS: LASERS
Great skin care forms the foundation of our “Saving Face” program and for some patients, this is all they want or need. For many others, we explore the next steps of improved health and appearance. This may include use of one of our lasers or light based devices.
The Diolite 532 is a target specific laser used to treat unwanted small red vessels (“broken capillaries”, angiomas, cherry hemangiomas) and some dark lesions (sun damage or lentigos, for example). No downtime is required. The Prolite Intense pulsed Light laser uses broad-spectrum light to treat larger areas of redness (rosacea, for example), brown spots, or a combination of red and brown. This has a larger spot size, and can treat the whole face, neck, and upper chest and even hands that show unwanted sun damage. Several sessions are used over time and there is no downtime.
The SpaTouch light system is used to reduce unwanted hair. The larger spot size makes this quicker and more comfortable than some lasers using a very small spot. “Hair reduction” is more accurate than “hair elimination” since many hair follicles are resistant to almost any kind of treatment. And darker hairs are more sensitive than light or white hairs and no downtime is needed but 6-7 sessions spread out about 5 weeks apart are required for best results.
Our newest laser is the Matrix Fractionated CO2 laser. This state of the art technology separates the laser beam into many small micro columns of energy, and treats a percentage of the skin surface each time, rather than the whole surface. Here we are stimulating the skin to make increased skin cells and collagen, resulting in a fresher looking smoother skin with fewer wrinkles and reduced pigmentation. More than one session is recommended and by using smaller micro beams there is less discomfort, faster healing, less risk and a quicker recovery. Usually 5-7 days of pinkness ensue so a few days of downtime are recommended.
Light to medium depth chemical peels have been used for many years to help rejuvenate and restore skin affected by photo-damage and aging. Whether it is TCA or phenol based peels, we have seen excellent results in treating unwanted pigmentation, sun damage, wrinkles, actinic keratoses (abnormal sun- induced lesions), and other skin problems. Depending on the extent of the area treated, a few days of downtime may be necessary.
Lasers and peels produce a variable amount of heat and can produce some discomfort, but we use a variety of topical anesthetic creams, cooling devices and gentleness to make these sessions as comfortable as possible.
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Another effective and popular step is to consider the advantages of injectables. BOTOX® and DYSPORT® are drugs containing botulinium A toxin. This purified toxin when used in very small droplets is very effective in reducing creases and wrinkles in the upper face, such as the vertical lines between the brows, forehead lines and “crow’s feet”. Taking effect within a couple of days after injection, the nerve-muscle junction is weakened and unwanted muscle contraction is reduced for about 3 months. This can produce a very natural and rested appearance in addition to reducing lines and creases in the skin. Many of our patients report reduced frequency and severity of headaches following BOTOX®.
Injectable fillers are the other major type. These are different from BOTOX® or Dysport® in that these are substances designed to add volume and support. Think of this as similar to putting air back into the balloon that has deflated. One of the early fillers was sometimes referred to as “collagen” and was made from bovine (cow) collagen. Today, we have many excellent filler materials and we use these to plump up unwanted creases, furrows, scars, wrinkles and other depressed small “shadows”. Sometimes we fill lips for additional definition and to reduce the “bleeding” of lipstick into fine lines. Other uses include plumping cheeks or softening the lower eyelid valleys (“tear trough”), as well as other uses.
The most common fillers are Restylane®, Juvéderm™, Perlane® and others, which use hyaluronic acid gel (a sugar- like substance already in the body). Also very effective for some areas like deep nasal labial creases and the marionette lines around the lips, is Radiesse®, a calcium-based filler. Evolence® is a collagen product from porcine (pig) collagen.
Each filler has pros and cons, and effects of fillers may last from 4-10 months, depending on the filler, where it is used, and patient variables.
Sculptra® Aesthetic (poly L-lactic acid) differs from the other fillers in that it is placed deep to the skin in order to stimulate a collagen producing response that adds overall volume to a face that needs more. It is indicated for improvement of nasolabial folds and other contour deficiencies in healthy people. The effect here is delayed, taking about 6 weeks to occur but effects may last as long as 18-24 months.
The fillers we use are FDA approved substances, and have the advantage of possible immediate improvement, in-office application and minimal if any downtime required. Bruising and swelling may occur and other possible side effects are discussed with patients prior to use. The injectable fillers can be used to delay the need for surgical procedures but they are not really a substitute for surgical facial rejuvenation.
Dr Chatham has extensive experience with lasers and injectables and administers all injectables and performs all laser treatments on his patients rather than delegate this to an assistant.
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