The Changing Face of Aging

Combination Treatments Make for Minimally Invasive Modifications


How we look and present ourselves to others can have a significant impact on our mental health and how we feel. Watson Clinic’s Dr. Faeza Kazmier understands this quite well. Her goal as a physician who specializes in plastic and reconstructive surgery is to help patients feel their best by looking their best, from head to toe. 


Some recent developments in cosmetic procedures have made it easier than ever for patients to achieve the results they are looking for through minimally invasive procedures. New combination treatments are making use of topical cosmeceuticals that are able to penetrate the skin barrier better than previously available products, along with deeper laser treatments. While these new combination procedures do not provide the same results as surgical treatments, they do offer superior results to either topical or laser treatments alone.


The topical cosmeceuticals that are now available typically contain growth factors. These are certain types of protein with the ability to stimulate the production of new cells. This property is utilized by cosmeceuticals to encourage the production of collagen in the skin to reduce wrinkles and lines. 


The challenge has been in finding a way to deliver these growth factors to the deeper layers of skin. Our skin acts as a barrier to keep most external substances out of our body, so cosmeceutical researchers had to develop methods to penetrate that barrier safely. The use of fat-based products has been found to be effective at delivering the growth factors through the skin barrier to the appropriate areas.


Previously, most topical creams, with the exception of Retin-A, had little effect on the skin. The new generation of topical products not only delivers superior results when compared with the creams and topical treatments available in the past but also combines well with other nonsurgical treatments. This greatly increases the range of treatments available to patients to achieve their desired results.


The problem with using nonsurgical practices like laser treatment and radiofrequency skin tightening on their own has been that they normally cause the skin to heat up too quickly to get a noticeable improvement in skin tone. Now, however, procedures have been introduced that incorporate products capable of supercooling the skin simultaneously. This allows the physician to apply these bursts of energy without damaging the skin in the process.


An example of this type of treatment is Kazmier’s use of Renuvion. This is an under-the-skin treatment using a laser that she performs in the operating room. It is a fairly quick procedure that can be performed in less than an hour. Patients typically see results after a few days, but since it involves stimulating the body’s own production of collagen, it can take six to nine months for full results.


“It uses helium gas to allow us to deliver the heat, and then within .44 of a second, the helium gas comes in and cools the tissue,” Kazmier says. “So we get that stimulation to produce collagen but without the damage of burning the skin.”


Kazmier is one of four Watson Clinic cosmetic specialists who recently ranked among the nation’s top 1% in regard to their training, experience and expertise in utilizing facial filler treatments, as well as the volume of injectable treatments they perform. 


These various non-surgical treatments tend to be popular among patients due to their affordability and shorter recovery times. They also give patients a chance to experiment with their looks without committing to the more pronounced, and permanent, effects of a surgical procedure. 


Dermal fillers, such as Juvéderm, are another popular choice. Fillers are substances approved by the FDA for injection into certain locations in the face in order to smooth wrinkles and fine lines. Many of them work by filling in space underneath the skin. They can also be used “off label” to create contours and smooth dynamic lines. The use of fillers can be preferable to using a neuromodulator like Botox because they do not act on the facial muscles.


Most fillers contain hyaluronic acid, a natural humectant that absorbs and retains water in the skin. This creates a favorable condition for the skin to produce more cells, thereby resulting in a plumping effect. There are also fillers that do not contain hyaluronic acid and work instead by stimulating collagen production. Sculptra is one example of this type of filler. 


None of the dermal fillers provide permanent results. They vary in the length of time that their effects last, ranging mainly from one to five years, and this is generally after several treatments.


An interesting effect of the COVID-19 pandemic was that plastic surgeons saw an uptick in patients wanting facial procedures performed. As people were quarantined, they spent more time in virtual meetings, which resulted in many people becoming more aware of their appearance as they suddenly came face-to-face with themselves onscreen regularly. 


When people could no longer travel and were suddenly housebound anyway, patients began pursuing surgeries that they had previously put off due to not being able to take time out of their lives to allow for recovery. This resulted in an increase in all types of cosmetic procedures.


Kazmier expects patients to continue to seek procedures that result in more subtle effects on their appearance. 


“Great results should look natural,” she says. “They shouldn’t look like they’ve had something done. It should really highlight their natural beauty and natural characteristics, and give them a refreshed look, as opposed to looking like they’ve had some cosmetic procedure done.”

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