December 22, 2010
A few weeks ago, I had the honor of presenting at the Cosmetic Surgery Forum in Las Vegas, Nevada with several of my esteemed colleagues. One of the panels I sat on discussed the use of combination laser therapy and facial injectables. On this panel was myself (Plastic Surgeon), a Facial Plastic Surgeon, an Oculoplastic Surgeon, and a Dermatologist. The intent was to demonstrate not only the effectiveness of combination therapy in addressing facial aging but also how each of us approached facial aging.
What I learned strongly confirmed what I have experienced in my own practice. The days of single modality treatment are gone. And while facelifts, laser peels, and injectables alone may work for some patients, for the majority they simply do not provide comprehensive results. To achieve the most optimal results, the face (like most other areas of the body) needs to be evaluated and treated on multiple levels. To address this, I often talk about what I call the “Holy Triad”. This refers to medical skincare, facial injectables, and laser conditioning.
First, we begin with medical skincare. Effective skincare can not only remove the immediate effects of aging to the skin (e.g.: brown spots and fine lines and wrinkles), but it can also help manage and maintain this lasting improvement. Without incorporating medical skincare into your facial rejuvenation regimen, you are effectively washing and waxing your fancy car and then sitting it out in the sun (without protection) to age and oxidize. That being said, medical skincare is the cornerstone of any facial rejuvenation process.
Next, we incorporate facial injectables. As we age and our skin becomes pleated and folded, we ultimately develop lines and wrinkles. To address this, neuromodulators (such as BOTOX® Cosmetic) help soften the pull of the underlying muscle on the overlying skin. The result is that skin is allowed to settle and relax so that lines often not only decrease but actually go away over time. Another aspect of the aging process involves the localized loss of volume to specific areas of the face. In contrast to the early days of filling lines and wrinkles, now we are replacing lost volume and plumping up these lines from beneath…and doing this in a more physiologic and natural manner.
Finally, to improve the tone and texture of our skin and to stimulate new collagen, laser resurfacing is often added. For many patients, resurfacing can involve localized areas (such as just around the eyes or the mouth) while in others, more benefit is achieved by full face, neck, and chest rejuvenation. And the good news is that the downtime with these newer lasers can be more precisely dialed in so that you can achieve not only optimal results but also do so with downtime that is appropriate for your busy life.
Combination therapy is here to stay and so the next time you ask for BOTOX® and multiple recommendations are made, don’t be surprised. Your practitioner is probably not trying to up-sell you, they’re just more experienced than the others and they get it!
*Photo Courtesy of Ambro
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