Whether it is fear of surgery or the stigma of having surgery, almost everyone who comes in to my plastic surgery office tells me they want to look younger but they do not want a face lift.

Recent technological advances resulted in new light based skin tightening devices which are being marketed as the non-surgical face lift. While skin tightening technology is impressive, and does work, the results of skin tightening to date hardly qualify as a face lift, non-surgical or otherwise. Skin is tightened but best results are about 20% to 30 % of what a traditional surgical facelift can achieve.

The new skin tightening is called non-ablative to distinguish the new skin tightening technology form the old CO2 laser resurfacing, the Gold Standard for Wrinkle Removal.

To ablate means to surgically remove, and the CO2 laser resurfacing ablated or removed old damaged skin and new skin grew to replace the old. In the process of Laser Resurfacing, heat generated by the laser injured the deeper skin layers and when they healed, with new collagen, the skin was contracted or tightened.

The newer skin tightening technology uses radiofrequency energy or infrared energy to heat the deep layers of the skin to cause contraction and tightening but first cools the skin before the energy is applied to prevent injury and ablation of the superficial skin by the heat energy. Thus the skin is tightened but the surface is not ablated, thus non-ablative skin tightening. There is no down time foillowing non-ablative skin tightening unlike the older CO2 laser resurfacing skin tightening.

Several new skin tightening machines are available. The LuxIR by Palomar, and the Titan by Cutera utilize infrared energy for skin tightening. The Aluma by Lumenis and Thermage utilize infrared energy for skin tightening. Refirme by Syneron uses a combination of light energies with radiofrequency for skin tightening.

All of the machines achieve about similar results when used properly. Generally there is less discomfort with the Infrared skin tightening machines. Complications have been minimal although some serious complications occurred with Thermage skin tightening early on.

In my practice I find that non-ablative skin tightening is most helpful for younger patients who do not have severe aging changes and significant sun damage, people in their 30’s and 40’s who want to correct or tighten early skin sagging along the jaw line or jowl area, neck and cheeks. I use the LuxIR on these larger areas. For skin tightening around the eyelids I use the Aluma which has a smaller treatment head and a suction device that will pull the delicate peri ocular skin into the treatment chamber for skin tightening.

The field of non-ablative skin tightening is in its infancy and will definitely become more effective in the years ahead. The companies are improving their products frequently. For now however the people who benefit most from the skin tightening machines today are younger people who still have thick healthy skin with early aging changes.

The use of the term non-surgical facelift to describe non-ablative skin tightening is an overstatement with technology available for skin tightening today. At best a 30% result is possible when compared to a traditional face lift.

To learn more read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

Be aware that skin tightening only achieves 20-30% of what a face lift can achieve:

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The new Aluma machine is available as a stand alone device or on multiplatform laser that also contains a Radiofrequency device, the Aluma, which is used to tighten skin. Radiofrequency is the technology used in the popular Thermage® skin tightening system but FACES uses a very different approach. The other skin tightening machines, LuxIR by Palomar and Titan® by Cutera® use infrared waves to heat and tighten skin.

The new Aluma system with FACES stands for functional aspiration controlled electrothermal stimulation. What differentiates this machine from Thermage® according to a recent report in Dermatology Times is that skin tightening with Aluma is less painful and much quicker.

The initial results of a study by Michael H Gold, M.D. and Mitchell P. Goldman, two very respected laser researchers showed impressive skin tightening results and patients reported excellent satisfaction and comfort with the procedure. Expectations are that the Aluma will be useful to tighten the neck, jowls, cheek, and eyelid and peri ocular skin. Some improvement in wrinkles has also been seen after skin tightening in this early study.

What is different about Aluma FACES is that the skin is gently pulled into a chamber by suction where the radiofrequency energy is applied to heat and tighten the skin. In some ways this is similar to microdermabrasion® in that microdermabrasion uses suction to pull the skin into a flowing stream of micro silica particles which exfoliate the skin.

The difference with Aluma FACES is that instead of exfoliation, the skin is subjected to Radiofrequency energy that heats the tissues in the dermis of the skin, causes remodeling of the collagen, which shortens the collagen and tightens the skin.

Time will tell if skin tightening new technology lives up to expectations but it looks very good. I will be using the machine for the first time next week and will keep you updated.

To learn more or ask questions read Save Your Face or contact me.

Dr Seckel
Boston, Massachusetts

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however the prolonged and difficult recovery following laser facial skin rejuvenation with both the CO2 and Erbium lasers prevents most people from considering this wrinkle removal technique. Initial recovery can take three weeks and the facial skin is left red to pink for up to 3 months. MicrolaserPeel®, another wrinkle removal technique, during which a superficial erbium laser skin peel is done is an improvement, but recovery is still 2-7 days, and the treatment needs to be repeated 3-4 times over several months to achieve the best result.
Recently we have introduced the ActiveFX® Laser , the latest technological break through in non-surgical facial laser skin rejuvenation and wrinkle removal. This technique uses the revolutionary ActiveFX® CO2 Lyte® laser which is a component of the Ultrapulse® Encore® laser made by Lumenis®.
The ActiveFX® Laser exfoliates or removes dead skin, wrinkles, fine lines, pigment, skin irregularities, and tightens skin with only 3-4 days of facial skin pinkness, even less in some people. The ActiveFX provides deep exfoliation, the crucial first step of the 6-step facial rejuvenation program and the beginning phase of any wrinkle removal program. You can have the procedure done on Thursday and return to work on Tuesday, thus you only miss one or two days of work. The procedure is done in the office and takes 15 to 20 minutes. We give patients a pill before hand for relaxation and apply a topical anesthetic to numb the skin so discomfort is minimal. No injections, needles, or other anesthesia is required.
Recently we have been using an additional treatment called Gentlewaves® immediately after the ActiveFX® laser wrinkle removal treatment and this treatment has reduced the pinkness and down time to 4-5 days! The Gentlewaves® is a safe LED (Light Emitting Diode the red blinking light on your TV remote) which soothes the skin after the ActiveFX® wrinkle removal treatment and significantly reduces pinkness and down time.

The benefit of the ActiveFX® laser skin peel for wrinkle removal over other superficial laser and IPL non ablative treatments also called photo facial treatments is that you get deep skin exfoliation and immediate skin tightening as well as wrinkle removal.
The ActiveFX® Laserlyte Peel® is also excellent for eyelid rejuvenation, and can improve or remove eyelid wrinkles and fine lines and tighten eyelid skin and can be done in combination with a laser transconjunctival blepharoplasty for a much improved blepharoplasty result for true total eyelid rejuvenation.

The ActiveFX® laser skin rejuvenation uses a gentle de-powered CO2 laser beam which is scanned over the skin in random fashion so that heat build up is minimized, thus redness or pinkness is lessened and recovery time is much quicker. Unlike the Erbium laser, the ActiveFX® laser Peel produces skin tightening as well as wrinkle removal, two crucial components for effective, real facial skin rejuvenation.
The ActiveFX® LaserlytePeel® is a revolutionary new advance in wrinkle removal therapy, facial skin rejuvenation and non-surgical facial rejuvenation.
The application of the ActiveFX Laser peel following laser laser transconjunctival blepharoplasty is a major advance in eyelid rejuvenation and the treatment of facial and eyelid wrinkles and eyelid aging changes.
To learn more contact me or read Save Your Face.

Dr Brooke Seckel

Boston, MA

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but no one wants to have a face lift or plastic surgery; everyone is looking for the non-surgical face lift.

In recent years technological advances such as Botox, and fillers like Restylane and Radiesse, and new Lasers, IPL and skin tightening machines like Thermage®, Titan®, LuxIR®, and Aluma®, have improved the plastic surgeons ability to rejuvenate the face non-surgically, but none have been able to deliver the often promised non-surgical facelift. Improvement in jowls, neck laxity, nasal labial folds and marionette lines have all required a surgical face lift. The best results of non-surgical skin tightening, the so called non-surgical facelift have achieved about a 30 % tightening of the facial skin. Dramatic results have been achieved in wrinkle removal when proper techniques have been applied, but true lifting or tightening of the facial skin, the non-surgical face lift has been modest at best

The new LaserLyte Lift™ is a laser face lift and a photo face lift and promises to achieve a much more significant rejuvenation and lifting of the face with a new non-surgical multi-modality technique three phase procedure which not only tightens the facial skin but also removes wrinkles and other aging changes on the surface of the skin—all achieved non-surgically with minimal or no down time, a true non-surgical face lift.

This new non-surgical high tech face lift or facial rejuvenation procedure is based on the theory that all of the skin layers must be treated and rejuvenated to accomplish true facial rejuvenation and is based on the principles of the 6-step non-surgical facial rejuvenation program outlined in my book Save Your Face.

The important changes in the facial skin which lead to an aged appearance occur predominantly in 3 layers-the epidermis or outer layer that you see in the mirror, and two deeper layers-the superficial and the deep dermis—the pink part of your skin you see when you scrape your knee.

As we age, the sun’s UV rays, and other age related factors damage all 3 layers of the skin. We see these changes in the form of wrinkles, brown spots and dry skin-changes in the Epidermis or outer layer. However the major changes causing wrinkles and sagging skin is damage to the 2 deeper layers of the dermis.

The result of aging changes in both layers of the dermis is the loss of collagen. Collagen plumps the skin and gives the skin its tone and elasticity. When we lose collagen from the dermis the skin loses volume and becomes wrinkled-the same way a plum turns into a prune when it loses water after drying. In addition when we lose collagen we lose elasticity, the skin does not snap back when we pull on it and release it, and the skin sags.

The key to non-surgical facial rejuvenation or a non-surgical facelift is to remove the superficial aging changes from the superficial epidermis and restore new collagen and thus volume and elasticity to both the superficial and deep layers of the dermis

Contemporary non-surgical methods such as laser, IPL or Photo Facial, Radiofrequency (Aluma®, Thermage®), and Infrared (LuxIR®, Titan®,) energies are capable of treating the surface of the skin and the deep dermis, but do not treat the middle layer of the dermis and thus cannot achieve complete non-surgical rejuvenation or a non-surgical face-lift.

New technology has finally enabled us to treat both the middle and deep skin layers to plump and tighten the sagging facial skin. Thus we are now able to treat all three skin layers affected by aging, removing surface irregularities such as wrinkles, brown spots, and dry skin, and restoring collagen and thus plumping volume and elasticity to the middle and deep skin layers.

Thus we can achieve a true non-surgical facial rejuvenation or non-surgical face lift for the first time addressing all three layers of the aged skin.

This procedure is called the Laserlyte Lift™ because Laser and other forms of light (lyte) energy are used to treat the three skin layers. The procedure takes time, as it requires multiple treatments scheduled several weeks apart over a time course of several months. However the results are striking-you can see them and believe them—you don’t have to try to convince yourself that they are there as you have with so many “miracle wrinkle cures” you have tried in the past.

The Laserlyte Lift™ the true laser face lift or non-surgical face lift involves three treatment protocols or phases.

Phase I begins with the important first 2 steps of the 6-step non-surgical facial rejuvenation program deep exfoliation and stimulation of new collagen growth near the surface of the skin. This phase removes wrinkles, brown spots and restores the skins shiny glow. This is the Laserlyte peel achieved with the Lux2940 ablative fractional laser. This peel is performed with a topical skin anesthetic, takes 25 minutes, and leaves you pink for 4-5 days. Some people only need one peel others may need 2 or 3. These peels are scheduled 6-8 weeks apart

Phase 2 begins about 6 weeks after your first ablative laser peel and is the start of your skin plumping and skin tightening regimen through stimulation of new collagen growth in the middle and deep dermal layer by the application of laser and Infrared or other energy which penetrates through the epidermis and superficial dermis to the mid and deep dermis, to restore collagen and elasticity and tighten the facial skin. I use the Lux1540 and  LuxIR Skin Tightening Technology by Palomar. Treatments are spaced 4 weeks apart and at least 4 sessions are required.

The start of Phase III, deep sub dermal skin and fat tightening provides significant firming and lifting of the facial skin. The new Palomar Aspire sub dermal laser stimulation provides powerful tightening of the of the deep dermal and sub dermal layers. This maneuver also tightens and lessens the fat beneath the skin which adds to the aged facial appearance. If you only need one peel Phase 3 can begin as early as 2-3 months and be alternated with Phase 2 at 2-week intervals. If you need 3 LaserLyte Peels then Phase 3 will not begin until 5-6 months.

While the Laserlyte Lift™ , the laser face lift or true non-surgical face lift, takes time it is the only method of non-surgical facial rejuvenation to actively treat all three layers of the skin and thus the only method to achieve an effective non-surgical facelift. In fact, the Laserlyte Lift™ achieves more thorough facial rejuvenation than a surgical facelift. A surgical facelift only tightens the skin, after a facelift you have tight “old” skin. The Laserlyte Lift™ renews and rejuvenates all three skin layers, thus when you are finished your face truly looks younger as well as tighter, a true facial rejuvenation and a real non-surgical facelift, and remember, you are avoiding surgery and its dangers and discomfort. More importantly you are achieving true facial rejuvenation with wrinkle removal and new collagen, which plumps and tightens your skin to a truly youthful appearance.

As technology advances we undoubtedly will be able to achieve results is less time. However at present the Laserlyte Lift is the only method for an effective non-surgical facelift and rejuvenation of all three skin layers and it takes

The new Aluma machine is a multiplatform laser that also contains a Radiofrequency device that is used to tighten skin. Radiofrequency is the technology used in the popular Thermage® skin tightening system but FACES uses a very different approach. The other skin tightening machine, Titan® by Cutera® uses infrared waves to heat and tighten skin.

The new Aluma system with FACES stands for functional aspiration controlled electrothermal stimulation. What differentiates this machine from Thermage® according to a recent report in Dermatology Times is that FACES is less painful and much quicker.

The initial results of a study by Michael H Gold, M.D. and Mitchell P. Goldman, two very respected laser researchers showed impressive results and patients reported excellent satisfaction and comfort with the procedure.

What is different about FACES is that the skin is gently pulled into a chamber by suction where the radiofrequency energy is applied. In some ways this is similar to microdermabrasion® in that microdermabrasion uses suction to pull the skin into a flowing stream of micro silica particles which exfoliate the skin.

The difference with Aluma is that instead of exfoliation, the skin is subjected to Radiofrequency energy that heats the tissues in the dermis of the skin, causes remodeling of the collagen, which shortens the collagen and tightens the skin.

Time will tell if this new technology lives up to expectations but it looks very good. I will be using the machine for the first time next week and will keep you updated.

To read more about non-surgical facial rejuvenation, use the following link: Aluma.

Or read Save Your Face.

Dr Seckel

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More importantly, with early intervention and new facial anti-aging techniques most people can prevent skin aging and facial aging and maintain a youthful skin and facial appearance and avoid looking older.

However, the shear number of new, heavily marketed facial skin rejuvenation techniques and the often-complex methodologies involved can be very confusing for the lay reader and physicians alike. To better understand the new facial rejuvenation treatments it is very helpful to first understand facial skin aging changes and then review how these changers can be reversed and the skin rejuvenated.

Facial Skin aging – Is that my mother I see looking back at me in the mirror?

The earliest skin aging changes most of us notice on our face, are fine lines and wrinkles around the eyes often referred to as crow’s feet and later deep furrows on our forehead called the frown lines and worry lines. These changes occur for most of us in our 30’s. We also begin to see brown spots and red spots or small blood vessels on our face and around the nostrils of our noses. Later the skin becomes dryer and loses the fresh glowing appearance of our youth. These superficial or surface changes are called type 1 skin aging or facial aging changes and are caused by sun damage and free radical damage from other inflammatory agents in our diet and environment and our heredity.

Later, in our late 40’s and 50’s we begin to see sagging facial skin. Usually the first sign is loose skin beneath our chin on the neck often called the turkey wattle. Later we see loose folds beginning along the jaw-line, often called jowls. As the skin sags we begin to see deep lines on either side of the mouth, called the nasal-labial fold lines and marionette lines. Aged skin also can begin to droop over the eyes and the eyebrows can begin to fall. These later skin-aging changes are called type 2 facial aging changes and are caused by the loss of skin elasticity. Sun damage, inflammation from free radicals released by our diet, and our heredity are the basic causes.

6-Step Facial Skin Rejuvenation – Help is on the way

Today we do not have to stand by and helplessly watch our skin age. With sun block, a healthy diet and lifestyle and new facial skin rejuvenation technology we can prevent or correct most skin aging changes. But first let’s understand what is meant by the term “skin rejuvenation.

To rejuvenate means to “make young or youthful again or restore to an original state”. To me this means correcting or removing not only wrinkles, but also the brown spots, red spots and dry skin, but also tightening sagging skin that is all of the facial aging changes, not just one or two. Wrinkle removal is only part of the process.

Filler-Contact Dr Seckel

True facial skin rejuvenation is possible with today’s new technology, but skin rejuvenation must be performed in a logical, comprehensive, step-by-step process that addresses all of the major skin aging changes. Most skin rejuvenation treatments offered today only address one or two changes and as a result are ineffective. A laser can remove brown spots and blood vessels, but the skin is left with wrinkles and sagging skin. A face-lift can tighten the facial skin but leaves you with a tight old looking face.

For effective modern skin rejuvenation I offer my patients a 6-step facial rejuvenation program® which addresses each of the facial aging changes described above. The result is true facial skin rejuvenation that makes the face truly look young or youthful again. The 6 steps to non-surgical facial rejuvenation are:

Exfoliation – removes dead dry skin cells and superficial pigment restoring a youthful glow to the skin and helping removewrinkles.

Stimulation of new collagen production – New collagen must be restored to replace the collagen damaged by sun and aging. New collagen plumps the skin, helps remove wrinkles and firms the skin

Removal of pigment and blood vessels - This step removes the brown spots and red spots or blood vessels from the facial skin

Relax muscles of facial expression – Frown lines, worry lines, and crow’s feet are caused by the pull of some of the facial muscles. When these muscles are relaxed, the lines disappear and wrinkles are removed.

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Fill deep facial lines – The deep nasal-labial fold and marionette lines are plumped up to make them less noticeable. These are deep lines, not wrinkles.

Tighten facial skin – The facial skin is tightened to improve the jowls, sagging brow and neck skin. Skin tightening also helps with wrinkle removal.

This 6-step facial rejuvenation program® is a comprehensive, scientific medically proven method for true facial skin rejuvenation, wrinkle removal and skin tightening.This is modern non-surgical method for effective true facial skin rejuvenation. The details of the program are carefully outlined in Chapter 5 of my book Save Your Face. For further information contact me.

Dr Seckel

Boston, Massachusetts

Facelift-Contact Dr Seckel

While Plastic Surgery is truly a much more comprehensive field including reconstructive surgery following burns, cancer surgery, and birth defects, the image most often projected in the media is that of image or beauty enhancement and non-surgical and surgical facial rejuvenation of otherwise normal people by surgery.

Blepharoplasty-Contact Dr Seckel

Revolutionary technological advancements in the past decade have significantly impacted the field of Plastic Surgery creating a shift from traditional surgical procedures to new non-surgical methods for correcting aging changes and improving appearance.

Laser Resurfacing-Contact Dr Seckel

Today Botox® injections can remove crow’s feet, frown lines, worry lines, and help lift the sagging brow. Prior to Botox® major facial surgery such as a brow lift and blepharoplasty (eyelid lift) were performed to correct these aging changes.

Botox-Contact Dr Seckel

New fillers such as Restylane® and Radiesse® are injected into the nasal-labial fold, lips, and marionette lines, those deep lines running from the lips down around the mouth and chin. Previously, a face lift was performed to correct these lines.

Fillers-Contact Dr Seckel

Skin tightening technology such as aluma, ActiveFX, LuxIR, Titan® and Thermage® are becoming better and can improve facial sagging in 30% patients if used early before the sagging is severe. Many patients choose to have one of these techniques rather than a face-lift. Many other new exciting techniques for laser restoration of skin collagen (Laser Genesis®) and improvement in skin wrinkling, removal of pigment, and removal of red spots and blood vessels on the face are already in use today.

These dramatic advances coupled with increasing public awareness of the importance of sun protection, a healthy anti-inflammatory diet, exercise, stress reduction, and a healthy lifestyle undoubtedly will impact the Plastic Surgery practice of the future. The Plastic Surgeon of the future will still have to be a highly skilled, knowledgeable surgeon, but I predict he/she will need to be an expert in the newer laser, light, pharmacological, and lifestyle therapies as well.

Plastic Surgery is becoming more non-surgical with every new technological advancement. The 6-step facial rejuvenation program encompases all the new non-surgical facial rejuvenation techniques. For questions read Save Your Face, or contact me.

Dr Seckel

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Wrinkles on the face are surface irregularities and must be smoothed out by deep skin exfoliation to remove dead skin and wrinkle debris from the surface of the face. Non-ablative technologies such as IPL, Photo Facial, Thermage, Titan, Aluma, LuxIR and other photo-facial therapies work by stimulating new collagen to grow in the deeper layers of the skin but do not provide skin exfoliation which is required to remove the surface irregularities. Restylane, Radiesse, Sculptra, Collagen, Hylaform, Cosmoplast, and Cosmoderm are non-surgical facial rejuvenation fillers which are injected into the deep layers of the skin to plump lines, but again they do not provide skin exfoliation and do not address the surface wrinkles.

Skin Exfoliation removes dead skin and surface irregularities similar to the way imperfections on wood are removed by sanding, but in a much gentler and safe way. Deep skin exfoliation also stimulates the deeper layers of the skin to grow new collagen. After exfoliation, once the dead skin cells are removed, topical creams such as Retin A, Tazarotine, Vitamin C, and Prevage will penetrated the skin more easily and be more effective.

Effective skin exfoliation can be accomplished by microdermabrasion, micropeel, and ablative laser skin exfoliation therapies like microlaserpeel, ActiveFX Laserlyte Peel, or by various chemical peels. I start my patients on gentle no down time methods like Obagi Skin Care and skin exfoliation with microdermabrasion first. When the patient decides they want more skin exfoliation and wrinkle removal I advance to the new effective deep skin exfoliation provided by the ActiveFX Laser Peel, an exciting effective laser skin peel which provides deep skin exfoliation and skin tightening as well with minimal down time.

There are many new exciting facial rejuvenation methods available today, but they must be applied in the proper order. Skin Exfoliation is the first basic step in the 6-step facial rejuvenation program. To spend money and time on therapies that work on the deeper layers of your skin to promote new collagen formation without first using skin exfoliation to remove dead skin and the wrinkle surface irregularities is in my opinion-wasted effort.

First things first, start with the first step, deep skin exfoliation for effective wrinkle removal. Contact me for further information or questions or read Save Your Face.

Dr Seckel

Boston, Massachusetts

I use this exciting new technology to treat fine lines, sun damage, brown spots, blotchy pigment, uneven skin tone, and acne scarring with excellent results.

Unlike so many widely advertised non-ablative, photofacial laser and IPL treatments that require 5-7 months to see a result, the results of the MicroLaserPeel are evident immediately. Better, the beneficial effects of the MicroLaserPeel, new collagen formation, and softer more uniform younger looking healthy skin continue for months after the treatment.

MicroLaserPeel removes the outer dead skin cells from the face and stimulates the deeper skin layers to from new healthy young skin cells and new collagen in the deeper skin layers. The result is fresher looking, glowing new skin with fewer fine wrinkles and fewer brown spots and pigment irregularities.

The first step in any skin rejuvenation program is exfoliation, the removal of the dead skin cells covering the outer surface of the facial skin. None of the many non-ablative laser and IPL therapies offered today provides this important first step. Only the MicroLasaerPeel using the Erbium laser provides this important basic first step facial rejuvenation process, in a uniform manner, with minimal down time.

The MicroLaserPeel is the perfect minimal down time alternative to the “gold standard” laser resurfacing for facial rejuvenation.

Contact my office via e-mail, or call 978-369-4499 for more information on any of the above procedures, or read Save Your Face.

Dr Seckel

Boston, Massachusetts

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A startling 12.4 million cosmetic plastic surgey operations were performed in this country last year and estimates are that nearly half of them were to correct facial aging and this does not include the millions of non-surgical facial rejuvenation procedures.

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As the baby boomers reach their 50’s everyone wants to look younger but no one wants to have surgery. Most people do not want to have surgery especially if it is not for serious medical reasons.

However, revolutionary advances in technology have made it possible for many people to reverse facial aging changes using new non-surgical facial rejuvenation techniques without having to undergo plastic surgery.

This past Wednesday, September 28, 2005, I spoke on a panel entitled Non-surgical Facial Rejuvenation at the meeting of the American Society of Plastic Surgeons in Chicago, Illinois. My topic was Botox, the soft tissue fillers including Restylane and Radiesse and the many skin peels used for exfoliation to remove wrinkles and signs of facial aging. I came away from that meeting very excited and enthused about all the wonderful new non-surgical facial rejuvenation therapies that are safe and effective for patients today.

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There are so many new wrinkle removing and skin tightening non-surgical facial rejuvention options available that the patient must understand exactly what facial aging change it is that they want to correct. Usually the patient just feels that their face looks older but cannot pinpoint exactly which facial aging change is causing concern. It is important to seek consultation with an experienced board certified Plastic Surgeon or Dermatologist who understands all the options so that the correct option is chosen for your very unique face. I advise you to avoid doctors who only do one or two facial rejuvenation procedures and tend to push patients to have the procedure that he/she performs rather than customizing the procedure to the patient’s needs.

The 6 Step Facial Rejuvenation Program™ consists of:

Step 1-Exfoliation-topical cremes, microdermabrasion, superficial skin peels with various fruit and salicylic acids to produce exfoliation to freshen the skin and give it a youthful glow and remove wrinkles. These treatments also stimulate the skin to form new collagen to replace the old damaged aged collagen, and help rejuvenate and tighten the facial skin.

Step 2- Stimulation of new collagen production- Controlled inflammation of the deep skin layer called the dermis causes the dermal skin cells called fibroblasts to manufacture new collagen to replace the collagen lost by sun damage and aging. Topical RetinA and the deep exfoliative process in step 1 start this process. Newer technological interventions like the Lux1540, Fraxel, Lux294o, Sciton Profractional, and Lumenis bridge therapy are powerful stimulators of new collagen production.

Step 3-Remove pigment and red spots-In addition to exfoliation new light and laser therapies such as IPL, Photo facial, Lux1540 and Fraxel® can be used to remove brown spots, pignent, broken blood vessels called telangiectasias, and rosacea from the facial skin. Pigment and blood vessels are a classic sign of facial aging and the non-surgical removal of these skin discolorations provides noticeable facial rejuvenation. These high tech yherapies can also remove wrinkles.

Step 4-Remove lines of facial expression wrinkles- Botox can be used to relax the muscles of facial expression and remove crow’s feet, worry lines, frown lines, and bunny lines and dynamic wrinkles, all of which are very early signs of facial aging. Botox® effectively removes these lines in most people for 6 to 9 months after a simple nearly painless injection.

Step 5-Fill deep facial lines called the nasolabial fold lines and marionette lines make the face look tired and old and coupled with the frown lines often make people look angry. Deep facial lines are deeper than wrinkles, and I do not use fillers for wrinkle removal. New soft tissue fillers can soften the nasal labial fold lines and marionette lines when they are injected into the skin beneath the aging lines. Commonly used soft tissue fillers are Restylane, Radiesse, Zyderm, Zyplast, Juvaderm, Sculptra®, Fascian®, Cymetra®, and Isolagen®. Each of these fillers has different characteristics and are better for some facial aging changes than others. For a thorough discusion of fillers consult Chapter 7 “No Down Time Facial Anti-aging Procedures” in Save Your Face, available on line at www.saveyourface.com.

Step 6-Skin Tightening. The final facial aging change to treat is loose sagging skin. While the plastic surgical operation called a facelift is still the “gold standard” for facial rejuvenation, several new technologies are evolving which can tighten aged facial skin. LuxIR and Titan®, devices using infrared waves, and Aluma and Thermage® which use radiofrequency waves, are all being used to heat the collagen in the deep layers of the skin called the dermis causing the collagen to shorten and tighten the skin. While these technologies are new and only about 30% effective and require multiple treatments, they will most certainly be improved in the future and effective skin tightening of aging facial skin will be possible. Some wrinkle removal is seen following successful skin tightening.

Non-surgical facial rejuvenation is here and is getting more effective as new products come out every month. One of my common expressions whenever I speak about the new non-surgical options for facial rejuvination is “plastic surgery is becoming non-surgical” and try to encourage my fellow plastic surgeons to embrace the new technology. I still believe that an experienced board certified plastic surgeon is the best doctor to provide the non-surgical facial rejuvenation procedures to patients because these doctors are the facial aging experts and they have the ability to do what is necessary for the patient whether it is Botox or a facelift. Each face is unique and a “one size fits all” approach just does not work in facial rejuvenation.

Contact me for more information on any of the above procedures, or read Save Your Face.

Dr Seckel

Boston, Massachusetts