Contact Dr Seckel

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.

Contact Dr Seckel

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.

On  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.

Botox-Contact Dr Seckel

Fillers-Contact Dr Seckel

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 face lift. 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

Concord, Massachusetts

The major advances in facial rejuvenation are:

1.Aesthetic Laser Facial Rejuvenation- New laser facial rejuvenation techniques can safely and effectively remove wrinkles, remove browns spots and pigment, remove blood vessels, remove unwanted hair, and smooth and tighten skin.

2.IPL-Intense Pulsed Light, also called photo facial rejuvenation, can safely and gently remove pigment, brown spots, blood vessels, shrink enlarged pores, and stimulate new collagen production in the skin and create effective facial rejuvenation. When IPL or Photo Facial rejuvenation treatments are combined with the light activating agent Levulan, in a process called Photodynamic Therapy even pre cancerous lesions can be removed and severe acne controlled.

3.Fractional Laser Therapy-new fractional ablative and non ablative Erbium and Co2 facial rejuvenation lasers effectively stimulate new collagen growth in the deeper skin layer called the dermis to replace age and sun damaged collagen, plump the skin and remove pigment, lessen wrinkles, improve acne scars, and tighten skin, with minimal down time

4.Skin tightening machines utilizing Infrared and Radiofrequency energy heat the very deep layers of the skin stimulate new collagen formation and tightening and provide significant facial rejuvenation.

5.Botox relaxes wrinkle causing muscles of facial expression and remove crow’s feet, worry lines, frown lines and bunny lines, a remarkable and safe advance in facial rejuvenation.

6.The Retinoids, in skin creams provide effective facial rejuvenation by exfoliating the skin and stimulating the growth of fresh new skin cells, and new collagen production in the dermis.

7.Soft tissue fillers, like Restylane, Radiesse, Juvaderm and others are used to plump deep facial lines like the Nasal labial fold line and the marionette lines.

However, the shear number of new, heavily marketed laser and photo facial 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. Lasers, IPL-photo facial and topical creams are the best facial rejuvenation techniques for Type 1 facial aging changes

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. Fractional laser therapy and skin tightening are the best facial rejuvenation methods for type 2 facial aging changes.

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

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.

True facial rejuvenation is possible with today’s new technology, but facial 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 facial 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 rejuvenation that makes the face truly look young or youthful again. The 6 steps to non-surgical facial rejuvenation are:

Skin Exfoliation – removes dead dry skin cells and superficial pigment restoring a youthful glow to the skin and helping remove wrinkles. Methods are topical creams like Obagi, microdermabrasion, dermasound, microlaserpeel, and activeFX laser skin peel. laser facial rejuvenation treatments are the most effective skin exfoliation techniques.

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. Newer laser and photo facial rejuvenation deep collagen stimulation methods are fractional laser treatments such as the Lux1540 and Fraxel lasers

Removal of pigment and blood vessels - This step removes the brown spots and red spots or blood vessels from the facial skin. IPL or photo facial rejuvenation are the preferred new methods

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. Botox injections are the most effective facial rejuvenation method available today. In the future we will likely have a similar product in a cream

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. Soft tissue fillers like Restylane, Radiesse, and Juvaderm are methods.

Tighten facial skin – The facial skin is tightened to improve the jowls, sagging brow and neck skin. Skin tightening also helps with wrinkle removal. LuxIR, Aluma with faces, Refirme, Titan, and Thermage are the most common photo facial rejuvenation skin tightening methods.

This 6-step facial rejuvenation program® is a comprehensive, scientific medically proven method for true facial rejuvenation, wrinkle removal and skin tightening. This is modern non-surgical method for effective true facial rejuvenation. The details of the program are carefully outlined in Chapter 5 of my book Save Your Face. In addition, Chapter 8 entitled High Tech facial Rejuvenation, the fundamentals of laser, IPL and skin tightening facial rejuvenation technologies are explained. For further information contact me.

Dr Seckel

Boston, Massachusetts

Contact Dr Seckel

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

Contact Dr Seckel

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.

Botox-Contact Dr Seckel

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

Contact Dr Seckel

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.

Contact Dr Seckel

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.

Botox-Contact Dr Seckel

Fillers-Contact Dr Seckel

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