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Summer 2010
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PRODUCT
EDITORIAL ADVISORY BOARD
PICKS
CellCeuticals
PhotoDefense, SPF 55+
Providing broad-spectrum UVA/UVB
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performance power with the addition of flower
and root extracts and vitamin D. Take that,
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Available at cellceuticalskincare.com, $45
Avène Thermal
Spring Water
Perfect for that trip to the beach
— or to recover from
it — Avène’s thermal spring
water is a mist away from
soothing, cooling and
rehydrating your skin.
Available at lovelyskin.com,
$11 (150 ml)
4
SUMMER 2010
Noah’s Naturals
Firming Bronzing Cream
Say goodbye to sun-damaged skin and hello
to a dose of color that’s formulated to prevent
and repair the signs of aging. Vitamins B5
and E, allantoin and beta-glucan work to help
improve skin’s elasticity and moisturization,
while mica, a natural bronzer, adds a touch
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Available at select retailers nationwide, $14.99
Michael S. Kluska,
D.O., F.A.A.C.S.,
F.A.C.O.S., is boardcertified in plastic/
reconstructive and
general surgery;
a fellow of the
American Academy
of Cosmetic Surgery
and the American
College of
Osteopathic Surgery;
and a member of
the Pennsylvania
Osteopathic Medical
Association and
the American
Osteopathic
Association.
NATIONAL
ACCOUNT MANAGER
Joseph Niamtu III,
D.M.D., F.A.A.C.S.,
is a board-certified
cosmetic facial
surgeon. He is
a fellow of the
American Academy
of Cosmetic Surgery
and the American
Society for Lasers
in Medicine and
Surgery. His practice
is limited to cosmetic
facial surgery.
Amy Ammon
Joel Schlessinger,
M.D., F.A.A.D.,
F.A.A.C.S., is a
board-certified
dermatologist
and past president
of the American
Society of Cosmetic
Dermatology and
Aesthetic Surgery.
He is in private
practice in
Omaha, Neb.,
and is the founder
and owner of
LovelySkin.com.
©2010 Advanstar Communications Inc. All
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be reproduced or transmitted in any form or by
EDITORS
CONTRIBUTING EDITOR/
SENIOR WRITER
CONTRIBUTING WRITERS
ART DIRECTOR
SENIOR PRODUCTION
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Susan R. Schell
Sarah Thuerk
Eliza Drewa
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Got
WITH SUMMER JUST AROUND THE CORNER, this is
the time of the year that we all begin to worry about
how we’re going to look in that bikini — too flat, too
big, too bumpy? Whether you’re a planner or a
procrastinator, we’ve got the 411 on how to get those
curves in the right places.
Tips and
tricks for
achieving
your best
summer
silhouette
CURVES AHEAD
Once you decide that body contouring is in your future, there
are three general categories that patients generally fall into, according to Michael Kluska, D.O., a board-certified plastic surgeon in
Greensburg, Pa.:
6
SUMMER 2010
Early Birds: Ladies, this is you if you’re forward planning enough to get
into a surgeon’s office in March or April. Will you be ready for summer?
Absolutely!
The Punctual Patient: The most typical patient; if you get
into the office in May, you may be ready for June, barring any
unforeseen issues that could arise.
The Procrastinators: Last minute more your thing?
Although your options are fewer, don’t count yourself
out. You may, however, have to work on making
sure that your expectations are realistic.
Regardless of which category you are in,
Dr. Kluska asks his patients to approach
their goals from a holistic, whole-health
perspective. First, he says, it’s critical to
make a commitment to yourself and to
your doctor, and to have a doctor who
makes a commitment to you. Second,
when it comes to body contouring,
Dr. Kluska asks all of his patients
to commit to a lifestyle change: Eat
right, eat the correct number of
meals and exercise regularly.
“I try to teach my patients that
Getty Images/Digital Vision
Furthermore, “Thin women eat small, frequent
meals. Their blood sugar is constant, which
keeps their insulin levels normal. The result is
increased energy and a higher metabolism.”
Dr. Kluska has his body contouring patients
cut out the “Cs”: cookies, candy, chips, cola and
cake. He also has them replace the whites with
whole wheat/whole grain pastas and breads.
“In my office, we call this ‘the Kluska Challenge,’” he says. “I literally watch people melt
fat away, especially when I’ve given them a
boost with liposuction or a tummy tuck.”
TIMELINE
If you’re an early bird, Dr. Kluska says, everything’s attainable for
late spring: body lift, tummy tuck,
liposuction, breast augmentation.
If you wait until April, you’ve got to be committed to the challenge to be ready for summer.
“The average person needs three to four weeks
to be back up and running, and three to six
months to see final results,” Dr. Kluska says.
Omaha, Neb., dermatologist Joel Schlessinger, M.D., F.A.A.D., F.A.A.C.S., concurs:
“The reality is that tumescent or SmartLipo
could have them bikini-ready in a month.” After a two- to three-day recovery period, expect
to be swollen for about a month, he says.
Dr. Kluska points out that while there are a
multitude of noninvasive options out there that
Getty Images/Stock4B-RF
“For a quick fix, traditional liposuction will
provide better results,” Dr. Kluska says. He
also points out that you’re likely to be happier
and have more permanent results with this
procedure.
The age factor
For those willing to make an ongoing commitment to improve the shape of their bodies, Dr.
Schlessinger has had effective results with the
VelaShape (Syneron) device. “Cellulite treatment
— every woman has that potential concern this
time of year,” he says. (And don’t we know it!)
However, “Treatment for cellulite is an ongoing
battle most people don’t understand.”
Surprisingly, the older you are, the
quicker the recovery. Not in terms of
ability to heal, but, interestingly, in the
ability to tolerate pain. According to Dr.
Kluska, those in the general age range
of 20 to 30 take longer to recover.
“(The majority of) ‘girls’ have never
experienced a C-section, hysterectomy or having babies, for that matter.
Surgery is a lot of pain for them,” he
says. Women in the 30-to-45 age range
“don’t have time to slow down, and
they’re happy to be back to ‘normal’
again,” he adds. Over the age of 45?
These women say, “‘Honey, this is nothing,’” Dr. Kluska says. “‘Let’s go.’”
The reality? According to Dr. Schlessinger, if
you continuously treat soft tissue for cellulite,
it’s fairly easy to keep it under control. “The
key is to treat early and treat often,” he says.
Treatment with VelaShape, Dr. Schlessinger says,
is essentially a suctioning and rolling of the skin
and fibrous bands, loosening the bands between
the fat and increasing circulation in skin, which
makes skin look more youthful. To be ready for
swimsuit season, you’re looking at four to 12 sessions, then every other month for maintenance.
SIZE RIGHT
A leg up
“The key to all body contouring is
functional form,” says Dr. Kluska,
who approaches each new patient
individually with an artistic eye and
the question, “How can I put them into better
proportion and form?”
“The most important thing to realize is that
everybody’s body is different,” he says. For
example, “If a woman is 5 feet, 3 inches and
125 pounds, with a thicker and wider frame,
and only wants a small C cup, she’ll still be
unhappy after surgery, because she’ll still be
out of proportion,” he explains.
To get the size right, “I look at the shoulders
in proportion to the chest, in proportion to
the waistline, in proportion to the hips. So
this patient would go to a larger size than she
originally anticipated,” Dr. Kluska says, “but
she’ll be happier in the end, because of better
proportion and form.”
Your summer silhouette probably
isn’t the only concern you’ve got
when it comes time to baring
some skin this season. Whether
you’re planning to get into a
bikini or not, chances are you’ll
be flashing some leg — and
treating those bothersome leg
veins can have a dramatic
effect on the appearance of
your legs, according to Dr.
Schlessinger. “We get some
terrific results,” he says,
pointing out that the best
results come from an annual trip to your cosmetic
surgeon’s office.
SUMMER 2010
But just because the technique works doesn’t
mean it’s right for every woman. According
to Dr. Schlessinger, if you have sagging in the
lower abdomen or stretch marks, you’ll want
to consider a tummy tuck, in which case you’ll
need to plan ahead. And if you’re that lastminute gal (we all know one of these!), a breast
augmentation and smaller-volume liposuction
is about all you’re going to have time to recover
from to be bikini-ready. Recovery time for
these is an average 10 days to two weeks.
may help to shrink fat cells, you could potentially spend $2,500 on multiple treatments, the
results of which could be minimal and last only
a couple of months.
Getty Images/Mark Andersen
their baseline metabolism is slow because
they’re not eating frequently enough or getting
the right amount of exercise,” he explains. “I
have patients who come in and tell me that
they’re eating only one meal a day and too
busy to exercise — they constantly chase the
kids and that’s enough. But they can’t lose the
weight.”
7
BeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmarts
Great
SUNSCREEN DEBATE
THE
C h e m i c a l , o r o rg a n i c?
Sun exposure causes skin damage. Consumers have largely accepted this as truth.
And, just as our awareness has grown, so has the sun protection product market.
W
e’ve officially entered the next generation of sun protection, and that means more than just an increase in the
number of bottles on the shelf at your local pharmacy.
The question of what number SPF you should choose has been
replaced by the question of whether you should buy chemical or
organic sunscreen. To make that choice, you’ve got to know what
the difference is, and whether one may be better than the other.
To understand the difference between the traditional chemical
sunscreens and the organic (also called “physical” or “all-natural”)
options, it helps to understand the difference between UVA and
UVB rays. Simply put, UVA rays are responsible for “A”ging; UVB
are responsible for “B”urning. UVA rays damage the skin’s collagen
and elastin, which are needed to keep skin looking young; UVB
rays burn the skin and are the main cause of skin cancer.
8 SUMMER 2010
Chemical protection
Historically, chemical sunscreens contained UVB-absorbing
chemicals. It is only more recently that they contain UVA absorbers as well. Any sunscreen containing avobenzone, oxybenzone or
octocrylene are chemical sunscreens.
Octocrylene is part of the cinnamate group of chemicals. Cinnamates have both UVA- and UVB-absorbing ingredients, which
is how they protect the skin from the sun’s harmful rays (they
absorb them, so your skin does not). Chemical sunscreens also
contain different benzophenones, such as avobenzone, which also
absorb UVA and UVB rays.
The skin actually soaks up chemical sunscreens, which is a key
difference between the chemical and organic sun-protection product categories. Because octocrylene is absorbed into the skin, it has
been shown in some studies to promote the generation of potentially
harmful free radicals. The health implications remain unclear, but
some experts have raised concerns that warrant further research.
Examples of chemical sunscreens are La Roche-Posay Anthelios
XL 50+, Lancôme UV Expert 20 and the new Eucerin White
Solution Fluid (Tinosorb S).
Going chemical-free
Organic, or physical, sun-protection products are called sunblocks, as
opposed to sunscreens. They generally contain zinc oxide and titani-
Getty Images/Image Source
BeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmarts
UYER, BEWARE
Waterproof and sweat-proof sun-protection
products may not be as effective as they
claim to be. Sun protection should be reapplied after swimming, or every two hours, if
you plan to be in the sun for long periods of
time. Additionally, babies under the age of 6
months should not have sunscreen applied
to their skin at all, and should remain out of
the sun’s reach altogether.
Getty Images/Image Source
um dioxide, which are not absorbed into the skin, but instead remain
on top of the skin and act as UVA/UVB deflectors.
Zinc oxide is the preferred ingredient, because it blocks more
UV radiation, according to Helen M. Torok, M.D., a board-certified dermatologist and owner of Trillium Creek Dermatology &
Surgery Center in Medina, Ohio. While the physical products are
more effective sun blockers, the downside is that many of them
tend to leave a white fi lm on the skin. But adding makeup colors
to the base product can make it into a wonderful makeup foundation that not only looks good, but also protects the skin from
harmful rays, Dr. Torok says.
In addition, many organic sunblocks are now using a process
called micronizing that essentially breaks down the zinc oxide so
it doesn’t leave a fi lm. L’Oréal holds the patent on an organic ingredient called Mexoryl (ecamsule), which has been shown to be a
powerful UVA blocker. It is only found in select L’Oréal products.
While chemical sunscreens offer both UVA and UVB protection, there’s also the possible generation of harmful free radicals.
Organic sunscreens, on the other hand, offer a broader protection
from UVA/UVB rays, but, depending on the formulation, could
leave you covered in an unattractive white fi lm that could also be
slightly uncomfortable.
Notably, these all-natural, physical ingredients in this new generation of sun protection offer a specific population of consumers sun
protection and tolerability. Those with sensitive skin, , eczema
or other skin allergies would be wise to use an all-natural product
versus a chemical product, as the ingredients are less likely to
exacerbate skin sensitivities.
Still can’t decide? Whether you pick a chemical or all-natural
product, the bottom line is, either one is better than no protection
at all.
SUMMER 2010
Examples of physical sunblocks include L’Oréal UV Perfect
(Mexoryl), DDF Organic Sun Protection and Obagi Nu-Derm
Physical UV Block.
Sensitive skin
9
BeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmarts
Plastic, not perfect
While the idea of cosmetic surgery often
equates with “perfection,” that’s not realistic.
With breast implants, while you may be
getting a permanent size and shape from the
implant itself, your skin continues to respond
to the aging process: it loses elasticity, droops,
and the implant goes along for the ride.
One of the current strategies for avoiding sagging is to place the implants under the muscle.
If you’re undergoing a breast lift at the time of
implants, some doctors may also be able to create scaffolding to hold those implants in place
using your own tissue.
The implant technology of the future might be
in a scaffolding product for tissue support, such
as Allergan’s new silk-based biodegradable
fabric technology. But time and research are
needed first to have a clearer understanding of
realistic results and potential complications.
Tissue technology
“The idea of using a fabric to keep implants in
place isn’t new,” says Michael Kluska, D.O., of
Greensburg, Pa. About five years ago, one of
Dr. Kluska’s colleagues developed and began
using a polytetrafluoroethylene (PTFE, the
same material from which Gore-Tex is made)
product for the same reason. “It (PTFE) is a
product that’s been used the past 30 years for
various surgeries. It mimics natural tissue,
grows into tissue and becomes static,” he says.
Beyond keeping the implant stable, it also
may decrease rippling (very common among
implant recipients) and, while not as common
(but much more of a problem), capsular contracture, according to Dr. Kluska.
Although the exact cause of contracture isn’t
known, doctors take various steps to reduce
the likelihood, including placing the implant
under the muscle and having patients massage
the breasts after surgery to keep the capsule
loose. As for rippling, it’s also less common
with an under-the-muscle placement, and may
be less common with silicone than with saline
implants. While these contours are completely
harmless, some doctors are beginning to use
fillers to smooth them out.
SCARED OF SURGERY?
10 SUMMER 2010
It’s true: The No. 1 cosmetic procedure in the United States is breast augmentation. But one doctor has taken a
step toward a nonsurgical option to offer the cleavage-challenged a solution. The procedure? It’s called cleavage
rejuvenation. No cutting, no anesthesia … and no major hit to the pocketbook.
According to Brad Calobrace, M.D., a Louisville, Ky., plastic surgeon and the brains behind this creative solution, cleavage
rejuvenation is a two-step process that (1) rejuvenates the skin in the chest area using a brightening cosmeceutical or laser
treatments, and (2) uses a hyaluronic acid filler to strategically create cleavage-inducing curves where the breasts meet the
chest. Results last about a year and cost anywhere from $1,000 to $2,000. Not bad for a quick summer fix!
Getty Images/Photographers Choice RF/Sheer Photo Inc.
W
hen we talk about breast augmentation, our minds go straight to the
implant option. Despite improvements in materials and techniques, there are
still a handful of potentially problematic issues
that could arise — from implants that shift to
ripples you can feel to capsular contracture.
Getty Images/Photographers Choice RF/Pando Hall
Implants
Great
BODY
efs b
THE
Getty Images/Lane Oatey
AGE BETRAYER
Are your hands giving away your years?
n the midst of your daily skincare
routine, stop and look around. You
have cleansers, toners and moisturizers for your face and neck, even your
décolletage. But what about your hands?
As it turns out, hands can be a dead
giveaway to your real age.
As we age, the skin on the backs of
our hands loses volume and becomes
thinner, draping the very structure of
the hand. Bones, veins and tendons, all
more visible, make hands look, well, old.
Many of us have had to learn the hard
way that it’s important to protect our skin
— from head to toe — from harmful environmental pollutants and UV rays before
the damage is done. But for the damage
that’s already been done, what’s a mature
girl to do? Thankfully, options do exist.
Pump up the volume
And not to worry — thanks to the numbing cream, the injections are relatively
painless and last up to one year.
Spot treatment
Whether or not you opt to plump up
your aging hands, if you want to get rid
of those pesky age spots (also known as
sun spots or liver spots), modern technology has a solution: the laser.
If you do get fi ller injections, Dr. Pilest
starts with those fi rst, followed by alexandrite laser treatment. Using high-powered
light, the laser breaks up the pigmented
areas to remove the spots. While the
technology does not damage surrounding
skin, you may experience some peeling
of the skin, which potentially lasts four
to five days after the treatment. It’s part
of the normal recovery process and will
improve the look of your skin.
After treating yourself to spot removal,
it’s important to take preventive measures to make sure spots don’t come
back. Those spots are actually dark
pigments that we acquire from sun damage. Dr. Pilest points out that post-procedure use of a topical cream containing
vitamin C, topical bleaching elements
and a sunblock of SPF 30 or greater is
a must to maintain your youthful-looking hands. (For the bleaching product,
he recommends SkinCeuticals Pigment
Regulator, which relies on kojic acid
rather than hydroquinone to keep the
skin on your hands bright and pigmentfree.)
The filler injections are painless and
last from six months to one year. Laser
treatments followed by daily use of the
proper hand cream will keep the “age
spots” at bay. Even better, the combination of injections and laser treatment
takes less than 45 minutes. The cost? In
Dr. Pilest’s office, Radiesse treatments
are generally $1,500 to $2,000, depending on the number of syringes injected.
To remove pigmentation spots with the
alexandrite laser, the average cost is
$500 to $750.
SUMMER 2010 11
To minimize the skeletal look to the
hands, fillers can work wonders. Fillers
can be natural (your own fat relocated
from another part of your body … I vote
thighs!) or synthetic (manmade). Fillers
are injected into the hands and create a
layered effect between the hand anatomy
and the skin. According to Nissan Pilest,
M.D., a board-certified dermatologist
in Irvine, Calif., Radiesse (BioForm
Medical) is his filler of preference. “It
stays better and lasts longer” than others
he’s tried, Dr. Pilest says. But you’re just
as likely to encounter other fillers, too:
Restylane (Medicis), Perlane (Medicis),
Juvéderm (Allergan), Sculptra Aesthetic
(Sanofi-Aventis). Oftentimes, it’s simply
doctor preference.
BREAST
Naturel
s bodybriefs bodybriefs bodybriefs bodybriefs bodybriefs bodybriefs
Au
Enhancing your bustline without implants
could have them asking, ‘Did she, or didn’t she?’
S
Getty Images/Digital Vision/Win Initiative
ome say we are a nation obsessed with
breasts. From padded bras to mold and
shape to surgical enhancement with saline or silicone implants, almost all of us have
taken some measure to improve the general
contour of this anatomic area. Beyond the
bras and before the implants, there is another
option: the “natural” augmentation.
GOING
braless?
The Breform, aka, “internal bra,” is a new lift-
ing technology out of South Africa that claims to
give you a permanent lift sans traditional bra. The
Breform is a piece of polyester mesh surgically implanted under the skin intended to give the breasts
an internal lift. A relatively new product, it is not
yet approved in the United States. (It is expected to
be available in Canada and Mexico sometime this
12 SUMMER 2010
year.) Ladies, let’s just say that for now, it’s too soon
to start burning your bras.
TISSUE TRANSFER
So what does the future hold for those interested in a more natural contour? The future
is now, says one plastic surgeon who claims
that he had a pioneering role in the quest for a
more “natural” breast augmentation method.
Involved in early liposuction efforts back in the
1970s, Mel Bircoll, M.D., says, “My liposuction
patients were very happy with their results. But
they used to tell me ‘Doc, if only you could put
that fat where I need it.’” One of the places they
were referring to, of course, was their breasts.
Dr. Bircoll, now retired from his plastic surgery
practice, spent three years refining his fat
transfer method and published his findings in
several papers during the 1980s and 1990s.
At the time, the idea of fat transfer wasn’t fully
accepted in the professional cosmetic surgery
world, but today it’s actively pursued by both
physicians and patients as a viable option for
recontouring (the face, in particular).
When talking about fat transfer, you’ll typically
hear that the results can be unpredictable,
the most common concern being that a good
percentage of the fat won’t “take.” The key, Dr.
Bircoll says, is in the transfer technique. He
grafts the fat in minute portions to increase the
likelihood of fat survival. “The fat has to have a
blood supply within 24 to 48 hours if it’s going
to survive,” he says.
TODAY’S PERSPECTIVE
“Fat transfer has been controversial (in the
past) because if fat doesn’t survive, it was
thought to create scarring and calcification,”
explains ITK Beauty Adviser Michael Kluska,
D.O., a plastic surgeon in Greensburg, Pa.
Scarring and calcification can mimic signs
of breast cancer, which means that patients
would likely have to undergo biopsies.
However, “We found that with good technique,
it didn’t increase signs and symptoms of breast
cancer,” says Dr. Kluska, who also points out
that fat transfer doesn’t cause breast cancer.
While all of this sounds well and good, fat
transfer is performed far less frequently than
implant procedures. Getting fat into a more desirable place requires a more involved process,
which includes first removing fat via liposuction, then preparing it and (finally!) placing it
where desired. And if those fat grafts don’t find
a blood supply, they won’t survive.
“In my experience, 20 percent to 70 percent
of the fat ‘takes,’ so you have to try to predict
this, and slightly overfill the area to correct for
deficiency,” Dr. Kluska says. But “overfilled”
means you could be walking around looking
like a cartoon version of yourself for a while.
“The process takes two to three treatments,”
Dr. Kluska explains. You can expect to get
some improvement in size in just one session,
but, realistically, this means that “If you’re a
large A, you might go to a small B,” he says.
Fillers
Getty Images/Photodisc
If you could replace lost volume forever, would you?
FINDING THE
FOUNTAIN
OF YOUTH
Whether you’re making an
annual foray into your cosmetic surgeon’s office for HA
replacement, or deciding to pursue a longer-term
correction, Dr. Niamtu lists six filler tenets to guide
you on your journey to the filler Fountain of Youth:
1. “Permanent” is not always better. “Permanent fillers could mean permanent problems,”
says Joseph Niamtu III, D.M.D., F.A.A.C.S.
2. The most popular fillers are popular for a
reason. “HA fillers are biocompatible (compatible
with living tissue), reversible and last about a year
— long enough to make it worth it,” he explains.
3. Don’t believe all the hype! “Because something’s new doesn’t make it better. If it’s good, it’ll
catch on,” he says.
4. Don’t have lofty expectations. “We don’t fully
understand how products are metabolized, so it’s
difficult to predict how long they’ll last, individually,” Dr. Niamtu explains.
6. If it sounds too good to be true, it probably
is. “There’s no such thing as a good deal,” Dr.
Niamtu advises.
Long-term correction
No doubt, the idea of a permanent filler is
attractive. At first mention, it sounds like a
one-time fix, and who wouldn’t want to “fix it
and forget it”? But “I don’t think any of them
are ‘permanent’ permanent fillers,” says Joseph
Niamtu III, D.M.D., F.A.A.C.S., a board-certified facial cosmetic surgeon in Richmond, Va.
“The face is dynamic, and skin changes over
time,” he says, which means that regardless of
how “permanent” the product itself might be,
you’ll need to have some touch-up work done
down the road.
So which fillers are considered permanent?
These include silicone, Artefill (Suneva Medical) and Sculptra Aesthetic (Sanofi-Aventis). Artefill may last forever, but as the face changes
over time, Artefill can move (sag) with the
aging face and require correction or repositioning. Sculptra Aesthetic, on the other hand, may
last for years, but the product eventually goes
away. “It’s called a permanent filler because it
stimulates collagen,” which is, of course, your
own “permanent” filler, Dr. Niamtu says.
Product perfect
Take heed: Results with permanent fillers are
only good if the product is injected perfectly.
“Even expert injectors can get asymmetric
results. It’s easy to over-inject with these products,” Dr. Niamtu says.
The golden rule with permanent fillers, according to Dr. Niamtu, is to have “appetizersized” portions. Unlike with HA fillers, “The
goal is not to get full correction. You have to
account for swelling and the effects of local
anesthesia,” he says.
What does this mean to you? It means that
you’ll likely undergo multiple injection sessions that build volume gradually. Because the
products may also stimulate collagen (and you
don’t know how much collagen will be produced), this can also affect results. As a result,
“It should be a gradual, sculpting process,” Dr.
Niamtu says. “I do it once per month until we
get close to the end result goal.”
Tried and true
Sometimes the tried and true is a better (in
other words, safer) option — especially, Dr.
Niamtu says, if it’s your first time venturing
into filler territory. “HA fillers are still popular
for a reason,” he says. “What’s powerful about
HAs is that you can reverse them. In other
words, if you don’t like your results, it’s very
easy to make them go away with a syringe.
Permanent fillers require a scalpel.”
SUMMER 2010 13
5. Never have a permanent filler the first time
you try fillers. “Test-drive the HA fillers first, to
make sure you’re happy,” he warns.
irst there was collagen. It required a preprocedure allergy test and lasted a mere
three months, at best. Then came the hyaluronic acid (HA) fillers Restylane (Medicis)
and Juvéderm (Allergan). No allergy testing
required, and results last about a year. And
fillers continue to evolve. The latest development? Permanent fillers.
Getty Images/Lena Clara
FACE
efs bodybriefs bodybriefs bodybriefs bodybriefs bodybrief
Can I
have facial
procedures
during the
summer?
Michael S. Kluska,
Joseph Niamtu III,
D.O., F.A.A.C.S., F.A.C.O.S.
D.M.D., F.A.A.C.S.
Dr. Niamtu:
(although temporary)
surgery, there are potential
plates in the bones are
That is an
with hyperpigmentation
risks and complications
closed.
intelligent
(blotchy pigmentation of
— including a surgery
the skin) and other annoy-
that does not give them
In addition to my two key
ances.
the result that they were
factors, other factors to
expecting.
consider include family
question. The
first answer is
that the best time to
have cosmetic surgery is
Alternately, some patients
when you can work it into
live in places like southern
With this in mind, I always
as well as how well the
your life’s schedule to have
Florida or California where
ask the younger patient a
patient does in school and
a relaxing and low-stress
it is always summer, and
few key questions to help
if he/she smokes.
recovery.
they don’t have the choice.
me determine their matu-
I treat many schoolteach-
rity. Why do you want this
When all of these factors
The second answer is
ers, and the summer is the
done, and what are your
are taken into account, it is
that cosmetic surgery is
only time they can have
expectations? If the patient
my opinion that most girls
more popular in the winter
cosmetic surgery, and they
can convince me that he/
are mature enough by age
months, as more people
do just fine. They just have
she is having this done for
16 or 17 (boys, 18-plus) to
are indoors and there is
to limit their outdoor activi-
the right reason, then they
handle both the emotional
usually less to do and less
ties that produce directsun
have passed the first test.
and physical changes that
The key answers include
one experiences with rhino-
phrases like “to make my
plasty surgery.
exposure.
sun exposure. I practice in
Richmond, Virginia, and
we have pretty brutal
summers, so it is a clear
Is 16
too young
for a
nose job?
Dr. Kluska:
nose match my face,” “I still
There are
want to look like me,” and
essentially
“I am doing this only for me
laser procedures in the
two factors
and no one else.”
winter when it is cooler.
that determine
advantage to consider
if the patient is
14 SUMMER 2010
home life and dynamics,
:
The second factor is physi-
Also, laser and chemical
old enough to undergo
cal maturity. With regard
patients must refrain from
nasal surgery. The first is
to the nasal cartilage,
direct sun for about four
mental maturity. A patient
most teenage girls are
weeks, and that can be
must be able to accept the
fully developed by age
difficult. Patients who have
changes that a rhinoplasty
16, and most boys by
facial resurfacing proce-
will make in his/her ap-
age 18. By these ages,
dures in the summer may
pearance, and they must
the cartilage has stopped
have increased problems
understand that with any
growing and the growth
For more Q&As with
the ITK doctors, or
to submit your own
question, go to
www.itkbeauty.com/
askthedoctor