Medical Aesthetics or Medical Esthetics and Cosmetic Medicine are relatively new terms which describe an emerging field of medicine in which medical science, medical procedures and medical expertise are utilized by physicians to enhance or beautify peoples outward appearance.

The fields of Medical Aesthetics and Cosmetic Medicine are major departures from traditional medicine which has always been directed towards curing disease, relieving human suffering, and improving the quality of human life. Whether we approve or disapprove of the diversion of precious medical talent and research effort away from the traditional, essential, and medically necessary health care field, this radically new cosmetic or aesthetic field of Medical Aesthetics is growing rapidly. These aesthetic or cosmetic medical services are in great demand and demand for these services seems to be here to stay.

With increasing demand for modern skin rejuvenation and other cosmetic treatments, and the trend for these services to be performed in Medical Spas with no doctor present, patient safety has become an increasingly important concern for patients, doctors, and regulatory agencies. The new, more effective laser and injectable Medical Aesthetic or Cosmetic Medical procedures require medical training and expertise and are not safely done in traditional aesthetic or esthetic salons and spas. From a public health and safety standpoint their is increasing concern that a Spa may not be the ideal environment in which to do potentially dangerous and invasive medical procedures.

In the paragraphs below, I will detail what I perceive to be the types of procedures which are currently considered to be within the field of Medical Aesthetics (Esthetics) or Cosmetic or Aesthetic (Esthetic) Medicine. Bear in mind that all of the procedures I discuss below should be done under the supervision of a physician if they are to be considered medical aesthetic procedures.

Medical Aesthetician (Esthetician) Services

Microdermabrasion:

Microdermabrasion is my favorite “no down time” skin care procedure or medical aesthetics procedure and is the most popular aesthetician service in my practice. In this procedure, a medical aesthetican, in my office, provides deep skin exfoliation on your face. The aesthetician uses a technique using micro crystals or various chemicals to exfoliate your skin, removing sebum, unblocking pores and removing dead skin cells and superficial pigment. These treatments also stimulate the production of new collagen in the upper layers of the dermis.

Following microdermabrasion, your skin looks and feels smooth and refreshed. Because dead skin has been removed, topical treatments like Retin A, Retinol, AHAs, and Vitamin C can more easily penetrate the skin. Skin biopsies have shown that, following six microdermabrasion treatments, the epithelium is thicker and healthier-looking and there is an increase in superficial dermal collagen. Both are important goals in any anti-aging treatment. In addition to providing significant microscopic improvement in the skin, microdermabrasion patients report high satisfaction with the treatment in clinical studies.

While these skin care treatments are performed in salons, I believe it is much more valuable if a doctor first examines your face and makes a total skin care recommendation. More importantly, microdermabrasion is most effective if used in an comprehensive, multi-step rejuvenation program involving prescription topical creams and other more sophisticataed procedures, which only can be done in a physician’s office.

Micropeel®

Micropeel is a Medical Aesthetics or Cosmetic Medicine procedure that is to a combination of dermaplaning (scraping dead skin off your face) and applying a dilute AHA (glycolic acid) solution following the dermaplaning. This is referred to as “the lunchtime peel” because pinkness is minimal and you can go back to work after this is done. This skin care procedure was developed by Biomedic® as a useful adjunct to anti-aging therapies and is useful for patients who have sensitive skin who cannot tolerate the microdermabrasion.

This procedure is also a very helpful skin care technique for acne patients. MicroPeel Plus is also available with added salicylic acid, which makes the peel go a little bit deeper for more effective skin exfoliation and the stimulation of new collagen growth in the dermis. This Medical Aesthetics or Cosmetic Medicine procedure is an aesthetician service that should be performed by a trained medical aesthetician in a physicians office.

Superficial Chemical Peels

Superficial peels with either AHAs (Alpha Hydroxy Acids) like Glycolic and Lactic Acid 20-30% or salicylic acid are a Medical Aesthetics or Cosmetic Medicine procedure that can be applied by medical aestheticians in a doctor’s office under the supervision of a physician and are an excellent skin care treatment. These peels provide skin exfoliation, removal of superficial pigment, and can also stimulate new collagen production.

The deeper skin care peels, with high percentage AHAs (50-70%), TCA peels and phenol peels should only be performed by a physician. These are not minimally invasive. Deeper peels, such as these, can be very effective, but there is significant down time.

I do not use deep peels because the risks of scarring and hypo-pigmentation (whitening of the treated skin) are too great. Most physicians today prefer laser resurfacing if a deeper peel is needed. This is a much more controllable, less risky form of facial resurfacing. Some doctors get beautiful results with the deeper peels and are more experienced than I am in their use. However I have simply seen too many patients who suffered complications after another doctor has done their peel, and at that point, unfortunately, there is nothing I can do to help them.

Dermasound

Dermasound is a new Medical Aesthetics osmetic Medicine skin care treatment that uses ultrasound for skin exfoliation and deep cleaning. Following Dermasound skin care treatment, a great deal of oil, sebum, and skin debris is removed from the surface of the skin.

It is postulated that Dermasound treatments can also improve the penetration of topical skin care creams. Patients with oily skin and acne prone patients benefit from a combination of Dermasound and microdermabrasion treatments done at the same session. Dermasound is becoming one of the more popular aesthetician services.

Permanent Eyeliner and Lip Liner-Micro Pigmentation

Many patients today desire to have permanent eye liner and lip liner applied. When done correctly micro pigmentation is a medical aesthetics procedure which can produce a beautiful result. The benefits are time saving and a permanent appearance.

Micro pigmentation for permanent eyeliner and lip liner is an aesthetician service performed in our office by a very talented and experience nurse-medical aesthetician.

Importantly we protect the eye with eye shields and use topical numbing cream on the eyelids and nerve blocks on the lips. These techniques significantly improve the safety and your comfort during these procedures.

IPL – Photofacial Skin Rejuvenation

The Medical Aesthetics or Cosmetic Medicine procedure called IPL stands for Intense Pulsed Light. IPL is not a laser procedure. IPL is a bright flash of visible light, like a flash bulb, but very powerful. IPL is produced by a machine that has different filters or lenses that can be used to control the color of the light or IPL beam that comes out of the handpiece.

The IPL can be tuned to target specific problems in the skin. When the IPL is tuned red, the IPL light is absorbed by blood in skin blood vessels, the light heats the blood, injures the blood vessel and the blood vessel is removed from your skin. The same tuning is possible to remove pigment. The technical term for this is photothermolysis. Photo means light, thermo means heat, and lysis means dissolve; thus the light energy heats the target and dissolves it.

IPL is unique because it is target specific. This means the IPL only removes the specific target, pigment or blood vessel and does not injure the surrounding skin. This makes IPL, or Photofacial, a “no down time” procedure with minimal or no recovery time required.

IPL is used to:

Remove pigment

Remove red spots, small blood vessels, and Rosacea

Improve skin texture

Reduce pore size

Rejuvenate the skin

Improve fine lines

IPL is a powerful therapy. Although performed often by a nurse or aethetician, IPL, in my opinion, requires medical supervision and should be performed under the supervison of a doctor, preferably in a doctor’s office. Three to four treatments are usually required for the best result.

Above before and after IPL (Photo courtesy of Palomar Medical)

IPL is a very safe, no down time procedure for the conditions listed above.

Eye protection is required for you and all personnel in the treatment room.

Skin Tightening- The “Non surgical Face Lift?”

Everyone over 40, and many in their 30’s, see facial and eyelid aging changes in their skin. No one wants to see these changes and many people consider some type of facial rejuvenation therapy. But no one wants a face lift, which is the only way to get the result pictured below: (Contact Dr Seckel)

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 in Medical Aesthetics and Cosmetic Medicine have 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 at best results are about 20% to 30 % of what a traditional surgical face lift can achieve.

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

Above, Before and After CO2 Laser Skin Resurfacing

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 CO2 Laser Resurfacing, heat generated by the laser injures the deeper skin layers and when they heal with new collagen, the skin is 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. The skin is tightened but the surface is not ablated, thus non-ablative skin tightening. There is no down-time following non-ablative skin tightening making it a more appealing option than 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 Medical Aesthetics or Cosmetic Medicine 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 are younger people who still have thick healthy skin with early aging changes.

The use of the term non-surgical facelift to describe the Medical Aesthetics or Cosmetic Medicine procedure of 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.

In my practice skin tightening is performed as an aesthetician service by a trained, very experienced Medical Aesthetician using the new Lux IRDeep skin tightening machine. The LuIR Deep® is one of the most effective skin tightening machines available. Most importantly for you it is the least painful of all of the available machines.

Above: before and after LuxIR skin tightening (Photo courtesy of Palomar Medical)

Fraxel and Lux1540-The new minimal down time “skin plumping” lasers for Fractional Skin Resurfacing

Perhaps you saw the piece about Fraxel on The Today Show (2/1/08). What is so exciting is that the new fractional laser skin resurfacing is a great improvement over older CO2 laser resurfacing. In the past, the Medical Aesthetics or Cosmetic Medicine procedure CO2 ablative laser resurfacing was the “Gold Standard” for wrinkle removal and skin tightening. However prolonged and difficult recovery time with peeling skin made this procedure unacceptable for most people.

During the past three years a new Medical Aesthetics or Cosmetic Medicine technology called fractional laser skin resurfacing has been developed which does not require significant recovery or anesthesia.

With Fractional laser skin resurfacing the laser beam is broken up, or fractionated, into many small micro-beams which are separated so that when they strike the skin surface, small areas of the skin between the beams are not hit by the laser and are left intact. These small areas of untreated skin promote a much more rapid recovery and healing with less risk of complications. The small areas of the skin treated by the fractional micro beams cause sufficient laser effect to promote new collagen production which plumps the skin improving wrinkles, pigment and acne scars.

The first fractional laser Fraxel and a newer technology called the Lux1540 have produced excellent results treating acne scarss and facial pigmentation and have improved skin texture.

To ablate means to “surgically remove.” The Fraxel® and Lux1540® are non-ablative fractional lasers which mean that when the laser beam strikes the skin the skin is not removed as it was with the traditional CO2 ablative lasers. Rather, the laser beam heats the skin to cause inflammation and new collagen production. The benefits of non-ablative Fraxel® and Lux1540® laser skin resurfacing treatments are dramatically reduced recovery time. After the treatment, your skin is pink the first day and the second day the skin may have “bronzing” which is easily covered by make up.

The new fractional laser skin resurfacing lasers safely go deep into the skin (see diagram below) where they can produce more effective new collagen production than more superficial laser treatments. This new collagen production replaces collagen that has been damaged by sun, aging, and acne. The new collagen produced can actually plump the skin wrinkles and acne scars and improve skin texture.

This skin plumping effect can significantly improve wrinkles and acne scars, reduce enlarged pores, remove pigment and actually improve surgical scars.

Above: Before and after Lux1540® treatment-Photos courtesy of Palomar and Dr. Dwight Scarborough

We have the new Palomar Lux1540® fractional non-ablative resurfacing laser in our practice and I am very impressed with the results. The Lux1540 treatment takes about 30 minutes and we use a topical numbing cream for your comfort. Your face will be pink the first day but your skin is intact- no oozing or open areas. The second day you may have a “bronze” cast to your facial skin but make up can be applied to mask this. In some patients who have more significant scars or wrinkles, we use higher settings. In these patients there may be peeling and redness for 3-4 days after treatment. Patients with thin skin from prior use of Accutane or previous dermabrasion or laser resurfacing can benefit from the skin plumping effects, but may also have more days of redness

The new fractional skin rejuvenation lasers are very exciting and a very significant development in Medical Aesthetics, Cosmetic Medicine and non surgical facial rejuvenation. For further information on facial rejuvenation and lasers read Save Your Face or contact me.

Topical Skin Creams-The Importance of Prescription Topical Skin Creams For Skin Rejuvenation

An effective daily topical skin cream regimen is one of the most important Medical Aesthetics or Cosmetic Medicine routines you can do to keep your skin looking healthy and to prevent facial aging. More importantly, prescription topical Retinoids like Retin A not only exfoliate the skin, stimulate the production of new collagen to replace collagen lost due to sun and environmental damage, but Retin A can actually reverse precancerous changes in your skin cells.

The effective skin health promoting effects of the retinoids has been known for over 20 years. Retin A is the only topical cream approved by the FDA for reversing aging skin changes, yet few doctors prescribe Retin A for its anti aging effects. Retin A is one of the first medical aesthetics treatments ever and my feeling is that if your skin cream does not require a prescription then it is unlikely that it is scientifically proven to work. You would not take a non prescription drug for an infection, high blood pressure, or other medical condition. Why is your skin health any less important?

I encourage all of my patients to use Retin A because I have seen dramatic and wonderful results in my patients. Patients who have very sensitive skin and cannot tolerate Retin A can usually use Vitamin C Serum instead of Retin A.

Over 20 billion dollars are spent each year on face creams to prevent facial aging yet most of them are not scientifically proven to work. As Dr. Klingman, the pioneer who developed Retin A, put it, “we have a marketplace that is absolutely crazy and the consumer is left to do her own personal clinical trial to see what works.” The most important thing I want you to remember is that there are only two treatments that have been approved by the FDA as effective for reversing facial aging changes– Retin A and laser resurfacing. The latter, of course, is a surgical procedure.

In my practice, Cheryl, my medical aesthetician, and I perform a careful medical evaluation of your facial skin as the first step in any medical aesthetics program and recommend the products that are most effective and safe for you.

My current Medical Aesthetics or Cosmetic Medicine recommendations for various skin conditions are:

1. Fine wrinkle removal, exfoliation, new collagen production and improved skin texture: Retin A or Vitamin C serum for those who cannot tolerate Retin A. Obagi Nu Derm System is an excellent Retin A based skin care program which includes 6 products-3 at night, 3 in the morning. The results of the Obagi System are dramatic and reverse many of the superficial aging changes in the skin. There is pinkness and mild peeling for the first two weeks, but after that you will see incredible improvement in your skin

2. Pigment Control-removal of sun damage: Retin A combined with 4 % Hydroquinone. The Obagi System works very well for pigment control.

3. Acne and break outs: Retin A and Pro Heal Serum® by Innovative Skin Care are excellent products for controlling the occasional break out. Patients with more severe flare ups and chronic recurring breakouts need the addition of Brevoxyl Washes and occasionally Differin® and Clindamycin® topical antibiotics. Severe cystic acne usually requires Accutane® which I prefer to be prescribed by your dermatologist. The Obagi System, a combination of 6 products including Retin A, produces phenomenal results for acne control once acute episodes are under control and is dispensed in our office.

4. Rosacea and facial red spots, blood vessels and telangiectasia- blood vessels on the face are a sign of inflammation most commonly secondary to years of sun exposure. Pro Heal Serum

4. Rosacea and facial red spots, blood vessels and telangiectasia- blood vessels on the face are a sign of inflammation most commonly secondary to years of sun exposure. Pro Heal Serum® is an excellent product for patients with sensitive blotchy skin and Rosacea. is an excellent product for patients with sensitive blotchy skin and Rosacea.

Topical creams are a very important part of your Medical Aesthetics or Cosmetic Medicine program for optimal skin health. However, good diet, hydration, exercise, and stress management will also contribute to your skin health.

One major benefit of having your skin care supervised by a physician in a medical office is that there are many additional treatments that will improve or enhance the results of your skin care program that can only be safely and effectively done in the office of a physician experienced in these new techniques.

For many of you, topical creams alone are not enough, and if that is the case we can provide you with the safe, effective leading-edge non-surgical medical aesthetics technologies necessary to help you.

If you would like to come in for a professional skin evaluation please call the office at 978-369-4499. Cheryl and I will give you our recommendations based on sound scientific principles and 25 years of experience. I will also give you a complimentary copy of my book, Save Your Face, so you can learn the basics of modern medical skin care and anti aging.

Injectables

Fillers- Radiesse®, Restylane®, and Juvederm®

Soft tissue fillers are an excellent Medical Aesthetics or Cosmetic Medicine method to rejuvenate and plump the aging lip and correct lip lines:

Above: before and after a filler injection in the lips

Soft tissue fillers like Radiesse®, Restylane® and Juvederm® are also used to camouflage Nasal Labial Fold lines and fill Marionette lines. (Contact Dr Seckel)

Younger women today want full voluptuous lips and fillers are an excellent way to create a beautiful full lip appearance.

Fillers can also be used to plump or fill acne scars and other skin depressions.

Soft Tissue Fillers-Characteristics

Modern fillers in use today are inert biological compounds that do not cause allergic reactions. Restylane® and Juvaderm® are made of Hyaluronic Acid a compound that is found in all human tissues. The fillers are synthesized and specially prepared for injection into human tissue. Restylane® lasts about 4-6 months. Juvederm® is also Hyaluronic Acid but has been modified to last longer, up to a year after injection.

Radiesse® is a long lasting soft tissue filler which is composed of Calcium Hydroxy Apatite, an inert material which actually stimulates your own tissue to grow into the filler and help plump the skin. Radiesse® is a long lasting filler which lasts up to a year in most people.

There are many other fillers on the market and they are all good. I use Restylane®, Juvaderm® and Radiesse® and will not discuss the others here.

Your Soft Tissue Filler Treatment

The soft tissue filler injection takes only a few minutes in my practice. I apply a topical numbing cream on everyone. I also recommend that my patients allow me to do a nerve block so that you do not experience pain with the soft tissue filler injection. I inject a small amount of local anesthetic underneath the upper lip much the same way the dentist numbs the front teeth-the same nerves go to the upper lip.

When I numb your lip you will have no pain when I inject the filler into the lip or the nasal labial fold.

Soft tissue filler injection is an art and a good looking result requires experience and careful technique. I numb your lip so I can do the injection properly. With you comfortable I can take the time and do the number of injections necessary to give you a good result.

I also have you take an herbal supplement called Arnica Montana which helps prevent bruising after the injection. I also apply ice packs to the treated area immediately after injection to prevent swelling.

Bruising does occur in some people, but the bruising is easily covered with make up.

Swelling does occur, especially in the lip, but it usually resolves in 24 hours. I recommend that you do not have a lip injection if you plan a social event that evening.

Overall patient satisfaction is very high. Your appointment will last about 20-30 minutes if a nerve block is done but the actual soft tissue filler injection takes only a few minutes.

Call me for an appointment or email me if you have questions. If you would like to learn more about soft tissue fillers read Save Your Face.

Laser Skin Care and Light Therapy

Laser Skin Care-What Lasers Do, How They Work On Your Skin

Laser skin treatments are Medical Aesthetics or Cosmetic Medicine procedures used for a wide variety of skin conditions. (Contact Dr Seckel)

Above: before and after laser skin resurfacing for wrinkle removal.

The most common medical aesthetics laser skin treatment or laser skin care procedure available today is laser hair removal but there are many other types of laser skin treatments available today. Laser skin resurfacing is rapidly becoming the most common laser skin treatments in use today. With regard to the issue of concern to you, wrinkles, fine lines, crow’s feet and facial pigment, I group the laser skin care procedures under the broad category of laser skin rejuvenation.

Laser skin treatments for laser skin rejuvenation are used in several different ways to rejuvenate the face and facial skin. Broadly, these laser skin care treatments can be classified as follows:

1. Laser Skin Exfoliation or Laser Skin Peel, Laser Skin Resurfacing – Lasers can be used to peel or exfoliate the skin to remove dead skin and smooth wrinkles and fine lines. Once the dead skin and surface of the wrinkles are removed by the laser peel, you see new shiny skin on the surface of your face. The skin can form new cells daily and deep laser exfoliation or laser skin peel is a very effective way to stimulate the production of new facial skin cells. Laser skin care for exfoliation or laser peel usually requires some down time for redness and healing because laser skin peel is an ablative laser procedure which means the dead skin cells and wrinkles are ablated or removed so that new skin cells can grow over the facial skin, The first exfoliative laser skin care procedure was laser resurfacing, a very deep laser skin peel, but the recovery time was very long and the skin was lightened, so laser resurfacing is only done today for very deep wrinkles and acne scars. More modern laser skin care for wrinkles and fine lines involves the use of fractional laser resurfacing with de-powered lasers that do not cause as deep a laser peel. Modern laser skin care for wrinkles uses superficial laser skin peels with minimal down time for recovery, usually 4-6 days of redness. Examples of the new laser skin care systems are the ActiveFX® laser skin peel with the Lumenis Ultrapulse Encore® laser, the Microlaserpeel® with the Sciton® Erbium laser, and the newest Lux2940® fractional ablative erbium laser made by Palomar. Exfoliative laser skin care is used for treating acne scars as well as facial aging, fine lines and wrinkles and to remove pigment.

2. Laser Stimulation of New Collagen in The Deep Skin Layer, The Dermis – A major cause of wrinkles and acne scars is loss of collagen in the deep layer of the facial skin called the dermis. Sun damage kills the collagen in the dermis of the skin. When the collagen dies, the skin loses volume and shrinks, and the overlying outer surface of the skin reveals wrinkles. This is similar to what happens to a nice plump plum which is dried in the sun. After the plum loses its inner water volume, the skin wrinkles and you have a prune. Laser skin care also describes laser skin procedures which can stimulate the production of new collagen to replace the damaged collagen and plump up the wrinkles and even acne scars in the skin. The laser skin peels do this by irritating the skin as the laser peel is done. The irritation causes inflammation of the skin and when the skin is inflamed the skin responds by forming new collagen. The newer laser skin care techniques are very effective at stimulation of new collagen formation even in the deeper portions of the dermis and are very effective at plumping acne scars and can improve wrinkles. Examples of non-ablative laser skin resurfacing techniques for new collagen production for treatment of facial skin aging and acne scars are the non-ablative fractional lasers the Lux1540® by Palomar® and the Fraxel® by Reliant® Technology.

3. Laser Skin Treatment of Pigment and Facial Skin Photo-Damage – The aging effects of the sun, called photo damage, are not only dry skin and wrinkles but also pigment, called brown spots, sun spots, age spots, and “liver spots.” Laser skin care procedures are very effective at removing pigment and photo-damage. The ablative laser skin care procedures, such as the laser peel and laser resurfacing, strip away the pigment, but only the superficial pigment. Newer Fractional laser skin care treatments go deeper and can remove deep pigment with even less recovery time than the laser resurfacing laser skin rejuvenation treatments. Microlaserpeel, and ActiveFX are the laser skin peel treatments, and the Lux1540 and Fraxel are the non-ablative fractional laser skin care treatments for pigment. Today laser skin care for pigment removal is more often done with newer IPL or photo facial treatments. IPL, or photo facial, uses light energy, not laser energy, to remove pigment, and is a more gentle treatment with no down time.

4. Laser and Light Skin Tightening – Laser skin care can tighten sagging facial skin but only minimally. All of the lasers mentioned above do tighten skin a bit because when they stimulate new collagen production in the skin, the new collagen is tighter and the tighter collagen tightens the skin. This effect takes months after the laser skin care treatment and is not nearly as noticeable as a face lift. Newer and more effective skin tightening treatments are possible but not with laser skin care. The more effective skin tightening treatments are done with Infrared or Radiofrequency energy with machines called LuxIR®, Titan®, Aluma with Faces®, Refirme®, and Thermage®.

5. Laser skin treatment for Broken Blood Vessels, Red Spots and Rosacea on the Face – Photo-aging and sun damage also cause broken blood vessels to appear on the face. Laser skin care can remove broken blood vessels on the face and legs. Both the 532 and 1064 Yag lasers are useful for removal of broken blood vessels. However the newer IPL and Photo-facial treatments are very effective, produce less down-time and are used more frequently today. The 1064 Yag laser is the choice for larger broken blood vessels and leg veins.

6. Laser Hair Removal – Laser hair removal is the most commonly performed laser skin care procedure done today. There are many different laserand IPL skin care treatments for laser hair removal. The diode laser Light Shear Diode® was the gold standard for many years but more recently IPL has gained in popularity.

7. Laser Tattoo Removal – Laser skin care for tattoo removal was one of the first applications of laser skin care. There are many different lasers for tattoo removal and different laser wavelengths are chosen for the specific color of the tattoo to be removed. Laser tattoo removal takes many treatments over a long period of time, but is preferable to surgery which can leave scars.

I am sure there are other Medical Aesthetics or Cosmetic Medicine laser treatments that can be classified as laser skin care, but the above are the most widely available and useful laser skin care treatments available today. As you can see, the applications in the field of Medical Aesthetics or Cosmetic Medicine are very different for each type of laser so it is very important that the type of laser skin care be customized to fit the facial skin problem that you are trying to correct.

A board certified Dermatologist or Plastic Surgeon , who is knowledgeable and specializes in laser skin care, are traditionally the most experienced doctors with lasers. Laser skin care, if not done correctly by board certified medical specialists, can damage your skin. The State Medical Boards and legislatures are trying to establish guidelines and licensing regulations in many states.

For more information on laser skin care, laser skin treatments, laser peel, laser skin rejuvenation, and non-surgical facial rejuvenation read Save Your Face or contact me,

IPL-Intense Pulsed Light-photo facial treatments

IPL is a very important Medical Aesthetics or Cosmetic Medicine procedure. I have covered IPL or Photo-Facial above under aesthetician services.

Future Developments in Medical Aesthetics and Cosmetic Medicine

The demand for Medical Aesthetics or Cosmetic Medicine services is high and will continue to grow as our population ages and with our cultural interest in looking and feeling your best. We are working on new laser technologies to dissolve fat and I predict that in a few years liposuction, as we know it today, will be replaced by new non invasive laser liposuction and lipodissolve technology. Skin tightening technology will continue to improve and eventually the face lift will be done much less invasively than it is today. Age management techniques in the form of molecular biological modifications and DNA and Gene therapies will definitely advance and are, at this point, more likely to be embraced by doctors involved in Medical Aesthetics and Cosmetic Medicine than by those in traditional medicine.

I am sure I cannot fully imagine what the field of Medical Aesthetics and Cosmetic Medicine will be like in another 20 years, but at the pace of technological breakthroughs of the past 10 years it is going to be very different than it is today.

For more information on the field of Medical Aesthetics, Cosmetic Medicine and non surgical facial rejuvenation read Save Your Face or contact me.

Be sure to sign up for my free email newsletter to keep informed of new developments in the field of medical aesthetics.

Dr. Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts

The effective skin health promoting and skin rejuvenation effects of the retinoids has been known for over 20 years, RetinA is the only topical cream approved by the FDA for reversing aging skin changes, yet few doctors prescribe Retin A for its anti aging effects. My feeling is that if your skin cream does not require a prescription then it is unlikely that it is scientifically proven to work. You would not take a non prescription drug for an infection, high blood pressure, or other medical condition, why is your skin health any less important?

I encourage all of my patients to use Retin A because I have seen dramatic and wonderful skin rejuvenation results in my patients. Patients who have very sensitive skin and cannot tolerate Retin A can usually use Vitamin C Serum instead of Retin A.

Over 20 Billion Dollars are spent each year on skin rejuvenation face creams to prevent facial aging yet most of them are not scientifically proven to work. As Dr. Klingman, the pioneer who developed Retin A, put it, “We have a marketplace that is absolutely crazy and the consumer is left to do her own personal clinical trial to see what works”. The most important thing I want you to remember is that there are only two treatments that have been approved by the FDA as effective for reversing facial aging changes– Retin A and laser resurfacing, the latter, of course is a surgical procedure.

Cheryl, my medical aesthetician, and I will perform a careful medical evaluation of your facial skin and recommend the products that are most effective and safe for you.

My current recommendations for various skin skin rejuvenation and treatment of other skin conditions are:

1. Fine wrinkle removal, exfoliation, new collagen production and improved skin texture: Retin A or Vitamin C serum for those who cannot tolerate Retin A. Obagi Nu Derm system is an excellent Retin A based skin care program which includes 6 products-3 at night, 3 in the morning. The results of the Obagi System are dramatic and reverse many of the superficial aging changes in the skin. There is pinkness and mild peeling for the first two weeks, but after that you will see incredible improvement in your skin

2. Pigment Control-removal of sun damage: Retin A combined with 4 % Hydroquinone. The Obagi Nu Derm System works very well for pigment control.

3. Acne and break outs: Retin A and Pro Heal Serum by Innovative Skin Care are excellent products for controlling the occasional break out. Patients with more severe flare ups and chronic recurring breakouts need the addition of Brevoxyl Washes and occasionally Differin and Clindamycin topical antibiotics. Severe Cystic Acne usually requires Accutane which I prefer to be prescribed by your dermatologist. The Obagi Nu Derm System, a combination of 6 products including Retin A produces phenomenal results for acne control once acute episodes are under control and is dispensed in our office.

4. Rosacea and facial red spots, blood vessels and telangiectasia- blood vessels on the face are a sign of inflammation most commonly secondary to years of sun exposure. Pro Heal Serum is an excellent product for patients with sensitive blotchy skin and Rosacea

Topical prescription strength skin rejuvenation creams are a very important part of your program for optimal skin health. However, good diet, hydration, exercise, and stress management will also contribute to your skin health.

One major benefit of having your skin care supervised in my office is that there are many additional treatments that will improve or enhance the results of your skin care program that can only be safely and effectively done in the office of a physician experienced in these new techniques. I have made a major commitment to effective safe skin care techniques for the past 12 years and you will not find the same level of care, experience, and dedication to your health and happiness in any other practice.

For many of you topical creams alone are not enough, and if that is the case we can provide you with the safe, effective leading edge non surgical technologies necessary to help you. These methods include:

Microdermabrasion: Microdermabrasion removes dead skin and superficial pigment and improves the penetration and thus effectiveness of Retin A, Hydroquinone and the other topical products

IPL: IPL (intense pulsed light) also called photo-facial, is the newest and most widely accepted method for removal of pigment and blood vessels from the face and Declote. IPL treatments give a wonderful head start to the Obagi New Derm System.

Non ablative “skin plumping” with the Lux1540 fractional laser: It has been 3 years since non-ablative fractional laser  skin resurfacing was introduced with Fraxel, and although I was skeptical in the beginning I am seeing results that show definite improvement is skin texture. The new Lux1540 stimulates new collagen formation in the deeper skin layers and actually plumps wrinkles and acne scars. The exciting thing is that this is a non ablative procedure which means minimal down time. You are pink for a day but no open wounds or oozing. With deeper treatments there is some “bronzing” of the skin the next day but this is easily covered by make up. While your topical skin creams stimulate new collagen in the upper skin layers, skin creams cannot reach the deeper skin layers where significant wrinkle causing collagen loss has occurred. The 1540 allows us to treat the deeper layers where significant new collagen production can be stimulated.

If you would like to come in for a professional skin evaluation please call the office at 978-369-4499. Cheryl and I will give you our recommendations based on sound scientific principles and 25 years of experience. I will also give you a complimentary copy of my book Save Your Face so you can learn the basics of modern medical skin care and anti aging.

Be sure to subscribe to my email newsletter to keep up to date with new developments.

I hope to see you soon.

Dr Seckel

Concord, Massachusetts

2/01/08

Revolutionary new advances in facial skin care in the past few years have made true facial skin rejuvenation a possibility for many people.

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.

Fillers-Juvederm, Restylane, Radiesse for the Nasal Labial Fold

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

Concord, massachusetts

978-369-4499