Aging Skin - Part 2

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3 Non-Surgical Ways to Rejuvenate the Face

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When you want to look and feel younger, your face is the front and center battleground of that fight. And while there are a few ways to surgically make the face look years younger (facelift, neck lift, nose job), many women might not be ready for the commitment or cost of a surgical procedure. If not, there are "best practices" for rejuvenating the face without reaching for the scalpel. We went to the experts to find out what they individually believe are the best treatments to get a younger face without surgery.

Seattle, WA, dermatologist Jennifer Reichel, MD, says first and foremost, start with a good skin-care routine. "Routine skin care by trained, experienced aestheticians is invaluable in producing, improving and monitoring the skin. Let's face it—beautiful skin always creates a more youthful look. A comprehensive skin-care program that may include professional products and treatments (like facial peels and photo facials) can minimize sun damage, soften fine lines, reduce acne, rehydrate dry skin and brighten dull, aging skin."

If you want to take it one step further, there are more options available to make the face look younger. Seattle Dermatologist Jennifer Reichel, MD, says before finding the best method for facial rejuvenation, your doctor has to take into account the age demographic of the patient. "When they are younger, we’re getting rid of wrinkles with products like Botox and hyaluronic acid fillers such as Restylane and Juvéderm. For restoring more volume [in older patients] we like Radiesse. If the patient needs more volume, we like to use the patient’s own fat and stem cells as fillers," this is called fat harvesting or fat transfer.

Dr. Reichel also says, noninvasive radio-frequency treatments, on the right patient, can work wonders: "We’re fans of Ultherapy,a new type of non-surgical, non-invasive procedure for the face and body that uses ultrasound and the body’s own natural healing process to lift, tone, and tighten loose skin.. I think you can also count Fractional CO2 in this area. It is an ablative laser, but it’s not as invasive as making incisions. It is a very effective tool in treating fine lines, irregularities and brown spots."

The physicians and skin care specialists at Pacific Dermatology & Cosmetic Center are a dedicated team with expertise in medical dermatology, Mohs skin cancer surgery, and aesthetic surgery. Dr. Reichel and her wonderful staff are committed to excellence in patient care.  Call us today to schedule your cosmetic consultation or medical dermatological appointment, 206.859.5777, we look forward to meeting you,


Fall is Coming...Peel Your Way to Flawless Skin

Credit: Harry Vorsteher/Corbis

There’s no better way to perk up dull skin than with a chemical peel. A beauty staple since the days of Cleopatra (who was said to bathe in spoiled milk, the basis of lactic acid), the formulations and peeling agents used today may have been adapted to meet modern-day beauty standards but the basic principle of exfoliation for an immaculate complexion remains a steady constant.

Light Peels - alphahydroxy acids (AHAs) and betahydroxy acids

Good for:  Lightly refreshing the skin

You’ll notice:  Subtly smoother, more evenly toned skin and less blemishes

Medium Peels- trichloroacetic acid (TCA)

Good for: Correcting moderate wrinkles, lines and sun damage

You’ll notice: Significantly smoother skin that’s more even in tone with fewer lines and spots

Deep Peels - phenol acid

Good for: Extreme resurfacing

You’ll notice: Drastically smoother skin sans wrinkles and pigmentation

Understanding the Strengths: Just like how ingredients, such as retinoids and vitamin C, are available in different strengths, so are the peeling agents used in chemical peels.

On the Low End: Each acid ranges in strength—single digits and 10 percent concentrations are on the more gentle side; 20 to 70 rank on the higher end.

Stronger Peels Offer an Advantage: The higher the percentage of the acid used in a chemical peel, the more damage reversal it can do for your   skin.

Formulation Counts: “The different percentages are like the difference between using an over-the-counter product versus a prescription-strength version,” says Santa Ana, CA, dermatologist Tony Nakhla, MD. Take, for example, glycolic acid. “It can come in different strengths and pH levels, or combined with other ingredients. These factors help to determine how efficacious the product is, and how deep it can penetrate,” says Boca Raton, FL, aesthetician Cheryl Staurowsky.

Skin Basics: Every 28 days or so our skin sheds—a natural healthy process that is essential. “Stimulating the natural exfoliation cycle purposely removes the outer layer of cells to improve the texture of your skin faster,” says Dr. Nakhla. That’s where exfoliating chemical peels come in. “Superficial peels act as a means of exfoliation, but at a stronger level than what can be achieved with a manual exfoliator or scrub,” says Dr. Nakhla.

How deep a peel can go:

Light peels reach just the epidermis, the outermost layer of the skin to lighten discoloration, transform texture and fight breakouts

Medium strength peels work on the middle dermis or the layer of skin between the epidermis and the dermis for more serious resurfacing.

Deep peels get down to the dermis, the lowest layers of the skin, to dramatically soften lines and wrinkles


Can you tell me if Ultherapy will work under my eyes?

Question: I have fine lines and loose skin under my eyes. Will Ultherapy help with this?
A: Ultherapy is a relatively new skin tightening device that has FDA approval for tightening and lifting facial skin. It uses ultrasound waves to target the tissues underlying the top surface of the skin to cause small areas of tissue damage that then results in collagen formation, new tissue remodeling and ultimately, tightening and lifting. The company recently added a new hand-piece (called a transducer), that has a depth of only 1.5 mm. Along with the other handpieces, this one can now be used under the eyes to tighten and smooth skin.
Since it is very new, we are really in the early stages of seeing how much true visible changes it makes under the eyes. We know that Ultherapy can be used to lift eyebrows and to tighten the jawline and plump cheeks. We have treated about 30 patients under the eyes over the last 3 months and are awaiting results. I do see where it may be necessary to do more than one treatment (perhaps 4-6 months apart) under the eyes. I suggest, when treating the upper face, that patients go for the full upper face treatment - as that will make the most difference overall. I am excited about this technology and would love to see you for a consultation.
Thanks. Dr Reichel.

Is a Liquid Lift Right For You?

Is a Liquid Lift Right For You?

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When injectables and fillers were first introduced, they pretty much served one purpose: to fill wrinkles. Over time, and with off-label experimentation, their use has become more widespread as the effects of volume loss are a constant complaint. Today, the "Liquid Lift"—the use of fillers to give a more lifted and youthful look to the face—is gaining popularity as replacing lost volume via injections allows the skin to take on a lifted appearance and redefines the natural contours of the face.

Call Dr. Jennifer Reichel today for your cosmetic consultation and see if a "Liquid Lift" is right for you.


Is sugar affecting our skin?

Fight the Negative Effects of Sugar in Your Skin

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Fight the Negative Effects of Sugar in Your Skin

Posted Monday, July 02, 2012 by Anjelle Ruppe, Contributing Writer

Sure, you know that sugar isn’t exactly the best ingredient to consume on a daily basis, after all, it's bad for your figure and can also cause wrinkles.

That's because sugar molecules in your system attach to fats and proteins in a process called glycation, which leads to advanced glycation end products, commonly called AGEs, that cause protein fibers to become stiff and malformed.

Unfortunately, the proteins in your skin that are most prone to glycation happen to be the same ones that make a youthful complexion plump: collagen and elastin. During the process, they become discolored, weak and less supple, which then shows up on the skin as wrinkles, sagginess and a loss of radiance.

What's worse, these external signs start to show up around the age of 30 to 35, when sun damage, environmental oxidative stress, hormonal changes and the development of AGEs begins to result in fine lines.

It’s important to note that refined sugar is not the only culprit. Whole grains, fruits and vegetables also turn to glucose when digested, although there is less damage and these foods are necessary for our health. So, we shouldn’t completely eliminate all types of sugar from our diets. Thankfully, there are some options to fight off the unwanted results of glycation.

With regards to your diet, stay away from white sugar and high-fructose corn syrup, which studies have found increase the rate of glycation by 10 times, along with simple carbs. You can also take supplemental carnosine, an amino acid that has been shown to protect against AGE buildup.

Skin care is also important to slow glycation. Products that contain viable AGE fighters began to appear five years ago. Now that glycation is widely known as a major cause of aging, there are plenty of anti-aging creams containing AGE fighters, too. Green tea has been proven to significantly interfere with the glycation process, while it also stimulates collagen synthesis. So, use a product that contains this antioxidant-rich ingredient, or drink it regularly, to protect your skin from glycation.

“Anything that stimulates the fibroblasts to build new collagen is going to help eradicate damage,” says New York dermatologist Fredric Brandt, MD, who also notes that retinoids and some dermal fillers fall into this category as well.

A couple of products that fight glycation in the skin are SkinCeuticals A.G.E. Eye Complex ($86) which targets advanced glycation end products with blueberry extract and Amore Pacific Time Response Skin Renewal Serum ($500), which harnesses the antioxidant and collagen-restoring powers of green tea stem cells.


Retinol: What is it? And How Does it Work?


Why Facial Volume Matters

Why Facial Volume Matters

You may not realize it, but a little plumpness is a good thing. Especially when we're talking about the face, as you can see in actress Elizabeth McGovern's photos, the image on the left taken in September 2001 and the one on the right last week.

Fat naturally adds the volume and support to the face that keeps wrinkles at bay and our skin looking youthful. However, we start to lose facial fat as early as our 20s, and it's a downhill slide, literally, from there.

Facial fat deteriorates naturally with age, but weight loss and hormonal changes can speed up the process. When this happens, we start to see less definition around the face, including sunken temples, forehead and brow wrinkles, the corners of the mouth turned down, hallowing around the eyes, flatter cheeks and slack skin around the jaw.

There are ways to restore facial volume and achieve smoother skin. Here's how:

Fat transfer: This is good option if you'd like long-term results, but can endure some downtime (up to two weeks). You will first undergo a mini-liposuction procedure to remove fat from another area of your body, then it will be prepared to be injected into your face. It's also a good option if you are wary of injecting other types of fillers into your skin. The fat is your own, so your body will not reject it.  We are able to store your fat in our medical-grade freezer for up to two years so it's easy to come in when you need another injection.

Fillers: Fullness can be restored through a variety of fillers including temporary (like Restylane, Juvederm and Perlane), or longer-term (like Radiesse). Injecting fillers is a non-invasive option that gives an immediate result. The cheeks, temples, chin and jawline are the areas best suited for fillers, and Restylane was recently given FDA approval for use in the lips. Some of the non-permanent fillers can last up to two years, but most need additional treatments.

Seek an experienced and board-certified physician to determine the right option that will give you the results you're after.  Call our office to schedule your consultation with one of our skilled physicians, 206.859.5777, at Pacific Dermatology & Cosmetic Center we have years of experience with facial fillers.


Stress Really Does Age You, Study Finds

Stress Really Does Age You, Study Finds

Posted Friday, February 24, 2012 by NewBeauty Staff

One of the most important factors in keeping your skin looking young and vibrant is good cellular health. Boosting or maintaining a healthy rate of cell turnover can mean the difference between dewy, fresh skin or a complexion that's clogged with dulling dead skin cells. Another important factor, how you respond to stress, has been found to play a key role in how your cells age, according to a study by researchers at the University of California, San Francisco.

The scientists studied the effects of stress on 50 women, half of whom were under chronic stress due to caring for a loved one suffering from dementia. The caregivers showed the most significant signs of anticipation in the face of a stressful event, which was reflected in cells that looked older than the non-caregivers.

The telomeres, the protective ends of the chromosomes, in these women were shorter than others who experienced less anticipation of stressful events, like having to speak in public or completing math problems. Short telomeres have been associated with premature aging.

Beyond the effects to your skin, this type of cellular damage caused by on-going stress is also linked to health concerns, such as cancer and heart disease.

"Our goal is to gain better understanding of how psychological stress promotes biological aging so that we can design targeted interventions that reduce risk for disease in stressed individuals," the study's lead author Aoife O'Donovan, PhD, told ScienceDaily.

We all deal with daily stress, but with the findings in this study that chronic stress accelerates cellular aging, practicing stress-relieving habits may be more important than ever. Delegating tasks, eating well, meditating and getting regular exercise and good sleep are all proven ways to ease the stress load. What are some of your tried-and-true stress relievers?


Don't Let Jowls Drag You Down

Don't Let Jowls Drag You Down

Around your 40s, you may start to notice the development of one of the most dreaded signs of aging: jowls. That sagging skin that begins to form along your jawline is caused by a loss of facial volume. If you have a fuller face, it may take longer for jowls to appear, but if you have a thin face, they may show earlier.

Luckily, there are a number of ways to slow the progression of jowls before they drag you too far down.

Skin tightening: Skin that is in the beginning stages of aging may respond well to skin-tightening devices, such as radio-frequency energy. A nonablative technique, like Thermage, utilizes electric and magnetic energy with radio waves in short, intense pulses to oscillate through the skin and deliver heat to the deep layers of the skin without damaging the outer layer of skin. However, if you have very saggy skin, this type of technology won't do much for you, and you may need surgery instead.

Fillers: Your doctor may opt to use a filler to build your cheeks back up, which may affect the look of your jawline, too. The key, Dr. Reichel says, is for the filler to be injected deeply, rather than superficially. Boosting the cheeks with fillers like RadiesseRestylane or Juvéderm may help create a more balanced, youthful face.

The Physicians at Pacific Dermatology & Cosmetic Center are here to help with all of your cosmetic needs and wants, call us today and schedule your appointment, 202.859.5777.


Even with Seattle's "Not-so-Sunny" Disposition,You Still Need to Prevent Sun Damage

Sun Damage: What to Teach Your Daughter Now

Sun Damage: What to Teach Your Daughter Now

Posted Tuesday, January 31, 2012 by Shellie Terry Benson, Editor

How much would you love to turn back the clock and undo all that sun damage you exposed yourself to? It might be too late for you, but it's not too late for your children. While wrinkles and sun spots develop after many years of exposure to the sun's ultraviolet rays, getting a sunburn at a young age is one of the top indicators for developing skin cancer later in life.

A team of researchers recently studied the sun-safety habits of children and found that more than half (53 percent) had suffered at least one sunburn before age 11. Further, they found that only one in four 14-year-olds regularly use sunscreen.

But what you do to protect your skin can have a profound effect on young teenagers who, despite their behavior, still look to you for guidance. Slather on the sunscreen and then cover them as well. Or better yet, encourage them to learn to properly coat themselves. Have them wear a hat on particularly sunny days and opt for lightweight cotton clothing to add another layer of protection. Explain the dangers of sun damage, both in terms of aging and health. Plus, if you follow those rules, your children likely will, too.  Also be open to discussions about examining moles and spots on their skin that may suddenly change, this will make them aware of what the suns more harmful rays can do long-term.


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