Dr. Patel’s Approach to Treating the Aging Face: 4D Anti-Aging
By
Dr. Shaun Patel
/
Clear + Brilliant, Dermal Fillers, Latisse, Skin Rejuvenation, Wrinkle
Relaxer
/
December 26, 2017
For me, it’s an exciting time to be an aesthetic medicine provider. Actually,
it’s probably just as exciting to be a patient, at least for those interested
in cosmetic medicine. Today, more than ever, aesthetic physicians have the
tools needed to provide natural looking and aesthetically pleasing results
without surgery and with minimal downtime. We are essentially able to freeze
the aging process.
Anyone that has seen me for consultation or treatment in my Coral Gables
clinic knows that I frequently describe my approach to treating the aging face
as “4D anti-aging.“ 4D or 4 dimensional antiaging is the idea that a
combination treatment approach using multiple (four in my approach) modalities
is required when addressing the aging face. To understand the important role
of each of the 4 treatments, it is important to understand the underlying
causes of aging.
First, hyperdynamic muscles such as muscles in the forehead and around the
eyes lead to dynamic and eventually static lines and wrinkles predominantly
on the upper face (i.e., frown lines, horizontal forehead lines, crow’s
feet). While we mainly focus on the upper face, hyperdynamic muscles are
also responsible for loss of jawline definition (platysma), vertical neck
bands (platysma), perioral or vertical lip lines (orbicularis oris), and
downturned corners of the mouth (DAO).
Second, age-related volume loss from fat, muscle, and bone atrophy leads to
sagging of the skin and changes in the face such as laugh lines, jowls, loss
of jawline and cheek definition, undereye and temple hollows, lip elongation
and volume loss and perioral lines.
Third, years of sun exposure and environmental stressors such as atmospheric
pollution, stress, smoking, and diet leads to skin changes that result in
hyperpigmentation, enlarged pores, uneven tone and texture, and loss of
radiance.
Fourth, collagen loss and elastin degradation lead to skin laxity which is
one of the hallmarks of the aging face.
So the four treatment modalities that I am talking about when I talk about 4D
antiaging are:
Regular treatment with neurotoxins like
Botox,
Dysport or Xeomin to reduce
muscle activity and soften the appearance of frown lines, forehead lines and
crow’s feet. By regular treatment, I mean at least 3 times a year. This is
an important point as many patients will come in and have Botox once or
twice and then not get it done again for years. In my opinion, this is
pointless. The best results are seen in those patients who maintain their
results with regular treatments. The muscles atrophy, the lines get softer,
and in many cases even difficult to treat “etched lines“ improve with
regular treatment.
Correcting volume loss with
dermal fillers such as
Restylane, Juvederm, and
Sculptra. When it comes to
treating age-related volume loss, my preferred filler is Sculptra. Sculptra
is a filler made of poly-L-lacitc acid particles. What makes Sculptra unique
is that unlike hyaluronic acid based fillers like
Restylane and
Juvederm, Sculptra works by
stimulating your body to produce more of its own collagen. We already know
that volume loss is in a big way due to collagen loss and so it makes sense
that the best filler to address this volume loss is one that results in more
collagen production. Now this doesn’t mean that hyaluronic acid-based
fillers are unnecessary. It just means that they should be used in
combination with Sculptra when possible and when appropriate. The way I look
at it is that Sculptra is a facial volumizer while Restylane and Juvederm
are line and wrinkle fillers (i.e., nasolabial folds, marionette lines,
etc.). Most of my patients see me once every 9-12 months (once full
correction is achieved) to maintain their filler results.
Skin resurfacing with fractionated lasers (Clear + Brilliant), microneedling, and
chemical peels to improve
skin tone and texture, address hyperpigmentation, shrink pores, soften fine
lines, and increase radiance. My patients really like that most of the
resurfacing treatments we offer are quick, result in only minimal downtime,
and provide noticeable and consistent results.
Skin tightening using radiofrequency based devices. While
both radiofrequency (Thermage, ThermiRF, Infini), ultrasound (Ultherapy),
and laser devices can be used to stimulate collagen production and thereby
improve skin laxity, my preferred treatment for nonsurgical skin tightening
is Thermage (either the 3rd generation Thermage CPT or the 4th generation
Thermage FLX). Thermage was the first energy-based device approved by the FDA for skin
tightening back in 2001/2002 and since that time over 2 million Thermage
treatments have been performed worldwide and over 50 clinical studies have
confirmed its safety and efficacy.
So that’s my approach to the aging face. There is just one more thing. In
addition to the four office-based treatment modalities above, I always start
my patients on a complete at-home
daily skincare regimen which brings it all together.
Important active ingredients I find myself constantly recommending are
physical sunblockers, antioxidants such as vitamin C and E, green tea, and
resveratrol, glycolic acid, retinol or retin A, and skin brighteners (both
hydroquinone and hydroquinone free products).
Latisse, a prescription topical
medication, has been proven to increase eyelash length and fullness and is
very popular among my patients. Some of my favorite medical grade skincare
lines are Alastin, Skinceuticals, Restorsea PRO, and EltaMD.
If you are ready to experience the 4D approach to antiaging, call Miami Skin &
Vein today at (786) 618-5039 to schedule your
personal consultation. We welcome patients to our Coral Gables office from
Miami, Fort Lauderdale, and neighboring Florida communities.
At Miami Skin + Vein, your journey to refined aesthetics begins with expertise and personalized care. Discover the difference that a physician-led, evidence-based approach can make. Schedule your consultation today and take the first step towards a naturally enhanced and more confident you.