May 4, 2009
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In my practice, Facial Rejuvenation often includes a multitude of treatments, starting with a series of peels combined with microdermabrasion, to a more complex approach that incorporates Botox Fillers and IPL technology.
What determines the treatment selected is a detailed history and physical with a close analysis of the degree of photoaging. For a younger patient with Type I photoaging, I concentrate more on the pigmentary changes, the vascular aspect, and the pores. For Type II photoaging, where there is involvement of the entire dermis, the approach is more complex. Type 3 is characterized by lipoatrophy, muscle and bone reabsorption, with deeper wrinkles and significant volume loss. This remains the biggest challenge for me. The majority of these patients have not had any aesthetic procedure and are often unwilling to accept surgical or ablative procedures and sometimes fillers, which could promote collagen or new bone formation, like Sculptra or Radiesse.
The IPL technology remains the gold standard for the treatment of actinic keratoses, rosacea, and acne. These technologies can increase collagen production, reduce pore size and improve the overall texture of the skin. The equipment available to my Westchester patients gives me the versatility of different energies, IPL technology with bipolar RF, IPL alone, or just RF which accomplishes volumetric heating and is used primarily for those patients who have important laxity.
In both my Armonk and Rye Brook, NY, practices I offer my patients combining technologies based on their needs and primary goals. IPL devices can eliminate inflammation, decrease the numbers of Propionibacterium and Demodex organisms, and reduce sebum production. These actions improve acne. Adding photodynamic therapy with aminolevulinic acid (ALA) will further improve results and even reduce the number of treatments.
The Sciton technology using special filters allows me to treat pigmentation and vascularity more aggressively. Patients with Rosacea see faster and more impressive results after only one treatment.
The Refirm ST (Syneron) combines infrared with bipolar RF and penetrates to a depth of 1.5mm. to 2mm. This skin tightening treatment is used by itself or combined with other Elos technology to improve texture and tighten the skin.
These treatments can be successfully applied to the neck, chest, and hands, areas that tend to be often neglected.
Used alone or in combination with chemical peels, microdermabrasion, mesolift, Botox, and Fillers these treatments can turn back the clock.