Cosmetic Dermatology

What is Cosmetic Dermatology?

Cosmetic Dermatology is the term used to describe the practice of a physician’s ability to repair, improve, and renew the skin through a variety of products, technologies, and procedures, such as Botox injections. Injectables, lasers and light devices, cosmetics, surgical procedures, healing solutions, and other therapies and procedures that pertain to appearance-related dermatology fall under this description.

Anti-aging skincare can be preventative and/or corrective. Fine lines, wrinkles, volume loss that contributes to sagging skin, discoloration from past sun damage, and scarring can be addressed. Dr. Balle will tell you about available cosmetic dermatology options and then discuss all the benefits and side effects. As a board certified dermatologist he is eminently qualified to perform these anti-aging procedures that provide you with a range of possibilities to regain a youthful appearance.

How can I benefit from Cosmetic Dermatology?

Our skin care practice is built around your needs and what you want to achieve. Our number one question for you when you visit our dermatology clinic is “What concerns you the most when you look in the mirror?” We have a number of non-surgical, minimally-invasive options to enhance your beauty and self-confidence. We approach skin rejuvenation from a multi-dimensional perspective. Often, a combination of treatment therapies will give greater results. Our goal is to help you achieve your personal best.

Anatomy of Facial Aging

Anatomy of Aging
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Facial aging process begins with the surface and subsurface structural changes in multiple facial tissue layers, including skin, fat, muscle and bone.

  • Facial tissue layers age interdependently, contributing to the overall facial appearance
  • Facial aging is due to changes in several types of tissue, including skin, fat, muscle, and bone.

Skin

Skin Aging
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With age, skin undergoes several changes, Changes include:

  • Thinner skin
  • Drier skin
  • Less elastic skin
  • Skin more likely to wrinkle or sag
  • Reduction in collagen

Collagen

Collagen
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Collagen loss is a key factor in the aging process. As skin ages, the middle layer of skin (dermis) thins due to collagen loss. This reduces the skin’s ability to retain elasticity (from elastin) and moisture (from hyaluronic acid). Due to this loss of elastin and hyaluronic acid, the skin becomes:

  • Dryer
  • Less supple
  • Less elastic
  • Thinner (volume loss)

Fat

Fat
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A youthful look depends on having the right amount of facial fat in the right places. Redistribution, accumulation, and atrophy of fat lead to facial volume loss.

  • Some areas lose fat. Examples are the forehead and cheeks.
  • Other areas gain fat. Examples are the mouth and jaw
  • Modification of the fat pads leads to contour deficiencies

In addition, the areas of the fat tend to become farther apart. Instead of a smooth, almost continuous layer, the fat pads appear as separate structures.\

Bone

Bone
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There is a significant loss of facial bone and age. Aging of the craniofacial skeleton may be due to changes in the relative dynamics of bone expansion and bone resorption leads to biometric volume loss. Without the structural support of bone, there are noticeable changes in the other layers of overlying soft tissue and skin.

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Signs of Facial Aging

  • Greater visibility of bony landmarks, lines and wrinkles
  • Prominence of transverse forehead link
  • Nasolabial folds become more prominent
  • Hollowing of the mid-face (loose skin)
  • Changes in the area around the mouth (vertical wrinkles, lip thinning and flattening)
  • Development of prejowl depression (marionette lines)

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Facial Mapping

Facial Mapping

With aging, the balance, proportions and symmetry of the face change. For example:

  • The lower face widens as the jowls form
  • The lower face shortens as bone is remodeled in the maxilla and mandible
  • The young face shows 1/3:2/3 ratio of upper lip to nose and lower lip to chin. With age, this ration approaches 1:1

Each of the facial sections show different changes with age are unique to each patient.

The goal is to achieve:

  • Symmetry on both sides of the face
  • Smooth convex contours
  • Homogeneous skin tone and texture

The transition between the anatomical regions of the face should be subtle and harmonious.

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Procedure Options

procedure_options

Facial rejuvenation treatments can be classified in three categories:

Resurfacing Options

Resurfacing techniques are used to modify the surface of the skin. They correct the effects of photoaging, including fine lines, irregular pigmentation and blemishes. Common resurfacing techniques include:

  • Chemical Peels
  • Microneedling
  • Skincare Products

Injectables

Injectables include a broad range of substances which are administered by injection. Their main usage is for the treatment of lines, wrinkles and folds, as well as hollowing and volume loss.

Three of the most common injectables are described below. Selection and results depend on age, category, and on the substance being injected.

Neurotoxins
Botulinum toxin is used to weaken muscles and minimize dynamic lines. It is injected directly into the muscle. Only lines caused by muscle contractions will be affected by botulinum toxin injections. The most common locations for treatment are in the upper third of the face – on the frown line, crows’ feet, and on the forehead lines.

Traditional Fillers
These are soft substances, liquids or gels, which can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill out cheek hollows, and repair other facial imperfections. They work by filling out the space below the wrinkles, replacing lost fat. They can be injected into the dermis or subcutaneous layer if the skin, depending on the filler and treatment goal.

Collagen Stimulators
As you age it is important to replace the collagen your body loses. Collagen stimulators are injected into the dermis or subcutaneous layer, filling the spaces where collagen has been lost. The newly-produced collagen provides provides a structural framework to hold hyaluronic acid and elastin and helps restore the dermis. Hyaluronic acid attracts water molecules to the dermis and restores skin moisture. Elastin provides elasticity and helps the skin stretch.

Energy Based Device Therapies

Various non-invasive treatments using machines.

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