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Grow old gracefully

Tuesday, May 29, 2018

With advances in cosmetic surgery, you can look younger than you are, says Dr. Viral Desai

The idea of growing older gracefully is a noble one. But these days, looking young, fresh and vital is not just a matter of vanity but also professional survival. Luckily the next-generation has both options—non-invasive and invasive cosmetic procedures.

Non-invasive procedures

There are various in-office procedures, most of which are intended to ‘resurface’ the epidermis: to remove the damaged epidermis and replace the tissue with remodeled skin layers and sometimes spur the formation of new collagen.

Chemical peels

Chemical peels are methods to cause a chemical ablation of defined skin layers to induce an even and tight skin as a result of the regeneration and repair mechanisms after the inflammation of the epidermis and dermis. Chemical peels are classified into three categories. Superficial peels, exfoliate epidermal layers without going beyond the basal layer; medium-depth peels, reach the upper reticular dermis; deep peels, penetrate the lower reticular dermis. The depth of peeling depends on the patient’s requirement and indication.

Visible light devices IPL, Lasers, RF for the Skin Rejuvenation, Resurfacing and Tightening

Nonablative skin rejuvenation or “subsurfacing” comes as a low risk and short downtime technology which can improve aging structural changes without disruption of cutaneous integrity. The mechanism of action is supposed to be a selective, heat induced denaturalization of dermal collagen that leads to subsequent reactive synthesis. Nonablative skin rejuvenation is not a precise term since rejuvenation is a controlled form of skin wounding aimed at achieving a more youthful appearance after the wound heals.

Injectable skin rejuvenation and dermal fillers

Thread lift A thread lift is a minimally invasive cosmetic enhancement technique that lifts sagging skin on the face and neck using surgical suture threads. A thread lift is not a substitute for a facelift; it provides modest and subtle changes rather than dramatic results. It also helps people buy time before a face and neck lift may be needed. The biggest advantage of a thread lift is the absence of visible scars and the very short downtime from routine activities. It is common to combine a thread lift with other non-invasive procedures such as anti-wrinkle injections, laser treatments and facial peels that help improve skin texture. Liposuction can be performed at the same time, to improve the contours of the face. Thread lifts cost less and require less downtime for many people. A thread lift is generally treated as a “lunchtime” or “weekend” procedure. It usually is performed in about one hour.

In a thread lift, barbed sutures (threads) are used to lift sagging eyebrows and eyelids, deep naso-labial folds (those furrows between your nose and the corners of your mouth) or aging neck tissues.

A thin needle is used to insert the sutures under the facial tissues. The barbs on one end of the thread grab and lift the sagging skin, and the teeth on the other end anchor the skin to the underlying facial tissues. No incisions or stitches are required, and no scars are produced. Additionally, barbed sutures can be used as an adjunct to a more traditional facelift.

Dermal filler HA is a naturally occurring protein that provides support to various parts of the human body: the skin, the joints, the bones and the ligaments. Injectable hyaluronic acid is produced in various thicknesses to meet individual patient needs and is approved by the US FDA. An alternative to HA is autologous fat—usually taken from the thighs or abdomen. The benefit of autologous fat is that it is cheaper than HA and there is practically no risk of allergic reactions. However, autologous fat is fairly unpredictable in terms of survival—a typical treatment with autologous fat lasts for around six months to about three to five years. Injected HA and fat are primarily used to improve the appearance of the skin’s texture. They can help fill out deep facial wrinkles, creases and furrows, “sunken” cheeks, skin depressions and some types of scars. They can also be used to add a fuller, more sensuous look to the lips. They are also used for cheek and chin augmentation, depressed and crooked nose correction.

Autologous fat A fat injection procedure is known as autologous fat transplantation or microlipo injection. It involves extracting fat cells from the patient’s abdomen, thighs, buttocks or elsewhere and re-injecting them beneath the facial skin, lips, breast, buttock or anywhere else as required. Fat is most often used to fill in “sunken” cheeks or laugh lines between the nose and mouth, to correct skin depressions or indentations, to minimise forehead wrinkles and to enhance the lips, for peri-orbital rejuvenation.

Autologous platelet-rich plasma (PRP)

Autologous Platelet-rich Plasma (PRP) has attracted attention for skin rejuvenation. PRP is derived from fresh whole blood, which contains a high concentration of platelets. Various growth concentrated platelets are activated by aggregation inducers. These factors are known to regulate processes including cell migration, attachment, proliferation and differentiation, and promote extracellular matrix (ECM) accumulation by binding to specific cell surface receptors. It has been shown that PRP may induce the synthesis of collagen and other matrix components by stimulating the activation of fibroblasts, thus, rejuvenating the skin.

Botulinum toxin

BOTOX (botulinum toxin) is a popular non-surgical injection that temporarily reduces or eliminates frown lines (worry lines), horizontal creases on the forehead, bunny lines around the nose, crow’s feet near the eyes and thick bands in the neck. The protein blocks the nerve impulses, temporarily relaxing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. Studies have also suggested that Botox is effective in relieving migraine headaches, excessive sweating and muscle spasms in the neck and eyes.

Invasive procedures

Facial Rejuvenation, also known as “rhytidectomy” or “meloplasty” is the surgery performed to tighten the skin on the face and neck and the removal of fat from the facial area and underneath the chin. The face takes on a more youthful appearance, looking firmer and more refreshed. Both wrinkles and those unwanted lines or excess skin that hangs beneath the chin are drastically reduced. A facelift restores smoother, more pleasing contours to your face and neck. It can help you look as good as you feel, and perhaps younger than you are. Deep folds in the face or brow caused by overactive muscles or by loose skin may be more effectively treated with cosmetic surgery, such as a facelift or browlift

Dr Viral Desai is a cosmetic and plastic surgeon, DHI Direct Hair Implantation and CPLSS  Cosmetic Plastic Surgery and laser super specialities, Mumbai

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