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Aging Skin: The Science And Art Of Skin Rejuvenation: Dr Lycka Article

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Hi! This is Dr. Barry Lycka, Edmonton Cosmetic Dermatologist. I'm so glad to be writing articles for you about some of the newest advances in the world of beauty and cosmetic surgery. In this article I share the conversation I had with Dr Tanya Kormeil where we talked about aging skin and the science behind the causes of aging skin,. We also talk about the art of skin rejuvenation.

Talking today about the science of aging and the technology that is available to roll back the years and provide facial skin rejuenation.

There are a lot of components to the aging face and each one has one or more techniques that can be used to rejuvenate it.

So how did Dr Kormeili fisrt get interested in the aging process?
She wanted to understand the processes of aging as a woman, and from observing the changes in herself, her female family members and women around her. She was interested from a scientific approach, rather from a position of pure vanity. And then by understanding the processes, she could provide help and solutions to help reduce the signs of aging on our skin and face.

2 types of aging are identified:

1. natural aging: which starts from birth and which goes on for as long as we live. It creates those signs of aging which steadily increase as our ability to fight the damage caused by our environment decreases
2. accelerated aging: due to our lifestyle choices - sun damage, smoking, partying too hard and so forth

So what are the components of the aging face?

1. Wrinkles - there are 2 types
wrinkles at rest - these exist without underlying movement
wrikles at movement / dynamic wrinkles - these are associated with movements in the underlying muscles.

So these 2 types of wrinkles need 2 different types of treatment. It is noted that if wrinkles are left too long, and become too deep set then it is often difficult to get rid of them as successfully as patients would want. So it is advisable to get the correct treatment at the appropriate time and not leave the wrinkles to get too bad.

2. Volume: volume is lost in muscle and bone and skin so there is an overall effect of everything moving both downwards and inwards, giving an aged shrunken look. There is also skin laxity which happens and adds to the aging appearance. By understanding where the volume loss occurs and what type of volume loss it is, this means that the correct way to repair it can be identified. The correct combination of fillers can be chosen to create the correct results.

Talking about FILLERS for a moment:
the first filler was collagen, but there were early problems associated with its use:
- it didn't last long and had to be re-done
- if it was extracted from bovine products then certain patients were allergic - everyone had to be allergy tested before it could be used
- repeated use could also lead to scarring

so it was the first filler but not ideal.

Moving onto the introduction of Hyaluronic acids as fillers - an amazing breakthrough.
One major benefit of these is that a molecule of hyaluronic acid can bind up to 100 times its volume of water so also helps to rehydrate and swell the area treated with the filler. This helps build back the structure and restores the natural anatomy which gives a much more natural result.

There is a whole range of these new fillers, and the important fact is that they provide the opportunity to use different fillers to repair different situations:
for example: to build stucture then radiesse and or sculptra would be suitable, then over the top of that would be layered other fillers to build volume.

Fillers are continuing to change and develop - there is a future opportunity to take tissue, grow the cells then to use it and put it back as a filler. This leads into a discussion regarding the problems which still exist in treating stretch marks - they are still a big problem as it is difficult to get the elastic fibres back into the area - the elastin, so more development of products to address this problem and put elastin back into the skin would be very welcome.

3. Skin Texture & Colour Changes
As we age we start to see both texture and colour changes, with red tones, brown tones and generally uneven skin tones. It is this overall blotchyness which our eyes have become conditioned into perceiving as aging skin - conversely we view an even skintone as a sign of youth.

So what are these skin tone changes?
Brown tones from pigment increase, and there are certain lasers, chemical peels and creams which can be used to reduce the levels of pigmentation. Sun damage is a factor here so the increased use of sunscreen is also important as part of the repair and protection of the skin.
Red tones are from tiny broken blood vessels, around the nose, cheeks and also from rosacea, and again sun damage - so different lasers and treatments used to treat the red tones.

By reducing the differences between the red tones, brown tones and the normal skin tone, we reduce the appearance of age and provide a more youthful look.

So we need to choose the correct technology to treat the appropriate problem, and lasers provide that opportunity - and with the ability to combine lasers to get the results that are required. Different lasers are used to teat different problems.
for example the following lasers were discussed:

pulse dye - to treat brown tones
ipl - to treat red tones
Fractional / ablative resurfacing - to correct collagen, pores, wrinkles, improve the overall texture of the skin.

Combining these laser technologies to deliver the results in one go is the exciting results of laser technological development.

And moving onto Creams - women love creams !
Dr Kormeilli described how important she finds creams within her practise and how much women in particular love to have creams as part of their daily skin care routines. Of particular value is the ability for a dermatologist to create a custom made cream which exactly matches the problems that are being treated and which complements in-office procedures.

Each patient is unique and so all of the different techniques, technologies and products need to be pulled together in an artistic & creative way to get the best results for the patients. It is very definately a blend of science and art.

A final aspect that both doctors were passionate about was the need for ongoing vigilance.
Skin cancers are on the increase, and dermatologists are always on the lookout for skin cancers - a lot of the damage they are consulted about is related to sun damage and therefore skin cancer is an ever present risk. Both doctors have countless examples and stories of how skin cancers were spotted by them as part of their general vigilance and determination to make people aware of a problem they are often unaware of.

So in summary regarding the science of aging skin and the art of treating it the key points are that from a dermatologists pont of view, restoring the health of the skin is the most important objective. This is because invariably the most beautiful looking skin is healthy skin. They want to build beauty that enhances health, by dealing with problems such as rosacea, acne, large pores, signs of aging and so forth, they are creating healthier skin which looks better.

A key trend they see in patients is that they want to focus on natural good looks and have a horror of looking false and overdone, as so many celebrities seem to do.

I look forward to connecting with you and if you have any questions for me on the various aspects of aging and skin rejuvenation then please contact me via any of the methods listed in the 'About The Author' box below, ask your question, (it goes directly to me) and I will be back with a private answer for you !

And keep looking out for more articles featuring cosmetic surgery & skin care advice, scar treatments and the latest in cosmetic procedures, cellulite treatment and anti-aging treatments.
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