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HealthBeat Special Report: Facelift Without Surgery
Rebecca Somach
Aging and the Skin
The number of older Americans is increasing. Today, about one in eight people (more than 12 percent of the population) are 65 or older. By 2030, one in five Americans is expected to be age 65 or older.
Aging takes its toll on the body. In addition to the increased risk for chronic medical conditions, signs of aging show up in the skin – especially on the face. Production of collagen and elastin, two structures that give skin firmness and elasticity, slows. The skin becomes drier and underlying fat disappears. The skin begins to sag and wrinkle.
Some people seem to already look old in their 30s and 40s, while others are lucky enough to maintain their youthful looks well past 50. Heredity plays a big role in the speed of skin aging. Another important factor in skin aging is sunlight exposure. Chronic, excessive sun damages the skin and can hasten the biological aging process, leading to the development of fine lines, rough and dry skin, pigmentation problems, and, in some cases, even skin cancer.
Non-Surgical Cosmetic Procedures for Aging Skin
Americans are increasingly turning to cosmetic surgery to “turn back the clock” and restore their youthful looks. The American Society for Aesthetic Plastic Surgery reports between 1997 and 2001, the number of cosmetic surgeries increased by 304 percent. While people tend to think “facelift,” many are opting for non-surgical cosmetic procedures, such as chemical peels, soft tissue augmentation (injectable fillers), and skin resurfacing.
Chemical peeling is the application of substances that intentionally irritate the skin, causing the surface layers to blister and peel. Peels range in depth from mild (superficial peels) to deep. Some of the chemicals used may include alpha hydroxy acids, trichloroacetic acid, or phenol. After the treatment, patients develop facial redness and scaling for three to five days. Medium to deep peels can also cause swelling, blistering, and peeling lasting for up to 14 days. Chemical peels are good for treating surface skin damage and are ineffective for removing deep wrinkles or sagging skin.
In soft-tissue augmentation, doctors inject substances under the skin to fill in wrinkles. Two commonly used substances are collagen and BOTOX®. Collagen is a fibrous substance found in many types of tissue. Small amounts of collagen are given in a series of treatments over time. Local anesthetics may be used to minimize discomfort. Collagen slowly breaks down in the body. So the effect lasts only from three to 12 months and the treatments need to be repeated. Most collagen is derived from cattle and some people develop an allergic reaction to the substance.
BOTOX (Botulinum Toxin Type A) is a purified form of the toxin produced by the bacteria, Clostridium botulinum (sometimes associated with food poisoning). When very small amounts are injected into a muscle, the toxin blocks the ability of the muscle to contract, smoothing out frown lines within about a week. The effect is temporary and lasts about three to four months.
BOTOX injections are becoming very popular. According to the American Society for Aesthetic Plastic Surgery, 1.6 million procedures were performed in 2001 – an increase of more than 2000 percent since 1997. Some women are attending BOTOX parties, where groups of patients gather to eat, drink and be injected. However, there are some risks to the procedure. Injecting too much toxin or placing the toxin in the wrong area can lead to droopy eyelids for several weeks. BOTOX injections can also cause muscle weakness, headache, respiratory infection, flu-like symptoms, nausea, facial pain, or redness at the site of the injection. To reduce the risk of side effects or complications, experts recommend the treatment be administered by a board-certified plastic surgeon.
Skin resurfacing is a treatment that removes the top layers of skin. As the area heals, the skin is replaced by new, healthier skin cells. There are several methods of skin resurfacing. Dermabrasion uses a rotating device with fine-grained sandpaper. As the wheel is applied to the face, the top layers of skin are sanded away. Patients can experience significant redness and discomfort after the procedure. A variation, microdermabrasion, controls the depth of treatment and barely erases the outermost layer of skin. In laser resurfacing, a laser light vaporizes the outer layer of skin. It’s the most popular type of skin resurfacing treatment. There is no bleeding and the results can usually be precisely controlled.
Radiofrequency Treatment for Wrinkles
A newer treatment for facial rejuvenation is the ThermaCool TC™ System (Thermage, Inc.), which combines the heating power of radiofrequency energy with cryogenic surface cooling. A small hand-held device is applied to the surface of the skin. Radiofrequency energy is directed at the deep tissues under the skin. At the same time, a freezing, cryogenic spray cools the surface of the skin. For patient safety, the skin surface temperature is continually monitored to prevent burns. The procedure creates a wound under the surface of the skin without harming the outermost layer. In response to the induced wound, the body produces new collagen fibers that are thicker and healthier. As the area heals, the underlying tissue becomes more “plump” and the skin tightens.
ThermaCool is approved by the FDA for treatment of wrinkles and fine lines around the eyes. It is sometimes used in the area of the jowls and neck. It’s ideal for younger patients who are just starting to notice fine lines and wrinkles. A single treatment takes about 10 to 15 minutes and, depending on the area of the country, costs from $1,000 to $2,000. Immediately after the treatment, patients can usually replace their make-up and go back to normal activities. Dermatologists generally recommend re-treatment about every year to year-and-a-half to maintain the results. ThermaCool can also be combined with other treatments, such as BOTOX and collagen injections for optimal results.
Preventing Skin Aging
We can’t stop nature from taking its course, but we can sometimes slow down the process. One of the most important ways to reduce the wrinkling and other signs of skin aging is to minimize exposure to the sun. Use a sunscreen with an SPF of 15 or higher – even on cloudy days, when the sun’s rays can’t be seen, but still penetrate the atmosphere. Wear a wide brimmed hat and sunglasses that block both UV-A and UV-B rays. If you smoke, stop. Cigarette smoking hastens skin damage – stealing oxygen from the cells of the body (including skin cells) and slowing healing time. Practice healthy skin care. Remove make-up every evening before going to bed and use moisturizers. Topical treatments containing vitamin C may also reduce the signs of aging.
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