Revitalize Your Skin with Cosmetic Dermatology (video/podcast)

A number of things can cause skin to lose its youthful appearance, including genetics, sun exposure and environmental factors. Even gravity can play a role in sagging skin. Plus, when we smile, frown, yawn or speak, those facial muscles pull on the skin and may cause wrinkles.

Additionally, skin becomes thinner and less elastic over time due to a loss of volume not only in the skin, but in the supporting tissue and even in the bones.

“You lose collagen and some of the fat underlying the skin, and there is a process of bone resorption or thinning over time,” says Dr. Almukhtar. “And believe it or not, this process starts at the age of 28.”

Cosmetic dermatologists use fillers, neurotoxins and other nonsurgical treatments to improve the skin’s appearance. The right treatment for you depends on your skin and your concerns. Here’s a look at the most common options, how long the results typically last and how much downtime you can expect after treatment.

Fillers are substances that fill and soften wrinkles and deep lines, such as frown lines. They are strategically injected into areas that need more volume and support, such as the temples, cheeks, jawline, around the mouth or in the neck.

Dermatologists use various types of fillers depending on the goal. Hyaluronic acid, a gel-like substance that is naturally present in skin, plumps the skin to increase volume and reduce lines. Results can last six months to two years based on where it's injected. Biostimulatory fillers don’t fill the tissues; rather, they stimulate the body’s ability to build collagen and add volume. These results may last up to two years.

“The beauty of fillers is that they have minimal downtime. Some patients might have some swelling or bruising for a few days that can be covered by makeup,” says Dr. Almukhtar. “But most of my patients actually go to work or resume their day immediately after the treatment.”

Neurotoxins are substances that impair the way nerve tissue functions. Cosmetic dermatologists use neurotoxins, such as Botox and Dysport, to temporarily block nerve signals that cause facial muscles to contract, causing lines and wrinkles.

Neurotoxin injections allow the facial muscles to relax, greatly reducing the appearance of wrinkles on the forehead, between the eyebrows and around the eyes. Results typically last three to four months depending on the individual.

As with injectable fillers, neurotoxin treatments have little to no downtime.

Micro-needling places tiny needles beneath the skin to stimulate the production of collagen. 

Radiofrequency micro-needling uses energy delivered through the tip of the needles to help tighten skin, stimulate collagen production and release growth factors to help build and thicken the skin over time.

Micro-needling is often used to help with rejuvenation, but also can treat acne scars or loose skin on the neck area. These procedures can take three months to take full effect as they stimulate the body’s ability to build and heal itself. Downtime is minimal due to slight swelling or bruising.

While cosmetic dermatology treatments can have excellent results, doing too much can result in an “overdone” or “fake” appearance. For example, too much Botox can lead to frozen forehead muscles that don’t move at all.

“That’s why it’s important to go to a board-certified dermatologist who’s trained in these types of procedures and can help provide a balanced, natural look,” says Dr. Almukhtar. “We have plenty of tools to help rejuvenate the skin, and when these procedures are done well, no one is able to tell exactly what happened.”

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