Cosmetic Rejuvenation - Fall 2014

FALL 2014
cosmetic
Rejuvenation
A CONSUMER GUIDE TO LIFE-ENHANCING PROCEDURES FOR HEALTHY LIVING
Produced by the Calgary Herald’s Special Projects department
ADVERTISEMENT
Saving face... Naturally!
One day you wake up, look at yourself in the mirror and suddenly you feel aged or tired and want to do something to change the way you appear.
Rejuvenation is a process that goes beyond the odd wrinkle, one has to look at the face 3 dimensional, the shape, texture and elasticity needs to be addressed
and how it all works together to create a new, refreshed you. At Calgary Vein and Laser we recognize that rejuvenation is not about botox and fillers, but
needs to include return of fullness to the face, relaxation of expressive muscles and improvement of skin quality.
Enhance shape and volume: When we are younger we have an upside down triangle, the cheeks are the base of the triangle and it goes down to a point at
the chin. As we age, the triangle reverses. Fillers reverse this change. Most fillers used today are hyaluronic-acid based. Hyaluronic acid is one of the main
components of the skin, so by using a filler made of the same substance you can minimize reactions and enable the filler to blend in very naturally with the
skin. These products are reversible, predictable and reliable which makes them safe. A treatment with fillers will last up to a year. Fillers smooth the static lines
at rest while botox, a neuromodulator, deals with action lines. Botox binds itself to the nerves that fire the muscle. This results in a weaker muscle, weaker
contraction and lines of expression begin to fade. Both of these technologies have been safely used for over 15 years.
Tighten skin elasticity: As we get older, the skin loses elasticity. Infrared, radio frequency and ultrasound energy can be used to tighten the collagen fibres,
stimulate new collagen, making skin less saggy and ultimately give a lift to the tissue. Titan, infrared energy, is an effective treatment with no down time.
Improve colour: Brown spots that commonly appear on the skin as we age can be improved dramatically with topical skin care, peels and Intense Pulse Light.
IPL can be very beneficial for the dischromia of skin colour, both red and brown, and improve texture resulting in rejuvenation. Fractionated laser resurfacing
is highly effective for removal of sun damage spots but can offer dramatic improvements with wrinkles, pores, improves laxity and skin tones. SmartXide laser
has been a great adjunct to our practice. Downtime is variable and results are natural.
Lifestyle: Use of broad spectrum sunscreen protects from UVA and UVB. UVB makes our outer skin burn or tan but UVA penetrates deeper into the skin and
causes premature aging and skin cancer. Sun protection factor needs to be at least 30 with regular reapplication as needed. Remember, you may not tan
through a window but your skin can damage. Ultra violet protection is also available in clothing and hats, read the label, the tighter the weave the better the
block. NEVER use a tanning bed!
Skin care is important to keep your skin in a healthy state. Exfoliants, antioxidants, collagen growth factors can make your skin glow. Foods high in
antioxidants may also help reverse and prevent skin cancers. A regular exercise program improves the circulation to the skin.
At Calgary Vein and Laser, Drs. Ron Young and Lilly Wouters along with their team of skilled technicians will help you find a solution for what is best for you.
Take your first step towards a youthful and fresh appearance!
SKIN REJUVENATION
• Certified BOTOX® injectors since 1996
• Tissue fillers – RESTYLANE, JUVÉDERM®, VOLUMA®,
LIP AUGMENTATION, ESTHELIS
• SOFTLIFT™
• VOLULIFT™
• ACCENT – fat melting, cellulite, body contouring
•
•
•
•
•
•
LASER-GENESIS Laser peels
IPL Photorejuvenation for brown pigment, age spots, rosacea
OBAGI / SKIN TX / VIVIER / PERRICONE / ALYRIA / PRODERM
Retin A, VITALIZE, TCA or glycolic facial peels
LATISSE®
Microdermabrasion
•
•
•
•
•
•
Anti-aging / Anti-pigment skin care
TITAN skin tightening
ULTRASHAPE (fat melting)
SmartXide DOT - Laser resurfacing
PIXEL – Wrinkles
SPIDER & VARICOSE VEINS (facial, body & legs)
Also providing solutions for:
• Skin
• Moles
• Body Shaping
• Rosacea, facial vessels
• Hair Loss
• Hair removal
• Wrinkles
• Scars
• Skin Tags
• Cellulite
• Brown Pigment
• Sun Damage
Serving Calgary since 1993
Cosmetic
Rejuvenation
Cosmetic Rejuvenation
is published twice a year by the Calgary
Herald’s Special Projects department.
Fall publication date: Oct. 4, 2014.
INSIDE
FEATURES
04
NO STRINGS ATTACHED
CO-ORDINATOR
Darren Oleksyn
06
MORE THAN JUST ARTWORK
CONTRIBUTORS
Rachel Naud, Karen Durrie, Joel Schlesinger,
Jacqueline Louie
12
CLEARING THE SKIN’S ROAD MAP
DESIGN
Darren Oleksyn and Charlene Kolesnik
13
SWEAT-FREE BODYBUILDING
PHOTOS
Thinkstock
14
BANISHING IRKSOME ACNE
SALES INQUIRIES
t: 403-235-7168
e: [email protected]
15
NO SURGERY REQUIRED
16
HELPING MEN MEASURE UP
17
SMOOTHING THE BUMPS
18
COLUMN
This content was developed by the
Calgary Herald’s Special Projects
department in collaboration with
advertisers to promote awareness of this
topic for commercial purposes. The
Calgary Herald’s editorial department
had no involvement in the creation of this
content.
BEFORE
Give your face a lift without need of a scalpel.
Tattoos offer a great way to disguise injuries and boost your look.
How to zap away varicose and spider veins.
Surgery lets men get great pecs without ever entering a gym.
The irritating skin condition can be addressed.
How to attack fatty deposits without breaking the skin.
Canadian doctor became a leader in penile-lengthening surgery.
Cellulite affects all body types, but there are treatments.
Dr. Andrei Metelitsa on how science can help keep you looking young.
AFTER
COSMETIC REJUVENATION
FALL 2014
PAGE 3
COVER
PAGE 4
COSMETIC REJUVENATION
FALL 2014
NO STRINGS ATTACHED
Looking to give your skin a lift without going under the knife?
Rachel Naud investigates the options
M
any aging Calgarians can be grouped into
four categories: the wrinklers, the sinkers,
the saggers and the sun damaged.
It’s not our fault, really. Father Time isn’t exactly on
our side when it comes to aging.
Remember those full, round cheeks? As we age, we
lose fat volume in our faces and those once chubby
cheeks develop a flat triangular groove as we get older.
Many of us also lose volume in the orbits of our eyes
that result in eye circles that may or may not be dark in
appearance, leaving us looking tired and weary.
We also lose volume in our lips and other areas of the
face, which causes the face to fall and contributes to the
appearance of lip lines and the deep brackets that
appear at the sides of the mouth.
Moreover, when we are young we have an abundance
of the structural protein collagen in our skin. Not only
is it plentiful, but it’s tightly coiled, much like a Slinky
right out of the box. However, from the age of 20 or so
we start losing collagen at a rate of approximately one
per cent to two per cent per year.
As we get older, not only do we have less collagen, but
the collagen that remains becomes more loosely bound.
We also lose elastin in our skin. The loss of collagen and
elastin are major factors that contribute to sagging.
While genetics play a role, so do factors such as
environment and lifestyle. Diet and exposure to toxins
such as cigarette smoke can speed things up or slow
them down, too. But the biggest culprit to premature
aging is excessive sun exposure. Too much ultraviolet
radiation can destroy collagen and elastin, resulting in
wrinkles. It can also cause sun spots and flushing of the
skin. This uneven pigmentation and texture further
contributes to the appearance of aging skin.
But it’s not all bad news. Even if Father Time isn’t on
our sides, the cosmetic industry is. Today, there are more
procedures than ever to help lift and tighten aging faces
and necks. And, even better, many don’t require a scalpel.
“A few years ago surgery was the only option,” says
Roberta Segar, a certified laser specialist and the
treatment director at Skinpossible Laser & Light
COSMETIC REJUVENATION
FALL 2014
Solutions in Calgary. “Advancements in technology
provide alternatives that are less expensive with no need
for downtime, few risks of complications and no risk
that you will look like anybody except yourself … only
better.”
This is what patients want, says Dr. Louis Grondin,
medical director at Calgary’s Sante Cosmetic Laser &
Vein Centre, who adds that the patients at Sante often
come in with concerns that include the formation of
fine lines and wrinkles, drying skin and sagging, as well
as the formation of brown spots (hyper pigmentation).
“When these signs of aging arise, they can have a
powerful erosive effect on our self-perception,” says
Grondin.
That’s why more people than ever are turning to
non-invasive cosmetic procedures to turn back the hands
of time. Technological advances have made the fight
against aging an easier battle to win.
“It will take time to prove it out, but it is quite possible
that if we start with a 40-year-old, we could potentially
keep him or her looking 40 when they are 60,” says Segar.
“Of course, we can never make a 60-year-old look 40
again, so the key is to start while you are still young.”
How? Skin-tightening procedures are all about
causing controlled injury to the skin to trigger a healing
response that will produce collagen.
“Simplifying this as much as possible, the greater the
injury, the more dramatic and long-lasting the result will
likely be,” Segar says.
There are many options available for patients who
want to rejuvenate, lift and tighten. Here are a few:
LASERS: Results from laser treatments vary greatly
depending on the type of laser used and the anticipated
downtime. With both lasers and light, the depth of
penetration is limited to approximately one millimetre,
but the energy is delivered precisely.
“Depending on the technology used, a single
minimally invasive treatment with a laser such as a CO2
(carbon dioxide) or an Erbium YAG can dramatically
smooth and tighten skin,” says Segar. “A series of three
to five treatments with light-based devices such as Titan
and SkinTyte can result is superficial tightening of the
dermis. All can unquestionably freshen a patient’s appearance.”
Grondin uses fractioned CO2 lasers to treat aging
skin, including non-ablative fractional lasers and fractional erbium laser resurfacing. During a non-ablative
fractional laser treatment, a laser beam is divided into
thousands of tiny treatment columns that target only a
portion of the skin. Non-ablative lasers do not destroy
the treated tissue, whereas ablative treatments utilize
controlled tissue vaporization.
With Fractional Erbium Laser resurfacing short,
concentrated pulsating beams of light are directed at the
affected skin in a very precise manner. The erbium laser
vaporizes superficial, damaged skin cells with minimal
burning of surrounding tissue.
“Once the skin is damaged and shows wrinkles, brown
spots, and has lost its lustre, the skin may need to be resurfaced with fractionated laser technology,” says Grondin.
“These laser treatments effectively remove sun-induced
structural damage to the skin.”
RADIO FREQUENCY: This technology uses bulk
heating and methods of delivering the energy to the
tissue for a firming effect; mainly a maintenance effect
against gravity. The depth of penetration is not
consistent or precise.
“Temperatures high enough to cause skin tightening
will usually be concentrated at 1.5 to 2 mms and up to
3.5 mm with some technologies,” says Segar. “The
various approaches produce a range of temperatures.”
ULTHERA: This patented device uses focused
ultrasound to cause precise injury. Ultherapy treatments
can be customized to penetrate to 1.5 mm, 3 mm, 4.5
mm or all three depths in a single treatment.
“Ulthera’s ability to penetrate deep enough to injure
the … muscle under the dermis puts it in a league of its
own,” says Segar. “It is the only device that has received
FDA clearance for a ‘lift’ indication.”
PAGE 5
BODY
MORE THAN JUST ARTWORK
Tattoos go beyond skulls and butterflies. Karen Durrie looks at how ink can fill out eyebrows and disguise injuries
J
ody Stoski remembers the 6-foot-4 soldier
who accessed her expertise in cosmetic
tattooing.
“He burned his eyebrows off in an accident in
the military. This big burly guy kept a brow pencil
in his pocket, and was very self-conscious. He’s
thrown it out now and has a new lease on life,”
Stoski says.
Although many are familiar with cosmetic
tattooing for permanent makeup such as
eyeliner or lip colour, it has a wider variety of
applications. It can be employed to camouflage
scarring, hair loss, wrinkles and even to
re-pigment nipples and areolae after
post-mastectomy breast reconstruction.
Stoski owns Cinnamon Girl Clinic. She trained
first as a makeup artist, working commercially in
film and television, before receiving training in
cosmetic tattoo artistry.
She sees clients for everything from permanent
eyeliner to cosmetic correction of cleft lips.
“We get people for many things that stop at
the plastic surgeon’s office that they can’t go any
further with. It often gets turned over to us to put
final touches on those areas.”
Stoski employs a disposable, manual tool to
create strokes that mimic natural hair for brows
and scalps, and says the result looks completely
natural and undetectable compared to real hair.
“We have people that have lost hair through
chemotherapy or alopecia. They provide a picture
of what they looked like before. It’s about
recreating a feature on someone so they feel
normal again.”
Eyebrows are the most common procedure
Stoski does, followed closely by eyeliner — these
are the “biggest real estate spots” on female faces,
she says, that can make them look vibrant and
young.
The procedure requires no preparation. For
breastwork, artists typically speak with
PAGE 6
oncologists first to ensure the client is ready.
There is not any downtime, and medical
ointment is the only real aftercare required.
Stoski prefers to go with the most conservative
version of colour first, then clients can see her for
a second session for adjustments on tattoo colour
or shape.
Dr. Kirk Barber, a Calgary dermatologist, also
employs cosmetic tattooing in his practice, under
the name of Pink Permanent Ink Clinic. Maria
Wu is the micropigmentation specialist at the
clinic.
Wu, who is trained by the American
Academy of Micropigmentation, works on brows
and handles scar coverage, hair replacement and
pigment replacement on people of any colour
who have vitiligo — a disease that causes the skin
to lose colour.
Cosmetic tattooing is markedly different from
the kind of work you would find at a tattoo
studio, Barber says.
“It does use an iron-oxide pigment put into
the skin, but that’s where the similarity ends and
begins. By that, I mean it’s permanent in that there
will probably always be some ink present, but the
likelihood of it lasting a lifetime is pretty low. The
colours fade over time, and people need to have
them refreshed over the years.”
Barber says the success or failure of cosmetic
tattooing is very dependent on the operator,
and because it is unregulated, people
considering the procedure should research the
skill, training and artfulness of the person
performing it, as well as the environment in
which it is being done.
“What we have done within my practice is
medicalize. We use standard inks from reliable
sources, sterilization of tools, proper lighting,
proper training and certification,” he says.
“It’s like being a painter. It’s truly an art, and
success is dependent on the artist.”
COSMETIC REJUVENATION
FALL 2014
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Of f e ri ng A w a r d W i n n i n g Tr e at m e n t s !
How did a small medical-aesthetics clinic
in the rural community of DeWinton
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When Skinpossible opened in 2009 it only
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new facility within the city of Calgary. The new
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do a better job to make the trip worthwhile. We
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only be as good as our technology,” she insists.
Skinpossible`s two most popular treatments,
Coolsculpting and Ultherapy, are unquestionably good technology. Both are NewBeauty
award-winners as best-in-class. Ulthera has
recognized Skinpossible as the top Ultherapy
treatment provider in all of Canada. Coolsculpting has recognized Skinpossible as a Preferred
Treatment Provider in Alberta. When asked to
elaborate, Roberta is happy to oblige. “I really
don`t mean to sound boastful, but we perform
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Coolsculpting, the non-invasive treatment
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offer Dual-Sculpting,” Roberta says. “This allows
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Skinpossible`s other award-winning treatment,
Ultherapy, is the new gold-standard at non-invasive skin tightening and the only FDA approved
technology for skin lifting. “It`s not facelift results,” explains Roberta, “but it is as close as
you can get to a facelift without going under the
knife,” she claims. Ultherapy is clinically proven
to tighten the skin on the neck, jawline, and brow.
It is also used to treat skin on the body.
Skinpossible is a private full-service medical
aesthetics clinic with the exquisite ambience of
a spa in a country setting. “Many of our patients
have expressed disappointment upon learning
we will be relocating to the city,” Roberta informs.
“I want to take this opportunity to assure everyone that the new location in Chaparral Valley will
be equally beautiful and offer the same degree
of privacy.”
Skinpossible operates under the medical direction of Dr. James Kennedy, MD, FRCSC.
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Coolsculpting Permanent Fat Reduction | Picosure Tattoo Removal | Ultherapy Skin Lifting and Tightening | Botox | Fillers
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Find out what’s possible
Skinpossible.ca
Call to book your free consultation
403.938.1112
BRIEFS
WHAT MEN WANT
SUGAR NOT SO SWEET
FOR THE SKIN
Cosmetics aren’t just for women
anymore. In fact, the number of men
undergoing cosmetic procedures has
increased dramatically. According to
the American Society for Aesthetic
Plastic Surgery (no Canadian stats
are available), the number of
cosmetic procedures for men
increased by more than 273 per cent
from 1997 to 2013.
The most common procedures
include breast reduction for gynecomastia (an enlarging of gland tissue
in the male breast), blepharoplasty
(to fix sagging eyelids), liposuction,
face/neck lifts and non-invasive
injectables.
If your expanding waistline isn’t enough
to drop the sugar addiction, this might do
it: sugar is aging you. How? When sugar
binds to a protein or fat in the
bloodstream, a process called
glycation, it creates a
byproduct called an
advanced glycation end
product (AGE).
The glycation
process damages proteins
and collagen in
the skin, which
can eventually
lead to sagging
and wrinkles.
Dr. Brad Mechor MD FRCSC
Rhinology - Rhinoplasty
Aesthetic & Revision
Rhinoplasty Surgery
Surgeon performed
Aesthetic injections
• Xeomin / Botox
• Enteis / Juvederm
• ZO Skincare
• Balloon Sinuplasty
(403)270-8060
www.drmechor.com
Fellow member of the
Canadian Academy of Facial Plastic
and Reconstructive Surgery
PAGE 8
COSMETIC REJUVENATION
FALL 2014
FREEZING AWAY
WRINKLES
VAMPIRE FACIALS
SUCK UP DOLLARS
Remember Kim Kardashian’s bloody
face? The image, which went viral last
year, is hard to forget. The pic that
had us all seeing red could be why the
popularity of vampire facials increased
by 800 per cent in 2013.
The procedure starts when a small
amount of blood is extracted from
the patient. The blood is then spun
in a centrifuge to separate the part
that’s filled with platelets, the plasma,
from the blood cells. The platelet-rich
plasma is then injected into the face.
It’s not just a funny term for someone
who’s had too much work done. Freeze
Therapy is a recent innovation in the
cosmetic industry that’s used to treat
wrinkles. The therapy freezes the nerves
that power facial muscles, causing an
effect similar to Botox, an injection that
causes temporary paralysis of muscles.
Although freeze therapy is in its early
stages, research has shown its effects
can last several months.
BELOW THE BELT
BEAUTY
SOLE SACRIFICE
For some, there’s no more sacred bond than
that between a woman and her shoes. And
despite the pain and damage these shoes can
inflict, women will do almost anything to put
their best feet forward ... including surgery.
Cosmetic foot treatments are growing in popularity and can include the injection of hyaluronic
acid into the bottoms of feet to alleviate foot pain.
Surgeries include the shortening of toes, to correct
a hammertoe or corns, and the lengthening of toes
if one toe is shorter than normal.
Women are turning to labiaplasty
to increase their confidence and feel
sexier. The procedure can reduce either
the labia minora or labia majora lips
(inner and outer vaginal lips). It can
help women who feel bulky in pants or
bathing suits to the point where they
won’t wear any revealing clothing.
It’s also popular with active athletes or triathletes who complain
of rubbing with biking or running.
Moreover, labia fat grafting, a procedure that involves removing fat
cells from the lower abdomen, hips
or lower back and injecting the skin
of the mons pubis and labia majora,
can give the pelvic triangle a much
more youthful and soft appearance.
­­— Briefs compiled by Rachel Naud
Autumn 2014
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COSMETIC REJUVENATION
FALL 2014
PAGE 9
For years, hair transplant treatments have been known for
being time consuming, ineffective, and leaving visible
scarring.
The new ARTAS robotic hair transplant technology
changes everything.
THE
ARTAS
ADVANTAGE
®
How is the ARTAS
procedure different from
older hair transplantation
methods?
The older, traditional form of hair transplantation is
called Follicular Unit Transplantation (FUT), or more
commonly, “strip” surgery.
In a “strip” surgery, a surgeon uses a scalpel to
remove a large piece of scalp from the back of the
head.
This invasive process requires stitches to close the
wound. The strip of scalp is given to a group of
technicians who then manually dissect each individual
follicular unit (a process that is not only inefficient, but
often damages a large number of the follicles).
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There are many reasons patients view
the ARTAS procedure as the treatment of choice:
1
2
Quick Recovery
The ARTAS system represents
the least invasive of all hair
transplant techniques, with
down-time as little as one to
three days (as compared to up
to several weeks for the ‘strip’
transplant procedure) allowing
you to quickly resume your busy
daily schedule (usually with no
overt indication that you have had
the procedure done).
4
Natural Look
5
Single-hair and follicular unit
grafts produce natural appearing
results (unlike “pluggy” hair grafts
that are often produced by manual
transplant techniques).
Comfortable
3
A local anesthetic will be used and
most patients will experience little
discomfort during the outpatient
procedure. You’ll be awake and
alert, you may choose to listen
to music or watch a movie during
the procedure and there will be
time for breaks. Post procedure
discomfort is minimal, with most
patients reporting little to no
post-procedure pain. This
compares to strip surgery, where
swelling, scalp numbness, scalp
tightness and lingering pain are
often experienced.
Better Growth in Less Time
Robotic precision harvesting
minimizes follicle ‘shock’ and
graft transection rates by up to
75% as compared to manual strip
surgery. Because a greater number of healthy, intact follicles are
more likely to survive, thrive and
produce hair, most patients see
improved new hair growth in less
time.
No Unsightly
Linear Scar
As each hair is removed
individually with robotic
precision, no stitches are
needed and the scalp retains
its natural appearance. As a
scalpel-free procedure, there
is no unsightly linear scarring
of the donor site associated
with the strip method which
necessitates longer
hairstyles to conceal.
6
Cost Effective
Robotic harvesting reduces
the procedure time on the
part of the physician, which
in turn can reduce the
procedure cost to the patient.
VEINS
CLEARING THE SKIN’S ROAD MAPS
Tired of watching spider and varicose veins weave their web?
Karen Durrie learns how they can be zapped away
T
hey may crawl up your legs, redden your nose,
or look like little “road maps” on parts of
your body.
They’re veins, and there are a number of procedures that can zap the offending blue or red vessels
into virtually nothing.
For varicose and spider veins, sclerotherapy is
considered the gold standard of treatment.
Ultrasound-guided sclerotherapy uses injections
of foam or liquid solutions that collapse and close
diseased veins.
Varicose veins are deformed, enlarged, superficial
veins whose walls have stretched, causing blood flow
to slow. Symptoms include pain, swelling, aching,
burning, tingling, itching and leg restlessness.
Cosmetically, legs appear bulgy and mapped with
visible purple veins.
Spider veins are really just tiny varicose veins, red
or blue in colour, and closer to the skin’s surface.
Both men and women can develop varicose veins,
and genetics, lifestyle, hormones and aging are
major factors in their appearance.
Dr. Lily Wouters, a physician with Young &
Wouters Calgary Vein and Laser, typically takes
a medical history and does a full assessment of a
patient’s veins before proceeding with treatment.
“They may come in and are only concerned about
a spider vein, but we assess in case there is a larger
vein they don’t notice. We diagnose and sit down
to make a treatment plan. This varies depending on
whether there are big veins or only small cosmetic
ones. One person might need two treatments and
another might need six,” Wouters says.
She then gives a cost estimate and a time frame.
If more than one sclerotherapy session is needed,
the treatments are typically one month apart, but
patients can see and feel the difference after just one
visit, she says.
For smaller veins, Wouters also uses laser therapies
that heat the insides of veins and shuts them down.
PAGE 12
Sclerotherapy must be performed by medically
trained practitioners, while laser treatments have
less-stringent rules and can be performed at
non-medical facilities such as spas.
Wouters suggests lifestyle tweaks as a way to keep
vein disorders at bay.
“I encourage exercise — walking. It doesn’t have
to be fancy. Keep to your ideal weight, and especially with a standing job, wear compression stockings,
which I have on all the time,” she says.
Varicose veins are progressive and can get worse
over time, causing complications such as aching,
fatigue, swelling, blood clots and ulcers.
At Vive Rejuvenation Laser Clinic, smaller
cosmetic veins on the face and body are effectively
eradicated using laser treatments, specifically the
ND YAG wavelength laser, which can treat both
lighter and darker skin tones.
It also treats superficial red and blue veins,
telangiectasia, hemangiomas, port wine stains and
spider veins.
“The advantage is no needle pokes, and the
laser is only interested in the hemoglobin in the
blood vessel, so it’s not affecting the surrounding
tissue,” says Angela Robertshaw, managing
director at Vive.
Smaller red and blue veins are heated up, coagulated, the walls of the vessel close in, and then
the vein slowly breaks up and is reabsorbed by the
body’s system.
A topical anesthetic is usually used, and there can
be some bruising and tenderness afterward, which
clears quickly. Followup appointments are necessary
to observe vein changes or to have additional
treatments.
“Facial veins are very quick and easy to treat,
and absorb quicker, because they are smaller,”
Robertshaw says.
Vive prices treatments based on how much time
each procedure takes.
COSMETIC REJUVENATION
FALL 2014
BODY
SWEAT-FREE BODYBUILDING
Joel Schlesinger looks at the ways men can pump themselves up without visiting a smelly gym
W
omen do it, so why not men?
Breast augmentation surgery is a plain Jane
cosmetic procedure these days. Virtually every
cosmetic plastic surgery practice offers and performs it
regularly.
But pectoral implant procedures, the male version of breast
augmentation, are rare.
That’s likely a function of supply and demand, says
Dr. Jerome Edelstein, a plastic surgeon with Edelstein Cosmetic
in Ontario.
The fact is not many men seek the procedure involving
silicone implants inserted under the pectoral muscle.
Edelstein is one of the few in Canada to offer the pectoral
implants at his Toronto practice, performing a few procedures a
year.
“It’s usually a younger male under 40, who, for whatever
reason, feels his pecs are underdeveloped and he can’t get them
to where he wants them to be through working out,”
says Edelstein, also head for plastic surgery at Humber River
Regional Hospital.
“It’s quite a good procedure.”
While facelifts, nose jobs, tummy tucks and breast implants
are commonplace at North American cosmetic surgical centres,
muscle-implant surgery tends to be much less common.
Calgary plastic surgeon Dr. Greg Waslen says no surgical
practice that he knows of performs pectoral implant surgery in
the city because few men are interested in this purely cosmetic
procedure that does not actually add muscle mass or increase
strength.
Yet, although muscle augmentation surgeries — including
buttock, calf and bicep implants —
­ may seem like a new
frontier of cosmetic surgery, these types of procedures have been
available for several years. It’s just that they’re not widely
marketed by cosmetic surgeons because they’re not in high
demand compared to other procedures such as breast
augmentation, says Dr. Lloyd Carlsen, with Cosmetic
Surgery Hospital in Toronto.
Carlsen, a pioneer in calf implant procedures, performed his
first such surgery — one of about 730 — in 1972.
“I’ve never advertised that I do it,” he says.
But word of mouth gets around.
COSMETIC REJUVENATION
FALL 2014
Although most of his patients are women, Carlsen says
he has performed a few calf implant procedures on men,
mostly bodybuilders.
“About two-thirds of the procedures are cosmetic,”
he says, adding the remainder are patients with
deformities.
Despite the fact Carlsen is one of the most
renowned surgeons performing the procedure,
even he says it makes up only a very small
fraction of his practice. It’s the same for
Edelstein, who has never bothered to offer
the other ones, such as bicep and calf
augmentation, because demand is low.
But Edelstein does often perform an
abdominal procedure for patients seeking a
six-pack stomach — only it doesn’t involve
muscle implants.
“It’s called abdominal etching,” he says.
“You have people who are in reasonably
good shape, but their stomach muscles are
not really that well defined, so you can
actually mark out where their six-pack
would be and go in with a liposuction
cannula and remove fat judiciously to create
a six-pack for them.”
As for gluteal implant procedures,
most patients are women seeking a Kim
Kardashian-like booty. But Edelstein adds
that more women are instead opting for an
alternative called the “Brazilian butt lift.”
“What you do is liposuction as much fat
as you can from everywhere else and you
put it into the butt.”
And while all these procedures add bulk
to a person’s physique, there’s one thing
they don’t do.
“They’re certainly not going to
make you any stronger,” he says.
That has to be done the old fashioned way: pumping iron instead of
getting pumped up with silicone.
PAGE 13
SKIN
BANISHING IRKSOME ACNE
There are treatments to get rid of the irritating skin condition. Rachel Naud explains the options
F
or some Calgarians, acne isn’t an
adolescent problem that ends
after the teen years. Thankfully,
adult acne comes with some treatments
that are more powerful than the overthe-counter solutions we used in days
gone by.
Acne is caused by the
overproduction of
sebum, an oily
substance
created by
PAGE 14
sebaceous glands to lubricate the skin.
Sebum flows from the glands toward
the skin’s surface through hair follicles.
Sometimes dead skin cells and excess
sebum block these follicles, spurring the
growth of bacteria and leading to
whiteheads or blackheads.
As well, an excess of sebum can break
through the wall of the follicle and seep
into the nearby skin tissues, creating
pustules.
While hormones are mostly to blame
for adolescent acne, the acne that occurs in adults often has a different
source, says Kirsten Patterson, medical
esthetician at FACES Beauty is Power in
Calgary.
“The type of acne that an adult can
have is usually less than a teenage suffers
from,” she says.
“Adult acne can also be caused by
other factors like cosmetics, certain
drugs, humidity, hormonal changes and
sweating.”
To win the fight against adult acne,
Dr. Louis Grondin, medical director at
Calgary’s Sante Cosmetic Laser & Vein
Centre, says the clinic focuses on helping
to keep the sebum pores open.
“Particularly in climates like Calgary’s,
this is a crucial step to reduce acne
pimple, nodule and cyst formation,”
says Grondin, who advises daily
exfoliation with a topical retinoic
acid. He says it is an excellent
pore cleanser and has a strong
anti-inflammatory effect
on acne breakouts.
For a stronger
solution,
Grondin says salicylic acid and Jessner
peels, as well as ultra-superficial
ablative and Q-switch lasers, have a
debris-cleansing effect on sebaceous
pores that can help rid acne.
Patterson says staff at FACES Beauty
is Power use smooth-beam lasers to
effectively treat acne. The laser is
attracted to the oil in the dermis. It
destroys the oil and dries the acne from
the inside out.
“We also have an acne program that
includes cleaning of the skin, as well as
a possible physician-grade peel added
for those with lots of congestion underneath the skin.”
Sometimes acne can cause scarring,
which most commonly happens after
a cyst fills with sebaceous oil bacteria
and ruptures into the dermis. The
outcome is loss of tissue as collagen is
destroyed.
“Skin overlying the collapse of the
area is provided no support and therefore the depression starts in the skin,”
says Patterson.
“This often leaves a jagged ice-pick
scar, as well as different marks from also
picking at the acne.”
At Sante, treatment for acne scarring
often involves a combination of
non-ablative fractionated and ablative
lasers as well as peels and de-pigmenting
skin care.
“We also strongly recommend a
well-balanced diet rich in anti-oxidants
and omega-3 fatty acids, which is useful
in supporting the skin’s ability to rebuild
itself and heal without inflammation,”
says Grondin.
COSMETIC REJUVENATION
FALL 2014
BODY
NO SURGERY REQUIRED
Karen Durrie discovers how new technologies can cut down fatty deposits without surgery
L
ooking to fine-tune your figure? A number of
cosmetic procedures make it possible to sculpt
and refine diet- and exercise-resistant fatty areas
without surgery.
One of the most popular treatments on the
market today is Ultrashape, which uses focused
sound waves to break up fat cells.
“It’s been around since 2000, so it’s a triedand-true, safe, non-invasive treatment,” says Angela
Robertshaw, managing director of Vive
Rejuvenation Laser Clinic.
“What we know is, across North America and
internationally, people want a non-surgical way of
keeping their bodies contoured.
“They are less interested in having surgery, which
has more risk and more recovery.”
Using the Ultrashape V3 machine, practitioners
use a hand-piece to deliver pulsed, focused
ultrasound to break apart fat cells in trouble areas,
including flanks, hips, inner and outer thighs,
upper arms, above the knees, and the abdomen.
There is minimal discomfort, Robertshaw says,
and typically after a series of three treatments spaced
from two weeks to one month apart, clients will see
between one to two inches — sometimes more —
of fat loss in treated areas.
COSMETIC REJUVENATION
FALL 2014
“It’s minimal recovery time, no wound healing,
and you can get up and go back to work, home or
even to the gym,” Robertshaw says.
Ultrashape permanently destroys targeted fat cells.
They are then metabolized by the liver and flushed
out by the body’s natural systems.
It’s important to note that body shaping
procedures work best on people who are not
overweight — they should usually be within their
ideal weight by a handful of pounds.
For Ultrashape, Robertshaw says clients with a
body mass index (BMI) of below 30 are ideal.
Because Ultrashape uses radio frequency waves,
there is also a skin-tightening effect from heating the
collagen layer under the skin.
“The area gets smaller, firmer and smoother,”
says Robertshaw.
Sante Spa offers several non-invasive treatments to
refine and contour the body.
At the spa location, Sante offers LPG
lipomassage, which is ideal for treating cellulite.
Mechanical roller heads massage and relax
connective tissue to enhance circulation, resulting
in a smoother appearance.
“It’s good for legs and buttocks in particular, and
is generally done in a series, with a consultation first
to evaluate if you are good candidate. It’s good for
people within five to 10 pounds of their goal weight,
so it’s for refinement, not weight loss,” says Amanda
Preece, marketing director for Sante Cosmetic Laser
and Vein Centre.
The number of lipomassage treatments needed for
optimal results varies depending on the individual.
CoolSculpting is another non-invasive treatment.
Controlled cooling is applied using a handheld
vacuum applicator device, which extracts heat from
fat cells, cooling them down and crystallizing them,
leaving surface skin and tissue unaffected. The
crystallized cells die and are then eliminated from
the body permanently.
Results are seen after one session, with the most
dramatic results visible after several sessions, and
within two to four months. CoolSculpting can be
used anywhere there is stubborn body bulging,
including love handles, muffin tops and
abdomens.
Mesotherapy injections are another way to target
fatty tissue under the chin, abdomen, love handles,
bra folds, arms, thighs and knees. The solution
injected through a fine needle to targeted areas
breaks down and reduces fat cells gradually over a
number of sessions.
PAGE 15
MEN
HELPING MEN MEASURE UP
Joel Schlesinger shares the story of the Canadian doctor who helped popularize penile-lengthening surgery
H
ere’s the long and the short about penile
lengthening surgery.
Or more precisely, it really starts with
Dr. Dao-Chou Long, a Chinese plastic surgeon, and
Dr. Robert Stubbs, a Canadian one.
More than 20 years ago, Stubbs met Long while visiting
Beijing for a conference. Long had pioneered a procedure
that had for a long time been thought to be too risky, and
for that matter, likely impracticable: surgery to lengthen a
flaccid penis.
Yet unlike an array of countless devices, herbal
concoctions and other dubious treatments that have
claimed to increase the size of a man’s member, but didn’t
actually work, Long had indeed done the impossible. He
had developed a procedure that added a few centimetres to
the length of a penis.
And Stubbs was intrigued.
“I heard about Long through research I’d been doing
because plastic surgeons work in that area for reconstruction,” says Stubbs, an Ontario-based plastic surgeon,
now retired.
“I sort of knew it was being done for
cosmetic reasons.”
PAGE 16
Stubbs came back from China in 1993 and decided to
add the procedure to his practice. And he set out to do it
the right way, under the supervision of a top urologist in
Toronto and the College of Physicians and Surgeons of
Ontario.
He performed hundreds of successful procedures over
four years, and published his findings in the Canadian
Journal of Plastic Surgery in 1997.
“It was the most hit on scientific medical paper of any
journal on the Internet at the time,” he says.
Although several other surgeons specializing in
gender reassignment and reconstruction surgery offer
other types of phalloplasty procedures, Stubbs was among
a handful of specialists to perform the cosmetic procedure.
Phallus augmentation “is done less frequently and the
most vocal proponent of this procedure is Dr. Stubbs in
Toronto,” says Dr. Kenneth Wilson with the Canadian
Society of Plastic Surgeons.
While other North American plastic surgeons offer
the cosmetic procedure, including Dr. Cameron
Bowman in Vancouver (one of the few in Canada), most
follow the technique Stubbs learned from Long and
then refined.
Like Long, Stubbs’ technique involves cutting the
superficial ligament at the base of the penis, which allows it
to hang lower.
“You can get about two inches by cutting this ligament,
and it gives a four-inch man a feeling he’s one of the guys,”
says Stubbs.
To improve the outcome, Stubbs developed a postoperative regimen involving weights that are attached to
the penis.
Although the procedure isn’t exceedingly complex, it’s
not without risks and involves a lot of “hand-holding,”
he says.
“I wrote the cookbook on how to do it, and if you can
read, you can do the operation, but what many doctors
didn’t understand is they had to also look after the patient,
and men can be babies.”
Even screening patients could be stressful. Stubbs says he
received death threats after turning down would-be
patients. And while he enjoyed the challenge of developing and perfecting the procedure, it took its toll.
“Winning and fighting was a phenomenal high,”
he says about surgery.
“It’s like a drug — your own endorphins kick,
but afterward your body pays for it.”
So, after performing more than 550 procedures,
he decided to retire seven years ago. However,
that hasn’t slowed demand for his services. Even
today, Stubbs still gets many emails from
desperate men, and he tries to let them down
gently.
“If it is a past patient or a serious inquiry, I
just say sorry and I am retired,” Stubbs says.
“If it is frivolous, such as someone
who wants another four inches for a
six-inch penis, I don’t even bother
replying.”
COSMETIC REJUVENATION
FALL 2014
SKIN
SMOOTHING THE BUMPS
There are methods to attack the cottage cheese-looking scourge of cellulite, Rachel Naud learns
C
ellulite is one of life’s biggest
frustrations.
While cellulite can be caused
by factors such as a poor diet, dehydration, slow metabolism and excessive body
fat, the truth is even the fittest Calgarians
can be inflicted with the bumpy, cottagecheese-like substance on their buttocks,
legs and thighs.
That’s why many people are looking to
cosmetic procedures to get rid of cellulite
and achieve the smooth skin they desire.
“This current generation is more
focused on personal appearance, looking
good and therefore feeling better
compared to previous generations,” says
Dr. Tom Woo of Calgary’s Laser
Rejuvenation Clinic and Spa.
“Looking your best will optimize your
chances for life’s opportunities.”
Cellulite is the contraction of the
vertical bands that separate the fat lobules — it almost looks like a stitched
mattress. It is fat beneath the skin that
appears bumpy because it pushes against
connective tissue, causing the skin above
it to pucker.
Over-the-counter creams are a popular
option for people who don’t want to
commit to anything invasive or don’t have
the budget to undergo a procedure, says
Woo.
“The most popular cream is aminophylline,” explains Woo. “This is a drug
used for asthma, but is applied in the
form of a cream.”
The downside? The cream has minimal
effect on the blood vessels and no studies
have confirmed its effectiveness, Woo says.
Medi-spas also offer treatments such as
Endermologie.
COSMETIC REJUVENATION
FALL 2014
“This technique uses rollers and suction
to physically cause stretching of those
vertical fibres,” says Dr. Woo.
“Treatments last days and upkeep
involves treatments every two weeks
or so.”
More invasive procedures include
liposuction and mesotherapy. Although
the former doesn’t offer the greatest
results in the fight against cellulite, it is
effective in fat removal. This can help very
overweight patients who might have fat
bulging out between the vertical fibres.
Mesotherapy involves injecting
medications such as vitamins and amino
acids under the skin to break down the fat
and the vertical fibres.
“Results can be long-lasting, but not
everyone has a positive effect,” warns
Woo.
“Studies have been equivocal, some
show mesotherapy is effective, and some
studies marginal. Patients can have
treatments every three months to upkeep
their results.”
Lastly, Velashape is one of the most
effective treatments for cellulite. The
technique combines mechanical massage
with a vacuum, infrared light energy and
bi-polar radiofrequency (sort of an invisible laser).
“Vacuum and specially designed rollers
for the mechanical massage smooth out
the skin to facilitate safe and efficient heat
energy delivery,” says Woo.
“The net result increases the metabolism
of stored energy, increases lymphatic
drainage and reduces or shrinks the size
of the actual fat cells and fat chambers.
This results in smoothing and cellulite
reduction.”
PAGE 17
COLUMN
BEATING THE AGING GAME
The fountain of youth might not exist, but Dr. Andrei Metelitsa says there are ways to keep looking young
T
Dr. Andrei Metelitsa is
co-director of the Institute for
Skin Advancement and clinical
associate professor at the University
of Calgary. He is a board-certified
dermatologist in Canada and the
U.S., having pursued an additional
fellowship in lasers and cosmetics
with world-renowned faculties from
Harvard and Yale universities. He
has authored a dermatology book
as well as more than 40 book
chapters and articles.
PAGE 18
he allure of new procedures continues to bring
innovations into the field of cosmetic medicine.
It is well known that the process of aging is a
natural and inevitable part of life. Regardless of one’s
genetic predisposition, our skin undergoes very predictable
deterioration changes that are commonly influenced by the
environment.
In addition to smoking and stress, cumulative exposure
to sunlight, referred to as photo-aging, is the most
significant contributor to aging.
I am therefore a huge proponent of preventive medicine
that includes sun protection and good skin hygiene.
However, many of our patients visit the office when the
aging process has already begun and more definitive
treatments are needed.
When faced with all of the plausible treatments that are
available today, one of the key questions our patients ask
is whether their results will look “natural.” This question,
reflective of a dark shadow around cosmetic procedures, is
driven by a number of well-known celebrities who have
undergone extensive and very obvious cosmetic
enhancements that, unfortunately, detract from their
natural beauty and inevitably diminish their appearance.
Understandably, while our new patients want to look
more youthful and refreshed, they may also be worried
about whether their results will be unnaturally obvious.
Such discreetness is even more important to our male
patients, who represent a rapidly growing proportion of
our clientele.
Luckily, most of our modern cosmetic procedures are
non-invasive, have minimal downtime and are able to
produce effective, yet very subtle results.
With the widespread availability of Botox and Dysport,
the dubbed “frozen look,” in which a person is unable to
show any aspect of expression, creates a negative
connotation that inhibits many possible patients from
pursuing such procedures.
But if done properly, such procedures should prevent
colleagues and friends from fully realizing the reasons
behind one’s youthful appearance. Newer techniques that
can be incorporated, even among our younger patients in
their 30s, ensure that lines are diminished while still
allowing patients to express emotions on their face.
As our patients age, cosmetic fillers such as Juvederm and
Restylane are typically used to address the loss of fullness
and volume, often in the regions of the mid-face and jowls.
Proper placement of such injectables that takes into
consideration a patient’s facial features is absolutely critical
and can produce very subtle results, generating a more
relaxed and rejuvenated face. After all, not many would
seek out a dermatologist and request abnormally large
duck lips or large, full cheeks that, in some way, were
misperceived in the past to reflect youthfulness and
attractiveness.
Similarly, when it comes to laser procedures, which are
often designed to eliminate brown spots, improve skin
texture or diminish facial vessels, safety is another
important concern.
Luckily, most of the innovations that have led to laser
procedures are not only extremely effective, but also usually
require a minimal recovery, often between one and three
days of mild downtime. As well, the permanent sideeffects, which often haunted previous technologies, are
now almost non-existent.
Once again, ensuring with a high level of certainty that
the end result is better than the original blemish is the
overall principle of modern cosmetic medicine.
In essence, the future of cosmetic medicine remains
bright, so we can stay youthful in a natural, safe and
cost-effective manner.
COSMETIC REJUVENATION
FALL 2014
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