COMPLIMENTARY WAITING ROOM COPY A SUPPLEMENT TO
Transcription
COMPLIMENTARY WAITING ROOM COPY A SUPPLEMENT TO
... for looking 10 years younger, instantly! BEAUTY FOR A LIFETIME Plus • Next-gen fillers • Better breasts Summer 2010 COMPLIMENTARY WAITING ROOM COPY Getty Images/Andreas Stamm A SUPPLEMENT TO editor PRODUCT EDITORIAL ADVISORY BOARD PICKS CellCeuticals PhotoDefense, SPF 55+ Providing broad-spectrum UVA/UVB protection, this skin protector punches up its performance power with the addition of flower and root extracts and vitamin D. Take that, photodamage! Available at cellceuticalskincare.com, $45 Avène Thermal Spring Water Perfect for that trip to the beach — or to recover from it — Avène’s thermal spring water is a mist away from soothing, cooling and rehydrating your skin. Available at lovelyskin.com, $11 (150 ml) 4 SUMMER 2010 Noah’s Naturals Firming Bronzing Cream Say goodbye to sun-damaged skin and hello to a dose of color that’s formulated to prevent and repair the signs of aging. Vitamins B5 and E, allantoin and beta-glucan work to help improve skin’s elasticity and moisturization, while mica, a natural bronzer, adds a touch of color. Available at select retailers nationwide, $14.99 Michael S. Kluska, D.O., F.A.A.C.S., F.A.C.O.S., is boardcertified in plastic/ reconstructive and general surgery; a fellow of the American Academy of Cosmetic Surgery and the American College of Osteopathic Surgery; and a member of the Pennsylvania Osteopathic Medical Association and the American Osteopathic Association. NATIONAL ACCOUNT MANAGER Joseph Niamtu III, D.M.D., F.A.A.C.S., is a board-certified cosmetic facial surgeon. He is a fellow of the American Academy of Cosmetic Surgery and the American Society for Lasers in Medicine and Surgery. His practice is limited to cosmetic facial surgery. Amy Ammon Joel Schlessinger, M.D., F.A.A.D., F.A.A.C.S., is a board-certified dermatologist and past president of the American Society of Cosmetic Dermatology and Aesthetic Surgery. He is in private practice in Omaha, Neb., and is the founder and owner of LovelySkin.com. ©2010 Advanstar Communications Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by EDITORS CONTRIBUTING EDITOR/ SENIOR WRITER CONTRIBUTING WRITERS ART DIRECTOR SENIOR PRODUCTION MANAGER Amy L. Stankiewicz Susan R. Schell Sarah Thuerk Eliza Drewa any means, electronic or mechanical including by photocopy, recording, or information storage and retrieval without permission in writing from the publisher. Authorization to photocopy items for internal/educational or personal use, or the internal/educational or personal use of specific Amber McGeachy Cynthia Lowe clients is granted by Advanstar Communications Inc. for libraries and other users registered with the Copyright Clearance Center, 222 Rosewood Dr. Jerry Lehman Danvers, MA 01923, 978-750-8400 fax 978-646- Terri Johnstone direct your written request to Permission Dept. fax 8700. For uses beyond those listed above, please 440-891-2650 or email: [email protected]. Got WITH SUMMER JUST AROUND THE CORNER, this is the time of the year that we all begin to worry about how we’re going to look in that bikini — too flat, too big, too bumpy? Whether you’re a planner or a procrastinator, we’ve got the 411 on how to get those curves in the right places. Tips and tricks for achieving your best summer silhouette CURVES AHEAD Once you decide that body contouring is in your future, there are three general categories that patients generally fall into, according to Michael Kluska, D.O., a board-certified plastic surgeon in Greensburg, Pa.: 6 SUMMER 2010 Early Birds: Ladies, this is you if you’re forward planning enough to get into a surgeon’s office in March or April. Will you be ready for summer? Absolutely! The Punctual Patient: The most typical patient; if you get into the office in May, you may be ready for June, barring any unforeseen issues that could arise. The Procrastinators: Last minute more your thing? Although your options are fewer, don’t count yourself out. You may, however, have to work on making sure that your expectations are realistic. Regardless of which category you are in, Dr. Kluska asks his patients to approach their goals from a holistic, whole-health perspective. First, he says, it’s critical to make a commitment to yourself and to your doctor, and to have a doctor who makes a commitment to you. Second, when it comes to body contouring, Dr. Kluska asks all of his patients to commit to a lifestyle change: Eat right, eat the correct number of meals and exercise regularly. “I try to teach my patients that Getty Images/Digital Vision Furthermore, “Thin women eat small, frequent meals. Their blood sugar is constant, which keeps their insulin levels normal. The result is increased energy and a higher metabolism.” Dr. Kluska has his body contouring patients cut out the “Cs”: cookies, candy, chips, cola and cake. He also has them replace the whites with whole wheat/whole grain pastas and breads. “In my office, we call this ‘the Kluska Challenge,’” he says. “I literally watch people melt fat away, especially when I’ve given them a boost with liposuction or a tummy tuck.” TIMELINE If you’re an early bird, Dr. Kluska says, everything’s attainable for late spring: body lift, tummy tuck, liposuction, breast augmentation. If you wait until April, you’ve got to be committed to the challenge to be ready for summer. “The average person needs three to four weeks to be back up and running, and three to six months to see final results,” Dr. Kluska says. Omaha, Neb., dermatologist Joel Schlessinger, M.D., F.A.A.D., F.A.A.C.S., concurs: “The reality is that tumescent or SmartLipo could have them bikini-ready in a month.” After a two- to three-day recovery period, expect to be swollen for about a month, he says. Dr. Kluska points out that while there are a multitude of noninvasive options out there that Getty Images/Stock4B-RF “For a quick fix, traditional liposuction will provide better results,” Dr. Kluska says. He also points out that you’re likely to be happier and have more permanent results with this procedure. The age factor For those willing to make an ongoing commitment to improve the shape of their bodies, Dr. Schlessinger has had effective results with the VelaShape (Syneron) device. “Cellulite treatment — every woman has that potential concern this time of year,” he says. (And don’t we know it!) However, “Treatment for cellulite is an ongoing battle most people don’t understand.” Surprisingly, the older you are, the quicker the recovery. Not in terms of ability to heal, but, interestingly, in the ability to tolerate pain. According to Dr. Kluska, those in the general age range of 20 to 30 take longer to recover. “(The majority of) ‘girls’ have never experienced a C-section, hysterectomy or having babies, for that matter. Surgery is a lot of pain for them,” he says. Women in the 30-to-45 age range “don’t have time to slow down, and they’re happy to be back to ‘normal’ again,” he adds. Over the age of 45? These women say, “‘Honey, this is nothing,’” Dr. Kluska says. “‘Let’s go.’” The reality? According to Dr. Schlessinger, if you continuously treat soft tissue for cellulite, it’s fairly easy to keep it under control. “The key is to treat early and treat often,” he says. Treatment with VelaShape, Dr. Schlessinger says, is essentially a suctioning and rolling of the skin and fibrous bands, loosening the bands between the fat and increasing circulation in skin, which makes skin look more youthful. To be ready for swimsuit season, you’re looking at four to 12 sessions, then every other month for maintenance. SIZE RIGHT A leg up “The key to all body contouring is functional form,” says Dr. Kluska, who approaches each new patient individually with an artistic eye and the question, “How can I put them into better proportion and form?” “The most important thing to realize is that everybody’s body is different,” he says. For example, “If a woman is 5 feet, 3 inches and 125 pounds, with a thicker and wider frame, and only wants a small C cup, she’ll still be unhappy after surgery, because she’ll still be out of proportion,” he explains. To get the size right, “I look at the shoulders in proportion to the chest, in proportion to the waistline, in proportion to the hips. So this patient would go to a larger size than she originally anticipated,” Dr. Kluska says, “but she’ll be happier in the end, because of better proportion and form.” Your summer silhouette probably isn’t the only concern you’ve got when it comes time to baring some skin this season. Whether you’re planning to get into a bikini or not, chances are you’ll be flashing some leg — and treating those bothersome leg veins can have a dramatic effect on the appearance of your legs, according to Dr. Schlessinger. “We get some terrific results,” he says, pointing out that the best results come from an annual trip to your cosmetic surgeon’s office. SUMMER 2010 But just because the technique works doesn’t mean it’s right for every woman. According to Dr. Schlessinger, if you have sagging in the lower abdomen or stretch marks, you’ll want to consider a tummy tuck, in which case you’ll need to plan ahead. And if you’re that lastminute gal (we all know one of these!), a breast augmentation and smaller-volume liposuction is about all you’re going to have time to recover from to be bikini-ready. Recovery time for these is an average 10 days to two weeks. may help to shrink fat cells, you could potentially spend $2,500 on multiple treatments, the results of which could be minimal and last only a couple of months. Getty Images/Mark Andersen their baseline metabolism is slow because they’re not eating frequently enough or getting the right amount of exercise,” he explains. “I have patients who come in and tell me that they’re eating only one meal a day and too busy to exercise — they constantly chase the kids and that’s enough. But they can’t lose the weight.” 7 BeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmarts Great SUNSCREEN DEBATE THE C h e m i c a l , o r o rg a n i c? Sun exposure causes skin damage. Consumers have largely accepted this as truth. And, just as our awareness has grown, so has the sun protection product market. W e’ve officially entered the next generation of sun protection, and that means more than just an increase in the number of bottles on the shelf at your local pharmacy. The question of what number SPF you should choose has been replaced by the question of whether you should buy chemical or organic sunscreen. To make that choice, you’ve got to know what the difference is, and whether one may be better than the other. To understand the difference between the traditional chemical sunscreens and the organic (also called “physical” or “all-natural”) options, it helps to understand the difference between UVA and UVB rays. Simply put, UVA rays are responsible for “A”ging; UVB are responsible for “B”urning. UVA rays damage the skin’s collagen and elastin, which are needed to keep skin looking young; UVB rays burn the skin and are the main cause of skin cancer. 8 SUMMER 2010 Chemical protection Historically, chemical sunscreens contained UVB-absorbing chemicals. It is only more recently that they contain UVA absorbers as well. Any sunscreen containing avobenzone, oxybenzone or octocrylene are chemical sunscreens. Octocrylene is part of the cinnamate group of chemicals. Cinnamates have both UVA- and UVB-absorbing ingredients, which is how they protect the skin from the sun’s harmful rays (they absorb them, so your skin does not). Chemical sunscreens also contain different benzophenones, such as avobenzone, which also absorb UVA and UVB rays. The skin actually soaks up chemical sunscreens, which is a key difference between the chemical and organic sun-protection product categories. Because octocrylene is absorbed into the skin, it has been shown in some studies to promote the generation of potentially harmful free radicals. The health implications remain unclear, but some experts have raised concerns that warrant further research. Examples of chemical sunscreens are La Roche-Posay Anthelios XL 50+, Lancôme UV Expert 20 and the new Eucerin White Solution Fluid (Tinosorb S). Going chemical-free Organic, or physical, sun-protection products are called sunblocks, as opposed to sunscreens. They generally contain zinc oxide and titani- Getty Images/Image Source BeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmarts UYER, BEWARE Waterproof and sweat-proof sun-protection products may not be as effective as they claim to be. Sun protection should be reapplied after swimming, or every two hours, if you plan to be in the sun for long periods of time. Additionally, babies under the age of 6 months should not have sunscreen applied to their skin at all, and should remain out of the sun’s reach altogether. Getty Images/Image Source um dioxide, which are not absorbed into the skin, but instead remain on top of the skin and act as UVA/UVB deflectors. Zinc oxide is the preferred ingredient, because it blocks more UV radiation, according to Helen M. Torok, M.D., a board-certified dermatologist and owner of Trillium Creek Dermatology & Surgery Center in Medina, Ohio. While the physical products are more effective sun blockers, the downside is that many of them tend to leave a white fi lm on the skin. But adding makeup colors to the base product can make it into a wonderful makeup foundation that not only looks good, but also protects the skin from harmful rays, Dr. Torok says. In addition, many organic sunblocks are now using a process called micronizing that essentially breaks down the zinc oxide so it doesn’t leave a fi lm. L’Oréal holds the patent on an organic ingredient called Mexoryl (ecamsule), which has been shown to be a powerful UVA blocker. It is only found in select L’Oréal products. While chemical sunscreens offer both UVA and UVB protection, there’s also the possible generation of harmful free radicals. Organic sunscreens, on the other hand, offer a broader protection from UVA/UVB rays, but, depending on the formulation, could leave you covered in an unattractive white fi lm that could also be slightly uncomfortable. Notably, these all-natural, physical ingredients in this new generation of sun protection offer a specific population of consumers sun protection and tolerability. Those with sensitive skin, , eczema or other skin allergies would be wise to use an all-natural product versus a chemical product, as the ingredients are less likely to exacerbate skin sensitivities. Still can’t decide? Whether you pick a chemical or all-natural product, the bottom line is, either one is better than no protection at all. SUMMER 2010 Examples of physical sunblocks include L’Oréal UV Perfect (Mexoryl), DDF Organic Sun Protection and Obagi Nu-Derm Physical UV Block. Sensitive skin 9 BeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmartsBeautySmarts Plastic, not perfect While the idea of cosmetic surgery often equates with “perfection,” that’s not realistic. With breast implants, while you may be getting a permanent size and shape from the implant itself, your skin continues to respond to the aging process: it loses elasticity, droops, and the implant goes along for the ride. One of the current strategies for avoiding sagging is to place the implants under the muscle. If you’re undergoing a breast lift at the time of implants, some doctors may also be able to create scaffolding to hold those implants in place using your own tissue. The implant technology of the future might be in a scaffolding product for tissue support, such as Allergan’s new silk-based biodegradable fabric technology. But time and research are needed first to have a clearer understanding of realistic results and potential complications. Tissue technology “The idea of using a fabric to keep implants in place isn’t new,” says Michael Kluska, D.O., of Greensburg, Pa. About five years ago, one of Dr. Kluska’s colleagues developed and began using a polytetrafluoroethylene (PTFE, the same material from which Gore-Tex is made) product for the same reason. “It (PTFE) is a product that’s been used the past 30 years for various surgeries. It mimics natural tissue, grows into tissue and becomes static,” he says. Beyond keeping the implant stable, it also may decrease rippling (very common among implant recipients) and, while not as common (but much more of a problem), capsular contracture, according to Dr. Kluska. Although the exact cause of contracture isn’t known, doctors take various steps to reduce the likelihood, including placing the implant under the muscle and having patients massage the breasts after surgery to keep the capsule loose. As for rippling, it’s also less common with an under-the-muscle placement, and may be less common with silicone than with saline implants. While these contours are completely harmless, some doctors are beginning to use fillers to smooth them out. SCARED OF SURGERY? 10 SUMMER 2010 It’s true: The No. 1 cosmetic procedure in the United States is breast augmentation. But one doctor has taken a step toward a nonsurgical option to offer the cleavage-challenged a solution. The procedure? It’s called cleavage rejuvenation. No cutting, no anesthesia … and no major hit to the pocketbook. According to Brad Calobrace, M.D., a Louisville, Ky., plastic surgeon and the brains behind this creative solution, cleavage rejuvenation is a two-step process that (1) rejuvenates the skin in the chest area using a brightening cosmeceutical or laser treatments, and (2) uses a hyaluronic acid filler to strategically create cleavage-inducing curves where the breasts meet the chest. Results last about a year and cost anywhere from $1,000 to $2,000. Not bad for a quick summer fix! Getty Images/Photographers Choice RF/Sheer Photo Inc. W hen we talk about breast augmentation, our minds go straight to the implant option. Despite improvements in materials and techniques, there are still a handful of potentially problematic issues that could arise — from implants that shift to ripples you can feel to capsular contracture. Getty Images/Photographers Choice RF/Pando Hall Implants Great BODY efs b THE Getty Images/Lane Oatey AGE BETRAYER Are your hands giving away your years? n the midst of your daily skincare routine, stop and look around. You have cleansers, toners and moisturizers for your face and neck, even your décolletage. But what about your hands? As it turns out, hands can be a dead giveaway to your real age. As we age, the skin on the backs of our hands loses volume and becomes thinner, draping the very structure of the hand. Bones, veins and tendons, all more visible, make hands look, well, old. Many of us have had to learn the hard way that it’s important to protect our skin — from head to toe — from harmful environmental pollutants and UV rays before the damage is done. But for the damage that’s already been done, what’s a mature girl to do? Thankfully, options do exist. Pump up the volume And not to worry — thanks to the numbing cream, the injections are relatively painless and last up to one year. Spot treatment Whether or not you opt to plump up your aging hands, if you want to get rid of those pesky age spots (also known as sun spots or liver spots), modern technology has a solution: the laser. If you do get fi ller injections, Dr. Pilest starts with those fi rst, followed by alexandrite laser treatment. Using high-powered light, the laser breaks up the pigmented areas to remove the spots. While the technology does not damage surrounding skin, you may experience some peeling of the skin, which potentially lasts four to five days after the treatment. It’s part of the normal recovery process and will improve the look of your skin. After treating yourself to spot removal, it’s important to take preventive measures to make sure spots don’t come back. Those spots are actually dark pigments that we acquire from sun damage. Dr. Pilest points out that post-procedure use of a topical cream containing vitamin C, topical bleaching elements and a sunblock of SPF 30 or greater is a must to maintain your youthful-looking hands. (For the bleaching product, he recommends SkinCeuticals Pigment Regulator, which relies on kojic acid rather than hydroquinone to keep the skin on your hands bright and pigmentfree.) The filler injections are painless and last from six months to one year. Laser treatments followed by daily use of the proper hand cream will keep the “age spots” at bay. Even better, the combination of injections and laser treatment takes less than 45 minutes. The cost? In Dr. Pilest’s office, Radiesse treatments are generally $1,500 to $2,000, depending on the number of syringes injected. To remove pigmentation spots with the alexandrite laser, the average cost is $500 to $750. SUMMER 2010 11 To minimize the skeletal look to the hands, fillers can work wonders. Fillers can be natural (your own fat relocated from another part of your body … I vote thighs!) or synthetic (manmade). Fillers are injected into the hands and create a layered effect between the hand anatomy and the skin. According to Nissan Pilest, M.D., a board-certified dermatologist in Irvine, Calif., Radiesse (BioForm Medical) is his filler of preference. “It stays better and lasts longer” than others he’s tried, Dr. Pilest says. But you’re just as likely to encounter other fillers, too: Restylane (Medicis), Perlane (Medicis), Juvéderm (Allergan), Sculptra Aesthetic (Sanofi-Aventis). Oftentimes, it’s simply doctor preference. BREAST Naturel s bodybriefs bodybriefs bodybriefs bodybriefs bodybriefs bodybriefs Au Enhancing your bustline without implants could have them asking, ‘Did she, or didn’t she?’ S Getty Images/Digital Vision/Win Initiative ome say we are a nation obsessed with breasts. From padded bras to mold and shape to surgical enhancement with saline or silicone implants, almost all of us have taken some measure to improve the general contour of this anatomic area. Beyond the bras and before the implants, there is another option: the “natural” augmentation. GOING braless? The Breform, aka, “internal bra,” is a new lift- ing technology out of South Africa that claims to give you a permanent lift sans traditional bra. The Breform is a piece of polyester mesh surgically implanted under the skin intended to give the breasts an internal lift. A relatively new product, it is not yet approved in the United States. (It is expected to be available in Canada and Mexico sometime this 12 SUMMER 2010 year.) Ladies, let’s just say that for now, it’s too soon to start burning your bras. TISSUE TRANSFER So what does the future hold for those interested in a more natural contour? The future is now, says one plastic surgeon who claims that he had a pioneering role in the quest for a more “natural” breast augmentation method. Involved in early liposuction efforts back in the 1970s, Mel Bircoll, M.D., says, “My liposuction patients were very happy with their results. But they used to tell me ‘Doc, if only you could put that fat where I need it.’” One of the places they were referring to, of course, was their breasts. Dr. Bircoll, now retired from his plastic surgery practice, spent three years refining his fat transfer method and published his findings in several papers during the 1980s and 1990s. At the time, the idea of fat transfer wasn’t fully accepted in the professional cosmetic surgery world, but today it’s actively pursued by both physicians and patients as a viable option for recontouring (the face, in particular). When talking about fat transfer, you’ll typically hear that the results can be unpredictable, the most common concern being that a good percentage of the fat won’t “take.” The key, Dr. Bircoll says, is in the transfer technique. He grafts the fat in minute portions to increase the likelihood of fat survival. “The fat has to have a blood supply within 24 to 48 hours if it’s going to survive,” he says. TODAY’S PERSPECTIVE “Fat transfer has been controversial (in the past) because if fat doesn’t survive, it was thought to create scarring and calcification,” explains ITK Beauty Adviser Michael Kluska, D.O., a plastic surgeon in Greensburg, Pa. Scarring and calcification can mimic signs of breast cancer, which means that patients would likely have to undergo biopsies. However, “We found that with good technique, it didn’t increase signs and symptoms of breast cancer,” says Dr. Kluska, who also points out that fat transfer doesn’t cause breast cancer. While all of this sounds well and good, fat transfer is performed far less frequently than implant procedures. Getting fat into a more desirable place requires a more involved process, which includes first removing fat via liposuction, then preparing it and (finally!) placing it where desired. And if those fat grafts don’t find a blood supply, they won’t survive. “In my experience, 20 percent to 70 percent of the fat ‘takes,’ so you have to try to predict this, and slightly overfill the area to correct for deficiency,” Dr. Kluska says. But “overfilled” means you could be walking around looking like a cartoon version of yourself for a while. “The process takes two to three treatments,” Dr. Kluska explains. You can expect to get some improvement in size in just one session, but, realistically, this means that “If you’re a large A, you might go to a small B,” he says. Fillers Getty Images/Photodisc If you could replace lost volume forever, would you? FINDING THE FOUNTAIN OF YOUTH Whether you’re making an annual foray into your cosmetic surgeon’s office for HA replacement, or deciding to pursue a longer-term correction, Dr. Niamtu lists six filler tenets to guide you on your journey to the filler Fountain of Youth: 1. “Permanent” is not always better. “Permanent fillers could mean permanent problems,” says Joseph Niamtu III, D.M.D., F.A.A.C.S. 2. The most popular fillers are popular for a reason. “HA fillers are biocompatible (compatible with living tissue), reversible and last about a year — long enough to make it worth it,” he explains. 3. Don’t believe all the hype! “Because something’s new doesn’t make it better. If it’s good, it’ll catch on,” he says. 4. Don’t have lofty expectations. “We don’t fully understand how products are metabolized, so it’s difficult to predict how long they’ll last, individually,” Dr. Niamtu explains. 6. If it sounds too good to be true, it probably is. “There’s no such thing as a good deal,” Dr. Niamtu advises. Long-term correction No doubt, the idea of a permanent filler is attractive. At first mention, it sounds like a one-time fix, and who wouldn’t want to “fix it and forget it”? But “I don’t think any of them are ‘permanent’ permanent fillers,” says Joseph Niamtu III, D.M.D., F.A.A.C.S., a board-certified facial cosmetic surgeon in Richmond, Va. “The face is dynamic, and skin changes over time,” he says, which means that regardless of how “permanent” the product itself might be, you’ll need to have some touch-up work done down the road. So which fillers are considered permanent? These include silicone, Artefill (Suneva Medical) and Sculptra Aesthetic (Sanofi-Aventis). Artefill may last forever, but as the face changes over time, Artefill can move (sag) with the aging face and require correction or repositioning. Sculptra Aesthetic, on the other hand, may last for years, but the product eventually goes away. “It’s called a permanent filler because it stimulates collagen,” which is, of course, your own “permanent” filler, Dr. Niamtu says. Product perfect Take heed: Results with permanent fillers are only good if the product is injected perfectly. “Even expert injectors can get asymmetric results. It’s easy to over-inject with these products,” Dr. Niamtu says. The golden rule with permanent fillers, according to Dr. Niamtu, is to have “appetizersized” portions. Unlike with HA fillers, “The goal is not to get full correction. You have to account for swelling and the effects of local anesthesia,” he says. What does this mean to you? It means that you’ll likely undergo multiple injection sessions that build volume gradually. Because the products may also stimulate collagen (and you don’t know how much collagen will be produced), this can also affect results. As a result, “It should be a gradual, sculpting process,” Dr. Niamtu says. “I do it once per month until we get close to the end result goal.” Tried and true Sometimes the tried and true is a better (in other words, safer) option — especially, Dr. Niamtu says, if it’s your first time venturing into filler territory. “HA fillers are still popular for a reason,” he says. “What’s powerful about HAs is that you can reverse them. In other words, if you don’t like your results, it’s very easy to make them go away with a syringe. Permanent fillers require a scalpel.” SUMMER 2010 13 5. Never have a permanent filler the first time you try fillers. “Test-drive the HA fillers first, to make sure you’re happy,” he warns. irst there was collagen. It required a preprocedure allergy test and lasted a mere three months, at best. Then came the hyaluronic acid (HA) fillers Restylane (Medicis) and Juvéderm (Allergan). No allergy testing required, and results last about a year. And fillers continue to evolve. The latest development? Permanent fillers. Getty Images/Lena Clara FACE efs bodybriefs bodybriefs bodybriefs bodybriefs bodybrief Can I have facial procedures during the summer? Michael S. Kluska, Joseph Niamtu III, D.O., F.A.A.C.S., F.A.C.O.S. D.M.D., F.A.A.C.S. Dr. Niamtu: (although temporary) surgery, there are potential plates in the bones are That is an with hyperpigmentation risks and complications closed. intelligent (blotchy pigmentation of — including a surgery the skin) and other annoy- that does not give them In addition to my two key ances. the result that they were factors, other factors to expecting. consider include family question. The first answer is that the best time to have cosmetic surgery is Alternately, some patients when you can work it into live in places like southern With this in mind, I always as well as how well the your life’s schedule to have Florida or California where ask the younger patient a patient does in school and a relaxing and low-stress it is always summer, and few key questions to help if he/she smokes. recovery. they don’t have the choice. me determine their matu- I treat many schoolteach- rity. Why do you want this When all of these factors The second answer is ers, and the summer is the done, and what are your are taken into account, it is that cosmetic surgery is only time they can have expectations? If the patient my opinion that most girls more popular in the winter cosmetic surgery, and they can convince me that he/ are mature enough by age months, as more people do just fine. They just have she is having this done for 16 or 17 (boys, 18-plus) to are indoors and there is to limit their outdoor activi- the right reason, then they handle both the emotional usually less to do and less ties that produce directsun have passed the first test. and physical changes that The key answers include one experiences with rhino- phrases like “to make my plasty surgery. exposure. sun exposure. I practice in Richmond, Virginia, and we have pretty brutal summers, so it is a clear Is 16 too young for a nose job? Dr. Kluska: nose match my face,” “I still There are want to look like me,” and essentially “I am doing this only for me laser procedures in the two factors and no one else.” winter when it is cooler. that determine advantage to consider if the patient is 14 SUMMER 2010 home life and dynamics, : The second factor is physi- Also, laser and chemical old enough to undergo cal maturity. With regard patients must refrain from nasal surgery. The first is to the nasal cartilage, direct sun for about four mental maturity. A patient most teenage girls are weeks, and that can be must be able to accept the fully developed by age difficult. Patients who have changes that a rhinoplasty 16, and most boys by facial resurfacing proce- will make in his/her ap- age 18. By these ages, dures in the summer may pearance, and they must the cartilage has stopped have increased problems understand that with any growing and the growth For more Q&As with the ITK doctors, or to submit your own question, go to www.itkbeauty.com/ askthedoctor