Topical Botulinum Toxin is Coming!

Botulinum toxin first came into clinical use in the early 1990s. Since then it has become very widely used, and is a billion dollar business. It acts by blocking the transmission of the signal from the nerve to the muscle, so the muscle is not stimulated and does not contract. Fortunately, the product is specific for the motor nerves and it does not affect the sensory nerves. Thus there is no localized loss of sensation or numbness associated with the use of botulinum toxin.

From the onset, the product has been injected into the target muscles. The toxin molecule is large, and it is difficult to get large molecules through the skin intact. Furthermore, in many areas the product must be placed precisely, so as not to affect muscles that would give an undesireable effect. Droopy upper lids or an assymetrical smile are examples of unwanted botulinum toxin effects.

Microlaserpeel + Broad Band Light: 1+1=3

Although patients commonly come in requesting a single procedure, very frequently they will get significantly better results if two or more procedures are combined. That is true of the MACS-lift (short scar facelift) combined with neck liposuction. It is also true of the microlaserpeel combined with the BBL (broad band light)

 

Fractional CO2 Resurfacing: Does The Emperor Have Any Clothes?

In an article published in the October 2010 issue of Lasers in Surgery and Medicine, the authors examined the results of fractional ablative CO2 resurfacing in 9 Chinese patients. The patients were being treated for skin rejuvenation and acne scars. Overall, the vast majority of the patients were pleased with their results, and there was mild to moderate improvement. However, there were significant problems with post treatment increase in skin color, and the authors raise the question of whether the results were enough to justify the treatment.

Hand Rejuvenation: An Underappreciated Treatment

"All the perfumes of Arabia will not sweeten this little hand." William Shakespeare, MacBeth

Fortunately, since Shakespearean times, we have become much better at improving the appearance of hands, although perhaps not much better at washing away their sins.

If you look at the hands of children, the skin is smooth and of uniform color. No bones or veins are visible. With time the hand skin becomes sun damaged and irregular discolorations and rough spots appear. As in other areas, the deeper tissues are lost, and bones and veins become more visible. Many people put up with this because they are not aware that treatments are available. We had a patient in this week who is very attractive with clear facial skin. She regularly gets Dysport and filler. Her hands look like the hands of an 80 yer old. When I mentioned her hands, she said that she feels like she should wear gloves all the time. We discussed other options.

Visia complexion analysis: Attractive skin

In the December 2007 Journal of the American Academy of Dermatology there is an article that analyzes what makes skin attractive. The authors suggest that men and boys have developed preferences for skin that signals youth and health. The study showed isolated patches of cheek skin to volunteers and asked them to estimate the age of the person. They found that even skin color was a key component in attractive skin, and the age estimates were relatively accurate. Even skin color is viewed as healthy and beautiful.