After having worked at The Sullivan Centre for almost a year now, I truly feel like I have learned many valuable life lessons. One of the most important things that I am now aware of is the importance of skin care. As someone who is in their early twenties, I was oblivious to the necessity and complexities of skin care. I knew that I should wash my face and put sunscreen on when outside for long periods of time, but that was where my knowledge ended.   I truly feel that many young people are unaware of what they should be doing to protect and care for their face and skin. Within my first week at The Sullivan Centre, I approached Dina, our wonderful aesthetician, and told her some horrific news…for the past eight summers I had been a lifeguard and swim coach. The years before that I was a dedicated pool rat; spring and fall consisted of weeks of soccer. Sun exposure had been an almost daily occurrence for most of my life. Dina informed me that work should begin immediately to attempt to save my skin for the future. Daily exfoliation, moisturizing creams, sunscreen and a few peels and microderms were necessary for the rescue. While I knew that I had already done some damage to my skin, it was not until about a month into my new skin care regimen that I realized how big of a difference it had made. I was not truly aware of the poor condition my skin had been in…it wasn’t that my old skin was bad, but how much better the new skin was. I am also much more aware of the faces around me and can tell the difference between who takes care of their skin and who does not. I especially notice who protects their face from the sun and who does not. I am coaching swim team again this summer and the parents all laugh, because now I lather on lotion and wear my hat and sunglasses every morning at practice, which would have been a rare thing in the past. But now I know. Not only do I know, but I have seen the difference that sun protection and skin care can make. And yes, I still have a tan and some freckles, but both are greatly reduced compared to previous years. I truly feel that it is necessary for more young adults my age, as well as teenagers, to speak with someone as knowledgeable as Dina to learn how to protect their skin. We as a generation have been led to believe that a tan is desirable, not dangerous…at least not now.   Most of us also assume that since we have nice skin now we always will, and that we do not need to do much to maintain it…which is a complete falsehood. So this is my thank you to Dina and all of The Sullivan Centre staff who have helped to teach me at a young age how best to protect and care for my face and skin. So take me up on my challenge, bring a teenager or young adult in for a complimentary Visia Skin Care Analysis and Consultation with Dina. Tell her Courtney sent you.

 

So far this year, the demand for Juvederm has been extraordinary. I attribute this increase to more marketing by Allergan as well as to the positive experiences of lots of patients. The area of injection where I am seeing the greatest interest lately is under the eyes. I have to admit, initially I wasn’t too enthused about injecting Juvederm in the under eye creases. I was not concerned because it was dangerous. In fact, when Juvederm, or any filler, is injected by an experienced Facial Plastic Surgeon who understands the complexity of the anatomy and potential risks, this is a very safe procedure. My hesitancy was a result of my bias that surgery is a better option for eyelid bags and under-eye creases. I still believe this to be the case. However, many people today are looking for, and satisfied by what I had believed to be a short term solution. To my amazement, many of my patients are satisfied with these results for up to a year or more. In fact, a recent study which evaluated the results of filler augmentation in the infraorbital region by the use of three-dimensional imaging revealed the maintenance of product in some patients as far as 22 months after their initial injection. Now I am more excited about offering dermal fillers as an option for under eye bags or creases. The other more permanent options include fat transfer from another body site to the under eye area, or repositioning the lower eyelid fat down into the under eye crease. Of course cheek implants are yet another option.

The other day one of my patients asked me with great excitement, “are you aware of the new facelift procedure which is done without any incisions?!” I had to admit, this was news to me but despite my skepticism, I agreed to look into it. She had gotten her medical information from The Doctor Show. I suspect the procedure my patient was referring to is called iGuide or trampoline platysmoplasty. I was able to watch a video of this procedure. First the neck is extensively liposuctioned, which is what I believe to be the major contributor to the results. Next a dissolvable suture is passed back and forth under the neck in a manner similar to lacing up a shoe. This is not new. We have seen threads and sutures passed under the skin and used for suspension before. The all have failed, as I believe the iGuide will. The video shows the suture being secured to the connection between the skin and the underlying fatty tissue. These sutures will pull through because the layer of fat tissue will not be able to hold the sutures. These flimsy connections are not able to support this degree of tension. The iGuide procedure is no different than the “quick facelift” procedure and “lifestyle” procedure which are heavily advertised these days. These procedures are not based no fundamental surgical principles and are destined for early failure. It is not surprising that I could not find any information about long term results with the iGuide procedure. If it is too good to be true, it usually is.