Protection and treatment for your skin

Doctor B, what do you think I need?” The conversation about facial rejuvenation often starts with this question. As a board-certified facial plastic surgeon, I begin my assessment of the aging face by evaluating it in layers – skin surface, muscles, deeper soft tissues and bone. We then discuss which treatment options for each layer will be necessary to achieve the best result.

Sun damage causes the breakdown of collagen and elastin, increases pigment and causes DNA damage that can lead to fine lines and wrinkles, discoloration and skin cancers.

I address skin surface changes in a few ways. Prevention is key! Protecting your skin with sunscreen daily and hats is crucial. The second line of defense is highquality skin care. Antioxidant serums protect the skin from UV radiation, growth factors and retinols, which help to build collagen and reverse the signs of aging. Everyone of all ages and skin types should be on some sort of skin care. If you don’t know where to start, an evaluation with me or one of our aestheticians can point you toward your goals, needs and price point.

Resurfacing

In terms of reversing signs of aging and building collagen in your skin, the next step is skin resurfacing. What we choose depends on the damage level, the downtime you can afford and the price point.

The best and most aggressive option is a resurfacing laser. The fractionated CO2 laser focuses many microchannels of light to resurface the skin and stimulate collagen production for skin tightening and smoothing. It works great for deep wrinkles, fine lines, wrinkles, acne and surgical scars. CO2 laser does have downtime, however. You can expect healing for seven to 10 days. This is a wonderful option to pair with eyelid or facelift surgery to really create a wow factor, but it can be done alone as well. The CO2 laser offers a noninvasive, luxurious treatment option that effectively addresses unwanted pigmentation, revealing a vibrant and rejuvenated complexion across the face, neck and décolletage.

Chemical peels and microneedling are also options for resurfacing. We can discuss many depths of chemical peels depending on your goals and the downtime available. Microneedling is the last option available for stimulating collagen and tightening the skin. The upside is minimal downtime: only a few hours of looking red (like a sunburn). We recommend a series of three treatments spaced four to six weeks apart to notice a difference with microneedling.

Muscles

Wrinkles that are caused by movement are called “dynamic wrinkles.” These are most effectively treated with a neuromodulator such as Botox, Xeomin, Dysport or Daxxify. These medications prevent the muscle from moving for three to six months, effectively relaxing the wrinkles. This will improve wrinkles on the forehead, crow’s feet, glabella (the 11’s between the eyes), and around the mouth. Neurotoxins will not improve “static wrinkles” or wrinkles caused by hanging tissues. Neurotoxins can be used creatively, such as the “botox brow lift,” “lip flip” and jaw slimming.

Deeper tissues and bone

When the skin starts to hang loosely away from the body, it requires a more robust approach than an energy-based treatment. Adding volume to deflated areas of the face can provide a rejuvenated, youthful look. Typical changes of aging include a flattening of the cheek, heaviness of the lower face, marionette lines and tired bags under the eyes. Hyaluronic acid fillers are injectable gels that build up the face and restore volume to camouflage signs of aging. The “liquid facelift” can provide you with a significant freshening of the appearance without the downtime of surgery.

Fillers can also be used to change the appearance of the jawline. We can change the shape of the chin or even create a more prominent jawline in men.

Surgery

Lastly, sometimes a minimally invasive treatment isn’t enough. During your consultation, I will assess your goals and needs. Together, we will decide if you would be best served with a minimally invasive option described above or if surgery would be a better course of action. It is my goal to make you happy.

Paige Bundrick, MD, is a double board-certified facial plastic and reconstructive surgeon with Bundrick, O’Neal and Kim Plastic Surgery at 2210 Line Ave. Shreveport, 318-221-9671.