Delay the Effects of Facial Aging Part II

Delay the Effects of Facial Aging Part II

In part I, we presented a variety of non-surgical cosmetic treatments that can help reduce the effect of the aging process on our face. We discussed how certain aesthetic medical treatments can improve the appearance of skin tone, texture, sun damage, red spots, broken capillaries and rosacea.

Remember: although the aging process will continue, however, we can delay some of the external factors that can accelerate the manifestation of lines, wrinkles and folds.

In this second article, we will discuss other factors that contribute to the aging of the face such as:

• Muscle contractions of facials muscles causing deepening of lines and wrinkles, being more visible with the face at rest.

• Loss of the volume due to breakdown of the collagen, hyaluronic acid and elastic fibers. Gravity will push down the supportive tissue and cause deeper wrinkles and folds and general loss of volume in the face.

I will be presenting how injectables such as Botox (BTA) and fillers can smooth out lines and wrinkles and fill in wrinkles, creases and folds while adding volume to the face.

Lines & Wrinkles due to Muscle Contractions

Studies have shown that receiving injectable fillers and products such as BTA (Botox, Dysport or Xeomin) can help delay the visible aging process and prevent lines and wrinkles from getting deeper.

BTA relaxes the contraction of the muscles that cause the lines and wrinkles. BTA was approved by the FDA for aesthetic purposes in 2002. However, BTA has been around for more than 20 years and it has been used for the treatment of muscle spasms, strabismus and constant blinking of the eyelids. More recently, BTA has been approved for treatment of migraine headaches, sweaty underarms and neurogenic bladder.

Treatments with BTA have been proven safe and simple to administer. A medical history is required to evaluate any contraindication to the treatment.

BTA treatments can last 3 to 4 months. Receiving ongoing injections will allow the muscle to remain relaxed, losing their tone and avoiding the progression to permanent wrinkles and creases that will become more visible even with the face at rest. After receiving a series of treatments with BTA, some of my clients have noticed that the treated muscles remained relaxed beyond the 3 to 4 months, requiring less frequency of treatments. Remember, results will vary per person.

Botox Treatment Before and After

BTA improves the appearance of: frown lines, crow’s feet, vertical lip lines, forehead lines, nose lines, wrinkles in the corners of the lips, vertical lip lines, gummy smile, dimpled chin, wrinkles around the neck and neck bands.

Prices will vary according to the geographical area and the qualifications of the injector. Most medical aesthetic clinics charge BTA by the unit, approximately $10-15 per unit.

Volume Restoration

As we age, we lose fat pads and bone, and due to the effect of gravity, the fat will move from one area of the face to another (e.g. cheek pads will become jowls).

Injectable fillers such as Restylane, Juvederm, Radiesse & Belotero are among the most known injectable fillers used for aesthetic purposes. It helps restore volume loss that occurs with aging due to the breakdown of collagen, hyaluronic acid and elastin. They last from 6 to 12 months on average.

If a client has had a significant amount of volume loss due to aging or rapid weight loss, a larger volume of injectable filler will be initially required to achieve a good aesthetic outcome. During the aesthetic consultation, it is very important to determine the approximate number of syringes that will be necessary to achieve a good volume restoration and cosmetic outcome, without overcorrection.

On occasion, I get clients, who due to budget limitations, can only afford one syringe and would like me to distribute it in multiple areas. In doing so, the results are minimal and the client are sometimes unable to see a significant difference.

I recommend that my clients, if they are ready to begin treatments with injectable fillers, receive the amount necessary that will improve the area of concern. Additional syringes can be injected during other office visits until the desired volume has been restored.

After a few months, the skin will gradually disintegrate the filler. These products can last up to a year after injected. Some patients will require less volume of injectable filler when they return for treatment touch-ups. Studies have shown that receiving filler injections can stimulate rebuilding of collagen, therefore, improving the tone and firmness of the skin and soft tissues.

Injectable fillers can improve the appearance of smile lines, marionette lines, deep forehead lines, deep frown creases, droopy eyebrows, hollow temples, sunken eyes, hollow cheeks, vertical lip lines, thin lips, sagging corner of the lip, undefined chin, undefined jaw line, and add volume to the hands.

Another advantage of receiving treatments with non-permanent injectable fillers is that the injection can be modified as the face continues to age.

There are other injectable fillers such as Artefill and Sculptra (semi-permanent fillers), which can last up to 3 years. With Sculptra, the results are not seen immediately, taking about 3 to 6 months to see results. A series of treatments are required during a period of three to six months.

Juvederm and Voluma, the newest HA (hyaluronic acis) filler, is approved by the FDA for cheek augmentation. However, similar results can be obtained with Restylane, Perlane and Radiesse.

Treatment with injectable fillers have been proven to be safe, and clients can see immediate results, restoring the youthful appearance of their faces.

Restylane before and after

It is not necessary to receive all these aesthetic treatments at once. At The Aesthetic & Wellness Center, we listen to your concerns and give you recommendations for the best non-surgical procedure for you. Also, we have now clarified any misinformation and misconception you may have about these treatments.

As we presented in part I, it is important nourish your body from the inside out, providing the right vitamins, minerals and supplements, helping restore your skin, as well as your hair and nails, which are actually extensions of your skin.

Start taking care of your skin today. The best complement we can receive from our families and friends is that we look great and don’t show our “real” age.

Delay the Effects of Facial Aging Part I

Delay the Effects of Facial Aging Part I

Delay the Effects of Facial Aging Part I

Give Yourself a Rejuvenated Face

Do you have new lines or wrinkles appearing overnight?

Have you been thinking of correcting your skin tone, blemishes and texture?

Is your face has been losing volume and your skin folds are becoming more prominent?

If your answer to any of these questions is “yes”, you will benefit from a variety of non-invasive and non-surgical medical cosmetic treatments. These treatments help restore and refresh the natural look and appearance of your face and skin.

It is well known that the aging process is inevitable; however, researchers have found that 30 percent of the aging process is genetic and 70 percent is affected by our lifestyle and behavior choices.

It is time you take matters into your own hands!

The skin is the largest organ of the body. It varies from one area of the body to another, and it also differs among individuals.

Natural aging of the face is caused by extrinsic (external) and intrinsic (internal) factors.

The most common external factor that causes significant damage to our skin is overexposure to ultraviolet light (sun rays). Smoking is another significant contributor to facial aging. Therefore, the number one anti-aging product is the application of a good-quality sun block, appropriate for your skin type. Also, if you are a smoker, discuss with your physician treatment alternatives to help you quit smoking.

Another crucial anti-aging treatment is the daily care you give to your skin. Cleansing, exfoliating, hydrating, treating and nourishing the skin are essential steps to maintain and optimize the condition of your skin by increasing the rate of cellular turnover. As we age, medical skin care products are recommended to achieve better results for your skin. These types of skin products contain a higher concentration of active ingredients which are regulated by the Food and Drug Administration (FDA). Commercial and store brand skin products have a lower concentration of these active ingredients, and you end up paying mostly for their name brand and advertisement.

As we age, these are the facial changes that occur:

– Loss of elasticity and tone due to collagen and hyaluronic acid breakdown causing lines and wrinkles. Collagen is the major structural protein for the entire body.

– Decrease in the cell turnover rate of the skin, causing the surface of the skin to become dry and rough.

– The upper layers of the skin can get very thin making it look translucent and revealing broken capillaries and increased redness.

– Uneven tone mainly caused by sun damage and hormonal changes during pregnancy, menopause and oral contraceptives.

– Frequent contraction of the facials muscles causes pronunciation of lines, wrinkles and creases that become more visible with the face at rest.

– Loss of volume from the “fat pads” and bone. Gravity causes stretching and laxity of the supportive tissue, making areas of the face drop, creating deep skin folds such as smile lines and marionette lines.

If you have been considering starting a medical skin rejuvenation process, I recommend you not to wait until the skin has lost a significant amount of elasticity, then requiring plastic surgery. However, a face lift will not provide relaxation of the dynamic wrinkles that occur with muscle contractions or restore volume loss that occurs with aging. These types of changes will require non-surgical medical cosmetic treatments. I admit there are some situations where surgical interventions are required, as with droopy eyelids, double chin or saggy skin on the lower face and neck area.

If you are on a budget and you would like to start improving the condition of your skin and delaying the aging process, there are some less expensive alternatives you can receive without breaking your pocket and with no downtime…

Restoring skin tone and texture, and diminishing lines and wrinkles:

I recommend my clients to start with a series of chemical peels or microdermabrasion or the combination of both. Chemical peels have been used for decades to revitalize and resurface the skin, by removing layers of dull and dry skin. There are several types of chemical peels and each type will have a different concentration of the acid in it.

Microdermabrasion (MDA) uses fine aluminum oxide crystals or a diamond tip to manually exfoliate layers of dead skin cells, revealing healthier skin.

The combination of microdermabrasion and chemical peel (Micro-Peel) will enhance the results, revealing healthier and smoother skin with an even tone.

On average, visible improvement of the skin occurs after the fourth or fifth treatment. According to the client response to the treatment, we can change the type and concentration of the chemical peels to obtain better results. Studies have shown that these cosmetic procedures help stimulate the rebuilding of collagen and skin cell growth, returning firmness and a healthy glow to the skin.

Clients with advanced aging of the skin can benefit from other types of aesthetic treatments such as ablative lasers, radiofrequency or deeper chemical peels. Usually, there is a downtime with these types of procedures, from 7 to 14 days.

Maintenance treatments are required and the frequency will depend on the rate of cellular turnover and sun damage. Prices for chemical peels can vary from $75 to $500 per treatment.

Repairing sun damage and improving skin tone:

If you are a good candidate, Intense Pulsed Light (IPL) is an excellent treatment to remove unwanted skin discolorations and sun spots without harming the skin.

– IPL technology utilizes a broad spectrum light source to target and destroys unwanted blood vessels, uneven discolorations due to sun damage or skin redness. Also, IPL can be used for hair removal. IPL can stimulate the formation of new collagen, toning the skin, and decrease lines and wrinkles. A series of treatments are recommended to obtain maximum results. Prices for IPL can vary from $250 to $ 500 per treatment.


– Chemical peels are another safe alternative for clients who have darker skin tone and who are not good candidates for IPL treatments.

Maintenance treatments are required, and the frequency will depend on your home skin regimen and sun exposure.

Removal of red spots, broken capillaries and rosacea:

As I previously described, IPL (Intense Pulsed Light) is an excellent modality of treatment, helping even out-skin tone by coagulating and destroying facial veins and broken capillaries, while leaving the surrounding skin unchanged and unharmed.

Vascular Lasers are another excellent alternative for larger facial and leg spider veins.
Maintenance treatments are required and the frequency will depend on sun exposure and Rosacea flare-ups. Prices for IPL can vary from $250 to $500 per treatment.


Studies have shown that by starting these treatments before the visible signs of aging on the face, it can delay the aging process from 5 to 10 years or even more in some patients. Remember, the end result will depend of your home skin care regimen, sun protection and application of a sun block with the right SPF for your skin type.

Also, it is important to provide your body with balanced nutrition, rich in essential nutrients, and supplemented with whole food daily multivitamins, calcium, vitamin D3 and omega-3 fish oil. These supplements will help restore your skin, as well as your hair and nails, which are an extension of your skin.

It is not necessary to receive all these aesthetic treatments at one visit. At The Aesthetic & Wellness Center, we listen to your concerns and give you the best treatment options.

Next month will continue our discussion in Part II.

Is Cholesterol That Bad?

Is Cholesterol That Bad?

Is it Cholesterol that Bad?

In previous blogs, I have presented the benefits of most of the major nutrients required for our existence. Carbohydrates, protein and fats provide essential substances that allow the body to function properly. This time, I will be discussing the importance of cholesterol and the risk when one’s cholesterol level is elevated.

For many years, cholesterol and fat have been blamed for the increase in the incidence and the mortality caused from cardiovascular disease, stroke and hypertension. The truth is that cholesterol is an extremely important substance—without it, the body will show signs of malfunction.

Most of the time, patients ask me what the benefits of cholesterol are and how much they should eat.

I will start by defining what cholesterol is. Cholesterol is a waxy, fat-like substance that is synthesized in the liver and is part of all cells in our bodies. The liver makes approximately 80 percent of the cholesterol needed and the rest comes from the diet. Cholesterol can be found in many of the animal products we eat such as red meats, eggs and dairy products.

Cholesterol is a complex molecule; it is not soluble in the blood, so it needs to be transported in the bloodstream attached to protein. This complex is called “lipoprotein”.

Cholesterol is an important substance affecting the following functions:

• Important precursor for the production of sex hormones and steroids
• Allows the body to produce vitamin D in the skin
• Important component of the digestive enzymes and bile acids in the intestine helping with the digestion
• Contributes to the structure of cell membranes
• Makes the myelin sheath that coats the nerve cells

A diet high in saturated fats, trans-fats and refined sugars can increase the production of cholesterol and can elevate the cholesterol level in the blood, leading to buildup of cholesterol plaques in the arteries.

There are different types of cholesterol depending on the amount of protein in relation to fat and cholesterol in the molecule.

Low Density Lipoprotein (LDL cholesterol): Also known as “bad” cholesterol. It is responsible for the cholesterol buildup in the arteries and heart.

High Density Lipoprotein (HDL cholesterol): Also known as “good” cholesterol. It is responsible to remove the cholesterol from other areas of the body back to the liver.

Very Low Density Lipoprotein (VLDL cholesterol): is similar to LDL and it has the same effect in the arteries and the heart. It contains mostly cholesterol and not much protein. This type of cholesterol also carries triglycerides (another type of fat).

What factors can affect cholesterol levels?

Cholesterol level can be affected by a variety of factors.

Diet high in saturated fats, trans-fats and refined sugars:
Individuals who tend to consume diet rich in these types of unhealthy nutrients may develop high cholesterol, increasing their risk for obesity, cardiovascular disease, diabetes and hypertension.

Age and gender:
Men tend to have higher cholesterol levels compared to women. After menopause, LDL cholesterol levels in women can begin to rise.

Excess weight:
Not everyone suffering from overweight or obesity will have high cholesterol. However, the incidence is higher in individuals suffering from these conditions.

Sedentary lifestyle:
Inactivity associated with unhealthy meals can raise total and LDL cholesterol and decrease HDL cholesterol.

• Heredity:
There are families with genetic disorders that can cause an elevation of their LDL cholesterol or low HDL cholesterol. Most of the time, a low fat or low cholesterol diet may not be sufficient to decrease the level of cholesterol in these individuals, and they may require pharmacological therapy.

1. Thyroid disease: Patients who suffer with hypothyroidism can have elevation of their total cholesterol levels. After the hormone deficiency is corrected, the cholesterol level usually returns to a normal level.
2. Diabetes: Individuals with poorly controlled diabetes tend to have a higher level of cholesterol and triglycerides.

Expecting mothers tend to have elevated total cholesterol that is considered “physiologic” normal. No treatment is necessary.

Certain medications such as anabolic steroids, Accutane, certain beta-blockers and diuretics may increase the level of total cholesterol, LDL or HDL cholesterol.

How much cholesterol should I eat?

Cholesterol is an important substance in our bodies. The Institute of Medicine recommends a daily cholesterol intake at 200 mg.

Remember, the body produces most of the cholesterol it needs. However, it is the LDL cholesterol that has been associated with the risk of developing atherosclerosis (hardening and narrowing of the arteries due to deposits of cholesterol plaques). Diets high in saturated fat, trans-fats and refined sugars can increase the bad cholesterol levels.

Is there a blood test that measures my cholesterol levels?

Knowing your total cholesterol and subtypes can help identify your risk to develop atherosclerosis. Most patients with elevated cholesterol do not experience any symptoms. Your physician can order a simple blood test, which measures the different subtypes of cholesterol and triglycerides in your bloodstream.

LIPID PANEL Recommended Level
Total Cholesterol-Normal <200 mg/dl
HDL Cholesterol-Normal >40
Major risk factor for heart disease <40
Negative risk factor for heart disease >60
LDL Cholesterol
Optimal <100
Near Optimal 100-129
Borderline High 130-159
High 160-189
Very High >190
LDL/HDL ratio
Cardiovascular risk Women Men
1/2 average risk 1.0 1.5
Average risk 3.6 3.2
2X average risk 6.3 5
3X average risk 8 6.1
VLDL Cholesterol 5-40 mg/dl
Cholesterol/HDL ratio Women Men
Cardiovascular risk
1/2 average risk 3.4 3.3
Average risk 5 4.4
2X average risk 9.6 7.1
3X average risk 23.4 11
Triglycerides-Normal <150mg/dl
Borderline High 150-199
High 200-499 3.3
Very High >500 11

There are new, specialized blood tests that measure the LDL particle size. It has been discovered that some LDL particles are more dangerous than others. Small LDL particles have been found to increase the risk of cardiovascular disease. You physician can order this test if you have a strong family history of heart disease and your LDL cholesterol is borderline.

What types of treatments are available?

The main goal of cholesterol treatment is to reduce LDL and increase HDL levels. The main non-pharmacological therapy is lifestyle modification (reduction of saturated fats, trans-fats, refined sugars and processed foods in your diet and practice a routine exercise program). However, patients with very high cholesterol levels unresponsive to diet and exercise may require pharmacological therapy. The most commonly prescribed medications are the “statins,” bile acid sequestrants , niacin and fibrates and Ezetimibe. Your physician will select the best treatment option.


Cholesterol is another vital substance that participates in a series of processes in the body. Eating a healthy diet and following a regular exercise program can reduce the risk of developing high cholesterol. As always, I strongly recommend you take an active role in your own health. Schedule an annual examination with your physician. Prevention is always the best approach, helping reduce the chances of preventable chronic medical conditions.

Want to test your cholesterol IQ? Click Here

LDL particles:

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