The clinical aesthetician at External Affairs looks at me with pity, then points a camera in my direction and shoots.
“These won’t be the most flattering photos,” she cautions as she pulls up a digital photo. Then, there it is, larger than life on the computer screen, mapped out as a 3D image. My face, in all its destroyed glory.
“Yikes!” I gasp. “I look like my mother! Who looks great but … she’s 91!” The aesthetician professionally ignores my outburst as she points to different colours, depths and textures on the image. These are my problem areas, she says, and gently explains how they could be corrected or minimized. So much to fix, but so many options. There’s still hope, even for this ageing baby boomer of the baby-oil sunburn generation with her damaged dermis.
Hope is what we cling to as we open a jar of the latest highly hyped (and highly priced) moisturizer promising miraculous results, or consider some of the tempting nonsurgical skincare options. But what really works?
Medical spas – which need to be staffed by nurses and in-house doctors – offer specialized treatments not available at non-medical/day spas. Medical spas can go beyond the typical spa facials and topical retinol and moisturizer treatments with more advanced facial techniques for more dramatic results. Medical spas can also access prescription-strength skincare products for both in-clinic treatments or for clients’ post-care home regimes.
I blink when I meet Becky Wilkins, founder and RN at External Affairs Medical Spa, and her long-time colleague, clinical aesthetician Carol Verbeek. These ladies glow. Wilkins, a registered nurse, is 50, Verbeek is 54 and their skin may be the best advertising around for the effectiveness of their medical spa. Both say their skin is better now then when they were in their 30s. Both also admit they work hard to keep it that way.
“My face is literally full of all these new treatments and techniques, so god forbid I ever quit!” says Wilkins. “I’d turn into one of those shrivelled applehead dolls!”
Both emphasize the importance of a multi-layered faceted approach, because beauty isn’t skin deep, it’s three layers of skin deep. “You can’t just treat the surface and get the desired results,” says Wilkins.
Three Fixes for Three Common Concerns
At the Dermatology and Hair Transplant Centre medical spa, Dr. Janice Liao helps patients with everything from dry skin to rejuvenation with fractional lasers. The three most common concerns Dr. Liao assists her patients with are itching skin, acne and hair loss. “Itching skin is caused by winter, dryness, excessive use of detergents and soaps and aging skin,” Dr. Liao says. “Treatment for this is mainly hydration.” Many patients turn to her for help with severe adult acne when it can’t be solved with over-the-counter scrubs. “Treatment is dependent on the cause but includes topical treatments, prescribed oral medications, medicated face washes,” Dr. Liao says, and notes that non-medicated treatments include microdermabrasion, Blu-U light treatment and Photodynamic therapy. “Hair loss is caused by various things such as inheritance, illness, prescribed and over-the-counter medications, thyroid problems, low iron and poor diet,” Dr. Liao says. “Treatment is again dependent on the cause, but includes prescribed oral medications, iron supplements, thyroid medication if needed, medicated shampoos and medicated scalp foams.” – Breanna Mroczek
Epidermis (Top Layer)
Microdermabrasion polishes the skin with tiny crystals gently blasted from a handheld tool. Many brides have this done. It’s fast, painless and, to use spa lingo, has no “social downtime.” Expect brighter, smoother skin instantly. Chemical peels are also effective, albeit temporarily, for removing dead skin cells, and medical spas can provide deep peels with prescription-strength glycolic acid. But avoid social events immediately after as skin may be red and flakey for several days.
Dermis (Middle Layer)
For a real change, go deeper. This is the skin’s live-action production centre, home to youth-granting collagen, elastin and fibroblast cells. Most of the so-called miracle ingredients in expensive skincare products can’t penetrate this layer, resulting in few of their promised effects. To actually change the dermis, you need aggressive techniques – think lasers. Some are kinder, like the pulsed light used for photofacials, which uses heat instead of light. But for dramatic effects, technicians bring out the big guns: Fractional lasers. Does it hurt? Well, the goal is to create tiny wounds all over your face. This wakes up tired cells and puts them back to work in healing mode to produce rejuvenated cells and collagen. Expect a week or more of aftercare and downtime. External Affairs uses the newer CO2 fractional laser, which uses micropulsing, resulting in less damage and faster recovery.
If lasers don’t sound appealing, how about microneedling? This technique also stimulates collagen growth and skin rejuvenation by creating hundreds of tiny, invisible pinprick punctures with a nine-holed tool resembling a punch gun. This technique is highly effective on its own, but some clinics add infusions of amino acids and vitamins to get these directly into the dermis where they can get busy repairing and rejuvenating. And, hallelujah, the recovery time is only 12 to 36 hours.
You have multiple fat pads in your face, and they’re all losing volume as you age, giving you a gaunt-cheeked, hollow-eyed look with droopy skin. The most popular – and highly effective – solution is injectable fillers.
A soft gel is injected into the face with fine needles to smooth wrinkles, plump and firm the face, and most contain hyaluronic acid, similar to a substance that occurs naturally in our bodies. There are many types of fillers, including Retalyn and Juvderm – the brand famously used for Kylie Jenner’s lips. A good technician will match the type of filler used to the area; for example cheeks need more volume than lips. It’s impossible to over-emphasize the importance of finding an experienced technician who understands how to match fillers to the contours of a natural face. We’ve all seen examples of overzealous filling and it ain’t pretty.
Hypodermis (bottom layer)
There’s always Botox. Botox is an injectable, but it’s not a filler as it doesn’t add volume, it’s a neurotoxin that works by temporarily relaxing muscles. Frequently-repeated facial expressions, like frowning, smiling or squinting, create what’s called “dynamic” wrinkles. Botox prevents such movement and smooths out wrinkles. Since it no longer has a patent on its brand name, Botox is now also marketed as Myobloc, Dysport and Xeomin – but the word is used almost ubiquitously. It’s like the Kleenex or Band-Aid of neurotoxin proteins.
Photo-worthy Skin for your Wedding Day
You’ve got a ring on your finger and you’ve begun to plan for the big day: In between finding a venue and making the guest list, take time for an enhanced skincare routine. “Your wedding day is incredibly important and special and there will be photos that’ll last a lifetime, but you’re not just investing in skin for that day, you’re investing in your skin in general,” says Leisa Krauss, Laser and Cosmetic Dermatology Manager at Symmetry Lasers and Esthetics. “We see a lot of men too; they think, ‘well my bride-to-be is going to look great, I want to look great too.’ Skin is skin. [Weddings] are a good reason to take a little bit better care of your skin.”
While procedures like microdermabrasion can provide a quick, temporary glow, Krauss recommends starting skincare treatments three to six months in advance. “We try and educate brides to come in earlier – we can’t fix acne scarring overnight.” – B.M.
Dr. Anil Sharma of Sharma Skin and Hair Surgery thinks Botox and fillers are only part of the solution. “People are starting to use [Botox] in their 20s, before lines even appear,” Sharma says. “But overuse can cause muscle damage, since the immobilized muscles waste away. And we still don’t know its long-term effects. I prefer long-term, more elegant solutions, like those offered by regenerative medicine. I believe this will be one of the biggest trends in the future.”
Sharma describes regenerative medicine as “aging backwards” since it uses the body’s own tissue to generate new tissue. This sounds like sci-fi territory, but, before arriving in Canada, Sharma used regenerative techniques frequently in a large, advanced aesthetic-surgery and cosmetic-dermatology clinic in the United Kingdom. He still practices in London, England, returning every two months at the request of loyal clients (including a 96-year-old), which keeps him current with the latest European techniques.
His private practice, along with some medical spas, are venturing into regenerative medicine with a technique marketed as The Vampire Facelift or Dracula Therapy, medically known as Platelet Rich Plasma, or PRP. Blood is the star of this treatment which injects a patient’s own blood back into a body part to promote healing. Or, for the so-called Vampire Facial, the PRP is micro-needled in.
PRP has been used in sports medicine for almost 20 years; Sharma has used it as a facial treatment for at least 10. A small amount of a patient’s blood is spun in a centrifuge to create a concentrate of platelets and growth factor cells. Sharma has discovered the trick is to centrifuge the blood at least three times; often what’s injected elsewhere is too diluted for good results. Improvements often last 18 months, about twice as long as most fillers.
Sharma also uses stem-cell therapy, which gets results by using a patient’s own tissue. His clinic is licensed to extract stem cells from bone marrow, usually taken from the spine or hip. Early in 2018, he expects upgrades will allow him to also extract stem cells from fat – a procedure he’s used in London for a decade. Sharma also offers the option of fat grafting to regain desirable facial plumpness. Instead of conventional fillers, a patient’s own fat is used as the filler. A small amount of fat is extracted (usually from the abdomen or thighs) and injected into the appropriate facial area. Because the injection comes from a patient’s own body, there’s no risk of allergic reaction or rejection. Recovery takes a few days, but the payoff is improvements that last a long time, sometimes permanently. Sharma also finds his clients are willing to forego a quick injectable fix to gain the longer lasting benefits of slower-acting fillers. As the injected substance disappears, it stimulates the body to produce its own collagen, rebuilding volume slowly and naturally.
Treat Yourself: New Year, New You
If your New Year’s resolutions involve looking good, feeling good and taking care of yourself, start with your skin. Not sure where to start? “We recommend a complimentary comprehensive consultation,” says Leisa Krauss at Symmetry Lasers and Esthetics. “Skincare is not one-size-fits-all by any means. We have 15 modalities of [laser] treatments as well as chemical peels, express facials … we want to tailor [skincare] exactly to our patients’ needs, make sure they benefit from it and are only paying for what they actually need.”
Consultations before any skincare procedure are important because, as Krauss notes, sometimes people think they know what they want – she uses the example of lip injections – but then find out that a different treatment, like Botox above the lip, would achieve the desired, or better, results at a lower cost with less downtime. – B.M.
But maybe you don’t find the idea of injecting your own blood into your face appealing. Or maybe you don’t want to peel off your skin with aggressive lasering. Then look for the more natural options, which won’t have the same rapid or dramatic effects, but will soothe and enhance your skin. Nicola Biggs, founder of Kolya Naturals, rerouted her career path to study plant medicine and a botanical approach to skincare after experiencing the treatments of renowned naturalist, Dr. Hauschka. In 2002 she opened a business based on an unusual combination: A natural skincare boutique, botanical apothecary, learning kitchen and day spa. Biggs firmly believes women can glow naturally no matter their age. She also believes skincare needs to be personalized; the same products don’t work for everyone. A conversation with herself and two other staff members quickly reveals all three follow a different natural skin regime. “They [natural products] work,” say Biggs. “But they can take longer depending on the person.” For example, if you want collagen-boosting and skin-smoothing results from retinol, try rose hip oil, which offers it naturally in the form of all-trans retinoic acid.
If you want to go further down the natural route, look up Ramona Bazgan, a former Kolya staff member who now practices facial rejuvenation acupuncture at Wellness Within spa. Bazgan uses needles – very fine, painless ones – to both relax and tighten facial muscles, reduce wrinkles and droopiness. And she does it without Botox. Or maybe you want to totally rethink this whole war against time and wrinkles. Biggs has some advice; stop fighting.
I quickly gave up the fight during Kolya Natural’s signature spa treatment – a two-hour facial that produces a zen calm even in adrenaline junkies like myself. Aging is a natural and inevitable process, not a battle we win or lose. Replace the tired old war metaphors with a new mental paradigm and shift your focus on nurturing and supporting the skin. Work with the rhythms of your body, not against it, and enjoy the process of aging naturally and gracefully.
Platelet Rich Plasma (PRP) treatments aren’t just for skin; they can be used for hair restoration, too. Dr. Jamie Olesen, the medical director of Hemingway Medical Spa, says that PRP is used to improve hair quality and thickness, and, while it isn’t as effective as a hair transplant, it’s a step up in effectiveness from taking related medications.
“I think that there’s a lot of stigma around using Botox, and everyone’s pretty shy about it and secretive,” says Olesen, “A common myth is that anybody who gets work done looks fake and looks like a Barbie doll. There are so many people walking around who you would never know had any work done, and that’s a sign of really excellent work that has been done because it produces natural outcomes and enhances your overall appearance without changing what you look like as a person.” Unnatural looks or the inability to make facial expressions is “usually an indicator that they’ve had too much Botox – Botox is meant to minimize the intensity of wrinkles and lines.” – B.M.
Which laser is right for you? If you’re wanting smooth skin and to minimize lines and wrinkles, a fractional or resurfacing/CO2 laser is right for you. According to Olesen, resurfacing lasers have the best outcome but, because they cause intentional damage to the entire surface of your skin, be prepared for about one week of downtime and social recovery time. For good results with about 24 hours of downtime, opt for a non-ablative fractional laser, which causes thermal injury to small sections of the skin while preserving adjacent tissue. – B.M.