Photoaging: What It Is and What to Do About It

Skin aging, including that from the sun (photoaging), is inevitable. However, we do have some degree of control over how the skin changes over time and it is treatable. One of the fastest ways to age healthy, firm, youthful-looking skin is to spend too much time in the sun. Sunlight is made up of a spectrum of different rays. Some of these, the UVA rays, can even penetrate through a thick layer of clouds, penetrate into shade and buildings and cars, and are present all the time. These rays also get absorbed into the skin, causing cellular changes that result in what is called photoaging.

Photoaging is simply aging that is caused by exposure to UV light. This may come from sunlight and also from tanning beds. Signs of photoaging and their cause include:

• Spots and hyperpigmentation. These may look like freckles, flat moles, large spots, or general blotchiness from injury of the melanocyte (the pigment producing cell).
• Fine lines and wrinkles from loss of collagen thinning the support layer of the skin and from loss of elastin. This is increased past 30 years of age since the body normally stops making collagen and elastin about then.
• Telangiectasia or increased red vascularity from the body constantly turning in its healing, which dilates blood vessels near the injury to bring in the immune/healing system. After continually doing this, the vessels just stay.
• Precancerous lesions that look red and rough or scaly from more severe injury of the cells. These are referred to as actinic keratoses.

Photoaging affects any area where the UVA rays can reach, and they can penetrate most clothing. It is, therefore, also commonly seen on the hands, arms, shoulders, legs, back, chest, ears, nose, lips, and other parts of the face.

What to Do About Photoaging

Our best advice for our patients is to try and prevent photoaging by avoiding as much sun exposure as possible. Even on a cloudy day, it is wise to wear broad-spectrum zinc oxide sunscreen on all exposed areas and wear sun protective clothing. Zinc is the only practical sunblock as it need to be reapplied only if you wash or wipe it off. All the others last at most 2 hours, and only an hour if outdoors. You can make normal clothing sun protective by washing them in Rit Sun-Guard. See our Info Sheet.

Once you have photoaging damage, there are several ways to correct it, including:

• Using quality skincare. Basic skin care includes an exfoliant to remove the excess cells caused by sun damage and time. It also includes a good sunblock to prevent further damage. To this, you can add ingredients like antioxidants like Vitamins-C to combat the breakdown of collagen caused by free-radicals. At 30, or if you have wrinkles,you add a retinol or tretinoin (Vitamin-A) and Obagi’s ELASTIderm to stimulate collagen and elastin production. If you have spots, we add hydroquinone. If you need all, the best option is Obagi’s Nu-Derm System.
• Antioxidants are also consumable and are found in citrus fruits and leafy green vegetables.
• Light chemical peels. Regardless of how pricy your skincare products are, they are of little value if there is a layer of dead skin cells blocking their absorption. Chemical peel treatment gently sloughs off this layer of cellular debris to reveal healthier, more uniform skin.
• Microdermabrasion does the same thing as a light chemical peel, it removes the uppermost layer of nonvital skin cells. This procedure works through gentle ablation using microparticles that dislodge cellular debris so it can be suctioned away from the epidermis.
• Microneedling can also help produce collagen and reduce light wrinkling.
• Significant wrinkles can be treated by filler injection using a hyaluronic acid filler that will stimulate collagen production.
• Leveling peels and laser smooth the skin and increase the collagen production. They are useful for severely wrinkled skin.
• Ellipse IPL® treatment is a form of light therapy that breaks up red or brown discoloration in or beneath the skin. It can treat both brown pigmentation and red telangiectasia. IPL, intense pulsed light, is a popular treatment for photodamage due to its effectiveness with little to no downtime.

We can help you address photoaging with a treatment program tailored to your needs. Call our Highlands, NC office at (828) 526-3783 to schedule your consultation.

Have the last few months of stay-safe-at-home led to unwanted weight gain? If you’re noticing a little extra padding around the midsection, hips, or thighs, you’re not alone. There is no way that 2020 will be known as a walk in the park kind of year. This past Spring, COVID-19 pulled the proverbial rug from beneath our feet. Folks are working from home, some are working much less than they used to, and many are questioning when life will go back to normal. It’s been a stressful time, to say the least. As such, this may have led to some comfort-eating. Experts encourage people not to worry about a little extra fat caused by the stress of the times. If you have lost back to normal, or, even if you gained nothing, but still notice unwanted areas of fat, there are alternatives. One is Zerona nonsurgical body contouring, which we are discussing here.

Zerona treatments take about 40 minutes on three days for two weeks. There is no downtime after treatments, and nothing special to do to promote fat loss other than assuring good dietary habits. The device works by emitting low-level laser energy into the fat cells. This energy emulsifies the fat and creates tiny holes in the membranes of the cells, resulting in the leakage of fat so it can be eliminated. Zerona does not destroy fat cells; it empties them. However, none of our patients who have undergone this fat-reduction process have relapsed. Patients who have Zerona treatments or even liposuction to remove unwanted fat can benefit from implementing healthy eating habits. We encourage patients to build fresh-food meals that are equal parts minimally processed protein, carbohydrate, and healthy fat.

Is Zerona right for You?

As we figure out how to live life as normal as possible, we all deserve to feel our best. Zerona nonsurgical body contouring can be a great way to jump-start a weight loss program or to get rid of those stubborn few areas. It differs from liposuction, which is best for very localized areas, in that the most common treatment areas include larger areas like the abdomen, flanks, hips, and thighs.

The team in our Highlands, NC office is here to help you look and feel like your best self. To schedule a body contouring treatment, call (828) 526-3783.

Anyone who has ever tried to lose body fat knows how difficult it can be to do without a lot of help. Eating the proper foods and exercising regularly are good and necessary for optimal health. They aren’t always the ticket to the slim body contours a person wants, though. At some point, many people hit a plateau that they can’t seem to overcome. Furthermore, fat loss does not happen uniformly, frequently from inherited tendencies so some areas of the body may reduce better than others. This is why there has been such a strong interest in surgical liposuction and nonsurgical fat reduction in recent years.

Examples of Nonsurgical Fat Reduction Body Contouring

Historically, body contouring has been achieved with liposuction and other shaping procedures like abdominoplasty. Now, we have several ways to reduce areas of excess fat without surgery. Common examples of nonsurgical fat reduction include:

• Injectable lipolysis. This is better known as Kybella, the injectable treatment that breaks down fat cells under the chin with deoxycholic acid. Though we have used Kybella, we find it more uncomfortable, more unpredictable, and slower to achieve results than liposuction and have abandoned it.
• Many people know cryolipolysis as CoolSculpting. This method of reducing fat works by freezing fat cells, causing crystals to destroy them. The body flushes these cells over several weeks. This, however, is quite uncomfortable and has a tendency for the removed fat to rebound
• Laser lipolysis destroys fat cells by heating them, leading to destruction. This, however, is more of a surgical procedure than regular liposuction.
• Radiofrequency lipolysis also heats fat cells through the skin. We have found it minimally reliable.
• Unlike other forms of fat reduction, Zerona disrupts fat cells using low-levels of cold-laser technology. This energy causes the fat cells to release the stored fat, is totally painless and somewhat more reliable than the other non-surgical modalities. This is what we use for our patients.

As you can see, each of these treatments works through unique technologies and techniques. Individual results can vary within any one of these modalities. Most forms of nonsurgical fat reduction offer some degree of gradual improvement over a few months. While none are intended for weight loss, each can result in a slimmer physique and better-fitting clothes. Also, none require downtime.

The Real Question to Ask

Many people procrastinate in getting treatment that can achieve their desired result because, with so many options, it’s difficult to know which one is right. This isn’t the real question. All you need to do is decide that you have done all you can with dietary and lifestyle modifications and that you still have some areas you would like to change. You then discuss with Dr. Buchanan how to achieve your desired outcome. Zerona nonsurgical treatment is ideal for larger to medium sized areas of excess fat. For small areas, minimally-invasive liposuction is frequently the best path to a better body.

We are here to help you find your way to your best self. To learn more about body contouring in our Highlands, NC office, call (828) 526-3783.

“Skin care” is a term that we use in two ways. We use it to describe the products that we apply to cleanse and treat the skin, and also to describe the act of caring for the skin. Because the term is interchangeable, there is a risk of blurring the lines between the two. People who wash their face and apply moisturizer or a serum or two often believe that this is sufficient effort to get the results they want. It’s not. Here, we discuss the common mistakes that people make with skin care and what needs to be done instead.

Mistake Number One

The most common mistake that people make in caring for their skin is not knowing exactly what their skin even needs. This is no fault of their own. Manufacturers of mass-produced cleansers, moisturizers, and specialty products are savvy about promoting the benefits of their items without acknowledging the lack of clinical efficacy or even making them seem efficacious when they are not. The only way to get clinical results from products is to use medical-grade products that have been picked out for your unique cosmetic and dermatologic needs by a medical professional.

Mistake Number Two

In addition to choosing products based on the marketing seen on television and in magazines or what your mother or grandmother told you, what many people mistakenly do is use those products routinely for months or years on end. The problem with this approach is that most of what is sold either does not do what the skin needs or actually does more harm than good.If professional treatments are utilized, they are usually chosen without any thought of how they fit one’s total skin care needs.

We Can Help You Correct These Mistakes

We divide ski care into Basic, Basic Plus, and Rejuvenative. Basic is what everyone needs, no matter their age, essentially from birth. It consists of a cleanser, a pH balancer (cleansing disturbs the normal pH, which causes the skin not to function well for a while), and a good practical sun block (we prefer clear zinc oxide). The pH balancer can be a simple acidic toner or an acidic serum, like Vitamin-C or something similar, depending on your other needs. Once a teenager, an alpha hydroxy product to remove thickened outer dead cells is added to Basic Skin Care. Professional treatments like chemical peels and microdermabrasion are inexpensive, convenient, and comfortable and can help remove built-up dirt, oil, bacteria, and dead skin cells.

The body stops continually making new collagen to thicken the dermis, the support layer of the skin, and elastin that provides the skin its elasticity around 30 years of age. Therefore, Basic Plus adds retinol or Retin-A to continue the skin making collagen and Obagi’s ELASTIderm to stimulate elastin somewhere around 30 years of age. Although there are thousands of products available, this is all most people need, unless they have significant damage from the sun or other insults.

With problems, modifying skin care to address the specific problem is all most people will need. However, it takes an expert in skin care and rejuvenation to determine what will work best with the least effort and expense.

At the Center for Plastic Surgery in Highlands, NC, we help patients manage their skin in ways that get results. We use only medical-grade products products that have been proven to achieve results. We also have professional treatments like peels, microdermabrasion, IPL light treatments, and laser resurfacing to provide a full spectrum of care.

Get the help you need to keep your skin resilient through the aging process. Call  (828) 526-3783.

We hear this question quite often. “Will one treatment be enough to achieve results?” Unless your cosmetic objectives can be met with a surgical procedure alone, this is an unlikely accomplishment. Even in the case of injectables and soft tissue fillers, which do achieve immediate results, improvements require maintenance every year or so.

To understand the role of professional treatments in ongoing beauty at every age, it can help to think of the skin the same way you do the body. Your skin needs to be “fed” quality products every day to rebuild itself just like your body relies on healthy foods to maintain vitality. Similarly, as much as we would like it to be true, we cannot work out one time and develop six-pack abs. Just like we won’t slim down after one healthy meal or strenuous workout, our skin will not look many years younger after one nonsurgical treatment.

One Way to Feed the Skin

In reality, there are several ways to feed the skin, but there is one objective that may trump all others: collagen and elastin production. By age 30, fibroblasts, the cells that produce collagen and elastin, begin to slow down. Not just a little, but a lot. Some studies suggest that fibroblasts go dormant, into a state of sweet slumber that allows the signs of aging to creep in. With the body wearing out its existing supply of collagen and elastin at a rate of about 1 to 2% a year, we typically see noticeable changes in the skin by age 40 and continually for the rest of our life. The key to managing aging skin, then, is to encourage the fibroblast cells to continually produce more collagen and elastin.

Professional treatments like fillers correct the signs of aging, which is certainly advantageous. However, injectables alone are not enough to effectively manage the signs of aging. By that, we mean to keep them from worsening. To do this, we recommend adding retinol or Retin-A and ELASTIderm to basic skin care starting around age 30.  The retinol or Retin-A (tretinoin) stimulates new collagen. The ELASTIderm by Obagi is the only product on the market that stimulates conversion of some of that collagen to elastic tissue. Other periodic collagen-inducing treatments like micro needling, actual dermal or just sub-dermal injection of the proper hyaluronic acid filler, peels or laser skin resurfacing can also help. Depending on where you are on the spectrum of collagen degradation, you may need one treatment a year, several treatments a year, or one treatment every few years.

If you are interested in reversing and managing the signs of aging, come talk with us. We may not be able to promise a one and done treatment for every concern, but we can promise that we are committed to long-term results and personal care for each of our patients.

Call (828) 526-3783 to schedule your visit to our Highlands, NC medical spa and plastic surgery office.

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Wrinkled or crepey facial skin is caused by an interplay of the skin and how it ages, gravity, loss of supporting volume, and action of the underlying muscles. As we age, the skin stops producing both collagen (the substance that gives the skin its thickness and strength) and elastin (the substance that makes the skin elastic). This happens around 30 years of age with collagen only being made after that as part of healing. With both collagen and elastin present, the skin contracts and then, because of its thickness, resists further muscle pull. With the loss of them, the skin does not contract and the muscle pulls the skin further than normal and causes it to pleat. With time, the muscles also hypertrophy and pull even harder and the places where the skin tends to bend become permanent lines. How much the skin crinkles or wrinkles varies due to your genetic predisposition and how you have treated your skin. Smoking, diet and other environmental factors speed the process. There are, however, several things that can be done to improve or reverse this.
 

Use of Botox®

If the muscle can be weakened with Botox® or a similar neurotoxin, the process can be slowed. This works best around the eyes and in the forehead where the muscle function is not essential. If started early, it can even slow the creation of wrinkles.
 

Improving the Quality of the Skin:

You can also slow the process and even reverse it by adding collagen and elastic tissue to the skin. Collagen can be added by use of tretinoin (Retin-A) or good retinol or by microneedling or similar laser procedures. We prefer tretinoin or retinol regularly as it continually stimulates collagen production, is less invasive and, we think, more reliable. Elastin can be added by use of Obagi’s ELASTIderm®, the only product proven to do this. We generally add these to Basic Skin Care at about 30 years of age when the skin stops producing collagen and elastin without some encouragement.
 

Reversing Wrinkles:

If the wrinkles are minimal or small, the above options will reverse them, but it takes about a year or so to do so. There are 2 things you can do to improve the wrinkles faster. One is laser resurfacing or a leveling peel that brings the surface of the skin down to the level of the bottom of the wrinkles and stimulates significant collagen production. Both these, however, have a prolonged recovery. The other is to fill the lines or depressions with a filler like Juvederm® Volbella and then crisscross it under the skin to stiffen it. This also helps the tretinoin work since it can increase the body’s use of the hyaluronic acid from the filler to convert it to collagen (something that is now proven to happen). Fillers are also the answer if the wrinkles are due to volume loss as they fill deep, replacing the lost volume, and stretch the skin back, flattening many of the wrinkles. This is especially true with lip wrinkles. The recovery from this is minimal with only a little swelling and, occasionally, some bruising that is easily camouflaged.

To find out more or to determine what is right for you, call 828-526-3783 to make an appointment at our Highlands office.

Whether you suffered from a lot of acne in your youth or if you have been hit with some serious hormonal, stress or sun damage induced acne as an adult or have wrinkles from aging, there’s one thing that’s for certain: you don’t want to continually look at them. The good thing about most scars and wrinkles is that they can soften with time with use of tretinoin (Retin-A), which makes them a lot less noticeable. If, however, you have scars or wrinkles that are deeper and you wish to reduce them quickly, then we may recommend a laser resurfacing to help eliminate them.

Luxor CO2 Laser

There are quite a number of different CO2 and combined lasers that can be used to flatten severe acne scars or wrinkles.  The Luxor Specialized CO2 Laser is unique by using very intense bursts of laser light which are spaced further apart than normal which reduces residual redness after the procedure better even than CO2-Erbium or other combined lasers. In non-computer mode it also allows  precise targeting of the scars or wrinkles to remove them with tissue reaction. All this means that you will have a faster recovery time. In fact, most people heal from this treatment after just 5-10 days.

What Is Healing Like?

Because the Luxor CO2 laser does not cause significant tissue heating, recovery is rapid. Initial care is gentle cleansing and ointment. Once the healing has started, we will show you how to apply makeup to disguise any redness.

If you feel like your acne scars or wrinkles would make even Frankenstein seem a bit concerned, then it’s time to take matters into your own hands and learn more about our skin resurfacing. Schedule your consultation appointment at our Highlands office today by giving us a call at (828) 526-3783.

Aging gracefully doesn’t have to be impossible. In fact, one of our goals here at the Center For Plastic Surgery is to help everyone age as well and gracefully as possible. If you have reached that point in your life, maybe around your 50’s, where you are looking in the mirror and wondering where your youth went, then let us help you find it again. Although we won’t be able to take you back more than a few decades,  we can reverse considerable aging of your skin, face and body.

Watch Your Skin Care

If your skin care regimen has not  maintained your skin looking young and radiant, then it is time for a medical grade system that will reverse everything that has happened to it. If you have maintained most of your skin’s youthful properties, you may just need to modify a few things to keep it looking healthy and young. Frequently, we don’t realize how our skin is aging until it actually requires a lot of work to reverse the problems. That is why we suggest adding retinol to basic skin care of a gentle cleanser, pH balancer, exfoliant and sun block at about 30 years of age. This can markedly help reduce fine lines and wrinkles later on.

Try Fillers and Botox

If you haven’t already, give fillers and Botox a try. Both of these injectables are great at reversing early facial aging without having to undergo surgery. Plus, because they are more affordable than surgery, they may be a good jumping off point. Botox is also one of the mainstays of preventing wrinkles by correcting the imbalance between thinning skin and increasing muscle function, one of the main contributors to wrinkles and crinkles. Once wrinkles are present, fillers are important also in reversing the problem without laser or peels.

Consider Surgery

There is absolutely nothing wrong with having a surgical lift; whether it be a forehead lift, eye tuck or something else. In fact, it’s the best way to get long-lasting results. Our present procedures are easier and have a faster recovery than those in the past.

As you can see, we have more than a few ways to help you maintain or get your youthful look back. To learn more about these and other options, schedule a consultation at our Highlands office by calling us at (828) 526-3783.

Sometimes, no matter how hard you try it can seem impossible to get rid of stubborn fat on some larger areas of your body such as your abdomen, upper thighs, flanks and buttocks. If you are dreading summer because you aren’t quite ready to hop into a swimming suit or other revealing clothing, then you may want to consider a body slimming procedure like Zerona. As a fast, and non-invasive way to get rid of fat, read on to learn more about why Zerona can be a better choice than liposuction.

It’s Surgery Free

If there’s one thing for which liposuction can be praised it’s that it gives great results, but the biggest downfall is that it’s invasive. Luckily, with Zerona patients won’t have to worry about any recovery at all. By using laser technology, each session only lasts about 20 minutes which means that you can easily come into The Center For Plastic Surgery for a treatment.

It Targets More Areas

Unlike liposuction that only targets specific areas of the body, Zerona covers a wider variety of areas across the body. For instance, if you are suffering from back fat or love handles that you just can’t get rid of with exercise and diet alone, then Zerona can target those areas.

Jump Starts Weight Loss

If you are overweight and are wanting to slim down, then Zerona can be used to jumpstart your weight loss. Unlike liposuction that’s only used to get rid of stubborn areas of fat on individuals who are otherwise at an optimal weight, Zerona can be used for people in all weight classes. By zapping fat right away, you can get the extra motivation needed to work on the rest of the fat on your body with a strict diet followed by an exercise plan.

If you would like to learn more about how Zerona can help you lose unwanted fat, contact The Center For Plastic Surgery today to schedule an appointment with Dr. Buchanan.

 

 

Sun damage produces a number of skin changes, the most common of which are red and brown spots. The brown spots vary from generalized “freckles” to scattered small spots to larger spots. Genes and hormones may contribute to larger dark areas called melasma. The red caused by sun damage is a form of “rosacea,” or “red skin,” more properly called telangiectasia. It is essentially an abnormal increase of the small capillary blood vessels just under the skin. Another type of rosacea is natural flushing, or dilatation of those normal capillaries due to heat, drinking, exercise or other stimulus.

Frequently, with good skin care, when you remove the thick outer layer of the skin, also caused by sun damage, the underlying red is exposed making it appear darker. An IPL can be used to treat both these problems.

» Questions? Contact us and let us exceed your expectations.

What Is IPL?

An IPL, or Intense Pulsed Light, is a laser-like machine that is used to treat a variety of skin conditions.

How the Ellipse Intense Pulse Light works

Instead of producing a single wavelength of light, it produces a spectrum of wavelengths. This allows it to target several areas where the target absorbs light and avoid having to use a very strong light pulse that can injure areas that are not targeted. For instance, Hemoglobin, the target when treating small vessels, absorbs light at 418, 542 and 577 nm (nanometers, a measurement of the wavelength of light).

No laser puts out just one of those. The Ellipse IPL, on one setting, emits light from 400-620 nm, thus encompassing all absorption areas, allowing it to work at a lower power setting, thus causing less discomfort and less risk of injury to anything other than what is being treated. Melanin, the target in brown spots absorbs between 550-950 nm. Another setting of the Ellipse IPL targets this spectrum and does not extend above 1000 nm where water in all cells absorbs the light, thus not causing heat damage to the skin.

How is IPL Treatment Performed?

Treatment consists of exposing the area to be treated to the light using a rectangular lens placed on the skin. Each treatment takes from 10-20 minutes. It is slightly uncomfortable when administered, but all discomfort resolves in about 5 minutes.

How many Intense Pulse Light Treatments may be needed

Any residual can be treated again in 3-4 weeks. To completely remove the problem may take 1-6 treatments, depending on the severity of the problem and your individual response.

What is the Recovery from IPL Treatment?

There is usually some increased redness when treating red that lasts about 4-6 hours. When treating brown spots, they generally turn darker. Some or all of the red fades in 2-3 weeks. The brown spots either fall off or also fade over the same time period. Most people can return to normal activities immediately after treatment.

» Questions? Contact us and let us exceed your expectations.

Possible side effects of Intense Pulse Light treatment

Although possible, blisters or other skin irritation is extremely rare, unlike with treatment of these problems with a laser. Other uses of the IPL

IPL Can Also Treat More Severe Sun Damage

The IPL can also be used to treat more severe sun damage like actinic keratoses. When this is done, the involved area is treated with amino levulinic acid that is absorbed over 6-18 hours into the severely sun damaged cell and converted to a porphyrin that has a very high affinity for blue light.

The skin is then treated with high doses of blue light (400-500 nm). Because only the severely sun damaged cells contain the porphyrin and absorb the blue light, only those cells are superheated by the light energy and destroyed. This method is as effective as using chemotherapy like 5FU (Efudex, Fluroplex) and imiquimod (Aldara, Zyclara), but, instead of taking 6 weeks or more, treatment takes only a day and recovery only a week or so for the places to crust and fall off.

Because active Acne areas are inflamed and also absorb amino levulinic acid, a similar treatment is available for severe Acne not controlled by standard means.

Patient Testimonials

“I have been a patient for many years. Dr. Buchanan is knowledgeable and experienced in aesthetics and takes time to discuss thoroughly any questions you may have. ” – C.B.

“It gets rid of the red sun damage. I have had a number of IPL’s with Dr. “B” & it is so good to look better! Dr. “B” is the ONLY one to help me over the years! He is the Greatest & recommend him often. Many many thanks!” – Real Patient Ratings

Schedule A Consultation in Highlands, NC

Call us toll-free at (877) 526-3784 to schedule your consultation with Dr. Robert Buchanan today! Our practice serves Highlands, NC & all nearby areas.