Microneedling, An Excellent Way To Rejuvenate Skin And Reduce Wrinkling

Microneedling is one of several technologies that markedly rejuvenates the skin and reduces wrinkling.  Here we will discuss those technologies and other things that you can do to improve the quality and appearance of your skin.

Retinol/Retin-A

The cornerstone of skin care to prevent wrinkles has been, for many years, the use of a retinol or tretinoin (Retin-A) after the age of 30.  This is because the skin stops continually making collagen, the substance that thickens the skin, at around 30 years of age.  If the skin is not stimulated to continue the process of collagen production, the dermis, the support layer of the skin, thins and multiple crinkles and wrinkles result.  If you have failed to use these in the past and have developed significant crinkles and wrinkles, then use of the more potent tretinoin is still the mainstay of skin rejuvenation.

Peels & Laser Resurfacing

Once you had developed aged appearing skin, the only treatment that could correct the wrinkling/crinkling was a leveling peel or laser resurfacing that removed the surface of the skin between the wrinkles to the level of the bottom of the wrinkles and allowed the skin to grow a new surface epithelium over a smoother dermal base.  The problem with this is that, because of limitation of the body’s ability to resurface the skin, they became the procedures with the longest downtime of any of the modern plastic surgical procedures.  Although we could push the body some, the minimum downtime where the skin is somewhat raw and oozing with either of these technologies is about 1 ½ to 2 weeks.

Intradermal Filling

Although fillers have been called “dermal fillers” for many years, until recently no one actually injected the filler into the dermis, the support layer of the skin.  If they did, frequently a greenish or bluish line would appear when light reflected off the injected filler.  Only in the last 10 years have we had fillers that did not cause this blue line, the Tindal effect.  Belotero Balance® introduced in 2011 was the 1^st.  Juvederm Volbella®, equally as good if not better, was approved in 2016.  These allowed us to actually inject fillers into the dermis elevating the surface of the wrinkle to reduce or eliminate it.  We have also discovered that if the product is placed just at the bottom or under the dermis perpendicular to the wrinkles, it can prevent further wrinkling of the skin and allow the tretinoin to use some of the product to thicken and stiffen the skin.  Other than some mild swelling and occasionally minimal bruising that could be covered with camouflage makeup, there is essentially no down time with this technique.

Microneedling/Fraxel Laser

The one thing that leveling peels and laser did was markedly stimulate the dermis to build significant new collagen at a faster rate than it did with just the use of tretinoin.  The 1^st improvement to markedly improve the rate of the skin’s collagen production was development of the Fraxel Laser, a laser that, instead of removing the surface of the skin, simply poked holes in it.  Since injury to the dermis is the one thing that causes the skin to markedly produce collagen, this significantly turned on the body’s healing processes.  This laser, however, is quite expensive and uncomfortable.  Microneedling was developed to answer these problems.  It does the same thing by using small needles that create holes in the dermis and also turns on the body’s healing processes, markedly stimulating collagen production.

The procedure, done in a physician’s office, uses a device that pushes the needles absolutely perpendicular so that there is only a very minute entry point.  Because of the marked success of this process, “Microneedling” rollers are now being sold for home use.  The problem is that they do not produce uniform holes to the proper depth in the dermis and, instead of entering and leaving absolutely perpendicular, they enter and exit at an angle actually tearing the skin.

Who is a Good Candidate for Microneedling?

Because it works by stimulating collagen productionin the dermis, the support layer of the skin, microneedling is an excellent treatment option for a wide variety of concerns. You should be a good candidate for microneedling whether your goal is to correct a cosmetic concern or simply to support your naturally aging skin that stops making collagen naturally around 25 years of age. Microneedling is efficient at reducing enlarged pores, softening lines and wrinkles, and reducing the appearance of scars and stretch marks. Since the skin loses collagen over time  mictoneedling is advantageous in the fight against sun damage and tissue laxity.

What Are the Benefits of Microneedling?

There are several reasons why microneedling is such a popular cosmetic treatment. The process takes only about an hour in most cases and it incurs essentially no downtime. Your skin may look red for a few hours after your treatment, but not so much so that you have to rearrange your schedule for several days. You may return to work or other activities immediately after you’ve had microneedling done. Another benefit of microneedling is that the treatment works naturally to rejuvenate your skin from the inside out. There are no incisions, no products, no “foreign substances.” It does, however, work better if you are on regular tretinoin (Retin-A) or, if you are younger than 45-50, retinol.

How Does Microneedling Work?

Microneedling is a form of collagen induction therapy that has been around far longer than most people realize. Ancient civilizations used this technique, though not in the same fashion we do today. The microneedling treatment that professionals perform is done with an automated instrument rather than a hand held needle or a needle-clad drum. The benefit of this is that the needles pass into the skin in a completely perpendicular pattern and penetrates only a specific depth. This significantly reduces the risk of tiny skin tears and the potential for scarring. During a microneedling session, the automated device quickly creates hundreds of micro-injuries in the dermis of your skin. Micro-injuries take very little time to heal. Their sole purpose is to trick the body into believing repair is needed. Repair comes in the form of increased collagen and elastin production, which the body makes for a prolonged period of time in response to the treatment. The increase in the body’s regenerative system works to rejuvenate the skin.

When Will I See Results from Microneedling?

You might notice some of your microneedling results the same day you have your treatment! Many people report feeling like their skin has a new vibrancy to it right after their appointment. This early improvement expands into others as your body begins to flood the treatment area with an ongoing supply of collagen and elastin. The results of a single treatment occur over time with multiple sessions being cummulative. If you are trying to reduce significant wrinkling, however, it may take a year or more to see the final results/

Is any Numbing Cream Applied Before?

Yes! Comfort is an important aspect of our treatment process. To minimize the sensation of this process, we’ll apply a topical anesthetic to the target area. This medication does not cause complete numbness like injections of lidocaine do. However, it achieves sufficient desensitization to make microneedling easily tolerable.

Can I Combine Microneedling with Other Treatments?

You can combine microneedling with other treatments to acheive more profound tissue rejuvenation. As previously said, we recommend everyone receiving microneedling be on either retinol or tretinoin. For significant wrinkling in the past we used leveling peels or ablative lasers. Their problem is that they have a 2-3 week down time. Instead, we now use microneedling after filling the worst wrinkles with one of the newer fillers that works well when injected in the dermis itself. (Although many people call them “dermal fillers,” we previously never actually injected the dermis with them since the old fillers caused a blue or green line, the tyndall effect.) We will discuss what you’d like to achieve and what concerns you have and will recommend a treatment plan using that information. To get the best results with the fewest risks and side effects, microneedling may be scheduled as a standalone procedure within your broader course of treatment.

No Downtime Skin Rejuvenation

These latter two developments have allowed us to now achieve skin rejuvenation comparable to leveling peels and laser but without the significant downtime.  Our present protocol for rejuvenation of sun damaged, wrinkled, crinkled skin is beginning tretinoin, injection of the wrinkles to reduce as much as we can using Volbella®, and then doing a series of Microneedling procedures, all with minimal to no downtime.

If you are interested in rejuvenating your skin, schedule a consultation with Dr. Buchanan at our Highlands, NC office. Call (828) 526-3783 today.

Over the years, we have come to understand  aging of the skin and how we can interact with this process to lead us to beautiful skin for much longer. Not long ago, we had only two options: age naturally or undergo plastic surgery to tighten weak, sagging tissue. The development of scientific based skin care, laser treatments, injectables, and even some plastic surgery procedures is still relatively recent. These techniques and technologies have become common and could only be created from a place of knowledge. Sure, skin aging is, to some extent, related to simple biology. However, from the study of twins with different lifestyles or different treatments, we have learned there are other factors involved. The more we understand them, the better we get at maintaining beauty at every age.

Hereditary factors are outside of our control. When we look at how our parents, siblings, and grandparents have aged, we get a good idea of how our process may go. Beyond that, though, we can alter our course by developing good habits and, when necessary, getting professional help.

Sun Exposure

It has become apparent from research that the sun ages the skin. As we have learned about the sun’s effect on the skin, we have also learned about the sun. The part of the sun responsible for the damage and aging is UVA, which is present all day, all year, and at every latitude. SPF does not let us know about protection from sun aging, only UVB and sun burn. We, therefore, need to apply a zinc oxide sunblock every day and reapply it if we wash or rub it off. Other sunscreens need to be applied every hour if outside or every 2 hours if indoors. It’s impossible to stay out of the sun. Even if we could, it would not be good for our health. The body needs a small dose of sunshine each day to produce vitamin D, which is essential for good immunity and bone strength. We also need it for proper sleep. Fortunately, we can get all we need even wearing sunblock.

Diet

We know that what we eat will affect our weight and our long-term health. We may minimize salt consumption to reduce our risk of heart disease. We may limit our sugar intake so we don’t gain too much weight. These habits are also good for the skin. Sugar and salt contribute to puffiness and inflammation that can cause skin sensitivities and premature aging. Skin-supporting foods include fresh fruits, leafy greens, lean protein, and healthy fats like nuts and olive oil, things good for you in general.

Smoking

Smoking, tobacco use, or vaping inhibits the oxygenation of tissues, including the lungs, other vital organs, and the skin. It does this by causing blood vessels to narrow. This reduces the production of collagen and elastin that firm and smooth the skin. It also reduces the repair system. Essentially smoking overwhelms the body’s regenerative processes and speeds aging.

Skin Care

Most people do skin care based on what their mother or a friend told them, what they have read, or what some company making skin care products have told them. One of the major changes over the last few decades is a scientific understanding of what proper skin care is and how to improve our skin. We don’t need most of what we are told we do. We need a cleanser, a pH balancer, an exfoliant and a sunblock as the basics. Moisturizers are, in fact, the worst thing we have ever done to our skin. Once we get to 25-30 we also need a retinol or tretinoin (Retin-A) and Obagi’s ELASTIderm to stimulate production of collagen and elastin respectively, as the body stops producing them naturally at about that age. If you have severe damage, we also now have treatment options based on science, though even some physicians are still peddling quackery.

What you do daily will affect your skin’s aging process. However, you don’t have to tackle aging on your own. In our Highlands, NC office, we offer a full complement of skin care and rejuvenation services as well as non-surgical treatments like Botox, fillers, and micro peels, which we include in our arsenal of skin care services. See how we can address your aging skin. Call (828) 526-3783 to schedule a visit with us.

Botox has been used for around 30 years for cosmetic purposes. After the FDA approved this drug for cosmetic rejuvenation, the first of its kind, in 2002, adults interested in looking younger have relied on Botox to achieve anti-aging goals of reduced wrinkles. While Botox is not magic, it does accomplish amazing results when treating dynamic wrinkles. We consider it a valuable adjunct to good skin care and maintaining a youthful appearance. If you have been on the sidelines and are ready to give Botox a try, you may be wondering what it will be like to get this injectable treatment. Here, we walk you through the process.

Your Botox Consultation

Because Botox has been around for so long, new patients tend to schedule visits with this treatment in mind. Regardless, an experienced provider will begin the appointment with a brief consultation. To know if Botox is right for you, we have to know what concerns you have and what you would like to achieve. Botox is a great treatment for crow’s feet, forehead lines, frown lines, and a droopy brow line. If you have concerns beyond these, such as depressed mouth corners or creases around your nose and mouth, we can discuss how to address those, as well.

Treatment

If you so choose, we can perform your Botox treatment right after your consultation. We usually use a topical anesthetic to make the injection as painless as possible. Also the injections are administered with a very small needle. You may feel tiny pinching sensations with each injection, though this is not painful. Each sensation lasts only a moment. Depending on the purpose of treatment, several injections may be given.

Recovery and Results

Botox is well-known for its convenience and safety. After treatment, most people experience nothing more than slight swelling and redness where injections have been given. Adverse side effects are rare. The most common is a slight bruising. A rare patient may develop a slight headache that may last a few hours or body aches that feel like the flu that generally disappear within 24 hours.

Full effects from the injections usually occur form about 6 hours to 6-7 days. Improvement typically lasts from 3 to 6 months. Touch-ups can be scheduled as needed.

If you’re new to Botox, you will appreciate our conservative, gentle approach. To schedule a consultation at our Highlands, NC office, call | (828) 526-3783.

It’s time to care for winter skin. When the temperature dips, and we have many months of cold weather ahead, it’s time to start thinking about the skin. Low temperatures affect the skin just as much as hot, humid weather. In this case, the skin on the face, hands, and body can get so dry and flaky that painful itching or cracking occurs. Here, we offer a few tips on caring for your winter skin so you can avoid unnecessary stress and discomfort.

Moisten the Air to Nurture Your Skin

When we worry about getting dry skin, we often think about what we use topically. During the winter months when the air naturally gets drier, daily lotion application is not the answer. The skin is moistened from what we put into the body and the air. To care for winter skin, dermatologists suggest drinking more fluids to sustain adequate hydration. The skin loses moisture when the air is extremely dry. Experts have long talked about the benefits of using a humidifier during the winter months, especially when the heater is running more often than not, as furnaces dry the air.

Switch up Your Products

The skin is more prone to irritation during the winter months due to the dryness of the air. Therefore, there is a need for gentler products. A foaming wash can be optimal most of the time, but a gentle cleanser may be best in the winter. Going from a 15 or 20% Vitamin-C to 10% or switching from one sunblock to another frequently helps. Adding Hydrate to an Obagi protocol can help some people.

Skip the Exfoliating

We usually tout the efficacy of exfoliation for maintaining healthy, glowing skin. This practice of loosening dead and damaged skin cells for faster turnover can be beneficial in the right circumstances. Reducing exfoliation can allow slightly more dead cells that reduce some of the evaporation from the skin into the dry air..

Dry Skin Thoroughly Before Going Outside

Whether you’re running errands and wash your hands or need to run the trash out after you’ve washed the dishes, it is necessary to avoid going out into the cold with damp skin. The cold air interferes with the integrity of your skin’s natural barrier, increasing the risk of chapping. On the same note of skin getting chapped more easily, it is also necessary to avoid licking your lips when outdoors in cold weather. Instead, maintain moisture with Jane Iredale’s Lip Drink (that also protects them from sun damage).

Our practice offers several skincare and medspa services to help you nurture your skin any time of year. To schedule an appointment, call | (828) 526-3783.

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.

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.

We’re not looking forward to the end of summer just yet, understanding there are many cool months ahead. Knowing that the time is coming when the temperature cools and the sun moves farther away from the Earth, we can plan ahead, though. Around here, planning ahead means discussing ways in which all the summertime sun exposure can be addressed. It may come as a surprise to know that chemical peels still offer a great value.

In recent years, several high-tech treatments have been developed. As they have, it has become easier and easier to forget what came before. For years before lasers and light treatments, chemical peels served doctors and their patients very well. We are still huge fans of the chemical peel, even more so with the variety of options that are available today. This method of treatment provides us with the opportunity to help people correct a wide range of sun damage, to improve the texture of their skin, or just to maintain the general health of the skin.

The way that chemical peels work is by removing a precise layer of tissue. Not all peels are intense. In fact, some peels don’t even cause noticeable peeling. DIY methods are posted across the internet, but do not offer what a professional peel does nor the insight to determine which peel will achieve your desired result.

A professional chemical peel is:

• Tailored to your skin. There are numerous chemical peel solutions used in our office. Each allows us to meet the needs of every individual patient. Before conducting treatment, we perform a thorough skin analysis and consultation in which we discuss your objectives and preferences. The personal attention of a skilled esthetician makes all the difference in making the most of a chemical peel.
• Professional chemical peels are the result of thorough research and development. Months, if not years, have gone into formulating the right ingredients in the right concentration to achieve optimal results across a wide variety of skin types. There is nothing more powerful than a professional chemical peel when it comes to achieving the ideal extent of exfoliation with the shortest amount of downtime.
• The safety of professional chemical peel treatment is maximized by the combination of our clinical consultation and careful selection of the right, powerful peel solution. Patients are also monitored throughout treatment to ensure the desired tissue reaction is achieved.

We are passionate about offering patients minimally-invasive, low-downtime treatments that bring beauty to the forefront. To learn more about our chemical peel treatments, call our Highlands, NC office at (828) 526-3783.

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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 have been a tobacco user for your entire life or if it’s just a habit that you just picked up, there’s no denying that tobacco isn’t good for you. With Surgeon General warnings on every cigarette box and with commercials that are enough to severely scare you, the information is out there.  With the holidays in full swing and the new year just around the corner, you may have a few resolutions that you want to make. If you are a tobacco user or smoker, why not quit before the new year even starts? Here at The Center For Plastic Surgery, we encourage all of our patients to quit smoking,  and, in some cases, will not do a surgery if the patient is smoking, because nicotine use slows down your body’s natural ability to heal and, may severely jeopardize the success of some procedures. To help you quit, we have created a brief guide of a few things that you can do.

Change the Habit of Putting Something In Your Mouth

Whether It’s after work, on your lunch break, or after a drink on a Friday night, one of the things that keep people coming back for more cigarettes is their habit of having something to put in their mouth. This is a hard habit to break, so we recommend you just modify it to something other than a cigarette or tobacco, or nicotine containing product. Electronic cigarettes are in the latter category. Instead, consider using something like a toothpick or straw as a substitute for the cigarette.  

Break the Nicotine Habit

The hardest thing of all is breaking your nicotine habit. When trying to quit smoking, try doing something like making a chart of how many cigarettes that you smoke each day and when. Then, make a goal of smoking two fewer cigarettes each day for 10 days, deleting one from the morning and one from the evening. If you can, continue this until you are no longer smoking. If you find it problematic, then just delete one ever day or, even, if you have to, every other day until you are no longer smoking. Make sure that you physically log your cigarette use so that you can see just how well you are doing.

Picture Your Life Without Nicotine

Sometimes, one of the best ways for you to quit smoking is to think of just how much better your life will be without nicotine. For instance, you can:

• Daydream of all the wonderful aromas that you can smell once you quit smoking.
• Think of how GOOD food will smell and tastes when you quit.
• Think of your lungs thanking you for setting them free.
• Think of your body being able to get more oxygen again.
• Think of those facial wrinkles no longer forming at such a rapid rate.
• If all else fails, talk to Dr. Buchanan about other options

Here at The Center for Plastic Surgery, Dr. Buchanan wants all patients to live healthy, cigarette-free life. If you want to learn more about ways that you can quit, contact our Highlands office or call us at (828) 526-3783.

We all think we know about the sun, what it does to us and how to protect ourselves from it. Unfortunately, most of us really do not know what we need to know. A great deal of this is because most of the people who write about this keep repeating information that has been outdated for years. Though you may think that this is implausible, several studies have shown that it takes an average of 13 years before a new discovery is adopted into general usage. Unfortunately, it has already been well over 20 years we learned new information about the sun and how to protect from it, and it has still not been generally accepted.

 

You only need to use Sunscreen when you “go out in the sun.”

 

This is based on what we previously knew about UVB. Since UVB is immediately absorbed rather than being reflected, it is much less strong in the shade or inside. It is also what causes sunburn. Because of that, it was considered really bad. Also, many modern windows block UVB so you would not sunburn inside. None really block UVA, which is present almost equally all day, all year, at all latitudes and even inside and in the shade. UVA is also the “bad guy.” It is what really causes sun damage. We remember the effects by “UVB, Burn, UVA, Aging.” We, therefore, need to protect from UVA all the time every day. This requires the proper sunblock and sun protective clothing.

 

 “You don’t need sun protection in the winter.”

 

This is similar to the above. While UVB is twice as strong in the summer as it is in winter, the strength of UVA is almost the same. This means that you need to protect from UVA aging all year. This is also true indoors and on cloudy days as UVA is unchanged in strength then also.

“SPF is what you need to look for in selecting a Sunscreen.”

 

SPF is a designation designed to tell you how well the sunscreen protects from sunburn. It has no bearing on whether it protects you from sun damage, however. As I said, sunburn is caused by UVB that is absorbed by everything, including your skin. This is the reason it causes a burn (all the energy is concentrated in the outer skin layer) and present twice as much in the summer as the winter, at noon as morning and evening and in Florida as in North Dakota (because of atmospheric absorption). Since it is UVA that is absorbed into all layers of the skin and causes cellular damage resulting in skin cancers and aging, you need a way to tell if what you are using does that. SPF does not do this.

 

All sunscreens protect from damaging rays equally,

 

Since December of 2013, any product labeled as a sunscreen or sunblock have to protect from both UVA and UVB. Any product that simply puts an SPF on the label but does not claim to be a sunscreen or sunblock does not necessarily have any UVA protection and any that it does have is usually short lived. Even those that are approved as sunscreens are not all equal in the protection provided. There is a long list of chemical sunscreens and the manufacturer can use a mixture of them. Some are better than others. The one thing they all share is that they only last about an hour if you are outside or 2 hours if you are inside. The physical sunblocks are zinc and titanium oxide. Both protect from both UVA and UVB and last until washed or rubbed off. However, zinc is by far the best, protecting maximally over a larger spectrum.

 

Something other than an applied sunscreen or sun protective clothing will protect you,

 

There have been many claims over the years. Most recently, several companies have marketed either a pill or something to drink that is supposed to protect you from sun damage. None of these products work, and the FDA has recently warned these companies to stop making such claims.

 

For proper sun protection, we suggest:

 

Since zinc oxide provides the widest spectrum of maximum protection and lasts as long as it remains in place, this is, not only the best, but the most practical. Probably the main reason it has not been adopted better is another myth, “it is that white stuff the lifeguards used to wear on their noses.” A recent health writer even bemoaned that we did not have a reasonable sunblock or “something other than that white stuff.” The fact is that it has not been “white” for well over 20 years and rubs in clear but provides superb protection. Instead of looking for SPF, we recommend that you simply look at the ingredients and buy one with at least 8% zinc oxide. This will give you all the UVA and UVB protection you need. We also suggest that your clothing is sun protective, either bought that way or washed with Rit SunGuard that washes in sun protection for 20 washes. We sell both in the office. Call, come in or visit our web site to find out more.