Take-Aways from Dr. Sethna’s Cosmetic Injectables & Fillers Web Chat

Dr. Anita SethnaOn Tuesday, November 19th, Dr. Anita Sethna of the Emory Aesthetic Center hosted a live chat on the topic of cosmetic injectables and fillers. Injectables and fillers have revolutionized the field of facial rejuvenation by filling in areas of the face that are missing fullness and restoring volume, without the need for surgery. During the chat, Dr. Sethna answered questions about the different types of products offered, how they each work and what provides the best individualized solution. She also shared a special offer currently being offered by the Emory Aesthetic Center for a limited time discount on dermal fillers and injectables.

There were a few questions from the chat that we didn’t have time to answer, and as promised, Dr. Sethna answered them below in this post.

My friend got Sculptra injections. What is that? Is it the same as other fillers?
Sculptra is poly-L-lactic acid. It is a collagen-stimulating product that is injected in several areas around the cheeks, sometimes temples to assist your body in producing its own collagen. The product itself dissipates over weeks and in its place is the collagen your body produced. The product takes several weeks to take effect, so it is different from traditional fillers, and should last up to 2 years based on the FDA approval. Several vials usually need to be injected to obtain the ideal results, sometimes 3 or more.

Is it true that Restalyne is painful? Which procedures are the least painful? 

Any injectable can be perceived as causing some pain just because it is placed with a small needle–the injectable itself usually is not painful. There are several steps we try to take to reduce the discomfort associated with any injectable. We can use the preparation from the company that contains lidocaine (an anesthetic that is safely used as long as you are not allergic), we can allow you to sit with topical numbing cream which we do in most cases, topical ice right before the injection to numb the skin, and depending on the area to be injected, we can use a blunt needle that requires one needle prick to allow it to go into the skin, but after that, is rounded at the edge so it causes much less discomfort during the injection. These types of blunt needles can also have the benefit of less bruising and swelling in most cases. These days, injectables tend to be pretty easy to tolerate because of these measures, and if these interventions are appropriate for you based on your consultation, they can be done without spending a lot of time in the office.

How do these products affect people of color? Should you see someone who has experience on darker skin?
Most of these products are perfectly safe for use in people of color. Seeing a physician with experience treating your particular skin type is always an option but not always feasible. That being said, there are a few issues that are more common in patients with more pigment in the skin: dark spots, dry skin, melasma, etc. that may be more easily treatable by someone with this particular experience. Topical medications such as hydroquinone and tretinoin are safe in most patients as long as you are not pregnant or breastfeeding, and can have real benefit for patients with these issues. Once you begin discussing other interventions, such as laser treatments, surgery or peels, it becomes more important to seek out people with real experience with darker skin types. Topical medications rarely cause significant issues or complications that are not reversible but surgical interventions/lasers/peels can cause irreversible damage if done improperly.

Which brand of skin care products do you prefer? 
There are plenty of excellent skin care products, pharmaceutical grade, as well as some over-the-counter. There are only a few that I believe truly need to be obtained through a pharmacy or medical-grade spa–tretinoin being one of them. There are several companies that offer these products, and under several trade names: Retin-A, Refissa, Renova just to name a few. Each may be formulated slightly differently to appeal to a different skin type. SkinCeuticals and Revision make some excellent topical vitamin C products that can help with brightening the skin and are easy to tolerate. Several companies make excellent daily sunscreens as well, but for that, i am often using CeraVe or neutrogena products that are relatively inexpensive and easy to obtain at the drugstore. Regular facial moisturizers and cleansers are also fine to obtain that way, and I alternate between some cleansers at our Spa as well as CeraVe products and sometimes Cetaphil. I firmly believe the cosmetic counters that attempt to sell very expensive anti-aging products, with no medical grade ingredients, are not worth the price consumers pay for them. They have expensive additives and perfumes that have absolutely no effect on the structure of the skin and tend to be completely ineffective. I encourage my patients to spend money on the few products that are medical-grade that can effect change on the skin, and the rest they can purchase at the drugstore. I have yet to have problems with this philosophy and it has fared well for me as well!

What creams/moisturizers do you recommend for the face to prevent lines?
Importantly, the best cure is often prevention. Using sunscreen daily (at least SPF 15 or 30 and NOT just the “SPF that’s in your makeup”) can prevent the onset or worsening of lines around the eyes and on the skin. After that, using tretinoin is a fantastic way of reducing the signs of aging. Tretinoin is a vitamin A derivative (not safe in pregnancy or breastfeeding) that resurfaces the skin, stimulates collagen and reduces dark spots/sun spots. I’m a firm believer in using these products every night or every other night to prevent premature aging. Retinols (one step down from tretinoin) are easier to tolerate in most cases and in some preparations, can be safe around the eyes as well for fine lines that are difficult to treat with other OTC preparations. The best idea is to meet with a true skin expert (medical aesthetician, dermatologist, facial plastic surgeon, etc.) to obtain the best initial advice and get a few items that will truly benefit your skin, and continue to wear daily sunscreen!

What is a Life Style Lift?  It seems too good to be true.  I’m interested in having something done on my aging facial skin.  I’ll be 50 in January.  It’s time!!
Lifestyle lift is a proprietary technique that is only taught to those people who perform it under that company’s marketing and treatment guidelines. There are surgeons who “sign-up” for this participation and are taught a specific type of facelift that has been registered. This type of surgical procedure is one that has been done by many of us for many years, but no one thought to trademark it until a few years back so that it could be marketed with a particular message and brand. In most cases, it is a short-scar facelift that has benefits in the right type of patient–very little concerns in the neck, some need for tightening along the jawline but not for a patient with excessive heaviness in the neck and jowl area. At the end of the day, whether or not one of these “short-scar” facelifts, of which there are now plenty of trademarked names, is right for you depends on your anatomy, and your desires. The right surgeon will consult with you about your concerns and be able to explain what type of surgical or nonsurgical procedures you will need to address your these areas in the best possible way. The worst decision is the one made just on price and not taking into consideration what would actually make you happy.

Can you recommend any doctors in the NY area? Atlanta is a little far to go for an injection.
There are some excellent facial plastic surgeons in the NY area: Dr. Steven Pearlman, Dr. Andrew Jacono, Dr. Thomas Romo, III, Dr. Philip Miller to name a few. I have met them personally at many conferences where they have all been speakers and have had the pleasure of hosting some at our Emory facility as well. They have phenomenal professional credentials and I would trust any and all of them to take excellent care of you!

Thank you to those who joined in Tuesday’s chat. If you missed it, you can check out the chat transcript here and you can also check out our Emory Aesthetic Center website for more information.

See you next time!

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