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“We don’t fix a flat or line chase”

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It happens to everyone…loss of facial fat pads in middle age. “I hear it all the time,” says Brian Whaley, ARNP-BC and Director of Rejuvenation at Essentials Medispa & Salon. Our patients “suddenly” notice that the firmness and lift in their faces have greatly diminished. It is normal in middle age for facial fat to decrease, which in turn has a hollowing and sagging effect. Indicators that most people notice are the deepening of the nasolabial folds and deepening of the tear troughs. These are both caused by a shrinking of the malar fat pads that lie just below the orbital bones of the eye. These are often called the apples of the cheek. Decreasing fullness here has a distinct elderly appearance and will continue unless corrected. “Filling in lines” is ineffective and amateurish – instead, an expert professional will treat the cause, not symptoms.

One may not be surprised at the treatments patients have undergone to address this problem, especially in this day and age. For some reason, providers are still injecting into the nasolabial folds. Whaley states, “This is a poor treatment choice that wastes money and does not improve the underlying problem of volume loss. The first thing I have taught my students is that A LINE IS A SYMPTOM, NOT A CAUSE. Fillers belong below the skin, not in the skin. The nasolabial fold is the medial margin of the flap over our oral cavities. This flap hangs under our eye which can cause tear troughs and flatten over the cheekbone, which can cause drooping of the corners of the mouth and marionette lines and the lowest tip of the flap is the jowl. The skin is a highly multifunctional organ system which renews every 60 to 90 days. Products injected into the skin are rapidly eliminated and also add weight, therefore dragging the skin downward even further. It is a mediocre cover-up and adds nothing to the improvement of contour. The line filling technique is antiquated and average; it is like using caulk in the bathtub!

Facial fillers that are properly injected deeply, just above the periosteum, replaces lost volume and adds the beautiful contours of youth. It can last up to two years, depending on the quality of the product. It is safer, more beautiful and less expensive than any “caulking approach” to a contour issue. Artistically placed filler, safely and meticulously performed, can bring back years of contour and make you appear younger, more attractive, and boost self-confidence! Interested or want to hear more? Schedule a free consult with Brian Whaley, ARNP-BC. You can age gracefully and modernly, subtle yet dramatic. Making Faces for 20 years.

The Verdict on Botox

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It is not infrequently that I hear the comment, “I’m not vain’ or “I want to grow old gracefully,” or “at my age, what does it matter? What is implied in all these comments? Is there a commonality amongst them? Should we not care about how our faces decline as they age? Don’t we have a choice besides watching our looks transform and do nothing, of course, we do! Science and medicine have improved our lives in so many ways, this is just another way of remaining well.

First, instead of answering these questions directly, I might ask a woman patient about the beautiful clothing they were wearing, or maybe I would compliment them on their hairstyle or how perfectly polished their nails are. With a man maybe comment on the level of fitness, head of hair or his nice watch. My question is, are these measures vain? Is it a character flaw, wanting to present oneself in the best light? Is it “not okay” to wear nice clothes or to pamper ourselves?

Folks will spend hours and hours at the gym reshaping their bodies, buy great gym clothes and the best supplements. Hire top trainers and fitness and diet coaches. They spend thousands of dollars on lotions and potions and over the counter anti-aging “medicines” and herbs. Runners buy shoes and pedometers and join health clubs. The quest for the beautiful body of our dreams seems to be widely accepted without question. So, why is the advanced, safe and proven treatments in medical aesthetics somehow vain?

Well, the fact is that self-improvement and investing in medical aesthetics has been found to build self-esteem and confidence. Medical aesthetics has proven to be reliable, safe and much more affordable than ever. Some studies show that an attractive face, scores higher on attraction models than those of the body, especially as we age.

There is nothing else that can halt the progression of the aging face. No cream can counteract the effect of facial volume loss. Rhytids (wrinkles) are inevitable unless the muscles are relaxed, long term Retin-A or skin resurfacing device is used. The advancement of this specialty over the last decade has been amazing. The melding of long-term corrections for the aging face and regenerative medicine holds great promise. We are living longer, and it is just logical that we want to look as good as we feel. No one says “I have a migraine but I want to tolerate it gracefully, we take the Excedrin”!

I recall a patient explicitly saying, “I have earned every wrinkle on my 60-year-old face.” I say, “That may be true, but what about the grey hair on your head”? (as blonde highlighted auburn locks shine, ( from afternoon re-coloring), the twinkle in my eyes evident to her, she laughs out loud!

I rest my case.

Best of health,

Brian Whaley ARNP-BC
Rejuvenation Director

How do I get rid of my wrinkles? – Contours of Youth

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How do I get rid of my wrinkles?

When it comes to the cause of facial aging, the blame has usually rested with the old standby culprit- THE WRINKLE!  This is not the case! Especially when most people are asking, “How do I get rid of my wrinkles?” The greatest culprit in the appearance of an elderly face is the loss of facial volume. Just like a container holds volume, we need to think of our face as a container for the tissue (fat pads) that lifts our skin off of the bone and creates beautiful cheeks and jawlines. Hollow facial concavities give an aged and tired appearance.

Why does my face wrinkle? What has been done to treat wrinkles in the past?

Facial fat pads become atrophic (shrink) in our middle years as a normal part of the aging process. Early treatment by implants and collagen were less than satisfying, so alternatives were developed. Fat transfers were available but a part of the population did not want surgery. In the early 2000s, hyaluronics like Restylane were introduced. These were well received by the public and volume replacement became common. Collagen and implants became less utilized, although fat transfers are still used in surgery. Unfortunately, over time injection techniques became more superficial and less effective. Instead of volume replacement, superficial lines were being targeted. This is a poor substitute for volume replacement, due to the short duration and lack of contour creation. The average aesthetic patient was becoming a line chaser instead of a volume replacer. Facial contouring is not chasing lines, it is replacing lost volume, creating contour, and treating the cause – not the symptoms of facial aging. Lines are caused by volume loss and if nothing is done, the face will become emptier and more skeletal as time goes on.  

How can I have a longer lasting wrinkle correction result?


Fortunately, the answer to volume loss has been discovered and we have many options at Essentials Medispa and Salon to address this problem. Products such as Juvéderm, Restylane, Versa, and Lyft are well tolerated and effective volume replacements. The duration of these products varies, but when injected properly and with proper amounts they can last up to two years. Essentials Medispa’s Rejuvenation Director, Brian Whaley recommends one year as the time frame to come in for a touch up. It is not advisable to allow treatments to wear off completely.
 
Another long lasting treatment for volume loss is found within bioactive formulas. Unlike hyaluronic medications, bioactive medications cause significant collagen growth. Collagen is the longest lasting form of volume replacement. Sculptra is our bioactive medication of choice here at Essentials Medispa and Salon in Melbourne, Florida. Once injected, patients can expect up to five years of volume correction.  Together with your practitioner, a maintenance schedule is setup so that a ¾ full approach is maintained. Volume replacement for facial rejuvenation is like the gym is for our bodies. It is best to first get to the place we want, so that we can then focus on maintaining our new body!