The Center for Disease Prevention & Reversal Blog

In my medical office in the Chicago area, I use many forms of facial filler as well as heat treatments such as Fotofacial and Refirme.

For younger women with just the beginning signs of aging, filler is ample for the nasolabial folds. But for older women with deeper creases and cheek fat that has fallen, I highly recommend using Radiesse to lift the cheeks and to promote collagen growth at a deeper level than what a hyaluronic acid (HA) filler would do.

With Radiesse as opposed to Sculptra, results are noticeable instantaneously and last for years. With Radiesse as opposed to HA fillers, the cheeks are lifted which is what minimizes the nasolabial folds. With filler, the nasolabial folds are flattened by the HA, but so is the mid face which makes the mid face distorted.

Distorting the mid face with HA fillers has become the norm, but being the norm does not make it aesthetically pleasing. There are numerous examples of this overfilled look.

Notice how Ms. Sommer's nasolabial folds are flattened and lengthened horizontally across her face causing an unnatural look. This could have been avoided by using Radiesse into her check bones to lift the fat that had fallen and created the folds in the first place.

When deciding who to see for non-surgical facial enhancement, ask for a consult, find out how much thought will go into what the physician is going to do. Many physicians prefer to sell HA fillers over Radiesse because the patient will be back for more within the years time. With Radiesse, the patient is not back for years.

HA is a better business model for the office but not always for the patient.

One often hears how healthy someone looks. What prompts people to say that someone looks healthy?

Most often, it is subtle cues such as texture of skin, even skin tone with a mild glow and bright eyes. Many of these features are interpreted unconsciously to be equivalent with health, vigor and youth.

Proper skin care and true health promote this glow and great skin texture.
poor nutrition with lack of exercise can take away from good skin tone and glow.

Many patients walk in to my Chicago area office complaining of dull looking skin and poor skin texture. In addition to possible fillers, many are in need of nutrients on and in their skin

A great skin nutrient delivery system are micro-dermal needles. This creates deep penetration of nutrients and a wonderful response of increased blood and therefore oxygen to the skin, bathing the firbroblasts in nutrients and improving the skin texture.

How do you know if you are getting all the nutrients you need? How do you know if you are absorbing all the nutrients you take in?

The gold standard is an intracellular level of vitamins, minerals, co-factors and anti-oxidants. This can be performed from a blood test. If Levels are low but you believe yourself to be obtaining ample amounts, digestive issues can be at play.

Beauty is not only skin deep, health factors into looks and how someone fells about them self. Next time you're thinking of going to a botox factory clinic, think again and come to a clinic where you health and beauty needs are met inside and out.

As we age, we lose volume in key areas. For the purpose of this blog article, I will be writing only about facial aging and changes.

Many patients show up to my Chicago area office complaining about smile lines (wrinkles from their nose to their mouth) and about their marionette lines. Women tend to suffer from Marionette lines sooner than men.

For both men and women, cheek fat pads fall as we age. This exacerbates the smile lines
as well as the marionette lines. A simple remedy has been to inject fillers such as Restylane or Juvederm to fill these lines. However, as the area around the upper lip or below the lower lip requires more product the face begins to get distorted.

A better way to deal with these issues is to inject either sculptra or Radiesse deep into the cheek area in order to encourage collagen production and fullness. This ultimately lifts the cheeks reducing both the smile and the marionette lines. This is a better procedure for patients with more than just a hint of lines.

The procedure can be carried out with topical anaesthetic applied first and with some numbing medication mixed into the solution. The procedure is very tolerable and there is no down time. There can be bruising and minimal swelling which can be reduced with icing the area post treatment.

Next time you look into the mirror and start lifting parts of your face to look like you did, pick up the phone and give my office a call.

Be careful what you wish for.

I've had more than a few patients walk in my Chicago area office with silicone filled lips or problematic bumps on their face from Sculptra that were unhappy with their outcome but could not do anything about it.

One of the unhappy patients had silicone enhanced lips and had never even had a temporary filler prior to the silicone. This, I believe is absurd, as it is always helpful for a patient to see how they will look like prior to a permanent change. Her doctor suggested a permanent implant the first time she asked for lip enhancement. This is a doctor to run from. The patient turned out looking like a pair of walking lips. She can have the implants removed, but this is not a simple procedure like injecting hyaluronidase into an area that was over filled.

While a patient might look good and be happy with a permanent implant down the road, one should always recommend trying the look temporarily at first to make sure it works.

Sculptra and some of the other fillers that stimulate lots of collagen production deep in the dermis, can achieve phenomenal results, they can also create lumps and bumps that are often visible. Even in the hands of a skilled doctor, there is a risk.

Sculptra seems to be the best for HIV related facial lipodystrophy. These patients have lost so much volume in their faces that they really can't look over filled compared to how abnormal they looked prior.

The over filled look, or even filling to perfection, can often look obviously abnormal. The planes of the face can become distorted. So if you think you want to fill to perfection, do it at first with a short acting filler. If you don't love the look, it will be gone in few months. If you love the look, repeat it the next time with a longer acting filler. Just remember, it is normal to have some amount of smile lines starting in your twenties. Smile lines can actually add more dimension to your face which is usually more visually appealing and interesting.

Growth factors are naturally occurring proteins that promote tissue growth. They are the hottest trend in upscale skin care lines.

The growth factors that are being used have been shown in the lab to promote collagen generation and to decrease collagen degeneration.

Skin is a wonderful impermeable protective organ. Water soluble topical applications to not absorb well.

Mesotherapy with needles or with an electric current greatly improve delivery of product.

The newest form of mesotherapy to hit the medical spa market is the microneedle derm roller. This is typically accompanied by pharmaceutical growth factors EGF and TGF, often with copper peptides.

In my Chicago area office in Evanston, I employ the use of full needle mesotherapy, electric mesotherapy which has the added benefit of an electrical current that contracts the muscles and tightens them, and microneedle derm rollers.

All the above methods greatly improve delivery of often expensive products that one would not want to waste by just applying them topically.

I can achieve lightening of dark skin spots while avoiding the use of hydroquinone by applying safer water soluble products.

By placing patients on oral astaxanthin which reduces collagen breakdown by 30%This accompanied by pharmaceutical EGF and TGF used with dermal rolling can not only prevent collagen loss, but can actually promote new collagen growth to the point of filling in small vertical lines.

Is it necessary to look like a kissing trout or a parading duck after having your lips augmented and having the lines of your top lip filled in?

I think not. I notice in my Chicago practice, many women walking around with lips like Daffy Duck. It has become a look that has been accepted and even revered.

This 'look' occurs because the vermillion border of the lip gets overfilled along with some of the vertical lines. And, If the nasolabial lines are filled completely, the top lip is driven inside causing the physician to then over fill the top lip.

From the doctors perspective, the more filler they sell, the more money they make.
The plastic surgeons have created this extreme look and women flock to it.

Often this Daffy Duck look goes along with huge breast implants and 6-inch high heels.
I believe that hyaluronic filler for facial enhancement should be applied in order to turn the clock back, not to create the look of another species.

Less is more. The results of having filler applied in wrinkles, and in an ever-disappearing mouth should simply be a return to a more youthful look of the person: shallower wrinkles and a neutral position of the corners of the mouth.

There are many techniques when filling in lines, some of the techniques just fill in lines and some techniques actually stimulate collagen production.

When I teach "filler technique" I encourage my students to use techniques that stimulate collagen production and not to overfill lines and wrinkles. In essence, I try to encourage a return to a more youthful look as the doctor-patient goal.