Warning: This post is for those of you who want to know more about how to fight the signs of aging. If you believe in growing old gracefully – more power to you. That’s great – really.  It’s time for the graceful agers out there to go read a different Better After 50 post. This one’s not for you.

If you are still with us, Better After 50 talked to NYC dermatologist, founder of Skinfluence TM and leading expert in aesthetic dermatology about what can be done to turn back the clock.

This is also not an article about skin care you can do at home. That’s a whole other blog post. It’s not about plastic surgery either, that’s another blog post too. This is about what procedures your dermatologist can do to correct the damage you inadvertently did to your skin and to address aging skin.

First let’s talk about that damage. This part blew our minds: Dr. Peredo explained, “The sun damage that happened to us in our 20s and 30s takes about 20 years to surface.” That’s right – your teenage self, who listened to Aerosmith, slathered on baby oil and iodine and used a sun reflector, caused the wrinkles and brown spots you see today. That is why many of Dr. Peredo’s patients, despite avoiding the sun and using sunscreen religiously, still see signs of sun damage. They – and all of us – are simply paying for the mistakes we made in our youth. Yikes!

 Dr. Peredo went on to say that we naturally start losing collagen in our 30s and cell turnover starts to slow, worsening with each passing decade. While some signs of aging can be genetic, a lot of the problems are caused by environmental damage – besides the sun, smoking can also lead to loss of collagen. Unfortunately, loss of collagen results in wrinkles and crepey skin. Dr. Peredo explained good skin care routines, sunscreen and good genetics help, but sometimes they are not enough. Compound that with hormonal changes – i.e., peri-menopause and menopause – and it is not uncommon for women in their 50s and 60s to see wrinkles, dull skin, blotchy skin tone, brown spots, melasma (uneven pigment), and skin texture problems such as crepiness (loss of elasticity, sagging skin) enlarged pores, and dryness. Those problems are not just confined to the face, but also appear in the neck and chest area. In the past, women could hide some of the signs of aging skin under layers of makeup, but according to Dr. Peredo, the trend today is to wear little or no makeup.  

Now that you are thoroughly depressed, it’s time to tell you that aesthetic dermatologists have ways to handle every sign of aging skin.

Micro-dermabrasion with infusion

A starter level treatment is micro-dermabrasion with infusion. This is by far the mildest treatment we will discuss – so gentle it can be done once a week, if your budget and time allow, and without pain or down time. Micro-dermabrasion uncovers younger, newer skin and infusions of serum target specific problems such as uneven pigment, dryness, loss of fullness, tired eyes and even hair loss. This treatment best addresses minor problems; Dr. Peredo described it as a way to look great before a party or event. Think of it as a super science-based facial. You can expect to pay between $200 and $300 (more if thinning hair is an issue), and you can easily squeeze in a session during your lunch hour.  

Non-ablative Lasers

For those of us who are over 50 and have deeper, more serious sun damage or pigmentation problems due to hormonal changes, micro dermabrasion is nice, it might help a bit, but it’s not going to do the heavy lifting – so to speak. For that you will need to consider non-ablative (low energy) laser treatment. Remember, we mentioned that cell turnover starts slowing down in our 30s – new skin cells don’t come to the surface as quickly – resulting in skin that looks dull and older. According to Dr. Peredo, non-ablative lasers “break up the traffic jam” and stimulate new cell production and new collagen growth – literally restoring the glow your skin had when you were younger. “The holy grail of looking younger and more refreshed is a skin surface that is bright, smooth and reflects light, it gives the impression of youth and beauty,” said Dr. Peredo. Not only does the laser treatment accomplish that, but the new collagen growth also stimulated by the laser reduces crepiness and wrinkles. In comparison, Dr. Peredo said she can accomplish in one treatment with a non-ablative laser as much, or more, than she can accomplish in 6 micro-dermabrasion treatments.

What’s the catch? A non-ablative laser treatment costs between $350-$1,000 depending on your particular needs and where you live. It’s a bit uncomfortable, so depending on the type of laser your doctor uses, pre-medication plus topical anesthetic may be required to manage that discomfort. Plus, there can be two to three days of down time due to redness. Initially, it is important to avoid exposure to the sun while the skin heals. (The length of time patients should avoid the sun can vary from a few days to up to 2 weeks depending on the type of laser and how aggressive the treatment is.) To see the maximum results, patients usually have 3-5 initial treatments over the course of 3-5 months, followed by maintenance treatments every 3-4 months after that. It’s a commitment, not a one-night stand. Dr. Peredo explained women should think of it “like getting hair color – you have to keep up with it.” But she describes the results as glowing skin that is as smooth and beautiful and radiant as the skin you had in your youth.

Which lasers your doctor selects will depend on your particular problems, and while some lasers address problems of texture, other lasers specifically target discoloration such as brown spots, redness and melasma.

Botox and Fillers

The two treatments we just discussed, non-ablative lasers and micro-dermabrasion, are meant to produce younger, healthy, glowing more uniform skin. But what if your skin looks pretty good, but there are deep crevices or lost volume? That’s where Botox and fillers become useful.

You are likely familiar with Botox – it temporarily relaxes facial muscles to give patients a more refreshed look by lessening or eliminating wrinkles in the upper portion of the face, particularly between the eyebrows, on the forehead and around the eyes (crow’s feet). What you may be less familiar with is that Botox can be used to perform something Dr. Peredo called a “Nefertiti lift” which lifts the neck and jawline.

With Botox there is no downtime and minimal, if any, discomfort or side-effects. Costs vary depending on where you live and how many areas are treated, but range between $200-$2,000.

Often Dr. Peredo combines Botox and filler in one treatment. A prime example might be for a patient with tired looking eyes. She can use Botox to lift the brow, and inject filler to lift the cheek and eliminate dark circles by filling the hollow under eye. She called the results “amazing.” This type of procedure costs anywhere from $1,000-$2,000 and lasts between 6-18 months.

Fillers are used to replace lost volume often associated with aging. This lost volume can result in deeper crevices such as the nasolabial fold, which is the line that runs from the lower corner of the nose to the outer corner of the mouth. It can be used for lines around the lips and even straighten a patient’s nose or lift the jawline. Patients can experience some swelling or bruising, which can be hidden with concealer, and discomfort can be addressed with a topical anesthetic. For most patients the downtime is a few days and generally results last between 6-12 months.

One of the most startling use of fillers is to literally perform a “liquid facelift.” Liquid facelifts can last 2-3 years with maintenance treatments needed after that. A complete liquid facelift is pricey, ranging between $6,000-12,000. After two weeks, patients see the full effects.

Dr. Peredo stressed that fillers are only as good as the expertise of the doctor who is administering them. Dr. Peredo feels the primary usefulness of fillers is not just rejuvenation, but to bring out a patient’s own beauty, or, as she likes to phrase it, “a better version of themselves.” Her goal is to make sure her patients do not look “done.”

While we discussed different options such as micro-dermabrasion with infusion, non-ablative lasers, Botox and fillers, these are not either/or propositions. The same patient often combines various treatments as needed, and all of these treatments require maintenance. As Dr. Peredo joked to a patient who complained about having to come back,” If you promise to stop aging, I’ll promise not give you all these treatments.”

Dr. Marina Peredo

Regarded as one of the nation’s leading aesthetic dermatologists, Dr. Marina I. Peredo, M.D., F.A.A.D, is a board-certified dermatologist with 20+ years of experience. Having founded Skinfluence, located in Manhattan, she employs a less-is-more philosophy as she works to reveal a patient’s unique self, over relying on a one-size-fits-all face. She is a national investigator and educator for pharmaceutical companies such as Allergan, Galderma, and Merz and has appeared on Good Morning America, FOX News, FOX & Friends and The View. Dr. Peredo received her medical degree from Mount Sinai School of Medicine, completed her residency at New York Hospital-Cornell University Medical College and is an Associate Clinical Professor of Dermatology at Mount Sinai Hospital, where she teaches residents and fellows and was 5-time recipient of the teacher of the year award.

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