Cosmetic procedures for rejuvenation

Transcription

1 Cosmetic procedures for rejuvenation SCBM 302 Regenerative neurobiology Lect. Somphong Narkpinit, M.D. Department of Pathobiology, Faculty of Science, Mahidol University somphong.nar@mahidol.ac.th

2 Perfect face? Ideal proportion Symmetrical face Averageness Natural looking Cultural influence

3 Analysis of face Contour : Ideal proportion, symmetrical, Volume Texture : Smoothness, colour, Brightness, flawless

4 Practical approach to facial rejuvenation; What do people want? Refreshed Rejuvenated appearance Smaller face, U V Shape Natural looking outcome Minimal downtime No general anesthetic Long lasting Safe/Effective

5 Ideal proportion

6 Analysis of contour in aging face Lid ptosis Dynamic wrinkles Sunken eyes Deep NLF Fine wrinkle Sunken cheek

7 Age related textural changes Superficial and deep rhytides Pigmentary disturbances Telangiectasis formation Loss of skin elasticity Actinic keratosis Sebaceous gland hyperplasia and skin tumor

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9 Common problems of skin texture Wrinkles Hyperpigmentation & PIH Dilated pore Acne scar Oily face

10 4 R for facial rejuvenation Resurface Relax Refill Redrape

11 Resurface Tropical agents-aha, Chemical peels, microdermabrasion Lasers long pulse ND yaq, Erbium Yag nonablative Lasers Fractional laser

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15 2 day 7 day

16 1 month 3 month

17 Relax Botulinum Neurotoxin A BOTOXī DYSPORTī NEURONOXī

18 Combination With Botulinum Neurotoxin A BoNTA + injectable fillers BoNTA + ablative laser resurfacing BoNTA + nonablative lasers/chemical peels BoNTA + surgery Data from Carruthers JD, et al; Kane M, et al

19 Botulinum toxin A

20 Structure of botulinum toxin

21 Mechanism of botulinum toxin

22 Structure of botulinum toxin

23 Excellent Results Good Results Average Results Glabellar frown lines Crows feet Forehead lines Brow lift Bunny lines Popply chin Platysmal bands Sub-orbital area Masseter hypertrophy Mental crease Perioral lines Nasal flare Horizontal neck lines Nasolabial folds (patient dependent)

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35 Refill RESTYLANE PERLANE Esthelis JUVEDERM

36 Standard filler

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46 Redrape Focused Ultrasound ; Ulthera Botox Radiofrequency ; Thermage PDO Thread lift Surgery ; Face lift Laser and chemical lipolysis

47 Radio frequency skin tightening (RF) Heat tissue and stimulate subdermal collagen production in order to reduce the appearance of fine lines and loose skin.[1] The technique induces tissue remodeling[2] and production of new collagen and elastin.[3] The process provides an alternative to facelift[4] and other cosmetic surgeries. Including Thermage by Solta Medical, Venus Freeze by Venus Concept, VelaShape by Syneron, Exilis by BTL, and 3DEEP by Endymed

48 Radiofrequency

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57 Thread Lifting & Rejuvenation Technique Mechanism of Action Activates reparative processes which also stimulates collagen remodelling Promotes local microcirculation

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61 Complication Keratolytic agents Laser (ablative and non-ablative) Dermal filler Botulinum toxin Thread rejuvenation

62 Supplement for skin rejuvenation

63 Anti aging skin care and supplements Retinol : ramp up cell turn over in the top layers of the skin, decrease wrinkles and improving skin tone Peptides : chain of amino acids that heal and renew cells Antioxidants : prevent cell damage and skin aging Peeling products : AHAs, BHA, Blue peel etc. allow the skin to peel away the top layers of the skin

64 Anti aging skin care and supplements Vitamin E Vitamin E (tocopherol) is an antioxidant that is present in the skin and found in various foods, such as vegetables, seeds and meat. It helps the skin look younger by boosting collagen production and in turn reducing the appearance of fine lines, wrinkles and age spots. Better through topical treatments than through oral supplements. Vitamin E is available in two forms: alphatocopherol (alcohol-based) and alpha-tocopherol acetate.

65 Lycopene Anti aging skin care and supplements Lycopene, a powerful antioxidant, is a carotenoid found in red fruits and vegetables. It s a great choice for improving skin texture because it promotes collagen production and reduces the DNA damage that leads to wrinkles. To get the most benefit from this powerful antioxidant, you can either take a daily supplement or look for skin care products that contain it in topical formulas (lycopene is easily absorbed by the skin).

66 Anti aging skin care and supplements Green Tea Helpful ally in preventing everything from heart disease and cancer to skin aging and weight gain. The secret ingredients are chemicals called catechins, which are antioxidants that can clear cell damage on the skin and repair wrinkles, blemishes or other impurities. When applied to the skin, green tea can reduce sun damage by reducing inflammation and tackling free radicals. When choosing a tea, its helpful to know that green tea has over five times the amount of catechins as black tea.

67 Anti aging skin care and supplements Resveratrol The antioxidant resveratrol is compound that is commonly found in grapes, nuts, fruits, and red wine, among others. Separate studies have shown that when topically applied, resveratrol protects against UVB-mediated cutaneous damage and inhibits UVB-mediated oxidative stress.

68 Anti aging skin care and supplements Grape Seed Grape seed is extracted from vitis vinifera and is rich in proanthocyanidins which belong to the flavonoid family. Proanthocyanidins are potent antioxidants with strong free radical scavenging activities. Grape seed extract has been shown to be an even stronger scavenger of free radicals than vitamins C and E.

69 Genistein Anti aging skin care and supplements Genistein is an isoflavone derived from soybeans with the capacity to inhibit UV-induced oxidative DNA damage. Genistein, either topically applied or orally supplemented, was shown to effectively protect human skin against UVB-induced skin photodamage Niacinamide Niacinamide (vitamin B3) is a powerful antioxidant that has shown to exhibit anti-inflammatory and depigmenting properties. It has also shown to improve the texture and tone of the skin, as well as reduce fine lines, wrinkles and hyperpigmentation.

70 Astraxanthine Anti aging skin care and supplements Improve wrinkles, elasticity, moisten skin Reduce visible sign of UV aging Maintain youthful appearance Work well when combine with Tocotrienol Dose dependently inhibit the stem cell factors-associated stimulation of pigmentation Cancer preventative properties Prevent photo aging of the skin 100 times stronger protective effects of cell against UV-light induced oxidative stress

71 SUN SCREEN

72 Re-apply sunscreen - Every 2 hours - Lack of photostability of some UV filter :Avobenzone - Sweat, humidity, rubbing

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74 Relation between SPF and amount of physical sunscreen applied

75 Choose for sunscreen

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77 Application for face (2mg/cm 2 ) 1 gram(cream) 10 baht coin (1 gram cream)

78 Percent of remaining non degraded Avobenzone after 50 J/cm2 of UVR

79 Beauty face Structure Texture Expression

80 Thank you for your attention

81 Post quiz activity Identify the aging signs of this patient and suggest the cosmetic procedures and the principals how to improve them?