Top cosmetic procedures for aging skin Jennifer Kherani, MD May 9, 2017

Top cosmetic procedures for aging skin

Skin is not only our largest organ, but also one of our greatest protectors. It serves as a barrier to infection, thermally regulates our body, and allows us to sense pressure, pain and temperature. While this proficient armor does regenerate itself, its abilities to do so diminish with age, and it also faces the risk of disease. The good news is that there are things we can do to defend our great defender. Innovations promoting smart prevention and wise intervention can now help us maintain health, rejuvenate radiance, restore youthfulness, and add longevity. If we are proactive and smart with our approach, we can improve our skin’s health and appearance.

We sat down with Dr. Marnie Nussbaum to learn a bit more about what it takes to avoid skin cancer and to erase the signs of aging. Dr. Nussbaum, a member of the Summus physician network, is a Clinical Instructor of Dermatology at Weill Cornell Medical Center. She graduated with honors and distinction, having trained at two of the most prestigious hospitals in the world. Dr. Nussbaum currently works in private practice in New York City and continues her pursuit of excellence in both medical and cosmetic dermatology, with a special focus on skin cancer, acne and aging prevention.

Jennifer Kherani: Speaking cosmetically, what are the one or two most effective, non-invasive procedures which, you would say, yield the most dramatic results? 

Marnie Nussbaum: First and foremost would be laser therapy. The Fraxel Laser, which is a fractionated non ablative laser, rejuvenates and takes years off of the appearance of skin. It removes aged layers of skin cells and, in doing so, is both medically useful and erases years of sun damage while minimizing fine lines and wrinkles. Clear & Brilliant is a less invasive laser treatment that helps individuals produce collagen, a structural protein found in skin and other connective tissues. This prolongs youthful skin appearance and, as such, is preventative. The Clear & Brilliant treatment has the added attraction of no downtime. Other highly effective procedures for anti-aging and skin maintenance are injectables, like botox and fillers. These procedures can enhance a person’s appearance by adding volume and relaxing the facial musculature. As with any procedure, an individualized approach is necessary to address personalized concerns

JK: Is there an age at which you feel it is too early for people to begin cosmetic procedures such as lasers, botox, and fillers?

MN: The short answer is no. Everyone needs to be treated individually. There has to be physician responsibility when individuals seek treatment at an inappropriate time or rather when it is unnecessary. However, there are individuals who have skin that begins to age more prematurely and rapidly than others. These are patients who could benefit from early interventional procedures as well as aggressive skin care prophylaxis.

JK: What is the most feared (albeit likely rare) complication from botox and/or fillers?

MN: Fillers can be injected intravascularly if they are inadvertently injected into a blood vessel. They can cause a blockage of blood flow and therefore skin necrosis or even complications like irreversible blindness. It is absolutely crucial to see only practitioners that are board certified and well trained. These complications are avoidable in skilled hands. There are both reversible and irreversible products, so ask questions before you decide to go forth with any procedure. With botox, there is a risk of undesirable cosmetic results if placed improperly. These are temporary and will resolve as the toxin degrades, but will cause distress over one’s appearance until that time.

JK: What are the latest products in the pipeline for youth preservation?

MN: Ultherapy and Cellfina. Ultherapy is a non-invasive way to lift and tighten skin on the face, neck, and also around the eyes. It utilizes high focus ultrasound and can be used at different settings to allow for the variety of treatment goals in younger and older patients. Cellfina is a vacuum assisted machine that breaks up areas of cellulite and is the most effective, non-invasive way to get rid of cellulite.

JK: Apart from cosmetic dermatology, you have a passion for skin cancer surveillance and prevention. What are your ‘words of wisdom’ for everyone who enjoys the sun but wants to be safe while doing so?

MN: Be vigilant! When there is a known family history, be on constant high alert but know that we are all at risk. The incidence of melanoma has quadrupled in the last 3 decades. We should all be doing monthly self skin checks with at least annual full body skin examinations by your dermatologist. If there is a personal or family history of melanoma, you may need to increase those full body checks to every 3-6 months. If there are any new growths or changes to long-term moles such as change in size/shape/appearance, bleeding, or itching, make an appointment to have it checked immediately. Skin cancer does not have to be black or brown, but may be red, flesh colored or even look like a patch of dry skin. Therefore, if something remains for two weeks always get it checked with your dermatologist. Remember to always use sunscreen, even in the winter at least spf 30. Apply it last after all other skin products. If you’re in the sun, reapply every 2 hours and check out Colorescience – it’s an easy-to-apply sunscreen mineral powder that can be applied over makeup. Lastly, know that you can get melanoma in or around the eyes, inside the mouth as well as in the genital area; therefore always be examined by a dentist, an ophthalmologist as well as gynecologist/proctologist for annual checks.

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