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Cosmetic dermatology is wonderful at improving facial and/or bodily features, but it is not permanent. Over time, you may need further treatments due to the effects of aging. So how can maintenance and treatment regimens help keep you looking as young as possible?The area(s) treated by cosmetic dermatology will still age right along with the rest of the skin. Because of this, it can be hard to determine exactly how long the results a treatment will last.

Skin and Its Construction

The skin is made up of three layers: the epidermis (surface), the dermis (below the skin) and the subcutaneous tissue layer (below the dermis). The epidermis is home to skin cells, amino acid chains, and pigment. The top of the dermis is made up of dead skin cells. Exfoliation gets rid of these dead cells, and improves its appearance. The dermis also has other parts to it, like oil, blood vessels, and hair follicles.The hypodermis has a very similar construction to the dermis, except that it contains fat as well. Connective tissue in both is supported by collagen fibers, which help support the skin in turn. Since collagen decreases as we get older, so does the elasticity of our skin. This can lead to thinning and sagging of the skin.

How Treated Areas Respond to Aging

Certain types of treatments can become more visible as we age. Breast implants are an example of this. If an untreated area has less collagen than a treated area, there may be more sagging in the untreated region. Remember, the treated parts of your skin or body may look better, but it will age just like the rest.

Losing Volume and Bone Mass

Facial bones lose their density over time, which may make the bone structure shift or otherwise change shape. The loss of collagen also plays a role. As a result, treatments like facelifts can result in distorted features in some people as they get older.

Laugh Lines, Crow’s Feet and Facial Movement

Due to the fact that we constantly move our faces throughout our lifetimes, we are bound to create wrinkles and other lines. This applies even after plastic surgery. Laughing, smiling, and frowning are still part of our non verbal expression as human beings, and this will affect the results of our treatment in the long term.

Treatment Plans

There are a number of ways to treat these changes in our appearance as time passes. Non-invasive and minimally invasive procedures may require ongoing visits. For instance, Botox lasts for three to six months. Restylane may last for six months or longer, while laser treatments may last up to five years or longer.In the best of all possible situations, plastic surgery results will last for ten years or more. Neck lifts can last for five, while eyelid surgery lasts for ten as well. Mini or micro procedures will only last five years. Implantable devices can vary; for instance, breast implants have up to a 30 percent reoperation rate due to aging of the breast or the patient’s desire for larger ones.

Things to Keep In Mind

There are a few things you will want to consider as you plan your treatments and comprehensive treatment plan. These are:

• Your doctor’s qualifications: How often has he performed this treatment?
• How you will look in the future: Will this treatment affect your facial expression and movement?

American Society for Aesthetic Plastic Surgery (ASAPS) statistics indicate that breast augmentation was the number one cosmetic surgical procedure performed on women in 2007 and breast reduction was number five on that list. Nearly 400,000 breast augmentation procedures were performed in 2007 and more than 150,000 breast reduction procedures. These numbers clearly indicate that many women have issues with the size and shape of their breasts and are willing to go under the knife to address them.Though not often discussed, it stands to reason that women opting for these surgeries are also concerned with the shape, size and location of the areola. The areola is the pigmented area of skin that surrounds the nipple. There are surgical procedures available to enlarge or reduce the areola and these are often performed in conjunction with the breast augmentation or reduction surgeries.There are now creative, new non-surgical options available to women that are unhappy with the shape or size of their nipples. It is important to many women that their areolae and nipples appear symmetrical, that they not be disproportionate or unmatched in size.Radiesse is a wrinkle filler that can be injected to create a larger nipple, enhancing its size and shape. Radiesse (formerly known as Radiance) is a filler FDA-approved for the correction of facial lines and wrinkles such as nasolabial folds. Radiesse is calcium-based microspheres suspended in a water-based gel and is injected into the skin through a simple, minimally invasive procedure offering immediate, visible improvement and providing long-lasting results.Radiesse can be injected to create a larger nipple and to smooth the texture of the nipple, addressing any asymmetries and improving the overall look of the breast. Radiesse can also be used to reduce the appearance of scars that were the result of previous surgical procedures.When used to treat facial folds and wrinkles, Radiesse is indicated to last for a year or more. Nipple augmentation or correction is a procedure that can be performed on an outpatient basis that takes only a few moments. And, as it is non-surgical there are none of the risks attendant with all surgical procedures.

Plastic surgery will not only affect your body, but it can also affect your mind, and this may not necessarily be a positive thing. Anticipation of the surgery, while exciting, can also be draining and stressful. If you are used to seeing your particular flaw every day, as much as you may not have liked it, its disappearance after plastic surgery may leave you disappointed and sad. In addition, family members may notice that the flaw is gone, and their hesitation to approve of your decision to remove it may make you uncomfortable. Lastly, the bruising and swelling, as well as overall pain and discomfort, may add to your depression.Depression after surgery is nothing new. In fact, the symptoms are similar to post partum depression. Disapproval from others, whether verbal or non-verbal, can make you feel angry and alone. Long stares from strangers can do the same. By the same token, the results can feel positive as opposed to negative.Those who are prone to depression and anxiety, as well as personality disorders, are more likely to experience postoperative depression. Many plastic surgeons provide pre- and postoperative counseling to help their patients make the transition, no matter how minor the surgery.

Confidence in Oneself

While plastic surgery can help improve self esteem, you must have a positive image of yourself before you ever undergo a procedure. Ideal candidates do not believe their lives will change completely for the better after surgery; they think positively about themselves in general, and see plastic surgery as a way to eliminate a flaw or problem area.

Great Expectations

Having realistic expectations for your plastic surgery experience is crucial to having a positive mindset later. Remember, the point of plastic surgery is to improve a specific area of your body. It will not necessarily change your life, although this is often a pleasant side effect.In a study done in 2005, the American Society of Plastic Surgeons noted that 75 percent of the respondents stated that they chose the procedure for an improvement in appearance and a more active lifestyle. The same percentage felt they had many more emotional and psychological rewards after the procedure. 45 percent also noted that they felt more attractive, and felt that they were benefited by it.

Important Things To Know

Make sure you discuss what your expectations are with your doctor. This will help you and your doctor synthesize your information, and keep you from developing unrealistic ideas about your surgery. Your doctor will also be able to discuss different procedures with you that may give you the results you want. It is important to distinguish between liposuction and a tummy tuck, and your doctor can help you make that kind of clarification. This kind of communication can help you figure out exactly what type of surgery you need to get your desired look.In addition, you should go over your medical information with your doctor. Cosmetic surgery can be as small as cutting off a skin tag or as major as a facelift; it is in your best interest to give your doctor as much information as you can so he can do the best job possible. In addition, your doctor may need to know some important information that you may not think is important. Do you have sleep apnea? Are you a heavy bleeder? Do you have a family history of circulation problems? Answering these questions may not mean you are disqualified from surgery, but your honest responses could very well keep you alive on the operating table.Patients who may be subject to great emotional changes will be screened by the plastic surgeons during their first consultation. Again, if you show signs of this, you may still be able to get surgery, but you may also be given a few precautionary measures to keep you safe.For those who are a high risk, the surgeon may recommend counseling before agreeing to do surgery. These would include:

• Patients going through divorce or other severe psychological stress may not be ready for surgery at that time,
• Patients with a desire to look "perfect" may also not be ready.
• Patients with mental issues will need to have their psychologist and their surgeon working as a team in order to qualify. This will not only consist of an evaluation of the patient's mental stability, but any medications taken before or after the surgery.

These precautions may seem time consuming and pointless, but as the saying goes, "an ounce of prevention is worth a pound of cure." It is better for the doctor to be fully prepared going into surgery than to have him attempt to rectify a potentially deadly situation.

Taken from Patients' Testimonials.When I meet Yolanda at Epione. I had been looking for someone who could help me for a long time. I have food allergies, was told I had Hyperglycemia, and was so frustrated. I have been working with Yolanda for 7 weeks and have already lost 11 pounds.I can't say enough about her program.When I started the program I knew it was different.I did not want a DIET. I wanted to loose weight by being educated on how to eat right.Her program looks at you as an individual. The best thing is Yolanda goes above and beyond what anyone else would do. She is always available and she helps you address the real reason why you put the weight on. It is hard to loose weight with no support. With Yolanda you have that support. It is worth every penny and more! No frozen pre-fixed meals, no pills that have side effects. Real ways to watch how you eat, find out why, and learn how to make smarter choices! That way, "I" can control keeping it off! I have more energy, feel more confident and am happy:) I have ten more pounds to go!! Oh and by the way, I was very adamant when I started that I did not want to workout. Anyone can workout 5 days a week, 2 hours a day and lose weight. I wanted to see how much I could lose without working out. I have so much energy I want to work out!!! That's the next step. If you have food allergies, Diabetes, or just want to lose weight I highly recommend working with Yolanda at Epione. You will not regret it!Thanks Yolanda!— Angela M

If you’ve ever had a problem with the shape of your nose, or had trouble breathing, rhinoplasty might be the solution to your problem. A rhinoplasty is simply a surgical alteration of your nose. Just about anything can be changed: the width of your nostrils, the shape of your nasal tip, and any irregularities in your nose shape. The bump in the middle of the bridge of your nose can be eliminated with a minor rhinoplasty.Rhinoplasty can also rid a patient of breathing problems, like ones that derive from a deviated septum. The septum is the wall in the nose that divides the nostrils. When it deviates, it can cause issues with breathing through the nose. Birth defects like cleft palates may require a rhinoplasty. Injuries such as a broken nose may also create breathing issues that require a surgical solution.

Getting Ready for Rhinoplasty

You may not eat or drink anything after midnight the night before your surgery. Try to quit smoking before you go in as well. One of the main reasons for this is because smoking can affect blood flow in the body. This, in turn, can affect the way your body heals. Drinking alcohol the week before surgery can have the same effect.Go over your medication with your doctor; he may ask you to stop taking certain prescriptions before surgery. NSAIDs, or Non Steroidal Anti Inflammatory Drugs, are an example. Other substances that may be contraindicated are Vitamin E, Omega 3 fatty acids and green tea. All of these can raise the possibility of increased bleeding. Remember, you must tell your doctor about all of the drugs and supplements you are taking, and never stop taking any medication without discussing it with your doctor first.

Risks of Rhinoplasty

• Nasal obstruction
• Touch ups
• Anesthesia problems
• Perforation of the septum (a small hole, which causes a whistling sound when talking or singing)
• Infection
• Bleeding
• Death

Different Versions of Rhinoplasty

Open Rhinoplasty is when the incisions are made in the thin strip of skin that separates the nostrils, called the columella. The columella and the soft tissue are lifted off the rest of the nose to allow the surgeon to see more clearly. This is done for major surgery.Closed Rhinoplasty surgery is has incisions made in the nose. The skin is separated from the bone and cartilage. The latter then can be reshaped or changed in whatever way is needed. Closed rhinoplasty is done for minor reshaping.Secondary Rhinoplasty, aka revision rhinoplasty, fixes problems from a previous nose surgery. Some may be minor, but many of them are major issues. This makes a secondary rhinoplasty harder to do. This type of surgery can also be done as open or closed.Filler Rhinoplasty uses injectable fillers to even out irregularities. Fillers can fill in depressions or make a bump less noticeable. This is the only solution that is not permanent.

How Do I Get a Rhinoplasty?

The first step is to see a doctor who specializes in this type of surgery. Your surgeon will take pictures of your nose at various angles. Your surgeon will also make sure that your expectations are realistic.Feel free to bring in photos of noses that you find attractive. This will help your surgeon establish what you are looking for, and give them an opportunity to show you pictures of people who have similar noses to yours, as well as noses that are similar to what you want. For the sake of balance, you may also want to consider chin augmentation as well.

The Procedure Itself

Rhinoplasty is considered an outpatient procedure. It will take place in a hospital or surgical room. The length of time needed will depend on the type of rhinoplasty chosen. A primary version could take up to three hours, while a filler procedure can take 15 minutes or so.Your surgeon will use local anesthesia with sedation or general anesthesia for a primary rhinoplasty. Since a secondary rhinoplasty is more complicated, general anesthesia is often best. For a filler rhinoplasty, a local anesthetic is all that is needed. The surgeon will then perform an open or closed rhinoplasty, and reshape the nose accordingly. The incisions are then closed and the healing begins.

So When Do I See Results?

Results will not be visible right away. It could take up to a year to see the full effects. Right after surgery, your nose will be packed with gauze to reduce bleeding and swelling. Pain medicine will help with the discomfort, and you should be able to control it without medicine within two days. Nausea is also a common side effect of this surgery.The first few days may involve some bleeding. Cold compresses and elevation of the head can help. After the first three days, you may be asked back so the surgeon can remove your stitches. For the first week, avoid any trauma to the nose, which includes blowing it. Decongestants will help. After this, the cast will be removed, along with the gauze and any other dressings. Splints may be placed around and inside your nose to help it keep its shape. The swelling will be mostly gone within a month. Within a year, all of it will be gone. After a year, you may then consider a secondary rhinoplasty.THE PURPOSE OF THIS ARTICLE IS TO ENHANCE, NOT REPLACE THE DISCUSSION AND CONSULTATION WITH YOUR PHYSICIAN SO THAT YOU CAN MAKE AN INFORMED DECISION BASED UPON THE RISKS, BENEFITS, AND ALTERNATIVES FOR YOUR SPECIFIC NEEDS AND DESIRES. AFTER REVIEWING THIS ARTICLE YOU WILL BE ABLE TO HAVE A MORE MEANINGFUL DISCUSSION WITH YOUR DOCTOR. PATIENTS NEED TO READ ALL CONSENT FORMS FULLY, AS THEY CONTAIN IMPORTANT INFORMATION REGARDING THEIR TREATMENT.

Psoriasis

According to the Nation Institutes of Health Psoriasis is a chronic (long-lasting), non-contagious, skin disease of scaling and inflammation that affects greater than 3 percent of the United States population, or more than 5 million adults. There are five types of psoriasis of which plaque is the most common. Typical symptoms for plaque psoriasis include:

• Plaques or lesions of red skin that are often covered with loose, silver scales. Plaques may be itchy, painful and sometimes crack and bleed. Psoriasis is most common in the knees, elbows, stomach, feet, hands, and face
• Crust on the scalp.
• Discoloration and pitting of the fingernails and toenails. The nails may also detach from the nail bed.

There are a variety of causes of psoriasis though some abnormality of the immune system is thought to be key culprit. Psoriasis episodes may be triggered by stress and/or injury to dry skin. Psoriasis also appears to have a genetic component, often running in families though commonly skipping a generation.Treatment for psoriasis ranges from steroids and salicylic acid applied topically; to phototherapy; to systematic and biologic medications for very serious cases.

Vitiligo

According to the National Institutes for Health 1 to 2 million people in the United States have this disorder. Half the people who have vitiligo develop it before age 20; most develop it before their 40^th birthday. The disorder affects both sexes and all races equally; however, it is more noticeable in people with dark skin. Vitiligo may appear in childhood. Adult onset generally occurs in men and women in their late 30s.The main sign of vitiligo is a loss of pigment that produces milky-white patches or depigmentation on your skin. This occurs when the body's cells that produce melanin doe or cease melanin production resulting in slowly enlarging white patches on the skin.There is no proven definite cause of vitiligo though there are several theories. Some believe it's an immune system disorder though there are reports of single event triggers (stress or sunburn for example). It's also believed that the increased occurrence of vitiligo within families indicates a hereditary component.There is no known cure for vitiligo. The goal of treatment is to stop or slow the progression of pigment loss. Sometimes it is possible to attempt to return some color to the skin. Treatment options include steroids applied topically or taken orally and photochemotherapy. In extreme cases surgical intervention may be an option, including skin grafting and melanocyte transplants.

Rosacea

National Institutes for Health data indicates that approximatelyt 14 million people in the United States have rosacea. This disease is most common in:

• Women (especially during menopause)
• People with fair skin
• Adults between the ages of 30 and 60.

Signs of rosacea include redness, papules, and swelling on the face. Though sometimes confused with adult acne, rosacea symptoms do not include blackheads. Rosacea frequently begins as a tendency to blush easily and may progress to persistent redness in the center of the face. Eventually this may spread to the forehead, cheeks, nose and chin. In extreme case the nose may thicken to produce a condition called rhinophyma.There is no known cause for rosacea though there environmental, genetic and vascular factors have been implicated. Rosacea suffers are urged to avoid oil-based facial creams and always protect themselves from the sun. Keeping the face physically cool by avoiding hot showers, baths and rooms is also recommended.

Treatment Options include

• Oral antibiotics
• Topical treatment such as Metronidazole cream or gel or creams containing azelaic acid
• Isotretinoin (This medication has serious side effects and is not suitable for everyone.)
• Medications to reduce flushing
• Nutraceuticals that target facial redness, inflammation and flushing
• Anti-inflammatory agents
• Oral non-steroidal anti-inflammatory agents
• Lasers can be used to reduce the appearance of blood vessels

Cellulite is the appearance of small pockets of fat on the thighs, abdomen, and buttocks of 90 percent of post-adolescent women. This uneven dimpling makes is a cause of distress for many and can occur in women of all sizes and shapes.

The Hormonal Connection

Cellulite tends to develop mainly in women undergoing a hormonal change. Puberty, pregnancy, and menopause are all examples of this. Hormones control lymphatic tissue, blood flow, fat storage and connective tissue buildup, all of which are factors of cellulite. Many different changes may happen to the fat layer over time, which can result in cellulite. And, as time passes, its appearance may worsen. A healthy lifestyle may help ease this problem and other treatments are available as well.

Treatments for cellulite focus on its appearance, not its elimination. Also, cellulite can continue to develop throughout out lifetimes, so no treatment can truly get rid of it. However, the appearance of cellulite can be improved by promoting drainage of the lymph nodes, tightening the skin, and enhancing skin tone. A holistic approach is the best way to treat this unsightly problem.

Popular Cellulite Treatments

Endermologie is a treatment that is FDA approved for cellulite reduction. Endermologie uses a set of rollers and regulated suction to massage away the cellulite. The massage stimulates blood flow and connective tissue growth, thus eliminating the cellulite. This procedure is non-invasive and non-surgical. It can also be used for skin toning.

OptiLipo is another treatment that involves small injections directly into the cellulite in order to dissolve it. The body then eliminates the fat with other waste. OptiLipo can be used on any section of the body that contains cellulite or smaller fat deposits, such as double chins or love handles.

Ultralipo is another advanced treatment for cellulite. It combines Transdermal Acoustic Therapy (TAT) and mesotherapy. The TAT treatment uses sonic waves to break up the collagen and releases the skin, smoothing out the texture. The mesotherapy then breaks down the fat tissue so that the body can rid itself of it. Patients may begin to see results soon after their last treatment, which can vary depending on the patient.

Massage in and of itself is excellent for increasing circulation and draining the lymph nodes. It can also relieve muscles spasms and gets rid of tissue buildup. Body wraps can cause temporary fluid loss due to compression and massage. They may use materials such as aloe, seaweed or mud. Unfortunately, massages alone will not decrease cellulite.

Electric muscle stimulators such as TENS units have occasionally been used to treat cellulite. The stimulators use a direct current to break up scar tissue below the skin, as well as fat cells and fluid pockets. Patients should be aware, however, that the FDA does not consider this type of treatment effective for cellulite.

Liposuction has been used to treat fat deposits and cellulite, but the focus is on fat areas, not the cellulite itself. Often, this distinction can be lost. In fact, when a great deal of fat is removed from an area that also contains cellulite it can make the cellulite look worse than it did prior to surgery.

Alpha-hydroxy acids and other creams and gels can help hasten the exfoliation process, which can help with new, tight skin growth. These are also not FDA approved for cellulite removal.

Losing weight can help shrink the size of fat cells, which will get rid of dimples. While diet and exercise can help reduce cellulite's appearance, they can never eliminate it completely. It can, however, make other treatments more effective.

Most people think of acne as something that affects only teens. But did you know that 50 percent of adult women and 25 percent of adult men suffer from it as adults? Regardless of age, you may find yourself with acne problems. Fortunately, there are plenty of new treatments on the market to help combat this issue.

What Causes Adult Acne?

So why is it, after using every cleaner and soap on the market, you can still find yourself with pimply skin? According to research, acne is caused when:

• Bacteria reproduce at an excessive rate
• Pores are blocked by oil and debris from the sebaceous gland
• The sebaceous glands are large and produce a great deal of oil
• Genetics and hormones usually play a large role in acne problems. It can also be caused by side effects of medications, pregnancy hormones, menopause, stress, oily makeup and profuse sweating.

When a pore is blocked by bacteria and oil, it cannot function correctly. This can lead to whiteheads, swelling, pus or fluid filled bumps, and scars. As with teens, adult acne often affects the face. However, it can also affect the arms, buttocks, legs and torso.Adult acne can leave sore, itchy, burning spots on the face. It can also be physically distracting, leading to low self esteem. Adults who rely on their appearance for work or relaxation are especially interested in treatments and remedies.

Hair loss affects both men and women. Women who suffer from hair loss tend to aggravate their condition more than men due to the varying procedures they use to style their hair. Blow dryers, dyes, straighteners, perms, and other methods can result in alopecia (hair loss) of various kinds.Men typically experience male pattern baldness, which is defined as a receding hairline and thinning crown, while women with female pattern baldness lose hair from the entire crown. Normal hair loss consists of losing 60 to 100 hairs a day, but when more is lost, the scalp may have trouble replacing them. According to the American Academy of Dermatology, more than 30 million women have a problem with excessive hair loss.

Causes of Female Hair Loss

There are many different reasons for hair loss, such as: skin diseases like lupus, hormone changes; major organ failure, such as kidney or liver; or any kind of cancer and chemotherapy. Other forms of alopecia include alopecia triggered by medication; traumatic alopecia or hair being pulled out of the scalp; and alopecia areata, hair loss in patches (which can often be reversed).Autoimmunity may also play a part in hair loss. Researchers have noted that autobodies can develop in the hair follicle for women with alopecia. In other words, the autoimmune system is destroying the hair follicles, which keeps them from producing hair. Figuring out exactly why hair is being lost is crucial to determining the best treatment.

Female Hair Loss Treatments

Minoxidil is the only medication approved by the FDA to prevent hair loss. This solution, applied to the scalp, stimulates new growth on the crown and reverses shrinkage. Patients use it twice daily and may start seeing results in four months. Steroids, which can be used to combat autoimmunity, are sometimes prescribed for women with this problem. These steroids usually come in lotion form and can be used in concert with minoxidil.Lasers may also help minimize hair loss. Red LEDs, or Light Emitting Diodes, can stimulate some hair growth by increasing blood to the hair follicles.Preliminary findings have shown that Botox injections into the scalp may effectively delay hair loss and even prevent baldness. Doctor Simon Ourian^™, Medical Director of Epione, an internationally recognized cosmetic dermatology destination in Beverly Hills has tested and refined the treatment over a period of three years with volunteer patients. "The idea behind the treatment is to reduce scalp tension and improve blood flow thereby improving the tissue environment surrounding the hair follicles," says Doctor Ourian^™. Recently Doctor Ourian^™ began adding a vitamin boost to these injections so as to enhance the efficacy of the treatments.According to Doctor Ourian^™"In my experience Botox and vitamin injections for baldness are safe and potentially more effective than anything I have seen before. Potential side effects are similar to those associated with a typical cosmetic Botox treatment and include temporary swelling, pain and bruising."Many women are now exercising the option of hair transplants, once solely the realm of balding men. There are many different options available, and all of them may contribute to a full, natural looking head of hair. The procedure takes healthy hair follicles, usually from the back of the head, and transplants them to the balding area. According to Doctor Ourian^™ though "a surgical treatment for baldness such as transplantation is a feasible option, it tend to be more costly than prescription medications or Botox injections."Drugs that stop the production of male hormones can also stop hair loss. Some women may experience a change in hormones with the onset of menopause or other conditions, and this can increase the amount of testosterone in their system. These drugs can block male hormones and keep them from interfering with hair growth.Other women may decide to use wigs and/or extensions, or other hairpieces, to hide their hair loss.

Preventing Female Hair Loss

The saying goes, "An ounce of prevention is worth a pound of cure." The following list can help women reduce, or even eliminate, the effects of alopecia.

• Wear hairstyles that are loose instead of tight
• Use shampoos that are not harsh on the hair
• Use conditioner regularly (there are situations in which conditioner can be used in place of shampoo; this practice is recommended for hair that is very curly)
• Reduce the amount of processing done to the hair, such as perms, coloring, flat ironing or curling irons

See a doctor at once if you think hair loss is an issue.

Fillers, From Animals to Sugar

The fastest growing segment of cosmetic science has been in the area of fillers. Bovine collagen, porcine collagen, and synthetic versions of calciums and sugars in humans are the favored methods for plumping up lips and cheeks, as well as filling in wrinkles and facial folds."I'm not one to say no one should ever get a facelift," Dr. Ourian^™ states, "but with the technology available now I do think it should be the final option, not the first. With fillers we can plump up areas of the face that have sunken with age. The results look natural rather than pulled."Bovine collagen was the most popular filler two decades ago, but patients lost interest due to potential side effects and allergy problems. Fillers using synthetic versions of hyaluronic acid, a natural sugar in the body, and calcium hydroxyapatite, or bone particles, were created to replace bovine collagen. Radiesse, Juvéderm, and Restylane are all examples of these types of fillers, and patients love them.Dr. Ourian^™'s preference is the calcium hydroxyapatite filler Radiesse. This is because the bone particle fillers trigger the body to surround the material with naturally made collagen. Chin and cheek implants, once a fixture before fillers, tended to look unnatural. Fat transplants were also a method of filling in sags and wrinkles, but since natural fat is absorbed back into the body, more was needed for the injection than looked appropriate. Also, the fat would not necessarily dissolve evenly. As a result, some patients would suffer through uneven lumps at the site of injection after it started to break down.

Nose Jobs On the Run

Got a less than a perfect nose bridge? If you've always wanted to get rid of that little bump or indentation, it can be done in minutes by a doctor. A filler injection is made and smoothed out around the area. You'll even have time to grab a little food before heading back to work. Touch-ups may be required for the next couple of years, and by then, science may have evolved to the point that the next one is permanent.

Waxing? Not Any More…

How do you get rid of unwanted body hair? Depilatory creams came out first, but they only kept the hair away for a day or so. Waxing was more popular, but that lasted for two weeks and could be very uncomfortable. Electrolysis was permanent, but was just as painful as waxing, and required more than one lengthy session. This is partly because each hair had to be burned out with an electric current.Fortunately, we have moved to the next stage in hair removal. Laser hair treatments get rid of hair without burning the skin or using harsh chemicals. The laser targets the dark pigment in the hair and destroys the hair at the root. Touchups may be needed, but long term hair reduction is possible.

In the Future, I See…

Because of the speed at which technology and medicine evolve, changes can happen in months, as opposed to years. In five years, Dr. Ourian^™ feels, patients will be less likely to get a full scale surgical procedure and be much more interested in total body approaches to regaining the appearance of youth. Many practices have already started to include a holistic approach, with skin care, med-spa and non-invasive treatments available.Fat and blood stem cells will be used to stimulate rejuvenation of the face over the next five years, according to Dr. Ourian^™. The fat can be harvested from anywhere, while the blood stem cells can be taken from near the belly button. The idea is to turn the body into a self healing organism. Dr. Ourian^™ is also looking forward to great advances in treating cellulite using non-invasive procedures to treat the unsightly affliction that is said to impact 90% of all females.

The recession has made it difficult for people to have cosmetic surgery the way they used to. But as the economy recovers, so has the number of procedures performed. The recession has had a notable impact on every business, including cosmetic surgery. However, recent improvements have led to an upswing in the physical enhancement department. Many women 50 and below have not forsaken their beauty treatments, regardless of their financial situation.Out of 1,000 women polled, 63 percent (ages 18–34) and 73 percent (ages 35–49) had a positive impression on procedures that fought the aging process. And according to E-Poll Market Research, out of the 18 to 34 year olds, 44 percent stated that Botox would be a routine procedure. Botox is given by injection to remove wrinkles, crows feet, laugh and frown lines. 70 percent of these women also stated that while the bulk of cosmetic surgery patients are women, it is perfectly acceptable for a man to have work done as well.Dr. Simon Ourian^™, Medical Director of Epione Beverly Hills, states that "Interest in cosmetic procedures is getting very strong again." He goes on to say, "This may be a sign that our economy is on an upswing."The procedures that have drawn the most attention have been the ones that are inexpensive, require minimal surgery, and have a very short recovery time. Age often determines the popularity of a particular treatment, but the most common ones are as follows.Botox: This noninvasive treatment is the most popular choice for patients over the age of 30. It is composed of very small amounts of the toxin Chlostridium botulinum, which freezes nerve impulses. This paralyzes the muscles in the area, which gives the face a much smoother look. Botox is used in the face and neck to eliminate wrinkles, lines and creases.Chemical peels: The skin's outer layer can be damaged by sun, wind or ordinary aging. And as time passes, skin can develop scars, wrinkles and uneven pigment. Chemical peels take care of this problem by using phenol, trichloroacetic acid or alpha hydroxy acids to remove the layer of injured skin. The chemical is applied to the skin then removed after a specified amount of time. Side effects may include redness and irritation, but these typically last for a short period of time. Aftercare instructions are provided by the doctor. If the instructions are followed properly, the patient is left with a smoother, more even appearance.Laser skin resurfacing and Coolaser treatment: This procedure uses a laser to treat damaged skin in order to allow healthy skin to grow in its place. A numbing solution is applied to the face first. With the Coolaser treatment, the skin is cooled before the procedure takes place. Only one millionth of an inch of skin is treated at a time, which allows the doctor to control how much treatment is needed and how deeply the skin is treated. The heat from the laser stimulates the skin to produce collagen, which results in smoother, tighter skin. Side effects from this treatment can include redness and irritation as well patient's skin is improved in appearance, and has had one of the greatest increases in use since 2005 among both sexes.Hyaluronic acid: This injectable filler is the base chemical in Restylane and Juvederm. It gets rid of wrinkles, certain types of skin folds, and other lines on the face. It can also be used to plump up thin lips and hollows under the eyes and in the cheeks. Side effects can include soreness and swelling at the site. Depending on the product chosen, the results can last from six to eighteen months.Liposuction: Liposuction is an invasive procedure, but it is the number one cosmetic surgery treatment chosen for people between 20 and 59. Liposuction removes fat deposits from the body, slimming and reshaping it in the process. The procedure has a much longer recovery time than any of the others listed here, and the side effects are more prominent (temporary numbness and bruising, among others) but the results can be quite impressive.

Stem cells have created controversy since they were first discovered. Scientists are still on the lookout for ways to use them, and the cosmetic surgery industry is no exception. The company NeoStem has thrown its gauntlet into the ring by applying for a patent for stem cell face lifts. According to NeoStem these pluripotent (able to grow into any type of cell) cells are injected into the face. As they grow, they reduce signs of aging, like wrinkles and sagging, and encourage cell growth and regeneration. The skin becomes plumper and better toned over treatments.The best part about the procedure is that stem cell facelifts are not major surgery. Healing time is only a fraction of what is needed for a traditional facelift. The patient is simply give a local anesthetic, and the injections are administered to the problem areas. Soon enough, the patient is on their way. The speed and efficiency of the process will be enough to make it very popular.L'Oreal and its scientists are currently researching stem cells and their effects on the aging process. Their hope is to figure out how stem cells help regenerate the skin. If they reach their goal, they will have made huge strides in determining how that knowledge can be used for anti aging products. They are hoping to make their mark in the anti aging market soon.

Research into the human genome has the potential to answer many questions for human beings. Scientists are now looking at the genome in order to find the genes that cause wrinkles. The researchers are hoping that the information they gain will help them slow down, if not stop, the aging process. Ideally, they will be able to create lotions, creams and other treatments that will help.A group of scientists, led by Procter & Gamble, have found roughly 1,500 genes that are connected to the aging process, thanks to genome research. After studying these genes, the team feels they have determined the major causes of wrinkles and other signs of aging. Due to this, they hope to be able to address aging itself soon.The truth is, the best anti-aging products on the market do not do a great deal to affect the aging process. They treat the disease instead of the cure by plumping up the skin or smoothing out wrinkles. And some of the traditional beauty secrets are actually based in truth. Showing the signs of age is based in environment and genetics. The scientific team from Procter & Gamble noted the following as major factors:

1. Photo Aging: Sunlight provides many healthful benefits, but too much can hasten the onset of wrinkles and other signs of aging. It can also affect the skin negatively by destroying the genes designed to keep skin healthy.
2. Antioxidants: These help the skin defend itself against free radicals, but they weaken over time. Free radicals can then affect the skin and cause more wrinkles.
3. Collagen: Unlike the genes that control hydration, the genes that control collagen destruction become more active as we get older. This may cause additional wrinkles. There may be as many as 40 genes that affect the destruction of collagen in the skin.
4. Inflammation and/or swelling: 400 genes affect inflammation, according to the research. They also become more active as we get older, and they contribute to wrinkles as well.
5. Hydration: The skin naturally collects and traps water. As we grow older, our skin loses its ability to do this due to the inactivity of the genes that control it. As a result, we hold less moisture in the skin and wrinkles start to develop.

In the future, researchers hope to be able to increase the longevity of healthy skin and eradicate the aging process. By identifying these genes, they have taken the first step to doing so.

Anika Therapeutics, well known for its research in hyaluronic acid products, has created a filler, Hydrelle as its latest entry to the market. This filler is a hyaluronic acid; it can be used to fill in facial wrinkles. In particular, Hydrelle works best on nasolabial folds, or laugh lines. According to the company, a Hydrelle injection is roughly half the size of a normal filler injection.Side effects are still the same—swelling, redness, tenderness and bruising. However, this is the first filler that contains lidocaine, an anesthetic. As a result, a patient who chooses Hydrelle will have fewer injections and less pain during the process. This will allow the process itself to be completed sooner, and the patient's recovery time will be improved. Physicians will also enjoy the benefit of having a painkiller automatically included in the medication, which saves them the step of having to numb the patient first. Patients interested in this treatment should make an appointment to talk to their doctors as soon as possible.

When looking in the mirror, most people's eyes are immediately drawn to their facial flaws. This can be a constant source of insecurity. While wrinkles might give us character, they can also adversely emphasize our age. Coolaser is a non-surgical method to arrest the appearance of the aging process. The treatment is relatively quick and easy, especially compared to a traditional surgical facelift, resulting in healthier and smoother skin.

Doctor Simon Ourian^™, Medical Director of Epione Beverly Hills, pioneered the development of the Coolaser. "I wasn't happy with the other laser modalities that were available," says Doctor Ourian^™, "so I set about to create a treatment process that gave me the precision I needed." Coolaser utilizes a laser light that is absorbed by the water in your skin cells. The absorption in turn causes the instantaneous vaporization or destruction of the cell. As Doctor Ourian^™ passes the laser light over your skin, a mere 30 millionth of an inch of tissue is removed at a time. This incredible control allows your Doctor Ourian^™ to treat only as deeply as needed, from removing wrinkles to merely refreshing your overall skin appearance. After the damaged skin is removed, new skin will quickly re-grow in its place.

You should avoid sunbathing or tanning for up to two months before your treatment. If you have cold sores, you may also want to discuss this with Doctor Ourian^™; this treatment may cause stress to your skin and trigger an outbreak. "In this situation I may prescribe a prophylactic course of an anti-viral medication such as Valtrex or Zovirax," says Doctor Ourian^™.

The Coolaser procedure is simple:

• Visit Doctor Ourian^™'s clinic for an initial consultation. There you will discuss your expectations, as well as your medical history.
• After this is done, you will make another appointment for the treatment.
• Then, after following the pre-treatment instructions given to you, you will go to the office on your appointed day and the staff will prepare you by cleaning and numbing your face.
• The entire process will take between 30 minutes and two hours, depending on the extent of the treatment.

After your treatment, you may experience some swelling. Cold compresses will help with this. Your skin may be sensitive, but refrain from picking at any crusting or you run the risk of scarring. And continue to avoid excessive heat, such as sunbathing or tanning booths. Acetaminophen is recommended for the pain. Last, but not least, temporarily refrain from strenuous activity and keep your skin moist to encourage even healing. The cost for each treatment can range depending on what area is being treated.

The benefits of laser skin resurfacing are obvious—with no cutting, minimal or no bleeding, it evens out skin pigmentation, removes or reduces wrinkles, reduces scars and acne scars and removes discoloration. The results of laser skin resurfacing are long lasting. The minor lines and blemishes will be gone, leaving you with a fresh perspective on your appearance. As with other subtle procedures, you will still look like you, only better.

My mother is a lucky woman. At the age of seventy two, she has managed to keep her skin looking young and supple. In fact, aside from her salt and pepper hair, she looks almost exactly the same as she does in her junior high school picture. Now, not all of us can be this fortunate. Over time, many of us will suffer the visible effects of aging, including wrinkles, laugh lines, and frown creases. Others of us are simply not satisfied with our overall appearance; we may feel our lips are too thin or our cheeks not full enough. Fortunately, whatever your condition, there's a way to remedy the situation. Juvéderm can help get rid of the appearance of these age related issues and keep us looking wonderful.Juvéderm is made up of hyaluronic acid, which is naturally found in the skin and absorbs water. This is what gives collagen its fullness and elasticity, and is present in healthy, plump skin. However, over time, there is less hyaluronic acid found in the skin, and the collagen starts to lose its features. In turn, our skin becomes thinner and saggier—not a desirable development.Doctor Simon Ourian^™, Medical Director of Epione Beverly Hills explains further, "Hyaluronic acid plays an important role in the way your facial skin looks, feels, and functions. It's a major component of the connective tissue matrix in the dermis—the dense, inner layer of skin beneath the epidermis. This matrix is made up of hyaluronic acid as well as two connective fibers—collagen and elastin. As we age and our skin is exposed to the sun's ultraviolet rays environmental pollutants and, our cells gradually lose the ability to produce hyaluronic acid. Our skin tissue becomes dehydrated and the collagen and elastin fibers lose their structure, resulting in a loss of skin volume and the formation of the facial wrinkles and folds.""However," concludes Doctor Ourian^™, "injections of Juvéderm help restore the skin to its fullness and hydrate it back to health. In fact, you don't have to wait for the effects; they're visible right away."The week before your appointment, you should avoid taking Aspirin, NSAIDs (non-steroidal and inflammatory drugs), St John's Wort, or high doses of Vitamin E. Also, avoid any alcohol. All of these can increase bruising and bleeding on the skin. If your treatment is around your mouth, be sure to eat before your treatment, since you will be asked to avoid moving your mouth for up to four hours afterward.First, you and your doctor will discuss your treatment. For example, what areas do you want improved and why? The doctor will evaluate you and your suitability for the treatment at this time. After that, you can schedule your treatment with Juvéderm. On your appointment day, after following the preparation instructions you were given, you arrive and the doctor begins. At your request, the doctor can numb your skin. The injections are done at specific points throughout the area, and only a tiny amount is injected at a time. The entire procedure will take 15 minutes per session. After the treatment is complete, you'll be on your way!After your treatment, you may experience some swelling. This will disappear in approximately twenty four hours. Tenderness and some redness are common. Also, discuss with your doctor the best time to start wearing makeup or other face products. Juvéderm is the only hyaluronic acid filler with FDA approval to last up to one year.

So you've worked really hard to lose weight. You've dieted, you've exercised, and you've done your best to avoid food cravings and other temptations. Despite your efforts, those stubborn love handles and double chin refuse to go away. If this sounds like you, it may be time to consider mesotherapy as a treatment.OptiLipo is a revolutionary treatment that melts fat away in specific areas using a chemical that appears in bile acids (found in the human body) and cell membranes. Injections are given every two weeks, with the number of injections varying depending on the amount of fat in the area. OptiLipo works particularly well with cellulite, dissolving and smoothing out the affected area. Due to the body's natural healing response, an additional benefit of mesotherapy is skin tightening."One reason that I'm pleased to offer mesotherapy," says Doctor Simon Ourian^™, Medical Director of Epione Beverly Hills, "is that we can use it to treat cellulite directly. Liposuction, on the other hand, does not treat cellulite and often ends up enhancing preexisting cellulite, making the cellulite more prominent. With mesotherapy the result is often a smoother skin surface.""What mesotherapy can do over the course of several sessions," continues Doctor Ourian^™, "is block the body's ability to store fat and stimulate its ability to burn it. We can target specific areas of fat and treat that area directly by injecting a blend of medications, vitamins and supplements."The optimal results of cellulite removal by mesotherapy are seen three weeks after the last treatment. Patients can see visible firming and smoothing of the skin, including:

• Improved skin texture
• Improved skin elasticity
• Increased tone and firmness
• Reduced circumference and a more refined figure

It is important to note that mesotherapy, as well as other cosmetic weight loss procedures, such as liposuction, are not recommended substitutes for a healthy diet and weight loss plan. On the contrary, mesotherapy is intended to aid a healthy diet plan and help remove fat pockets that diet and exercise alone may not remedy. An ideal candidate is within 25 pounds of their ideal body weight. Being as fit as possible before undergoing the procedure will maximize the end results.During your treatment, the desired area will be injected and the process will take between 15 to 30 minutes, depending on the treatment area. After treatment, side effects are minimal. In rare cases, small nodules may form in the injection areas. These aren't harmful and should disappear in a matter of weeks. OptiLipo doesn't involve surgery or anesthesia.Although an effective treatment for many, mesotherapy isn't an ideal treatment option for everyone. Diabetics, people on blood thinners, those with hypertension or heart problems, or any debilitating condition, should not undergo this treatment.

We've heard a lot about ways to take care of our skin, from simple moisturizing to complicated beauty regimens. But what, exactly, are we trying to take care of? We live in a society of treating the symptoms instead of the disease. Because of this, the truly basic components of our skin—amino acid peptides—should be discussed. Here's what they are and how they play a role in our skin, as well as how to rejuvenate and rebuild them.So here's some information worthy of your high school biology class: our skin is made up of a number of different proteins, such as hemoglobin in the blood, keratin in the skin, melanin (which gives us our skin color), and so on. Each one of those proteins is made up of amino acids. Chains, or peptides, of these amino acids are what give the proteins their structure. When the skin is damaged, these amino acid peptides are damaged as well.Fortunately, you can reverse the damage done to amino acid peptides. The right type of skin cream works below the surface of the skin, encouraging the amino acids to produce collagen and elastin. Collagen helps our skin stay firm, avoiding wrinkles and sagging, and elastin keeps our skin from losing its flexibility. Since our skin loses more and more collagen over time, boosting its production by stimulating the amino acid peptides will keep you looking younger longer.When Doctor Simon Ourian^™, Medical Director of Epione Beverly Hills, designed his EPIONE Signature Series Restoration Firm & Fade he instructed his laboratory to include ingredients to boost collagen. Says Doctor Ourian^™, "I wanted the Restoration Firm and Fade to not only lighten and even out skin tone but to help the skin build collagen. That's why we included tetrahexyldecyl ascorbate and dipalmitoyl hydroxyproline in the formulation."Doctor Ourian^™ continues, "Studies have indicated that tetrahexyldecyl ascorbate not only stimulates collagen but also inhibits the production of pigment, promoting a more even skin tone. It does this without exfoliating or irritating the skin. Dipalmitoyl hydroxyproline is a plant-derived, natural amino acid that is essential for skin collagen synthesis."Doctor Ourian^™ reminds us, "Keeping your skin young looking, however, involves more than just a great skin cream and a daily cleansing regimen. Exercise helps you keep your body healthy, and forces you to drink fluids (especially during warm weather). The better your body functions, the better your skin will look, and the longer it will take to show damage. Drinking a lot of water will also keep everything hydrated and functioning the way it should.""Last but not least," concludes Doctor Ourian^™, "stay out of the sun. Beach trips are wonderful, but make sure you're wearing an SPF with a minimum of 30, a wide brimmed hat, and sunglasses. Don't forget to reapply that sun block every two hours for best results! I recommend EPIONE Sunblock – Protect & Correct (SPF 40+)."Amino acid peptides may sound like something that belongs in a lab, but they're a very real part of your skin's health. Remember, your skin is the largest organ on your body. Treat it well, and you'll reap the rewards. For more information on EPIONE Signature Series Restoration Firm & Fade and EPIONE Sunblock – Protect & Correct (SPF 40+) go to www.epioneskincare.com.

Your weight can cause problems with acne.Being a person of generous proportions can be a wonderful thing. You never have to worry about anyone seeing your ribs, you have a healthy appetite, and, if you happen to be a woman, you have curves that other women can only dream about. Unfortunately, you tend to be worse off when it comes to acne.Doctor Simon Ourian^™, Medical Director of Epione Beverly Hills, sees patients in all shapes and sizes. He explains that "carrying extra weight can lead to several skin conditions." Doctor Ourian^™ contributed to this article and goes on to say: Here are some of these conditions and what you can do about them. Your diet may be high in fact and sugar. This means an increase in the amount of sebum (oil) in your skin and it will clog your pores. This, of course, leads to breakouts. The goal is to figure out how to get your skin to shed this oil, as opposed to having it stay on your skin. Changing your diet can help; eating meals higher in fiber and protein instead of fat and sugar can help your skin clear itself up. In the meantime, wash your skin regularly and use a cleanser designed for acne control. Pay attention to ones that have no soap or oil in them, otherwise you may find yourself breaking out due to dry skin.As a large person, you may also notice that you sweat more than your skinnier counterparts. This is mainly due to the fact that you generate more body heat than they do with a lot less effort; great on a freezing cold day, but very irritating on boiling hot ones. This sweat, coupled with the oil mentioned above, can also clog your pores and lead to acne. There a very simple way to deal with this. Again, wash your skin regularly. Removing the sweat will keep it from causing breakouts and will also keep you smelling fresh and clean.The healthiest way to handle all of these skin problems is to lose the weight one way or another. Along with the previously mentioned change in your diet, an exercise program is a great way to burn those calories. You don't have to do anything overly strenuous to begin with. A walk around the block is the perfect beginning. As you notice your stamina improving, gradually work your way up to more strenuous activity. And do your exercise with a friend or at the very least an iPod, to keep yourself motivated. The best bonus of all is that not only will you notice a change in your skin, but a change in your overall health as well. You will find yourself with more energy and, in the long run, a longer life span. Of course, before you start any type of exercise or diet regime, check with your doctor to make sure it will work for you. At Epione we offer nutritional counseling and a weight loss program for our patients. The weight loss will result in clearer skin and an even more wonderful you.

A new procedure helps treat acne for all skin types.How do you treat your acne? Do you squeeze your pimples? Do you use expensive creams and abrasive pads that irritate your skin and leave you blotchy and uncomfortable? Do you wash your face religiously and hope that the pimples disappear before any important events? There are many different ways to treat acne, but as you can see, they can range from useless to scar inducing. And many of these treatments don't take people of color into account, whose skin will develop raised scars if not treated correctly. Well, worry no more, because Epione Beverly Hills has developed a skin treatment called the Coolaser that gets rid of acne and other skin problems.So how does Coolaser work? The skin is cooled down using a combination of numbing cream and super cooled air, and then a rapid pulse laser is flashed on the area. The light instantly vaporizes the skin cells on the first layer of skin. Your body then begins to replace the old skin cells with new, younger looking ones right away. A moisturizing cream is applied to your skin right after the procedure, soothing your skin and eliminating dryness. Since the lights treat at a depth of one ten millionth, this means a faster recovery time and less scarring for you. Before you know it, in 15 minutes or less you'll be back on the town!The lack of scarring is what draws olive and darker complexioned people to this method. Keloids, or raised scars on the skin are not an attractive option for many people. In fact, they may feel as though they're stuck. If they treat the acne using conventional means, it may not work and they wind up with acne scabs and scars. If they use more high tech methods, it may go wrong—and they could still end up with scabs and scars. Coolaser avoids the entire problem by not overly damaging the skin. Scar tissue doesn't have a chance.Patients that have had Coolaser treatments typically report that the procedure only causes mild discomfort that usually fades soon after the treatment. Best results are usually obtained by staying out of the sun and using the creams provided. In particular, users who suffer from severe acne report a dramatic improvement in their looks and skin tone after having Coolaser done. After having suffered from acne for years, they can finally have the smooth skin they've been waiting for all their lives. Many wish they'd discovered the process sooner, and most recommend it to anyone with a skin problem.There's no better way to treat severe acne than Coolaser. It's quick, it's easy, and it's effective. Men and women can use it. So can any skin type, without fear of scarring. The fast recovery time and dramatic improvement are an added bonus as well.