A DRINK THAT MAKES YOU FEEL AND LOOK BETTER! WIN/WIN!

8greens

A drink is not what I expected to be featuring on this blog, but I have become a fan of this particular product.  I struggle to drink the fluid I am supposed to, (other than my morning coffee and a margarita here or there!)  so a product that tastes good and has health benefits is a win for sure.

8greens or 8G was developed by a woman looking to improve her own health.  Dawn Russell, a cancer survivor, was seeking ways to improve her daily intake of nutrient rich food, greens in particular.  Over a number of years she was able to perfect her recipe and deliver a product that tastes good (refreshing citrus flavor) and provides the consumer with a kick of energy producing nutrition.

8G contains spinach, wheatgrass, kale, bluegreen algae, spirulina, aloe vera, chlorella and barley grass.  This proprietary blend, according to the web site, has:

  • as much Vitamin C as 6 oranges
  • as much B12 as 7 cups of milk
  • as much B5 as 15 cups of broccoli
  • as much B6 as 6 cups of spinach
  • as much zinc as 10 cups asparagus
  • is alkalizing
  • decreases inflammation
  • increases circulation
  • increases collagen

It does not have:

  • sugar
  • wheat
  • gluten
  • allergens
  • dairy
  • preservatives
  • salt

The greens are dehydrated (with no enzymatic or chemical  breakdown of the nutrients  in the process) and are in small effervescent tablets that dissolve quickly in water.

One a day is recommended although as many as 3 a day are considered fine.  I felt the need to figure out the price per serving as the product is not inexpensive.  I buy the six packs which are $78.  Each tube has 10 tablets so that comes out to approximately $1.30 a serving.  My soda machine here at work is $1.00 a soda so it actually seems pretty reasonable to me.  And a whole lot healthier!

What I notice when I drink an 8G is more energy and focus, likely due to the B vitamins.   I like the idea of getting extra greens as I love my veggies and eat a lot of salads, but know I frequently do not get the recommended daily intake of greens/veggies.   It is a way to help with my hydration, which I struggle with.  I try to have one 8G a day and a cup of green tea.  Two  fluids with health benefits.  I tell myself my morning coffee is also loaded with antioxidants:-)

The product is available on the 8G website, 8greens.com, and at Nordstrom and Neiman Marcus.

If you are a soda drinker, this is a great replacement.   Cheers!

 

 

CURRENT FAVORITE EYE PRODUCTS

I have a few eye products in my rotation and feel they all have passed the test of time.  I have been using several of them for a number of years.

My two favorite eye creams, which I have at all times, are:

Alastin Eye

Alastin™ Restorative Eye Treatment™

  • Tri-Hex Technology™ which is a group of peptides that help to stimulate elastin and collagen, minimizing fine lines and increasing skin turgor around the eye area.
  • strengthens skin which helps to minimize any sagging, especially of the upper eye lid.
  • reduces puffiness and dark circles
  • brightens and evens skin color
  • has a gel like consistency,  although it is a cream, I like using it as an AM eye cream because it wears well under eye make-up.

microeye

Neocutis Micro⋅Eyes Rejuvenating Balm

  • Utilizes MPC™ technology which is also a group of peptides which have anti-aging skin benefits.
  • minimizes fine lines, crepiness, puffiness and dark eye circles.
  • wild yam and moisturizing lipids fight dryness and textural issues.
  • THIS is a super hydrating eye cream if you have issues with dry skin in the eye area.  It is like butter! (in a good way)
  • I like this product at night, as it is hydrating enough that I prefer a lighter cream during the day under make-up.

 

maybelline

Maybelline  Instant Age Rewind® Treatment Concealer

  • This very reasonably priced product has been on the market for a number of years and is available at your local grocery or drug store.  It is a product I use under my eyes everyday as part of my make-up routine.  It works just as well as any high end under eye concealer I have used and has the added benefit of having several peptides in its ingredient deck.  I prefer the brightener, which is a pinker shade and really brightens the undereye area.  The product is available in multiple shades for a variety of skin tones.  My feeling is if I am using an under eye concealer on a regular basis, why not have it have benefits for my skin!  I think I have been using this for 7+ years and occasionally try a higher end option, but go back to this tried and true product.

 

VYCROSS TECHNOLOGY

 various vycross

It has been a while!  I hope everyone had a good summer and that the new school year is off to a good start!

I thought I would do a quick blog on some of the newer HA (hyaluronic acid) dermal fillers that have come on the market.  As an injector I have been utilizing Allergan’s offerings with Vycross® technology.  These products inject very smoothly, have good malleability and moldability and tend to create less swelling for my patients. (not ZERO swelling, but less)   As an injector it makes my job easier and for my patients the treatments are well tolerated.  Additionally, the product lasts longer due to Vycross® technology.

The Juvederm® family of products have been available for a number of years.  Juvederm Ultra® XC and Juvederm Ultra Plus® XC utilize hylacross technology, the predecessor to the newer line of products.   Vycross® technology blends different molecular weights of hyaluronic acid and have enhanced cross linking to increase the duration of the product in the dermis.   The newer products, Juvederm Voluma®, Juvederm Vollure™ and Juvederm Volbella® have given injectors and patients more options to choose from.

The products have differences which make them suitable for different areas of the face.  Voluma® has 20 mg/ml of Hyaluronic Acid, tends to be very cohesive and is frequently utilized in the mid face to replace lost volume and to create lift.  Vollure™ has 17.5 mg/ml of Hyaluronic Acid and tends to be much less cohesive than Voluma® and works well in areas where finer correction or more subtle volume is desired.  Volbella® has 15 mg/ml of Hyaluronic Acid and works well in fine lines, such as perioral lines (smoker lines).  Volbella® smooths very easily once injected.  In general, the less the HA concentration the softer and smoother the product.   You and your provider can determine which products to use to achieve your aesthetic goals.  It may be that you can benefit from several of the products.

vycross face

All of the products mentioned have 0.3% lidocaine added to make the injections less painful.  I also pretreat with topical numbing and use ice during the treatment.  There are also occasions when a 2% lidocaine dental block is helpful.  For example, lip injections.

The duration of the products varies patient to patient and the companies literature tends to promise more than it can deliver.  BUT, I do find these products are outperforming their predecessors and longevity has improved.  All of the HA fillers have a good safety record and have minimal side effects.

 

DON’T BE SCARED

injection

I received an email from a client this weekend referencing an article which ran in the New York Post on July 7th.  She asked, “Should I be scared?”

The article, “Doctors warn popular cosmetic procedure may cause blindness”, written by Rebecca Sullivan, addresses some of the worst, and rarest, complications with injectable fillers.

One of these very rare complications is blindness.  There have been approximately 100 cases documented of blindness related to the injection of  dermal filler world wide.  These cases, statistically, are extremely rare.   The incidence has been highest when injections have been performed deep in the glabella area.  (between the eyes)  There have also been cases involving injections into the nasolabial folds and the nose itself.  When filler is injected deeply it can be introduced to one of the facial arteries and then can make its way to the retinal artery, resulting in blindness.  Blindness has not been reversible in the documented cases.  This rare adverse event has been reported with the injection of autologous fat and dermal fillers, such as hyaluronic acid fillers.  (Restylane®, Juvederms®, for example)   The occlusion of an artery can also cause soft tissue damage or tissue death (necrosis) . Although, still very rare, there have been more cases of this adverse event reported than blindness.  Infections have also been reported and are also very unusual.

Just the prospect of any of the above can make someone think twice before pursuing facial injections.  Here are a few pieces of information to put you at ease as a patient.

  • Seek out a provider with experience and an extensive understanding of facial anatomy.
  • Seek out a provider at an established and reputable office, ideally with a physician  on site.
  • Ask your provider if they have hyaluronidase in the office.  This is an enzyme which breaks down hyaluronic acid fillers.  If can be utilized in an emergency, but most often is used in outcomes that the patient or provider want to reverse.
  • Know that the majority of complications (such as swelling and bruising) are mild and self limiting.

Even in the hands of the most experienced injectors, risk still exists.

As a provider:

  • Know your facial anatomy!
  • Avoid deep injections in high risk areas.
  • Have an emergency protocol and kit available should the need arise. (hyaluronidase, nitro paste, ASA)
  • Aspirate before injecting.
  • Inject slowly
  • Only place boluses on periosteum.
  • When appropriate, utilize a cannula, especially in high risk areas of the face.

I have seen several references to this article on social media.  I think it is important to inform the public that facial injections have a long and safe track record.  I think that the article referenced does shed light on the fact that facial injections are not without risk and a patient should be educated and informed.  Choosing a provider wisely is so important.

But, in the right hands, you should not be scared!

 

 

NOT JUST YOUR FACE

We make a considerable effort to protect and care for the skin on our faces but can neglect the skin on our neck, décolleté and hands.  As we officially enter in to these summer months, I wanted to remind everyone to also pay attention to other commonly exposed areas.

Sun screen and antioxidants are the best defense.  Avoiding the high sun hours between 10-2 or even 10-4 is helpful. (although tough to accomplish if you love the outdoors!)

But what if there already is damage?  What can be done?

Pretty much anything that can be done to the face can also be done off face.

hands

chest # 1

IPL (Intense Pulsed Light) is very effective at removing sun spots (hyperpigmentation).  The hands and chest are commonly treated with this modality.  The pigment will return if the area is not protected from the sun though, so invest in a sunscreen with zinc!  Additionally, consider protective clothing if your will be out during hours of the day when the sun is intense.

For those fellas out there (or even women with very thin hair) make sure to protect your scalp as well.  Since I am adding to the list, let me also include ears!  This is not only about hyperpigmentation, skin cancer commonly occurs in all of these areas!

Enjoy these warm summer days!  Safely!

 

SKIN CANCER AWARENESS MONTH

SUNSCREENSMay is Skin Cancer awareness month, so I thought I would do a quick blog on sun protection and skin care in regards to sun exposure.

Approximately 1 in 5 Americans will have some type of skin cancer in their lifetime.  Skin cancers are the most common type of cancer in the United States of America.  Protection from damaging UVA/UVB rays can help improve ones odds significantly.

Some basic tips include avoiding sun exposure between 10-4, wearing broad spectrum sunscreen, wearing protective sunglasses, wearing broad rimmed hats and seeking shade whenever possible.  But when you find yourself in the sun, your choice of sunscreen protection is important.

When purchasing sunscreen look for broad spectrum, meaning, protects against UVA and UVB radiation.   Broadly, UVB rays burn our skin and UVA rays go deeper and damage the skins structure. Both increase cancer risk.  Both contribute to premature aging of the skin.

In the sunscreen market there are chemical sunscreens that are referred to as absorbers.  They absorb the UV rays and convert them to heat.  There are a long list of these chemical agents and some cover either UVA, UVB and some absorb  both.  There are approximately 20 FDA approved agents.  These chemical agents have a maximum amount of absorption and then loose their effectiveness unless reapplied.  Physical agents, such as zinc dioxide and titanium dioxide, reflect the UVA/UVB rays.  I always discourage patients from focusing too much on the SPF factor because an SPF of 15 filters 93% of the UV rays while SPF of 30 filters 97%.  Going to an SPF of 50, 70, 80 or 100 does not significantly improve your protection factor.  Reapplying, however, does.

I am a big fan of physical agents as they are the least likely to cause irritation, work immediately upon application and offer broad spectrum UVA/UVB protection.  When applying make sure not to miss the eye area, ears, backs of legs, feet, lips, and if you are bald or have thinning hair, the scalp.  Sunscreens with zinc and titanium are not the thick greasy kind we remember from our childhood.  They are now micronized and have a cosmetically elegant feel.  Do not under utilize your sunscreen.  When applying to your whole body you should use several tablespoons of sunscreen.

There are increasingly sunscreen garments that can add protection.  Rash guards are increasingly popular and fashionable.  When purchasing sun protection wear make sure it has a UVP rating on the label.  Do not rely solely on this as a means to protect your skin.

Finally, I wanted to review protecting eyes.  Repeated and cumulative UVB/UVA exposure to the eyes can contribute to cataracts and macular degeneration.  Eyelids (upper and lower) are one of the most common sites for non melanoma skin cancers.  The lower lids are more effected than the upper lids.  Sunscreen and sunglasses with UVA/UVB protection are vital.  Skin cancers on the eyelids do not always present the same way as elsewhere on the face.  These types of cancers tend to infiltrate and can effect ocular structures, thus putting site at risk.  Those with light colored eyes and skin are more at risk.   Ideally your eyelid skin is evaluated by your dermatologist yearly.

That brings me to the importance of yearly skin checks.   A yearly skin check should be part of your routine medical evaluation.  Depending on your risk factors a physician may determine if this should be done more or less frequently.  There are also physicians who will skin map you if you are at higher risk.  (take photos to reference back to,  helping to  evaluate changes over time)  I had mine mapped as I am a fair red head who spent part of her childhood in the South Pacific with year round sun exposure and am covered in acquired nevus (brown skin lesions/freckles).   If you feel you have too many spots to keep track of skin mapping may be a good option.

I am a huge fan of the Elta MD® line of sunscreens (thus the photo) and encourage everyone to find their favorite sunscreen.  If you love it you will use it!

Happy Memorial Day weekend!  Protect yourself while having fun out there  🙂

HOW ABOUT THE NECK?

neck

A youthful neck only lasts so long.  It is an area of the body we commonly receive consultations on.  Did anyone read Nora Ephron’s brutally honest and sarcastically funny book, “I Feel Bad About My Neck And Other Thoughts On Being A Woman”?!  She had a thing or two to say about her neck!

But seriously, we tend to take good care of our faces but neglect our necks.  There are many options for our necks.  From topicals creams,  injectables, skin firming treatments, and finally, surgery.  This will be a quick and easy breakdown of modalities to address a variety of issues that can effect the neck.

As we age the skin on our neck becomes thinner, the platysmal bands show, looking  like cords in our neck.

platysmal bands

Platysmal Bands

Our sub mental fat pads can become more apparent and we loose the definition along our jawline, altering our profile.

neck fat

Sub mental fullness

The tissues can become looser, frequently due to repeated pulling of the platysma muscle along with the loss of collagen and elastin.

loose neck

Loose skin/loss of collagen/elastin

Skin can  become discolored.  A condition called Poikiloderma is common in both men and women.  The skin is marked with a combination of hyperpigmentation and redness (from vascular injuries from sun exposure).  Poikiloderma frequently involves the chest in addition to the neck.  Most often the medial neck is not affected.

poikiloderma

Poikiloderma

I think we can agree the first photograph in this blog looks better than all the others!  So, how to get closer to that….

Platysmal bands can be easily corrected with Botox®.  Botox® is injected along the platysmal band and within two weeks the band will relax and not show.  Additionally, doses of Botox® can also be injected along the mandible (jaw bone) to improve the jawline contour.  This is sometime referred to as a Nefertiti Lift.  This is a quick, non-invasive procedure.

Sub mental fullness can be addressed with Kybella® injections.  The injection of this acid breaks down the fat which is then eliminated by the body.  A series is generally recommended.  Other than 48 hours of socially awkward swelling (think bullfrog), this is a low down time procedure.  The procedure is ideally repeated at 4-6 week intervals.  We are noticing patients experience some skin retraction with this procedure as well. (likely as a result of the inflammatory process in which collagen is stimulated)

The loss of skin turgor can be treated with a skin tightening treatment, such as Ultherapy®.  During this treatment heat is delivered deep in the tissues, using ultrasound, creating tightening and lifting.  This is also a low to no down time procedure as most people can receive an Ultherapy® and return to their activities without anyone knowing.  The improvement is gradual over the next 4-6 months as the collagen that was stimulated grows in.

Discoloration, such as Poikiloderman, can be treated with a series of IPL treatments.  Again, other than redness the day of treatment, this is a minimally invasive/no downtime procedure.  We recommend a series of 3-5 treatments.

I do not want to underestimate the importance of good skin care.  Sunscreen is a no brainer.  There are also products specifically formulated to treat the skin of the neck and décolleté.  My current favorite is Neocutis® Microfirm™.   This topical product, utilitzing peptides and glycolic acid,  increases elasticity and improves skins crepey appearance.  It can also help to fade hyperpigmentation.

microfirm

Finally, there comes a time when the tools and products we have in a medical spa are not enough.  There is a time when the neck is best addressed with a skilled surgeon.  A neck lift involves redraping the skin.  Additionally the platysma muscle is reattached and tightened.  You and your skin care provider ideally have honest conversations along the way allowing to make this call when it is appropriate.

Anyway, don’t forget your neck!  Hope this gives you some helpful tips:-)