Predicting the Future

Dr. Patricia Wong's Newsletter
735 Cowper Street
Palo Alto, CA 94301
650.473.3173

Patricia Wong, M.D

Have you ever wondered what you will look like 20 years from now?Do this revealing test in the privacy of your home.Place a small mirror between your legs with your feet hip distance apart. Now bend over with your palms in front of your feet and place your head between your legs and look into the mirror.Notice the increase in deep lines in your face and wrinkles that appear under the eyes and on the cheeks. As we age, the collagen and elastic fibers that provide tissue supportbecome fragmented and disappear.  This causes a decrease in skin elasticity and fullness; your face begins to sag and sink into itself and this causes increased lines on the lower face as gravity pulls facial tissue south.

Osteoporosis of the facial bones also occurs. You should be consuming 1000mg to 1500mg of calcium a day in your diet to help minimize these changes.If your vitamin D level is low, take a supplement 800 IU a day. Your vitamin D level can be checked by a blood test. Thinning of facial bones causes the bones to become smaller and the skin drapes over the smaller bones rather than in a smooth taut manner.

Antioxidants can help combat oxidation of collagen and elastin fibers but it is equally important to be on an effective skin care regimen that stimulates and increases collagen production. The most effective treatments are prescription strength creams. Laser facials can stimulate fibroblasts (collagen producing cells in dermis of the skin) to make collagen. Typically 6 treatments are recommended to see results. Laser facials are painless and there is no down time. This treatment is best used as a preventative measure and will not reverse deep lines and wrinkles. The latter require more intensive treatments for improvement. Volume loss is best corrected with dermal filler injections. This may require 4-6 syringes of filler depending on how much volume needs to be replaced. Sunken cheeks will sag onto the mouth and cause deepening of the so-called smile lines.

The Food and Drug Administration has tightened restrictions on permanent dermal fillers becauseof complications that can occur 1-6 years after injection. The most recent filler to be discontinued is ARTEFILL. The company has declared bankruptcy. Patients were developing purple red hard bumps underneath the skin on their face. These nodules may not go away with treatment and may require surgical removal. Currently, the best option is hyaluronic fillers, such as Restylane. Hyaluronic acid is a normal substance present in the dermal layers of the skin. Hyaluronic acid composes the dermal matrix to which collagen fibers attach, giving your skin structure and volume. Although these are temporary fillers, the results can last up to 12 to 18 months. Also, if you are not satisfied with the correction it can be reversed with an enzyme injection that will dissolve the filler. Current studies demonstrate that hyaluronic filler can stimulate your own cells to produce collagen. This is an addedbenefit.