Dr. Katie Beleznay

Vancouver Skin Care Specialist

Dr. Katie Beleznay is a leading dermatologist specializing in the latest treatments to repair and rejuvenate the skin

Q&A on Cosmetic Treatments

I was recently interviewed for an article in the Vancouver Sun where I shared some thoughts on popular cosmetic treatments. Below is a summary:

Who is a good candidate for treatments such as microdermabrasion, dermal fillers and botox? 

Anyone looking for a little pick-me-up for their skin, whether they are looking to improve the tone and texture, lift sagging skin, or reduce fine lines and wrinkles, is a good candidate for these types of treatments. However, not everyone is a good candidate for each of these treatments. A person who has significant photoaging (i.e. sun damage) and wrinkles may not see a dramatic improvement with microdermabrasion; conversely a younger patient with good volume and minimal lines/wrinkles may not be the best candidate for filler (at that time) and may want to focus on preventative skin care strategies first.    

Are there any age ranges that are too old or too young for certain types of treatments? 

There is no optimal age for getting these treatments. It really depends on the individual and their skin. There are patients in their late 20’s who have deep frown lines and may be great candidates for neuromodulator treatment such as Botox. In fact, studies have shown that starting with minimal amounts of Botox earlier on can have a preventative effect to reduce deep lines and wrinkles later in life. On the other side there are many patients who benefit from cosmetic treatments well into their 70’s and beyond.  

How do people go about finding a reputable practitioner? Especially when it seems like almost every salon and spa offers some type of non-surgical treatment? 

Trusting the practitioner you see is important, not only for best outcome with the treatment, but also for reducing complications. When it comes to injectables there are certain risks that can be mitigated when being treated by a physician who has specialized fellowship training in cosmetic medicine. I think it is worthwhile to review the credentials of the practitioner and meet with them for a consultation to make sure you feel comfortable proceeding with the proposed treatment plan.

How do medical professionals manage people’s expectations pre and post-treatment? 

Managing expectations is a very important aspect of what medical professionals need to do. It is important for patients to have a thorough consultation with their physician up front to make sure they know how many treatments will be required, anticipated effects from the treatment, how long the treatment will last, etc.  With any treatment, some people are going to be on the lower end of response and others may get a dramatic improvement. So it’s important to counsel around that.  For all cosmetic treatments we do photos before the treatment and at follow up after the treatment, so that we can review together the progress that is being made - this is especially useful for treatments that require multiple visits.     

Botox Basics

Some of the most frequent questions I get asked are about Botox and how it works, so I wanted to share some basic information for anyone thinking about getting botox treatment. Botox can be used for many things, including treatment of migraines and excessive sweating, but this post will focus on cosmetic Botox treatments for reducing wrinkles.

Botox is a brand name for botulinum toxin A, a neurotoxin that causes the condition known as botulism. The type of botulism most people have heard about is food borne and can be very serious if not treated as it can spread through the blood stream. In the use of injectable Botox, botulism occurs in a contained location, specifically where it is injected in the face. Here the botulinum toxin attaches to nerve endings. Once attached to the nerve endings it inhibits the release of the neurotransmitter responsible for triggering muscle contractions. 

Essentially Botox “freezes” the muscle, thereby reducing the appearance of wrinkles as muscles remain relaxed. The effects of Botox will last for 3-6 months.

One of the most common uses for cosmetic Botox is to treat the hyperdynamic lines, often called “worry lines” or "frown lines" found in the upper third of the face. These lines are formed due to repetitive muscle action in specific areas. A specific area of use is the glabella, where Botox is used to treat the “11s” (the lines made when you furrow your eyebrows). Botox can be used to treat horizontal forehead lines, “crow’s feet” and "bunny lines." We also use Botox to provide a lateral eyebrow raise, to help with dimpling of the chin, and to minimize large masseters (the muscle on the lateral face that we use to chew). There is a large list of areas that can be treated with Botox but these are the most common.  

Many people think of wrinkles and assume Botox is the best treatment. However, it’s important to understand that Botox works to treat dynamic wrinkles, not static wrinkles.  Dynamic wrinkles only appear when you make facial expressions, for example when you furrow your brow, frown, or smile, so you don't see them when your face is still. Static wrinkles, on the other hand, are wrinkles you have even when your face is at rest. For example, if you have 11s in between your brows without moving your face, those are static wrinkles. 

If Botox were to freeze the muscles around a static wrinkle, it wouldn't make that much of a difference in the appearance since the wrinkle would still be there with or without any muscle contraction. However, with long term use, Botox can help prevent shallow static wrinkles from growing deeper. 

The bottom line is that Botox can help reduce wrinkles in motion, not wrinkles at rest. Botox will not help for lines that are deeply etched in your skin. For these static wrinkles we often need to consider soft-tissue fillers.

Obviously the decision of whether or not Botox (or any other cosmetic treatment) is right for you is one that deserves careful consideration and should include consultation with a dermatologist trained in the use of injectables. My hope with this post was simply to provide a better understanding of how Botox works. For additional information, there is a good post on Real Self that addresses some common myths about Botox.

Double Options for Double Chins

People often complain about the dreaded double chin. Until recently patients have had very few options for treatment of this condition. For many, fullness under the chin is simply the result of genetics or aging. And for those who have developed a double chin due to weight gain, they may find it frustrating that even with weight loss their double chin will persist.

Fortunately there are new treatments designed to reduce or eliminate submental fat (the fat below the chin). Targeting this area for treatment can help patients rediscover or redefine the shape of their chin and jaw. Currently there are two primary treatment options, both of which are available through my cosmetic practice at Carruthers & Humphrey.

Belkyra

Belkyra is a new non-invasive injectable treatment. Carruthers & Humphrey was one of the first Canadian clinics to offer Belkyra to patients. Our office was involved in the clinical trials and helped bring Belkyra to market. 

The Belkyra injection targets the cell membrane of the fat cells that cause the double chin. The fat cell are disrupted and the contents diffuse into the surrounding subcutaneous space. The body then naturally removes these free fatty acids safely. Belkyra is generally effective after two to four treatments with relatively easy recovery.

CoolMini

A new specialized applicator from the makers of CoolSculpting, the CoolMini is designed specifically for the treatment of small areas, including submental fat. CoolMini is an an effective and non-invasive way to target fullness under the chin. It can also be used on other areas such as the ‘bra bulge’ and localized fat around the knees. As with CoolSculpting for other areas, the procedure freezes and ultimately kills fat cells in the targeted area. Over the following weeks and months, your body disposes of the dead cells and the result is a visible reduction in fat in the treated area.

If you are interested in learning more about treatment options please speak to Dr. Beleznay or contact the office to book a consultation.

2016 AAD Updates

I recently returned from the 2016 American Academy of Dermatology Conference in Washington D.C., where I had an opportunity to share some of my research and get updates on all the latest in the field of dermatology. It was a wonderful meeting with over 18,000 in attendance! 

Once again there was much discussion of psoriasis and the new biologics available for treatment, as well as the importance of screening for other medical conditions such as high blood pressure and heart disease in these patients. Counseling psoriasis patients to stop smoking, minimize alcohol consumption and maintain a healthy weight was emphasized.

Another interesting topic was a review of treatment of pre-cancerous lesions such as actinic keratoses with topical chemotherapy creams. This can be combined with therapies such as liquid nitrogen for improved outcomes. Photodynamic therapy is another way to treat these lesions for both a medical and cosmetic improvement. As the population ages and there is an accumulation of sun damage, treatment strategies for both pre-cancerous lesions and skin cancers will become even more important.

On the cosmetic side there was a focus on combination therapy for rejuvenation of the aging skin and discussion on complications from treatments. I had the opportunity to present on facial vascular anatomy and strategies to prevent and treat vascular complications including blindness from filler.  I also was invited to teach in a hands-on workshop where I educated other dermatologists how to inject filler in various areas of the face to get the best cosmetic result. Participants were able to practice injecting directly into a training model to practice their skills.

Overall it was a great meeting with lots of pearls shared. I'm looking forward to next year's meeting in Orlando.