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. In the use of injectable Botox, the effect occurs at a contained location, specifically where it is injected in the muscle. 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 reduces the strength of the muscle in that area, thereby minimizing 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 dynamic 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.  For deeply etched in static lines, soft tissue fillers may need to be considered as well.

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 specialist trained in the use of injectables. My hope with this post was simply to provide a better understanding of how Botox works. 

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.  

5 Winter Weather Skin Tips

The seasons have changed and the holidays are upon us. To add to all the year-end excitement (or stress) of visiting family, office holiday parties, and crowds at the mall, many people are also dealing with increased skin issues due in part to colder weather. 

If you want to protect and rejuvenate your skin this winter here are my top 5 tips along with products I recommend to my patients, especially this time of year.

1.    Stay hydrated. This is important year-round but often as temperatures drop people forget to continue drinking water and instead increase their intake of coffee, which can dehydrate the body and dry out your skin and lips. Wine and salty foods, which tend to be consumed in larger amounts throughout the holiday season, also have a dehydrating effect. So be sure to drink plenty of water.

2.    Increased hand washing = increased moisturizer. Tis the season for colds and the flu. In order to keep your health in tip-top shape, prevention is key with hand washing and/or use of a hand sanitizer regularly. It's actually a misconception that hand sanitizers are more drying. Studies have shown that soap and water can dehydrate your hands even more. Either way, after cleansing your hands, it is important to rehydrate using a thick moisturizer. Carry them in your purse or pocket if you can.  

3.    Switch to Creams and Balms. Lightweight moisturizers should be substituted for heavier creams and balms that provide deeper nourishment for the skin. Generally I recommend maintaining your daytime routine and switching to something heavier at night. Vaseline also works wonders on dry, cracked skin on hands and feet.

4.    Always Remember SPF. No dermatologist’s list would be complete without a reminder to protect your skin from the sun, no matter what time of year. Especially if you are a winter sports person, remember that the sun reflects off the snow, amplifying the effects. Using suncreen or lotion with SPF year-round will help maintain your skin over the long run. And don’t forget to use lip balm with SPF too.

5.    Humidify. Using a humidifier is a good way to replenish your skin’s moisture. If you don’t have one you can also get a humidifier-like experience by closing the bathroom door when you shower to create a more humid environment.  However, long, hot showers will work against your skin so limit showers to 5-10 minutes and keep the water warm but not hot.

Some of my favorite products to protect against harsh winter weather are:

• Hand moisturizers: Norwegian formula hand cream, Cetaphil hand barrier cream. Consider putting thick moisturizer like Vaseline in a cotton glove for better penetration. 
• Body moisturizers: CeraVe Cream, La Roche Posay Lipikar Baume, Aveeno eczema cream.
• Sunscreen: La Roche Posay Anthelios (SPF 30, 45, or 60), Neutrogena Ultra Sheer (SPF 30, 45 or 60). There are many other good brands out there and the most important thing is to be sure that whatever sunscreen you use has broad spectrum coverage.