Dr. Katie Beleznay

Vancouver Skin Care Specialist

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

Shaping the Perfect Profile

Was Marilyn Monroe onto something? In the cosmetic world there has been a big focus on the lower face and jawline, emphasizing the importance of the chin for balance and symmetry. In this age of selfies, there has even been a term coined: “profiloplasty,” which refers to aesthetic treatments used to improve a patient’s profile.

At a recent meeting we discussed that injectors shouldn’t just be giving our patients mirrors, but showing them photographs, so they can see their face in 3 dimensions rather than just the frontal view.  It impresses me how many millennial patients seem to know their proportions; they often ask about the chin and jawline and want to improve the profile of their nose. How do people know what their nose looks like in side profile or that their chin is slightly retruded? They know because they take selfies from all angles!  As cosmetic physicians it’s important that we think of the face from all angles. Yes we can fill a cheek or soften a fold, but we need balance, symmetry, and harmony between the different facial features. A full cheek may look imbalanced if present with a weak chin and lower face. 

This brings me back to Marilyn Monroe. In the US, a person’s right to medical privacy ends 50 years after their death and in 2013 Marilyn Monroe’s medical records were auctioned off.  These records seemed to indicate that Marilyn Munroe had chin augmentation in the 1950s. Could this have contributed to her iconic beauty? Most would agree that she is one of the timeless beauties. So perhaps Marilyn was indeed onto something with the focus on her chin and in photographs she really worked those angles to emphasize her stunning chin and jawline!

Marilyn

Say Cheese: The Power of a Smile

There has been a great deal written about the benefits, from happiness to health, of smiling. Studies have shown that forcing ourselves to smile tricks our brain into thinking we are happy. The simple act of smiling spurs a chemical reaction in the brain, releasing dopamine and serotonin. Dopamine increases our feelings of happiness while serotonin is associated with reduced stress. So a forced smile is certainly better than no smile at all.

Research has also been done that demonstrates the power of a genuine smile. This genuine smile is referred to as a Duchenne smile, named after French physician Guillaume Duchenne who studied the physiology of facial expressions in the nineteenth century. In one long-term study,  photos of young women were reviewed and those with a Duchenne smile were significantly more likely to report higher marriage satisfaction and overall well-being up to 30 years later. One could conclude that those who smile regularly and sincerely are more likely to lead happy lives.

Can you tell the difference between a genuine smile and a fake one? Studies have shown that even at young ages children can tell insincerity with facial expressions. When you look at the two images below, the smile on the right portrays two hallmarks of a Duchenne smile: contraction of the zygomatic major, raising the corners of the mouth, and the orbicularis oculi, raising the cheeks and producing crow's feet around the eyes. Since contraction of the orbicularis oculi happens naturally when we smile but cannot easily be faked, the absence of crow’s feet can signal an insincere smile (or the result of being “over frozen”).

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For patients undergoing treatment with neuromodulators (Botox, Dysport, Xeomin), preserving the natural smile is essential. Patients who receive too large a dose of a Botox in the crow’s feet may appear to have a fake or insincere smile even when they are genuinely happy. Don’t get me wrong, I think a small amount of neuromodulator for crow’s feet is a wonderful option to soften lines and prevent wrinkles. Also receiving cosmetic treatments can help patients to feel better about their appearance overall, increasing confidence and happiness (resulting in more smiles!). Choosing the right injector will make sure that your emotions continue to show and your face doesn’t appear “frozen.” One of my guiding principles as an injector is to make sure patients achieve natural looking outcomes. Understanding the facial anatomy and ensuring that injections to lessen the appearance of crow’s feet do not eliminate the appearance of that natural, genuine Duchenne smile is very important!

Tips for Radiant Winter Skin

This post originally appeared on the Carruthers & Humphrey blog

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It’s no great surprise that your skin care routine should be modified alongside the seasons — but winter can be particularly stressful. In addition to harsh weather, there’s the added pressure of the holidays and often an increase in food and alcohol consumption, all of which impact your health and the health of your skin.

While much of our advice rings true throughout the calendar year (yes, always use an SPF — even in January!) there are a few specific things you can include during the winter to keep your skin extra protected.

Ante up your moisturizer.

If your cure for a stubborn winter chill is a hot shower or bubble bath, you definitely aren’t alone. But all that extreme heat can do a number on your already dehydrated skin. Be sure to lock in moisture post-shower by applying a thicker emollient or moisturizer, like Skinceuticals Triple Lipid Restore for the face and Cerave moisturizing cream for the body.

The same goes for hand washing during cold and flu season: increased hand washing necessitates increased moisturizing to avoid having this exposed surface dry out even faster. And if you’re especially prone to dry, cracked lips, consider using a hydrating balm or ointment like vaseline and keeping a lip treatment like HA5 Lip in your pocket throughout the season.

Tack on laser treatment.

Winter is a great time to get laser or light-based treatments, because it is recommended to minimize sun exposure following treatment. While you make plans to approach 2019 with a refreshed outlook and updated goals, why not add a rejuvenated appearance to the list with IPL or Clear + Brilliant?

Reconsider your drink order.

New Year’s resolutions aside, there are other reasons to consider minimizing your alcohol consumption at this time of year. When your skin (not to mention your overall health) is already working overtime to combat cold, dry weather, limiting your alcohol intake can go a long ways — and the same goes for caffeine. By setting some healthy restrictions on these dehydrating beverages, you can keep your skin healthier and more hydrated all winter long.

Boardroom Botox: Can Cosmetic Procedures Boost Your Career?

The following Q&A was conducted with The Kit for an article that was published in October 2018.

1. When did you first notice an increase in patients electing to have procedures done because of their careers? Were you surprised at first? And how common is it now?

Looking younger and feeling better about their appearance are common reasons patients give as to why they are choosing to have cosmetic procedures and these directly or indirectly impact both their personal and professional lives. So I don't think having procedures done for career benefits is a wholly new phenomenon but rather it is becoming more top of mind for patients when they discuss their motivations. I don't see that many patients that I would say are doing cosmetic treatments solely for career reasons, but for some it may be the impetus ie. applying for a new job or wanting to look and feel on top of their game. Feeling and looking good can of course impact confidence and studies have shown that both appearance and confidence can impact job opportunity, promotion etc.

2. What are some of the things patients routinely say to you about why they’re having something done/why it’s so important?  Has anyone told you they actually felt pressure or faced comments at work that made them worry about looking older?

I have had patients who have shared personal experiences where they felt that appearing younger provided them an advantage in a business setting. And even if it is simply a matter of feeling more confident, that alone can be a major career benefit. I had one patient where in her company the people all being hired around her were younger and she felt some pressure to fit in.  For others it’s more about maintenance and prevention, so not so much about wanting to look younger, but rather wanting to work on steps to maintain healthy skin. Sometimes there is a driving force like they got their passport photo after 10 years and were surprised at the changes since their last photo or they have an upcoming high school reunion or wedding.

3. What is driving this phenomenon? Are people under more pressure to look younger in general, but especially in the context of work/career?

I think that some people express a desire (or feel pressure) to look younger, but it has also become more acceptable to talk about that and to act on it. Coupled with that is the fact that cosmetic procedures have become more mainstream thanks in large part to the many non-invasive options that require very little down time (away from work) and the open discussion and wealth of information about options on social media. People are constantly seeing before and after photos of people after various treatments and all the information about the different options is quite accessible.  I had one patient say … she invests in nice clothes and purses, she dyes her hair every 6 weeks, and she started to realize that if she’s spending so much on that, she wanted to also invest in her face to make sure she is doing what she can to keep things looking healthy and vibrant. Even though there is often a request to “look younger” I try not to focus on “anti-aging”, but rather review specific personal goals to help people feel great and look and feel rejuvenated whatever their age. 

4. Around what age do people tend to start coming to you with career-related concerns? Does it differ for men and women? What’s the youngest you’ve seen people start worrying about looking older on the job?

It varies quite a bit and really depends on the industry. For example those in the entertainment industry may start earlier. I do have patients in their 20s who see me for small treatments simply to maintain their appearance and slow down signs of aging. In fact, starting small doses of "preventative" botox early can save you from needing more significant treatments down the road.

5. What do women and men typically have done? And how does this tend to evolve over the years (for example, might someone start with Botox in their 40s, then begin adding treatments as they age?)

When people start out they may focus on their skin and developing a personalized skin care plan that is preventative and can help give the skin a little glow. Those with concerns like sun spots or redness may consider a laser or light based treatment to help. Botox and filler have become increasingly popular. They are non-invasive and there is increasing evidence on their ability to not only improve appearance, but also prevent signs of aging over time, and there has been a renewed focus on natural looking outcomes.

In terms of what options are best at which age, it has less to do with age and really is patient-specific i.e. some people in their 20s may have deep frown line and conversely someone in their 60s may not and may focus on other things such as skin tightening or body sculpting. Similarly some patients genetically may be prone to a double chin (at any age) and they may consider an injectable like Belkyra to help reduce that.

6. What are some of the most popular options out there now?

The popular options vary depending on individual patient needs. Complexion enhancing treatments are always popular, so for example IPL to help remove brown spots and reduce redness or microneedling that can stimulate collagen production and help smooth out skin and minimize the appearance of pore size and acne scars. Neuromodulators such as botox are extremely popular and can help soften lines and wrinkles in different areas of the face. Fillers can provide a little lift to help with sagging skin and can be done conservatively for a natural looking outcome. CoolSculpting is quite popular as an option to permanently reduce pockets of fat. There are many other treatments available and I like to review the patient’s main goals for treatment.

There are always new treatments in this field.  Belkrya, which we have been using to reduce the fat in the double chin area, is now commonly being used in other areas. One area we are more frequently treating is the jowls to help contour along the jawline. 

We are also more frequently seeing people for treatment of their necks. One common concern is necklace lines, so called “tech neck”. These lines may be increasingly seen from looking down at computers or phone. SkinBoosters or Volite (both a hyaluronic acid solution) can help to soften those lines. Volite is new to the market in North America, but has been available in Europe and popular there. It is an innovative injectable designed to improve skin quality and help with hydration and elasticity and is commonly used on the face and décolletage. 

If you’re interested to learn more about cosmetic treatments, contact us to book a consultation.