Renew. Revive. Refresh. The Wonderful World of Aesthetic Dermatology
In 1960, the first working laser was used. The following year saw the first medical use of a Ruby laser which treated retinal tumors of the eyes. As tools, lasers have revolutionized our ability to treat the skin. Over the last half a century, this evolution has opened up possibilities of treating sun damage ranging from premature wrinkles and lines to brown spots, dilated red and blue vessels and even precancerous sun spots. Various scars can be improved as well as treating disfiguring birthmarks. In short, lasers improve the quality of the skin.
There are four aspects of aging skin, termed "the 4 D's":
- Deterioration - this refers to the skin itself - approximately 90% of our skin's aged appearance is from sun damage - lasers help address this
- Deflation - we lose volume as evidenced by hollowing around the eyes, cheeks and mouth - dermal fillers address this by supporting and lifting
- Descent - skin laxity, a result of collagen loss, leads to jowls and neck folds - this can be addressed non-invasively such as with focused ultrasound and pulsed radiofrequency therapies
- Dynamic lines - this refers to excess lines such as frown and crows' feet lines due to over-expression - Botox is the common treatment used to soften these lines
Dermal fillers have also evolved such that we treat the entire face rather than simply chase wrinkles. By restoring lost volume, more natural and longer sustained results are possible such as with the non-animal hyaluronan fillers like Restylane and Juv?derm. Botox has been around for over 20 years and while being a worldwide phenomenon, it originated here, in Canada - Vancouver in fact. Paradigm shifts have occurred that have led to more natural and better results while reducing risks and minimizing downtime.
Another exciting area is in non-invasive body contouring. Utilizing focused ultrasound technologies, systems such as the UltraShape V3 and LipoSonix permanently remove fat around the tummy, hips and thighs as well as provide gentle skin tightening.
If there is a cautionary point, it is the footnote that, concurrent with the rapid evolution of technologies, there is also a rapid increase in treatment providers which include many non-physicians such as dentists, nurses and nail technicians. For the public, the lines are blurred when they seek treatments with so-called aesthetic specialists who are not true medical specialists. Their learning curves are necessarily steep and they do not have the knowledge that a five year Residency and Royal College certification in Dermatology provides to properly diagnose and treat the skin.
My own history is that of a physician of 24 years with Royal College of Physicians and Surgeons of Canada and American Board Certification in Dermatology over 15 years ago. I have always been fascinated with the skin and its ability to interact with the environment. I spent part of my Dermatology Residency studying photobiology, the interaction of light and the skin, at St. John's Hospital, in London, England. In 1998, I established Cosmedica Laser Centre in Victoria, BC. The concept was to offer a comprehensive service to my patients employing the latest in technologies.
I am thrilled to be working in this field of "happy medicine," to brighten peoples' days and see the extra degree of confidence they now wear. In upcoming issues of Homes & Living, I will address some of the latest trends and exciting developments that help to create the "Wow" we all deserve and restore healthy skin.
Dr. Mark Lupin BSc MD FRCPC FAAD
Dermatology Director - Cosmedica Laser Centre
Regional Director - Canadian Dermatology Association
Clinical Instructor - University of British Columbia