Q: When it comes to fillers, how do you avoid that unnatural look?
A: My approach to using fillers is to augment a patient's natural beauty and to help diminish the visual impact of the natural aging process. Facial fillers replace the volume that we naturally lose or that falls to our lower faces as we age. To ensure a more natural look, it is essential to thoroughly examine the needs of each patient to replace volume carefully.
Q: How long do filler treatments typically last?
A: How long a filler treatment will last depends on the treated area and the product used. I think of different fillers as building a house. First, you want thicker, more substantial fillers for the foundation in areas like the cheeks, temples, or chin. These facial fillers tend to last the longest, and some can last up to two years. Then, you think about the furniture, which is the medium thickness fillers that are useful for the nasolabial folds or the marionette lines. These fillers can last up to one and a half years. Lastly, think about the throw pillows and other accessories, which are the thinnest fillers for fine lines, tear troughs, and the lips. These fillers last about a year. That said, every patient is unique, and the amount of time that it lasts can vary from person to person.
Q: How does hyaluronic acid improve skin complexion? Is it true that it can be drying?
A: Hyaluronic acid is a natural component of our skin. It binds water leading to a plumping effect in the skin. Many facial fillers are made up of hyaluronic acid to help replace age-related volume loss. There are products on the market for topical application of hyaluronic acid to help with anti-aging, wrinkle reduction, and improving skin tightness. Whether or not a product feels drying depends on the formulation, whether it is alcohol-based (like a gel) or cream-based. Often it is a test and trial process to see if a product works for you, your skin, and your skin care goals.
Q: Wrinkle reducers vs. fillers? How are they different?
A: Wrinkle reducers are useful as a preventative measure. For instance, using a retinoid to help with photoaging and fine lines is a great habit to develop early on. Furthermore, starting neurotoxin treatments to minimize wrinkles on the forehead, frown lines, or the crow's feet can help reduce wrinkles that over time may become deeper and remain while your face is resting. Even at this stage, a neurotoxin can be used to soften wrinkles. These treatments are wrinkle reducers, and they are one way to help diminish the effects of aging. Facial fillers, on the other hand, are most frequently used to replace volume. As we age, the skin on our face naturally falls from the triangle of youth (where much of the volume is in our cheeks and it tapers down to our chin) to the inverted triangle (where the volume is now down around our jowls and our cheeks have thinned). Facial fillers help revert this natural process by refilling volume in the upper face to restore the triangle of youth. Naturally, fillers can be used in other places to replace volume loss as well.
Q: At what age do you recommend patients start wrinkle reducer injections?
A: Decisions regarding when to start using neurotoxins for wrinkle reduction are highly personal. What I tell patients is that we are treating what is bothering you. So, if you look in the mirror and do not like the wrinkles you are seeing, it is an excellent time to see someone for a cosmetic consultation. Nevertheless, it is easier to prevent wrinkles at rest with neurotoxin than treating them once they appear. If you are concerned about developing wrinkles, it is also a great time to see a board-certified dermatologist to discuss preventative options.
Q: According to the Skin Cancer Foundation, at least one in five Americans will develop skin cancer by 70. Tell us a little about the importance of annual full skin exams and what they entail.
A: Skin cancer is extremely common, which is why annual skin exams are so important. When you see a dermatologist, you have an expert examining your skin to make sure that nothing is growing or hiding. Moreover, it allows you to ask questions about different things that you’ve noticed on your skin. Dermatologists look everywhere because, believe it or not, patients can get skin cancer anywhere. We do these exams all the time and consistently perform them in a highly professional way so that you can feel comfortable. At home, I recommend that patients give their body a good look over (including your back in the mirror) at least once a month. You will learn to know your body well and will start to recognize if something new appears. If you have something growing or changing or something new appears, I highly recommend making an appointment for a professional evaluation. Furthermore, if you have a partner, it is also helpful to ask them to spot unusual changes in your skin. You would be amazed by how many people find their skin cancers and come in because something new has appeared or something has started to change size, shape, or color.
Q: What SPF level should our sunscreen be and how often should it be applied?
A: I always recommend at least an SPF of 50. When studies are conducted in laboratories to determine the SPF, the layers applied are thick and consistent – much thicker than we apply in real life. To get as much benefit as possible from what we reasonably apply, I recommend using 50 SPF and reapply every one and a half to two hours, especially if you've been swimming or sweating. When in doubt, reapply! For those that do not love sunscreen, I highly recommend UPF clothing. You can find UPF clothing all over the place now. Most of it is rated as at least UPF 50. And, when you wear UPF clothing, you do not have to worry about reapplying because you are wearing a piece of clothing to protect your skin. That is my sun protection of choice.
Medical Provider Highlight: Dr. Schneider is a board-certified dermatologist and fellowship-trained Mohs surgeon specializing in Mohs micrographic surgery, facial reconstruction associated with skin cancer removal, and medical dermatology. Her expertise extends to pediatric dermatology and treating pigmentary disorders and cosmetic dermatology, including injectables such as neurotoxins and soft tissue fillers. Dr. Schneider sees patients at Skin Cancer & Dermatology Institute's Carson location.
Get to know Skin Cancer & Dermatology Institute, and learn more about medical dermatology, Mohs surgery, and cosmetic surgery at SkinCancerDerm.com. Appointments may be made online or by calling 775.324.0699.