Cosmetic Dermatology Botox

Women who are trying to look younger

There is a misconception that cosmetic dermatologic procedures, including things like Botox and filler injections, are something for older women who are trying to look younger. Perhaps this was true years ago, but both the science of the field and the patient population has changed significantly. Many of the same treatments that help make you look younger also can prevent aspects of the aging process in the first place (eg, Botox can prevent wrinkles before they appear). I am also treating more and more men who want to look more youthful and energetic in an increasingly competitive workplace. Furthermore, cosmetic treatments can correct the appearance of many real medical conditions: everything from Kenalog for keloids, Fraxel for burn scars, and Sculptura for HIV-associated lipodystrophy.

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Who can benefit?
Almost everyone can benefit from cosmetic dermatology. Diligent application of sunscreen from an early age can prevent most of the signs of photoaging in addition to preventing skin cancer. Nightly application of a topical retinoid starting in your early teens can prevent fine wrinkling and pigment unevenness. In patients’ twenties and thirties, it is conceivable to consider therapeutic and preventative treatment with Botox and fillers. It is important to see a cosmetic dermatologist for these treatments, as any physician can legally inject them (and even dentists, nurses, and other non-dermatologists can depending on the state), but these treatments require significant skill and an ability to manage rare (but possible) side effects.

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Evidence
There is also evidence that starting earlier is more effective. Years of topical retinoid or chemical peel use result in a healthy, attractive “glow” that can’t be achieved overnight. Botox acts by weakening the muscles that cause wrinkles. It is easier to prevent these wrinkles by injecting earlier than it is to treat them after they have been present for years.

Botox antibodies
These points aside, there are also reasons to avoid cosmetic treatments in inappropriately young patients. For example, the more Botox injections you receive, the more likely you are to develop antibodies to the treatment and thus become resistant to subsequent injections. Further, there are risks of side effects with any procedure. The more procedures a patient receives, the greater the cumulative risk of having a side effect. In addition, patients are less happy with side effects for “preventative” treatments than they are for problem-directed treatments. For all of these reasons, the careful, practiced judgement of your dermatologist is of the utmost importance. Together, the two of you will develop a cosmetic plan to maintain a healthy, youthful, and attractive appearance.

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Dennis A Porto, MD DennisAPorto.com

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