Botox? Juvéderm? Facial Peels? Not All Treatments Are Created the Same

Botox? Juvéderm? Facial Peels? Not All Treatments Are Created the Same

For those of us who are not brave enough to “go under the knife” in order to permanently adjust the landscape of our face, which may include ridding ourselves of deep lines, wrinkles and discoloration, there are several other non-invasive options. We spoke to Dr. Nicole Rogers at Old Metairie Dermatology about the different procedures available—from injections to peels—to give us a temporary fix for a fraction of the cost.

Dr. Nicole Rogers
Dr. Nicole Rogers

Exilis This is an advanced technology that can tighten the face, soften lines and enhance the jawline and neck. “This is the next generation of the thermage treatments and is basically a mono-polar radio frequency skin-tightening device,” said Rogers. “It’s great for people who are not ready for surgery or for those who don’t quite need it yet or they just want to address those saggy areas like the jowls or the neck or even saddlebags. What’s neat about it is that it’s so advanced, it has a temperature control; where we used to have burns with the original radio frequency technology, this is actually much better, much safer, and patients do really well with it.”

Fraxel If you suffer from skin damage due to sun exposure, uneven pigmentation or acne scars, this treatment may be an option for you. In the past, plastic surgeons would use CO2 lasers and because it was very painful, patients were given anesthesia. Rogers mentioned that there were sometimes also pigment problems with this procedure, resulting in a ghost-like appearance from the neck up. Fraxel penetrates the top skin layers and the light energy stimulates collagen and resurfaces the top layer of the skin. “So instead of knocking off the entire surface, you’re actually drilling tiny holes into the skin; they’re so teeny-tiny and microscopic that you could have hundreds or even thousands of them within a small area,” explained Rogers. “This way, the skin can heal from the inside out without causing permanent pigment changes. People also have less downtime and the results are fairly comparable.“

Beware of spa chemical peels...they should only be administered by a board certified dermatologist or plastic surgeon
Beware of spa chemical peels...they should only be administered by a board certified dermatologist or plastic surgeon

Dermal Fillers Rogers mentions that Juvéderm XC is still her “favorite workhorse” since it is a smooth gel that contains lidocaine which lessens the pain for patients after the initial injection and the results last for up to a year. For those who have deeper wrinkles and need extra volume, she’ll sometimes use Sculptura but very sparingly and carefully as sometimes (rarely) permanent nodules can form under the skin. Bottom line, Rogers believes Botox is still the “gold standard” and when applied correctly, will not result in an expressionless look. There’s also Xeomin that can be used if or when Botox stops working due to the development of antibodies. Although it is available in Europe, the US might not see it for another year, which Rogers believes is a good thing. “I think they’re more liberal in terms of their regulatory policies about new things in Europe. Sometimes we’ll have a little bit of cosmetic envy when they get things before we do, but the difference is that we see and hear about the problems that happen before they make it to the United States; I guess it’s a mixed blessing in terms of how strict our FDA is,” said Rogers.

Start young with a little sunscreen and it will go a long way when trying to avoid the filler and resurfacing procedures later
Start young with a little sunscreen and it will go a long way when trying to avoid the filler and resurfacing procedures later

Chemical Peels Rogers admits that there isn’t any one treatment that’s going to continue to stop the clock but there a lot of little things along the way. “We do all the salicylic acid and glycolic acid chemical peels, and they’re really actually pretty safe,” explained Rogers. One thing she recommends is to carve out some downtime in your schedule depending on the strength of the peel. “You’re going to have more peeling the longer you keep them on and the higher concentration that you use. I think the thing for people to realize is that no one chemical peel is the same… no two or three are alike.” Bottom line, be honest with your doctor about your expectations and your schedule. Also, many women are turning to spas for peels to save money and Rogers said that this is not necessarily a good idea. “I’d be very cautious. If it’s that cheap, you don’t know what they’re using, you don’t know how long they’re leaving it on for and how much training that person has,” said Rogers. “I’d stick with the medical facility and a dermatologist or plastic surgeon…make sure they’re board certified.”

If you don’t want to venture down the plumper-filler road, Rogers recommends using sunscreen and a topical retinoid. When used consistently topical retinoids can have dramatic tightening effects on the skin, shrinking the pores and increasing the turnover rate of your skin cells. “You’re always going to have that fresh rosy glow to your skin, and some people don’t like the fact that you can have a little flaking or peeling, but if it’s the price you have to pay in order to not go forward with all kinds of dramatic things, I think it’s worth it.”

For more information about the skin procedures mentioned or for a consultation with Dr. Rogers, visit the Old Metairie Dermatology website.