So, you have great results from our procedural team at Cutis Dermatology. The next step is to prolong the results. This page will tell you how!Read to the very end to understand.
What skin care is best to upkeep the results?
It depends on your goals. It is important to integrate skin care in a timely manner- too soon & skin irritation can ensure. Be guided by your nurse, therapist, or dermatologist.
Antioxidants include ascorbic & ferulic acid. This acidic formulation is often too irritating for patients to introduce early. Most can start 6-8 weeks following level 3+ laser resurfacing.
Start with a good formulation of retinol. You can introduce this 3-6 weeks after resurfacing, be guided by your nurse. The next vitamin is niacinamide or B3, followed by L-ascorbic acid.
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How to start skin care?
Slowly, especially following laser resurfacing. The biggest gain you will have is to understand your skin’s threshold for irritation. This is often markedly lowered in the first few weeks following lasers.
With any active ingredient, start application every other night. You can then increase by one night a week, as tolerated. If you have irritation, try diluting your active ingredient with a moisturizer, then slowly increase. It is not a race.
You are far better off with a retinol (at least initially) compared to prescription retinoids, especially following larger laser procedure. Our nurses & dermal clinicians will guide.
This result from erbium laser resurfacing will last for many years to come, providing simple skin upkeeping treatments & skin care are performed.
Lasers can erase decades of sun damage. Results can be maintained with using low downtime fractional lasers or clinical chemical peels.
What is our most popular program for maintenance?
For upkeep following laser procedures the best maintenance is LARI or laser assisted retinoid infusion. This simple 7-minute procedure combines low level CO2 fractional lasers with high strength prescription retinoids.
For upkeep following skin tightening procedures the best maintenance is with RF or radiofrequency skin tightening with Tempsure or NuEra.
For upkeep following pigment correction procedures, the best maintenance is Pico laser resurfacing. Between 2-4 sessions are conducted over a 12-month period.
What does a simple but effective skin maintenance program look like?
A basic but effective program to reduce laxity & maintain skin turgor is as follows
- Radiofrequency with NuEra or Tempsure twice a year
- One vial of PPLA (collagen stimulating filler) once a year
- LARI laser resurfacing once a year
What is LARI & how does it work?
LARI combines a high density but low power CO2 laser with retinoids. CO2 lasers are the most efficient lasers to generate collagen. As a guide-
- Procedure time: 5-8 minutes
- Downtime: 36 to 72 hours
- Cost: $590-$990 (depending on the level of laser / settings / inclusion of other wavelengths)
- Performed by our senior laser nurse
- Suggested frequency 1-3 sessions a year, depending on goals
Who is suited for pico laser toning?
Pico toning is best for darker skin types, or ethnic skin (it is due to the physics of the laser). A simple pico toning program is-
Pico laser toning 3-4 times a year. This will keep pigmentation away, improve collagen, reduce wrinkles & improve pores.
What is the difference between collagen stimulating dermal fillers & Hyaluronic Acid fillers?
HA fillers are popular to enhance areas such as the cheeks, lips & jawline. Collagen stimulating fillers do just that- namely recruit your immune system to produce new collagen. These fillers last longer than HA fillers & provide a greater amount of skin tightening, especially if combined with heating devices such as RF.
What can collagen stimulating dermal fillers achieve?
Fillers are great at stimulating collagen production. This is very different from fillers to improve volume. Collagen stimulation means skin tightening without the bulk of hyaluronic acids. Our most popular fillers include;
- Sculptra or PLLA mixed in a bespoke dilution.
- Radiesse or Ca hydroxyapatite
- Profhilo or hybrid low & high molecular weight fillers
What chemical peel options do I have?
If you are more inclined to peels compared to lasers, consider AHA or glycolic acid peels. A series of 20,35, 50 ,50, 70 % can be performed twice a year. Peels are awesome for keeping away sun damage, pigment & sunspots.
What does Clear + Brilliant do?
Clear + Brilliant is a form of fractional laser resurfacing. It is essentially a mini-Fraxel with a downtime of 36 to 72 hours. It is ideal for patients who would like to maintain the results following Fraxel.
How do I upkeep my results following skin tightening?
Skin tightening maintenance is vastly different from laser procedures. For skin tightening we want to stimulate deep dermal collagen, meaning procedures provide energy to the lower dermal areas of skin.
These treatments include RF, or HIFU (High Intensity Focused Ultrasound). Skin tightening procedures have little if any downtime.
Davin’s Final Say
Maintenance. You do it for households, gardens, cars, & more, so why not skin? With the technology of lasers, dermal fillers & energy devices, I can turn back time by over two decades. What I cannot do is to hold time back- that is on you & the choices you make.
Following skin resurfacing, skin tightening & rejuvenation procedures, the aim is to keep you refreshed for as long as possible. Here are my top 10 tips.
1. Healthy Lifestyle
No smoking, keep sun exposure to a minimum, give your skin the nutrients it deserves from good food.
It’s repeated time and time again. Use a high factor SPF at least twice a day. The biggest contributor of collagen depletion outside of genetics is sun. It takes no more than 40 seconds of your day to apply & reapply sunscreen. Brands don’t matter- start with a SPF of 50.
3. Don’t forget the power of injectables
Lasers & surgery address skin quality & tightness, dermal fillers address volume depletion whilst Botox relaxes muscles, reducing dynamic wrinkles (movement related wrinkling). I use both hyaluronic acid fillers as well as collagen stimulation ones.
4. Skin Care
This won’t reverse wrinkles, nor will it tighten skin, but it can maintain the quality of your skin. I start all patients on simple retinol at 0.5 to 1.0 percent, usually 2-8 weeks following lasers of deep chemical peels. The timeframe & concentration depends on your skin’s sensitivity as well as the depth of resurfacing. My next ingredient is ascorbic acid in the morning. This does 3 things. Firstly, it acts as an antioxidant, removing free radical damage. Secondly, it reduces pigment output, & lastly it potentiates collagen regeneration. From there, its vitamin B, ferulic acid, & skin care acids such as lactic, & glycolic acids.
5. Home Maintenance
I am a fan of microcurrent devices in some, but not all people. This treatment can increase the firmness of skin. What it can’t do is to provide a face lift. By profiling patients, we can get close to 80% predictive results. Ideal candidates have thick collagen, little or no sun damage, with a normal layer of fat.
6. Radiofrequency Devices
This includes NuEra & Tempsure-Pelleve. RF devices are much more powerful than home microcurrent devices. RF heats the deeper dermal layers to provide immediate collagen contraction. The second aspect of RF compared to microcurrent (apart from the amount of energy generated), is the delayed phase of collagen remodelling. It is this second wave of energy that increases collagen levels.
7. Small Lasers
Including C+B, CO2 as well as soft lift 1570 Hybrid lasers. These lasers can dial in the energy required to provide collagen remodelling, & at the same time reduce downtime (typically 12 to 36 hours).
8. Dermal Hydration
Dermal Hydration can be achieved with hyaluronic acid fillers including Restylane & Profhilo. The later consists of 64 mg of hyaluronic acid that ranges from low to high molecular weight. This filler integrates nicely into the dermis to provide hydration, in turn reducing wrinkles. It also has collagen stimulating properties, but not as much as true collagen stimulating fillers.
9. Collagen Stimulating Dermal Fillers
These fillers stimulate collagen & are different compared to hyaluronic acid. Examples include Poly-L-Lactic acid, & calcium hydroxyl apatite. Placed accurately, these fillers work over a timeframe of 3-6 months to increase collagen production.
Not just any threads, but strategically placed monos or helix threads to key areas. Threads can evoke an inflammatory reaction that gives rise to fibrosis or collagen generation. I normally use threads in combination with heating devices such as RF devices. These threads last 9-12 months, typically longer than anchoring threads.