SmartLook Skin Refreshening
In facial plastic surgery, there are multiple factors in facial aging. One which we have no control over and is arguably the most important is our genetic structure. This factor is provided to us by our birth parents and at this time is not changeable. Other factors that affect aging are (1) dietary-including alcohol/tobacco consumption, weight gain/loss, (2) environmental- UV exposure based on the geographic location in which we live and the use of sun screens; Wind and its drying effects; average relative air humidity; air pollution levels, and (3) medical conditions diabetes, scleroderma/collagen vascular diseases, chronic stress, chronic fatigue, and hormonal effects.
Aging occurs in two primary ways that are especially noticeable in the facial areas, Gravitational and Soft Tissue Wasting (also called Deflation). These affect the skin and underlying supporting structures of the face and neck. Gravitational forces provide a continual downward traction force. The result is lengthening of the deep SMAS network that attaches to the facial skeletal structure. The overlying skin is unable to resist such force. The skin is dynamic and a continually renewing organ of the body. It therefore grows to continually cover the underlying continually stretching SMAS. Deflation is relative to the effects of the afore mentioned aging factor on all the soft tissue structures of the face. There is musculature atrophy. The SMAS loses tensile strength. The skin including the subcutaneous fat and dermis thins. The resulting lack of support for the epidermis creates new lines, wrinkles, and skin folds, all signs of aging.
To counteract the gravitational aging effect numerous lifting techniques have been designed over the decades. Whether considered “deep, superficial, SMASectomy, plication, imbrication, ‘S’, ‘J’” or whatever, all have the same desire to result in lifting the supporting structures of the face and reanchor them to the skeletal structures of the skull. The next step in almost all techniques involves the removal of an amount of extra skin that results from the effect of the lift procedure and then skin incision closure. The loose excessive skin surface area is reduced. Some deep folds are removed and heavy lines softened. Aged thinning skin, although less loose and better draped on the surface of the SMAS is still thin, poorly toned and sallow in surface appearance. It appears dull and lacks the youthful glow created by reflection of ambient light on tones skin. The fine crepe-like rhytids are primarily unchanged, because although stretched and redirected the skin is “dynamic” and will grow to its natural resting tone for its age. No significant new collagen stimulation occurs from surgical lifting.
Counteracting the wasting/deflation effects of aging has traditionally relied upon some topical or external forces being applied directly to the skin to stimulate collagen growth or by injection of “filler” substances. These are ever increasing in number as FDA approval occurs. The external forces for skin replenishment include; external beam lasers and IPL (intense pulse light), LED devices, and chemical solutions such as TCA, Jessener’s, Gordon-Baker, Retinoids, Glycolic, Lactic and other fruit acid peels. These skin replenishes all attempt to effect the actively growing primary source of skin renewal, the Dermis. The Dermis supplied by a vascular plexus is THE source of epidermal cushioning and support. Even dermabrasion is known to have a wounding effect that stimulates the dermal plexus to grow and by better oxygenation result in dermal growth stimulation. In more simple terms “the dermis is where the action is.” Unfortunately, every one of these techniques also requires a trans-epidermal crossing of the media. This means greatly less total energy/material delivery to the Dermis due to dissipation of energy in the epidermis or failure of penetration of media. A worse problem is that too much epidermal absorption of energy can then cause it to be permanently damaged creating scar tissue and/or color change. What has been needed is a means of bypassing the epidermis safely and effectively to directly deliver media to the Dermis.
Now there has been for the first time, by Cynosure, the development of a safe and dependable system for the under the skin delivery of laser energy. The negative effects of through the skin laser delivery are eliminated. The full amount of energy is directed to the best location for skin replenishment and therefore skin support is maximized. Two techniques were designed; one is a stand alone procedure for the face and neck skin. This is named ‘SmartLook’ Skin Refreshing. The second is an adjunct to face lifting techniques to create heretofore unobtainable safe full face skin rejuvenation without compromising skin viability that may cause tissue loss by damaging the dermal plexus. This is named the ‘SmartM.A.C.’ Couture Lift.
Numerous surgery techniques have been postulated in the advancement of facial rejuvenation. Deep plane, superficial plane, SMASectomy, SMAS plication/imbrication, FAME lift, long flap, short flap, “S” lift, “J” lift, and the multiple trademarked face lifts on the market are all technical changes meant to achieve superior results. These have been technique driven advances. The use of Cynosure’s Smartlipo 1064nm laser to safely deliver under the skin thermal energy is a major technological advance that we believe has created the next generation of improvement in facial plastic surgery results. This manner of collagen synthesis stimulation and reorganization has not been achievable previously. The results of improved facial skin tone and elasticity combined with skin shrinkage we feel are truly revolutionary in our field.
All subjects treated have shown no negative effects on skin pigmentation. Treatments have been performed on multiple skin types including subjects of Caucasian, Black, Hispanic, Middle Eastern, Scandinavian, Eastern European, and Asian heritage. No hyper- or hypo-pigmentation has developed or any sign of keloid formation. In actuality, if the subjects had areas of melasma, actinic induced depigmentation, or rosacea there were was objective visible improvements in most all cases.
Bruising is generally mild in laser alone patients and reduced in lift/laser cases when compared to average face lift alone patients. Pain was reported as mild to none. Patients having surgical lifting concurrently had noticeably less utilization of pain medication than the usual face lift alone patient.
Observed changes in the skin are as follows. Pore size is reduced. The improved skin ambient light reflex results in a more youthful glowing complexion. Improved skin tone/elasticity provides a gentle lifting effect on the treatment zones whether surgical lifting was performed or not. Treatment zones can include all areas of the face and neck excluding the nose and upper eyelid skin. Skin improvement is evident as early as 2 weeks. The first 3 months post procedure are when the majority of skin changes are seen with mild further improvement noted up to 6 months. Improvement is then stable. Longevity of results will be affected by all the same aging factors that were present at the time of procedure as with any rejuvenation technique. No procedure stops the aging process.
With demand for maximum cosmetic results with minimally invasive procedures and rapid recovery time, this new application of a well-studied technology will have a central place in my practice of aesthetic plastic surgery.
SmartLook Skin Refreshening - Real Patient Before & After Photos
Advanced Microneedling (PiXel8-RF)
Dr. McCoy Moretz is proud to now offer advanced microneedling at Face of Beverly Hills with the PiXel8-RF (radio frequency) Micro-Needling System. The PiXel8 RF Advanced Microneedling device differs from conventional microneedling previously offered by Dr. Mac at our clinic (and still available for booking).
Microneedling, also called collagen induction therapy, is primarily used to reverse the signs of aging. Microneedling with PRP, or platelet-rich plasma, is done using a professional-grade derma roller. This procedure is still offered by Dr. Moretz and Face of Beverly Hills in addition to our advanced microneedling procedure using radio frequency technology.
The process of advanced microneedling begins with steps comparable to those used in conventional microneedling to stimulate collagen production in the skin. Similar to the professional-grade derma roller used in our standard microneedling with PRP procedure, a tool is applied to the skin for the microneedling process. The tool of the PiXel8-RF Advanced Microneedling System makes perfect contact with the skin and microneedles smoothly penetrate the skin with less irritation than the derma roller and other microneedling methods.
However, what makes the process particularly unique are the steps that follow. The PiXel8-RF Advanced Microneedling System then emits bipolar RF energy from the tool to the skin where the microneedling has just taken place. This denaturalizes the tissue surrounding the microneedles. This results in collagen regeneration and begins the process of new elastic production.
Some of the benefits of PiXel8-RF microneedling include:
- Minimal Downtime & Discomfort
- Safe to Use on Multiple Skin Types
- Energy Delivered to the Epidermis, Dermis & Sub-Dermis
- Low Risk of PIH (Post-Inflammatory Hyper-Pigmentation)
- Insulated & Non-Insulated Needles (see benefits below)
By using insulated or non-insulated needles, the PiXel8-RF delivers thermal energy to multiple treatment areas safe and effectively.
The PiXel8-RF is also considered “color blind” in that it can be used on all skin types as the RF does not target the melanin in the skin.
There may be other benefits to advanced microneedling over conventional microneedling. For questions, contact us to book a consultation with Dr. Mac Moretz. Dr. Moretz will be happy to review the benefits of advanced microneedling in reaching your cosmetic goals!
Lifestyle for Beautiful Skin
Here are a few Anti-Aging tips:
1. Have a Glowing Green Smoothie every day. Uncooked greens and vegetables are a powerful beauty secret. The living enzymes in uncooked greens and vegetables contribute to skin health by acting as catalysts that assist body processes like digestion, detoxification, and rebuilding.
About 50% of the body’s energy can be consumed in the various processes of digestion. By eating raw foods which have their enzymes intact, our energy can be freed up for other tasks, including repairing and rebuilding the collagen in the skin, keeping it youthful looking and minimizing wrinkles and the visible signs of aging. Unfortunately, the valuable enzymes, proteins and vitamins found in foods are heat sensitive and can be damaged or destroyed by normal cooking temperatures. In fact, cooking can easily destroy a food’s entire enzyme reserve. So pack as many completely raw greens, salads, veggies, sprouts and fresh herbs into your diet as you can!
An easy way to get a large amount of easily digestible greens is consuming my Glowing Green Smoothie every day if possible, or at least 3 times a week. Because the greens have been blended and therefore “predigested,” much of the nutrition which has been kept intact within the cellplast walls is burst open and readily available to the cells, without us having to use up our precious reserves of enzymes. Consuming the Glowing Green Smoothie regularly will start to shift the pH of the body into a more alkaline state, provide lots of energy, and start to detox acidic byproducts out of the body. Best of all, by adding the Glowing Green Smoothie into the daily diet, other toxic foods naturally start to be eliminated as energy increases! You feel so good that you stop even wanting those foods. These would include coffee, sodas, foods with processes flours and refined sugars, etc.
My delicious recipe is available online at www.kimberlysnyder.net.
2. Use Stevia or Raw Agave Nectar as your main sweetener, and cut out all refined sugar as well as artificial sweeteners, including Splenda, Equal and Sweet ‘n Low and all products that contain them. So yes! The Diet Coke must go. The glycemic index is a measure of how various foods affect our blood glucose levels. Stevia is 0 on the glycemic index, and raw agave is a fairly low-glycemic raw plant sweetener. In contrast, ALL artificial sweeteners are high on the glycemic index, around a rating of 80 (on a scale of 0 to 100). Even normal sugar only scores a 70! Artificial sweeteners can also stimulate your appetite, increase carbohydrate cravings, and stimulate fat storage and weight gain. These and all other high glycemic foods can contribute to glycation (wrinkling) of the skin by constantly causing inflammation to the skin. If we keep our blood-sugar levels in equanimity, our skin will also stay more smooth and young-looking.
3. Use ONLY Celtic or Himalayan sea salt. These specific sea salts are unique among salts because they are dried by the sun and wind (if you are unsure of a brand be sure to check the label)- a process that allows 70 minerals and trace elements, enzymes and even marine microorganisms to remain intact. Other sea salts are kiln-dried, which causes valuable magnesium and most other minerals to evaporate. Normal table salt is the worst of all, being irradiated and denatured sodium chloride. It not only has no nutritional benefit, it is “mineral hungry” and will deplete your skin of minerals and hydration, which is very aging. So ban all other salts, and make the switch to Celtic sea salt!
4. Eat your Papayas. Papayas are extremely beautifying for the skin and hair. They contain a lot of alkalizing minerals such as calcium, Vitamin A and collagen-healing Vitamin C, while their enzymes soothe the digestive tract. Papayas are also very high in the protease enzyme papain, which will cleanse the skin and tighten the skin’s collagen tissue.
5. Drink Detox Tea and the Detox Smoothie. Our bodies are constantly exposed to toxins from the environment, our diet and chemicals from products we put on ourselves. Over time, these toxins promote illness and can accelerate skin aging. The liver is the blood’s filtering system, and when it becomes overloaded, the liver stops effectively filtering and neutralizing the toxins that enter the body. These excess toxins continue circulating and are deposited in fatty tissue, building up over time. The long-term effects of toxic overload are manifested externally in the form of wrinkles and spotted, leathery skin.
Fasts and cleanses are important, but it is also important to detox on an ongoing basis, as new toxins are constantly entering our bodies. One of the easiest and tastiest ways to promote healthy liver function is to drink Detox Tea and/or the Detox Smoothie 2-3 times per week. My recipe is available online at www.kimberlysnyder.net.
6. Add sea vegetables to your diet. Sea vegetables are about 12 times richer in minerals than average vegetables. They are an especially good source of iodine, which regulates the metabolism by feeding the thyroid, iron, B6, B12, and the beauty mineral magnesium, which opens over 300 different detoxification pathways in the body. You can throw sea vegetables such as dulse, hijiki and arame in salads or make nori wraps stuffed with salad. All are available at any health store.
7. Eat only organic produce. I cannot stress enough how important it is to choose organic, albeit more pricey. Organic produce has approximately 88% more nutritional value than commercially grown produce, and this would absolutely include the beauty minerals (zinc, selenium, iron, etc.) that we need to keep our skin and hair luscious and healthy. Organic produce is grown in living, mineral-rich soil, which is the source from which these minerals are obtained.
One of the scary and huge problems with commercial produce is the spraying of pesticides. Pesticides are designed as neurotoxins, to attack the brain and the nervous system of biological species. Though our nervous systems are much more advanced than insects and it takes longer to poison us, it still happens and I believe has contributed to the rise of many diseases in our generation. These toxins in commercial produce are also aging and dulling to the skin as they infect the blood, which is supplying the skin cells. Remember: the cleaner the blood, the more beautiful the skin.
8. Consume plant-based protein sources. One can get more than adequate protein from plant-based sources, such as from greens, seeds and nuts, spirulina, blue-green algae, raw hemp protein powders, and bee pollen. The mighty gorilla, the strongest animal on earth, pound for pound, has a diet comprised of over 90% raw greens. Plant-based proteins are comprised of single-strand amino acids, making assimilation much easier into the body, and at the price of much less energy. Cooked animal protein is actually a denatured protein, since it is cooked at high temperatures, and requires an extremely high amount of energy and to digest. Ingesting excessive cooked and processed foods make us feel less energetic and alive, since the food has been heated, the enzymes denatured and destroyed and the food “dead.”
Studies have shown that when you cook your protein you lose 50% of it in its actual form. This means that 20 grams of raw plant protein is equal to 40 grams of cooked protein. Cooked animal protein is also acid-forming in the body and causes inflammation in the tissues, which by nature is aging. So replace these cooked animal proteins with the highly alkaline, collagen-building and anti-aging goodness of the wide variety of plant proteins wherever and whenever possible.
9. Be sure fatty fruits are a regular part of the diet. Fatty fruits powerfully work to make the skin supple, moisturized and youthful from within. Some of these common fatty fruits include avocados, coconuts (and coconut oil/butter) and durian. Avocados contain the beneficial monosaturated fats, as well as oleic acid. They are full of antioxidants and rich in necessary minerals like potassium, calcium, vitamins A, C and K, folic acid, copper, sodium and are extremely high in dietary fibers. Coconut oil is a cold pressed, cholesterol-free oil containing Lauric Acid, that stimulates thyroid function, increases metabolism and promotes weight loss. This medium chain good fat will keep your skin smooth and soft.
CO2 Fraxel Laser is one of the newest developments in nonsurgical facial rejuvenation. Patients choose CO2 Fraxel for its ability to treat deep wrinkles and other signs of aging, discoloration, and sun damage. What has patients particularly excited about CO2 Fraxel is its ability to remarkably transform the appearance of the face without the need for invasive surgery.
CO2 Fraxel uses what are known as fractional carbon dioxide lasers. These lasers have the longest wavelength of all lasers, meaning they can be used safely for most skin types, including darker skin. The focused laser beam is precisely targeted towards problem areas of the skin. The goal of the procedure is to stimulate the skin to produce collagen, shed damaged skin cells, and generate new ones while healthy skin is left unaffected.
CO2 Fraxel can treat:
- Deep Wrinkles and Fine Lines
- Drooping Skin (such as around the eyes)
- Uneven or Rough Skin Texture
- Acne Scarring
- Precancerous Growths
- Sun Damage
CO2 Fraxel is adaptable based on the needs of the patient, meaning the laser can be adjusted to treat deeper wrinkles or more severe skin conditions. While this may result in a longer recovery window following the procedure, the recovery time is still considered minimal compared to many surgical alternatives. A CO2 Fraxel Laser procedure may even be combined with procedures involving fillers like Botox to further enhance results.
To learn more about your eligibility for this procedure, contact Dr. Mac today!
Results, Downtime, and Side Effects
The results from CO2 Fraxel are long lasting, especially when combined with a healthy lifestyle, including proper diet and exercise. Results are seen immediately after treatment, with the natural restoration of collagen continuing for up to six months.
A topical and local anesthetic is used during the procedure for your comfort. The procedure only takes about an hour, after which you are able to drive yourself home and resume normal activities as needed.
Side effects are minimal, with most patients describing a sensation like a mild sunburn lasting only a few hours after the procedure. The deeper the treatment, the more noticeable this side effect potentially may be. Regardless, there are typically no other side effects and any experienced are usually mild.