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Multiple types of anti-aging treatments are required to address the various etiologies of facial aging. Soft-tissue augmentation provides a minimally invasive option for patients seeking to look younger. However, due to changes in facial skin, musculature, fat and bone, anti-aging treatment requires a multifaceted approach. Injectable fillers may be combined with neurotoxins to resolve superficial wrinkles and restore facial volume. These modalities may be used with laser resurfacing or chemical peels to address epidermal and superficial dermal problems. Combining injectable soft-tissue augmentation treatments allows clinicians and patients to take advantage of the benefits of each modality and to address the multiple effects of facial aging. This review is based on clinical experience and a MEDLINE search for articles about volume replacement and soft-tissue augmentation. It provides a rationale that supports the use of combination techniques/products for soft-tissue augmentation.
Changes to the aging face result from a dynamic process involving thinning of the skin and loss of collagen, fat redistribution, muscular recontouring and bone remodeling. (1-3) The rate of change differs in the major facial compartments (skin, muscle, fat and bone) and changes in one compartment affect all compartments. (1), (3) With increasing age, more prominent wrinkles, folds and furrows arise due to further loss of skin elasticity and structural organization.
Many patients require more than one type of aesthetic treatment to address these multiple etiologies and maximize treatment outcomes. (2), (4), (5) The variety of available treatments has greatly expanded the ability to reverse the visual signs of facial aging. Because each modality has its own strengths and limitations, combinations of products may be required to achieve optimal outcomes. The purpose of this article is to briefly review available soft-tissue augmentation modalities and to discuss relevant clinical experience with possible combinations of products.
Head-to-head comparisons have not been identified for most combinations mentioned in this review. Further combinations of anti-aging treatments described herein have not been reviewed or approved by the U.S. Food and Drug Administration (FDA).
Anti-aging Treatments
Numerous treatments are available for soft-tissue augmentation (Table 1). Each treatment, used appropriately, can help restore the youthful appearance of the face; the selection of treatments with complementary modes of action may produce a synergistic effect. Furthermore, application of different modalities can be varied either spatially or temporally, potentially optimizing outcomes and improving tolerability.
TABLE 1.
Comparison of Injectable Anti-aging Treatmentsa
Onset of Effect Mode of Current Indicated
Operation Areas
Radiofrequency 4-12 weeks Collagen Protuberant
contraction, jowls, neck skin,
collagen nasolabial folds,
synthesis eyebrows
Neurotoxins 3-4 days Muscular Dynamic lines and
relaxation wrinkles, mostly
in glabella
Collagens Immediate Volume and Soft-tissue
collagen contour
replacement deficiencies,
including
wrinkles and acne
scars
Hyaluronic Acid Immediate Water Moderate to
Derivatives retention severe facial
wrinkles and
folds, including
nasolabial folds
Intense Pulsed 1 month Wavelengths Lentigines,
Light between 550 and telangiectasis
1100 nm
Calcium Immediate Hypothesized Moderate to
Hydroxylapatite collagen severe facial
stimulation wrinkles and
nasolabial folds,
facial
lipoatrophy in
people with HIV
Injectable PLLA Gradual Hypothesized Shallow to deep
foreign- body nasolabial fold
reaction, contour
collagen deficiencies and
stimulation other facial
wrinkles
PMMA Rapid to Collagen Deep defects,
gradual component gets glabella,
absorbed over nasolabial folds
short term.
PMMA
microspheres
form permanent
scaffold
Ablative Laser 1-2 weeks Thermal in Fine and some
superficial coarse wrinkles
dermis; and overall
wound-healing dyspigmentation,
response dark discolored
under-eye
circles, and skin
texture
Nonablative Primarily Fine wrinkles and
Laser thermal, skin texture
focused in
dermis
Chemical Peels Depends on depth Chemical Superficial: mild
of peel exfoliant actinic damage,
wrinkling,
dyschromia,
actinic
keratoses, and
active acne.
Medium-depth:
severe
dyschromia,
moderate
rhytidosis,
laxity, photoaged
skin, actinic
keratoses
Duration of Effect Benefits
Radiofrequency Several months Generally safe,
limited downtime,
depending on
specific device
Neurotoxins 3-4 months Rapid results
Collagens 3-6 months Bovine: reliable,
contains lidocaine,
ease of
administration
Human: no allergy
testing required
Hyaluronic Acid 3-12 months, Reliable, well
Derivatives depending on tolerated, no
formulation allergy testing
required. Longer
lasting than bovine
collagen
Intense Pulsed 6-9 months Improvement of skin
Light texture and
irregular
pigmentation
Calcium 12 months Long-term results,
Hydroxylapatite no allergy testing
required, no
concern for
antigenic or
inflammatory
reactions
Injectable PLLA Up to 2 years Safe, long-term
results
PMMA Permanent Longevity
Ablative Laser Improved appearance
of photoinduced
rhytides and
dyschromia
Nonablative Limited downtime.
Laser Superficial layers
spared
Chemical Peels Variable Improved skin
texture
Adverse Events
Radiofrequency Common: pain Rare:
fat atrophy
Neurotoxins Common: headache,
respiratory
infection, and
blepharoptosis
Collagens Bovine:
hypersensitivity or
allergic reactions,
skin testing prior
to use,
reactivation of
herpes possible
with lip injection
Human: rare but can
include bruising,
erythema, and
swelling
Hyaluronic Acid Common
Derivatives injection-site AEs:
temporary pain,
induration,
bruising,
tenderness,
itching, edema, and
erythema. Serious
AEs rare
Intense Pulsed Slight erythema and
Light edema, immediately
after treatment
Calcium Injection-site
Hydroxylapatite bruising, edema.
Nodules rarely
develop if injected
superficially
Injectable PLLA Most common AEs
injection-related.
Serious AEs
infrequent;
injection-site
nodule, granuloma,
erythema, pain,
inflammation,
edema,
hypersensitivity,
and pruritus
PMMA Reports of
persistent erythema
at injection site
Ablative Laser Oozing, bleeding,
infections.
Downtime. Potential
serious AEs:
postinflammatory
pigmentary changes,
scarring
Nonablative Inconsistent.
Laser Common AEs usually
transient:
erythema,
periocular edema,
skin bronzing
Chemical Peels Increased downtime
with deeper peels
(a) References (4), (6), (13), (14), (17), (18), (21), (23-28), (35),
(36), (44), (47-50).
AEs=adverse events; HIV = human immunodeficiency virus;
PLLA=poly-L-lactic acid; PMMA=polymethyl methacrylate.
Aging can be one of the most dreadful diseases which can give a feeling of helplessness. In olden times there were stories about the way people used to maintain their skin texture. Even though many say that beauty is skin deep, people would still thrive to have a younger look. Having a clear skin and then maintaining can be a very tedious task and one should take good care of their skin.
Taking care of your skin by doing some facial exercises can be very helpful. Wrinkles are a depiction of your lifestyle. The food you eat and the stress and other activities which lead to causing blemishes on your face as well as wrinkles. Proper care has to be taken if one has to make their face clear as ever. After a certain age your skin starts sagging which is due to the less care taken when the time you were young.
Some of the good skin care steps should be followed routinely which would involve cleaning, toning, moisturizing, sunscreen, skin treatments if needed. Protecting your skin from sun and avoiding oily foods can help you in creating a clear skin. You will find many products which claim to be anti-wrinkle creams and new product that is getting very high marks for AMAZING RESULTS IS HAULRONIC ACID FOUND AT WWW.PHOTOFACIALMACHINES.COM This anti-aging cream are very huge in the skin care market and the results are AMAZING.
Eating fruits and vegetables are very important as these fruits and vegetables have the necessary ingredients to help you in clearing your wrinkles slowly and steadily. It is said that one should have juices which are high in carotene and try to spice up your normal dish into something very interesting. Mangos, Papaya are the tropical fruits which can be a very interesting ingredient to your recipe. Broccoli is also very good for your skin.
Using LED Therapy found at www.PhotoFacialMachines.com can greatly increase your skins ability to produce new collagen. Thus eliminating wrinkles.
Taking care of your skin should not be confusing nor should it require you to use a large multitude of products just to make your skin feel cleaner. In spite of all the sales hype that we see on TV and in print trying to persuade you that you need all different kinds of products most people only need a gentle cleanser and a moisturizer with anti-aging ingredients included. With that said, there are exceptions that may have a type of skin needing special care so it is important to know what kind of skin you have.
Begin by assessing what your skin type is. If your face feels dry and tight with possibly some rough patches or redness you probably have dry skin. You may even suffer from flaking and irritation. The best treatment for this type of skin is to use rich moisturizers and never use cleansers that strip oil from your skin. You should also add Omega-3 oil to your diet.
If your skin is shiny or feels slick, especially on your forehead, nose, and chin then you probably have oily skin. Although, you may not think of it as a blessing when you are young it is actually a blessing in disguise because it naturally guards against wrinkles and the effects of aging. With oily skin, you want to use cleansers that will clean the skin without removing this natural anti-aging oil and use LED/PHOTON Treatments to renew the skin.
Skin that is prone to acne and those who are older are more unique and will require more specialized treatment. Mild cleansers are still best and moisturizers should be oil free but formulated for the specific condition you may have. Follow up with LED Blue Light from a Professional LED PDT Machine. As found on PhotoFacialMachines.com.
New Injury Case Report
The patient was a 19 year old male driver of a vehicle rear-ended by another vehicle travelling approximately 60 miles an hour. The injuries expected from this magnitude of collision would have been significant and the patient would have been symptomatic for approximately three to four months. He was treated with Frequency Specific Micro-current within five hours of the accident using the frequencies for new injuries. The next day he was almost pain free with full range of motion. A second treatment the next day reduced the pain to 0-1/10 on a visual analogue scale. On the fourth post accident day, when the pain would have been at its worst had he not been treated with FSM, he was pain free.
This information can be verified by Dr. Michael Hatrak, the patient's father. (001 - 770 940-9200)
The Four Hour Window
In over 100 cases, collected by the 300 FSM practitioners in the US and the 100 in Australia, new injuries produced by trauma, accidents, falls, or surgery respond dramatically to the effects of FSM. If FSM can be applied in the first four hours after the injury it is almost as if the inflammatory process never sets up. The current increases energy production in the cells and restores the normal bioelectric activity of the tissue. The frequencies that produce the most profound effect are the ones thought to reduce bleeding from torn or injured tissues and reduce inflammation. One hour of treatment, using these and many other frequencies, seems to be adequate to eliminate or greatly reduce the pain and greatly reduce the amount of time needed for healing. In most cases the patient is pain free within two to three days as long as there is no fracture. Fractures improve and heal at a rapid rate if treated within this four hour window. Soft tissue injuries are pain free in one to two days. The new injury protocols include frequencies thought and observed to improve concussion and cognitive function. At this time, only case reports document these effects but animal and functional MRI studies are planned.
Is there any one FSM does not work on?
Patients who are dehydrated cannot benefit from FSM. It has been observed that patients who are dehydrated athletes with large muscle mass and inadequate water in take and patients over 70 who are chronically dehydrated have the most problems. Every patient is advised to drink at least one quart of water in the one hour preceding treatment. Patients who are chronically dehydrated may need more.
No technique is 100% effective and FSM is no exception. The effectiveness of FSM depends almost entirely on an accurate diagnosis. Shoulder pain can come from muscles, tendons, bursa, discs, nerves or joints. FSM will treat all of these pain generators effectively. But, if you are treating for muscle and the shoulder pain is from nerves or the bursa you may change the muscle but you won't change the patients pain since it is not coming from the muscle.
Risks and Side Effects
FSM is delivered by battery operated device and provides sub-sensory current. It cannot be used through a pregnant uterus or in patients who have pacemakers. Patients must be well hydrated for optimal current flow and optimal results. The only common side effect occurs following treatment for chronic muscle pain when some patients experience what appears to be a detoxification reaction approximately 90 minutes after treatment. This reaction can be prevented by consumption of adequate water and an anti-oxidant supplement. There are no other known side effects or risks.
FSM for Contact Sports
The benefits of FSM for the players of contact sports are obvious. In the U.S. the physicians who treat professional athletes have requested a special seminar, a special program for trainers, and an automated treatment unit designed specifically for athletes.
Frequency Specific Micro-current and the National Football League
Frequency Specific Micro-current was discovered by the American NFL in 2003. Bill Romanowski brought FSM to the Oakland Raiders with his chiropractor. Tony Parrish and Terrell Owens were treated along with eight linemen from the San Francisco 49ers in August 2003 by Dr. McMakin. Now, NFL teams and athletes from other sports are using FSM in record numbers. The results are impressive and consistent. Chronic injuries clear up in record time. FSM can remodel scar tissue in one sixty minute session that would take months to do manually.
New injuries heal in record time. In animal studies, FSM increases the rate of ATP production by 500% and has been shown to reduce inflammation by 62% in four minutes. Imagine these benefits applied to new injuries and you can see why Jeff Spencer takes his FSM training and his FSM units with him when he treats the US Postal team on the Tour de France. When Terrell Owens was injured in December 2004 and wanted to be able to play in the Super Bowl 6 weeks later, FSM was there when he got out of surgery and was a part of the team who made his amazing recovery and spectacular performance possible in Super Bowl 2005.
Everyone said the injury needed 13 to 18 weeks to heal and remodel. FSM, Terrell and the treatment team did it in 6 weeks.
The National Qualification in Frequency Specific Microcurrent includes frequencies and protocols that are useful in all types of conditions including those particular to athletes.
What is the difference between the microcurrent and a laser?
Microcurrent provides electrons and in published studies increases ATP production in cells. Lasers provide photons. I am not aware of any research suggesting that laser treatment increases ATP production. Lasers oscillate at set frequencies and provide beneficial results. They are doing it by some other method than frequency specific resonance and ATP enhancement.
What is the difference between microcurrent and TENS?
Microcurrent is approved in the category of TENS devices determined by the U.S. FDA. TENS devices deliver milliamp current and block pain messages that are tying to get up the spine to the brain. Microcurrent delivers microamperage current which has been shown in published studies to increase ATP production in tissues.
What is the difference between microcurrent and ultra sound?
Ultra sound creates ultrasonic vibrations and creates heat by vibrating the water molecules in the tissue. It does not provide current nor does it change ATP status. It provides beneficial results it is just completely different than micro-current.
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