The Wellness Traveller interview with:
Dr David Alessi of the Alessi Institute; on Facial Rejuvenation
Wellness Traveller: Non-surgical facelifts and facial rejuvenation procedures are increasingly popular in today’s vanity–focused social world. What would your advice be to those considering these procedures but are concerned about undesirable results?
Dr Alessi: My advice to those considering any kind of facial rejuvenation procedure, whether surgical or non-surgical would be to go to an expert. These procedures are becoming very common but also, the number of doctors doing them is increasing, and many of them are not well-trained. Always look for Board Certification. Non-surgical procedures should always be done first (if at all possible) because the chance for a bad outcome would be lower with a non-surgical procedure. There are many non-surgical procedures that are great, such as “Profound” that can tighten the skin, and fillers such as “Voluma” to fill in the sunken look that occurs with the ageing process. In terms of invasive procedures, those that are the least invasive should always be done first. Everybody is an individual and no surgeon should use a cookie-cutter approach to every patient. It depends on what the patient’s concerns are, the surgeons should listen to the patient and come up with a surgical plan, or a non-surgical plan that the patient agrees with and fully understands.
Wellness Traveller: You are renowned for your “natural looking” results. How do you achieve this? Does this stem mainly from your technique, experience and products you use?
Dr Alessi: In terms of obtaining ‘natural results’ it’s mainly by understanding anatomy and beauty, and not cutting corners. For example, when doing a neck-lift or a face-lift, many surgeons will cut corners by only pulling back the skin. That will give a ‘too-tight’ appearance and an Old Hollywood Actress appearance to their look. For facial rejuvenation surgically, as somebody ages not only does their skin sag but also their fat and muscle will sag at the same time. These all need to be put back into place to achieve a very natural look. Also understanding the ageing process and putting things back to where they were when the individual was younger is very important. It’s not just about tightening skin but also to reconstruct the underlying structures.
Wellness Traveller: Botox v fillers:? What are your views on these procedures? How long do the results last and is there any medical research to indicate that repeated treatments can be detrimental to health?
Dr Alessi: These are both very safe procedures and they do different things. Botox is for lines that are there part of the time, such as the lines in between the brows and the forehead that contract with muscular movement. The best uses for Botox would be forehead lines, the lines in between the eyes, and crow’s feet. We also use Botox to make the eyes a little bit bigger, and also to help keep somebody’s mouth look like it’s slightly smiling rather than looking like a fish mouth. There is no evidence to suggest that any repeated use of Botox or fillers can be detrimental to health. There is no incidents of cancers, or other medical problems occurring because of these fillers, assuming the individual does not have an allergy to the fillers or the Botox.
Fillers are used for filling in lines that are there all the time such as the lines by the nose that go to the corner of the mouth, called the nasolabial folds, or for noses that have a defect in the bridge that needs to be filled out a little bit. It can also be used for the Tear Trough that is underneath the eyes (which gives a hollowness to the eyes), to fill out lips, or it can be used to make hands look younger, and there are multiple other uses. Most of the fillers used nowadays are made out of a Hyaluronic acid so if the result isn’t exactly what the patient wants then it can be dissolved easily. There are different types of Hyaluronic acid depending on how cross-linked they are, and will change how long the substance will be in there. It also changes the consistency as to whether or not it’s thick or thin. Thicker fillers are used for deeper correction such as giving new cheekbones and nasolabial folds. Thinner fillers are used for underneath the eyes and for the lips. These are done very frequently and an expert of hands can be a wonderful result for patients. In terms of fillers, we actually do a lot of fat injections. Fat will function just as any other filler except the only issue with fat is that sometimes the fat can go away. However, with better processing of the fat, the chance of the fat surviving for a long-term or forever is much higher.
Wellness Traveller: Being at the forefront of the Facial Rejuvenation area of the medical profession, can you provide any insight on new developments?
Dr Alessi: In terms of any new developments in medical procedures for Facial Rejuvenation, there are better and longer lasting fillers. There is still the search for the perfect filler, that is one that will last forever but can be dissolved very easily. Also, there is research in terms of neurotypes of Botox-like substances that will last for longer periods of time. There is research on topical Botox that will avoid the use of needles. Additionally, there is more research on better types of radio frequency that can tighten the skin non-invasively.
Wellness traveller: We all want to keep our skin looking as young as possible for as long as possible. What is an essential part of the routine for our daily skincare regime?
Dr Alessi: In terms of keeping your skin looking as young as possible, for as long as possible, the four things you need to do are:
1) moisturize; 2) stay out of the sun; 3) avoid stress and; 4) don’t smoke.
Also, hormonal changes especially pre-menopause or menopause can have a detrimental effect on the skin. Hormonal Replacement Therapy (HRT) is a wonderful treatment to keep your skin looking as young as possible and for as long as possible. Basically, if somebody follows the four main points above, then the skin will look great for a long time. In terms of moisturizers, there are many different types. The main factor is not the cream itself, but the fact that the skin is staying moist. Antioxidants can be very useful in helping to inhibit sun damage and free-radical damage.
Dr Angela Lamb, assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai
Ageing can be prevented with lifestyle tips. She recommends wearing sunscreen every day as sun exposure facilitates wrinkle formation and leads to dark spots on the hands and face. Stress causes ageing biological cells, so she encourages everyone to practice yoga, meditate or sleep to relax the mind and body. Even subtle habits like sipping through a straw can contribute to ageing as they use the muscles in your face more frequently and creates fine lines and wrinkles.
Dr David Stoll, dermatologist and author of A Woman’s Skin
Dt Stoll advises against smoking since it causes a decrease in blood circulation, which may contribute to premature skin ageing and wrinkles. He also encourages everyone to sleep on their backs to prevent the skin from sagging overnight. Exfoliating is an important skincare practice to remove dead skin and enhance your complexion and to further supplement your skincare routine, he recommends using retinoids to boost collagen production and leave your skin looking younger than ever.
Dr. Andrew Weil, founder of the Arizona Center for Integrative Medicine
Dr Weil recommends graceful ageing by taking control of your health. He believes aerobic and weight-bearing exercises will help you live longer and look younger by warding off diseases. Additionally, a well-balanced diet full of natural foods will fight inflammation and rejuvenate your skin. In order to feel happier and maintain a healthy status, he recommends engaging in satisfying activities, like volunteer work and employment.