About Preventing Skin Laxity and Maintaining Skin Quality

As is the case with so many other facets of our health – when it comes to preserving skin quality, prevention is the best cure. It is much easier to maintain and nurture skin that is healthy though regular, minimally invasive maintenance treatments, than it is to try to restore skin that has been neglected for decades. A basic skin health regimen that our board-certified dermatologists recommend consists of:

Daily:

• Sun protective measures including the consistent use of high quality sun screen. You might also consider the addition of a wide-brimmed hat, sun-protective neck gaiter and gloves, SPF rated clothing, SPF face shield, and UV-blocking tint on car windows.

• High quality topical skin care regimen consisting of:
  • Washing one’s face at least twice daily with a gentle yet effective cleanser
  • Vitamin C +/- other antioxidants
  • Growth factor and peptide containing serum
  • Moisturizer with active ingredients
  • Retinol/Retinoid
  • Eye cream with active ingredients for texture and laxity
  • Neck and décolletage cream with active ingredients for texture and laxity

Every 3-4 months:

• Neuromodulator treatment to help prevent the formation of deeply etched wrinkles, to preserve definition along the lower face and jawline, and to maintain skin quality by combatting excessive oil production and redness

• Gentle laser and/or energy-based device treatments to stimulate fibroblast activity for enhanced collagen and elastin production, and to address surface irregularities such as pigment and vascularity. These treatments are very easy to recover from, with virtually no downtime.
  • 1064-nm Nd:YAG laser skin tightening
  • Intense pulsed light (IPL)
  • Picofacial®

Every 6-12 months:

• • • Soft tissue fillers that are utilized in both a regenerative manner to replenish your skin’s extracellular matrix, as well as a corrective and enhancing manner to reflate, reposition, and showcase your natural features.

Every 12-36 months:

• • • Fractional ablative or nonablative laser treatments such as Fraxel re:PAIR^®, Fraxel DUAL^®, and Halo^® which can improve dermal skin quality while also blending surface textural irregularities.

Optimizing treatments to boost the results of the aforementioned:

• • • Platelet rich plasma (PRP) can be applied to the surface of your skin following laser treatments, or blended with various soft tissue fillers, to both enhance results and expedite healing. PRP is comprised of a high concentration of your body’s own platelets, which are blood cells that contain numerous growth factors and stimulating proteins within them. To obtain PRP, your dermatologist will perform a blood draw from your arm, and subject this blood to a special separation technique that isolates the platelet fraction.
    • Exosomes, like PRP, can be applied to the surface of your skin following laser treatments. Exosomes are tiny extracellular vesicles that are released by various cells, including stem cells, that contain a number of useful proteins, lipids, and genetic material such as microRNAs. These molecules all play crucial roles in intercellular communication, and consequently, cellular behavior and function. Some of the possible benefits of exosomes include collagen stimulation, anti-inflammatory effects, skin hydration and moisture retention, wound healing, and regenerative effects.
    • Polydioxanone (PDO) threads can help temporarily lift and reposition lax, hanging skin. These threads are eventually broken down by your body in the same way that absorbable surgical sutures are. When this happens, new collagen formation occurs, which helps to improve skin quality. For this reason, PDO threads can also be placed within the skin itself—not to achieve a lifting effect, but to achieve a biostimulatory effect to improve the health and structure of your skin.

Why does skin become more lax with time?

The aging process brings about a myriad of changes in the skin, including those that cause the skin to appear lax, thin, and wrinkled—like crepe paper. Several factors can cause the skin to lose its firmness and elasticity over time. These include:

• • • Decreased collagen and elastin production: Collagen and elastin are important structural proteins in the skin. As we age, the production of these proteins decreases, while our existing collagen and elastin breaks down. Decreased production of these proteins means that our skin is not able to replace what is lost during the natural breakdown process – this leads to an overall reduction in the skin’s collagen and elastin content over time. As a consequence, skin quality decreases—the skin appears more thin, wrinkled, and lax.
    • Chronic sun exposure: Ultraviolet (UV) radiation from the sun accelerates the breakdown of collagen and elastin fibers. Interestingly, fibroblasts—which are the cells in our skin that synthesize collagen and elastin—make less of these structural proteins when they are surrounded by less of them in their environment. You can therefore think of this as a self-perpetuating problem—as collagen and elastin content decreases in the skin, fibroblasts are less able to synthesize replacement collagen and elastin, which further decreases their content in the skin, and so on.
    • Genetics: Genetics play a role in determining how skin ages. Some individuals of certain racial backgrounds may be genetically predisposed to maintain better skin quality as they age. For example, histologic studies have demonstrated that individuals of African descent possess fibroblasts that tend to be large, multinucleated, and more metabolically active. Larger, more active fibroblasts are better able to synthesize collagen and elastin, which is why those of African descent are often able to maintain their skin’s quality until much later in life. However, while this may be beneficial from an aesthetic standpoint, these fibroblast characteristics are also responsible for why those of African descent are more likely to develop keloids and hypertrophic scars as a result of skin injury.
    • Lifestyle habits: Smoking, poor nutrition, rapid weight gain/loss, extreme physical or emotional stress, illness, excessive alcohol and/or drug use, and other factors, can all have adverse effects on one’s skin quality.

On what other areas of my body can I take preventative measures to maintain skin quality?

It is possible to treat virtually any area of the body to try to preserve skin quality, before laxity becomes too much of an issue. While the face, neck, upper chest, and backs of the hands are the most visible and therefore the most important areas to invest in, it is also possible to treat the following:

• • • Arms
    • Abdomen
    • Buttocks
    • Thighs

I have not taken any preventative measures to preserve my skin’s quality throughout the years, and have a lot of laxity and sun damage as a result. What are my treatment options?

If you are confronting severe skin quality issues on the face, the most appropriate treatment for you will likely be fully ablative laser resurfacing. This is the most effective laser treatment for tightening skin, improving deeply etched wrinkles, and erasing decades of sun damage. It must be stated that, if your facial skin laxity is severe, a face-lift may be your best course of action. If you are not interested in a face lift, you may be a candidate for a Nasolabial Fold Lift which is a minor, easy to recover from, aesthetic surgical procedure that is performed within the comfort and familiarity of Gateway Aesthetic Institute and Laser Center by our board-certified dermatologists. This procedure removes heavy, sagging, jowling skin along the folds of the mouth, is performed with local anesthesia only, takes about an hour, and requires sutures to be in place for one week. Click here to learn more about the Nasolabial Fold Lift.

If you are seeking to correct skin quality issues on other parts of your body, our board-certified dermatologists offer a number of treatment options that might be able to help you. However, if your skin quality issues are severe enough, then a surgical intervention such as a brachioplasty (for the arms), thighplasty or thigh lift (for the upper legs), or tummy tuck (for the abdomen) may be your best course of action. Our physicians can meet with you in consultation to determine whether surgery is the best approach for you to obtain the results that you are seeking, or whether a less invasive approach can be offered to you at Gateway Aesthetic Institute and Laser Center.

Once your severe skin quality issues have been improved to the greatest degree possible by more intensive measures, then it will be possible for you to transition to a preventative maintenance regimen, as is described at the top of this section.

Why trust Gateway Aesthetic Institute and Laser Center to help me take preventative measures to preserve my skin’s quality?

Although it was already stated at the top of this page, it really cannot be reiterated enough – when it comes to maintaining skin health, prevention is absolutely the best cure. At the Gateway Aesthetic Institute and Laser Center, we believe that the health of your skin is intimately connected to all facets of your well-being. Skin that is healthy, radiant, and fresh allows you to confront the world with confidence, go make-up free, and showcase your natural and authentic appearance.

Our board-certified dermatologists are laser and skin-care experts, who by virtue of their education and years of specialty experience understand how cutaneous biology, regenerative medicine, and laser physics should intersect to maintain the health of your skin. Their knowledge, combined with our wide array of lasers and energy-based devices, allows us to customize your treatments to evolve with you as you progress through the various stages of life.

Artistic skill combined with sound medical and aesthetic judgment are the keys to natural, attractive, and well-balanced results. Our physicians take a holistic approach to skin assessment, and take great joy in creating comprehensive, individualized treatment plans that combine a variety of treatment modalities to help patients feel confident and refreshed. When you place your care in the hands of our highly experienced, specialty-trained physicians, you can feel confident that your safety, well-being, and beautiful aesthetic outcomes will be meticulously handled, and that your skin will continue to look natural and healthy for years to come.