Maturing facial skin is an aesthetic concern for many patients as the natural aging process causes their looks to change. People begin to notice wrinkles and the ways in which they can detract from their central features where they first form, around the eyes and lips due to their regular movement. The same areas that captivate others’ attention during conversation or social interactions are now sources of discomfort when facial folds create obvious signs of aging. While procedures like face lift surgery and cheek implants are a great solution for advanced signs of aging, many patients opt to undergo treatments beginning as young as their mid-thirties or early forties to treat early signs of aging, recondition the skin, and prolong the need for more extensive surgical work. Both men and women can benefit from facial cosmetic procedures to enhance their looks, and restore youth to their face. Dr. Ran Y. Rubinstein of Laser & Cosmetic Surgery Specialists, PC is an skilled practitioner in anti-aging medicine, including popular dermal filler & Botox injections, and laser skin resurfacing ranging from gentle Clear + Brilliant Perméa laser treatments to most aggressive C02 Fraxel Repair laser treatments.
Treating the Skin from the Inside Out
There are a number of procedures that can treat the existing signs of aging in the skin, though a more holistic approach is preferred by facial plastic experts and dermatologists alike. Treatment methods that can actually improve the skin’s cellular composition are ideal to perform alone or alongside a more advanced anti-aging option, like brow lift surgery. The patient’s preferred aesthetics will determine how their treatment plan is formed.
Dermal injections and laser treatments are ideal options for restoring the structures of the skin at deeper levels so the patient’s appearance is restored from within. Skin removal is not required, and in most cases, the epidermis will continue to improve over time. While procedures like eyelid lift offer near-instant results (following a brief healing period), it can take longer for the effects of nonsurgical options to be completely visible.
Restylane & Juvederm – Multi-use Injectables
Restylane & Juvederm are similar injectable dermal fillers that are FDA-approved for use in medicine. Restylane is manufactured by Galderma and Juvederm by Allergan. Dr. Rubinstein uses both of these filler family of products. The gel is introduced to mid-to-deep tissues of the face or body to deliver a hyaluronic acid (abbreviated as HA) formulation below the skin. Found naturally in the human body, hyaluronic acid has the ability to attract and absorb water molecules. It can enhance the viscosity, or thickness, of other fluids and is also used medically to reduce joint pain and inflammation. Hyaluronic acid can be compared to a sponge, absorbing water at a ratio of 1:1,000.
When injected into wrinkles and folds of the face, Restylane & Juvederm effectively plumps these areas to create some immediate effects, and can also enhance the production of collagen, which is essential to skin health. Restylane & Juvederm are seen as multitasking HA fillers, with different versions to raise depressed skin wrinkles and also offer temporary lip augmentation. Over time, the lips can lose volume, and restoring their fullness or enhancing their appearance can create a dramatically younger look. Patients should be over 21 years old, though most people seeking anti-aging remedies tend to be at least 35 years old. Dr. Rubinstein offers a variety of Restylane & Juvederm fillers described below:
Restylane & Juvederm Ultra – lip injections for a fuller, shapelier pout as well as facial folds such as marionette lines and nasolabial lines
Restylane Lyft & Juvederm Voluma – treats nasolabial folds, cheek augmentation, contouring of the midface area. Used in Liquid Face Lifts
Restylane Defyne & Juvederm Ultra Plus – improves the look of deeper marionette lines and nasolabial folds
Restylane Refyne & Juvederm Vollure –targets mild to moderate smile lines that develop around the mouth
Restylane Silk & Juvederm Volbella – intended for natural-looking more subtle lip plumping effects & lip wrinkles
Laser Correction of Facial Wrinkles
Lasers have been used in the medical field for decades, and their technology is continuously evolving. These powerful light sources have the ability to cut through tissue and perform delicate procedures causing less trauma and increased healing times compared to the use of certain surgical instruments. At lower wavelengths, lasers can still create changes within the skin without the serious external impact seen in medical surgeries. In facial plastics and dermatological practices, specialized lasers heat tissues below the skin to promote long term changes to collagen and elastin, the skin’s building block. Dr. Rubinstein provides his patients with top-of-the-line clinical equipment to ensure the best aesthetic results. Commonly, the Fraxel Re :pair, Fraxel Dual and Clear + Brilliant lasers are employed to combat existing signs of aging.
Fraxel re: pair Laser
Through this ablative CO2 laser, patients will see maximum improvement after just one or two sessions. The result is vertical layers of skin removal that promote healing of the tissues, resulting in fresh skin and a youthful appearance. Fraxel re: pair is reserved for the most serious skin damage that affects, including lines and wrinkles that affect its deeper layers. The name itself (“Re:Pair”) is a play off the pair of lasers, fractional and CO2, that are dually effective in skin resurfacing, also causing the skin to repair itself. The uniformity of the fractional laser light treatment and CO2 evaporation of tissue ensures an effective treatment from the forehead to the neck, and even some areas on the body. This controlled resurfacing leaves certain parts of the skin untouched for faster healing times. Fraxel re: pair treats skin conditions ranging from wrinkles and loose skin to sun-induced hyperpigmentation. Even scarring can improve though this technology.
Clear + Brilliant Perméa Laser
While Fraxel re: pair is a procedure to combat advanced signs of aging and other difficult-to-treat skin issues, the Clear + Brilliant Perméa laser, is aimed at improving early signs of aging and other issues of the skin specifically, areas of unwanted pigmentation. Nicknamed the “baby Fraxel,” Clear + Brilliant creates similar fractionated columns of micro injury, prompting collagen to form at the site to promote healing. The non-ablative laser sessions can be performed every two week for four to six sessions total for optimal aesthetic improvement. Many patients are drawn to Clear + Brilliant Perméa because it is gentle on the skin, yet effective in its rejuvenation. Pigmentation issues can be permanent, and they are cumulative. Acne scars, brown spots, and post-pregnancy or other hyperpigmentation can detract from the skin’s natural glow, but can be improved or eliminated with the Clear + Brilliant Perméa laser.
For those who want the more aggressive wrinkle & scar results of Fraxel re: pair without the same downtime plus the gentle reduction of pigmentary issues seen with the Clear & Brilliant there is Fraxel Dual. It’s called “Fraxel Dual” because its two laser in one. The Fraxel Dual 1550 targets the wrinkles and scars much like the Re: pair and the Fraxel Dual 1927 goes after finer lines, large pores, and age spots. A series of 3 to 4 monthly treatments are needed. Some patients will have only the Fraxel Dual 1550, others just the Fraxel Dual 1927 and many a combination of the Fraxel Dual 1550/1927 in one treatment session.
Complementary Procedures for Facial Wrinkles
Face wrinkles and other signs of aging occur in all maturing skin. While Dr. Rubinstein supports aging gracefully, this can be achieved through cosmetic medicine. He produces natural results that make people feel great at any stage in their adult life. There are numerous options to restoring a youthful appearance of the facial skin and features, including plastic surgery of the face. Juvederm and other HA injections, laser treatments like Fraxel re: pair, Fraxel Dual, and Clear + Brilliant Perméa can be standalone cosmetic plans, or paired with facial plastics like:
- Face lift
- Brow lift
- Eyelid surgery
- Cheek augmentation (with implants or fillers)
- Fat transfer (fat injections)
- Neck liposuction
FAQs About Facial Wrinkle Treatments
The purpose of aesthetic medicine is to correct existing concerns, create healthier skin, and prolong the need for future treatments. Unfortunately, there is no way to stop the hands of time; however, facial plastic surgeries that are often performed more than once during a person’s lifetime, like face lift and eyelid surgery, may only require an initial procedure. Laser skin treatments like Fraxel re: pair and Clear + Brilliant Perméa and dermal filler treatments maintain results in problem areas of the face.
There are a number of ways to jumpstart collagen production in the skin. As people age, collagen is not produced at the rate or quality as it was during their younger years. When it is activated, the results are stronger underlying skin structures that create a more appealing look. Some treatments create damage to the skin, through thermal or micro injuries, so collagen is formed to heal the areas. Fillers such as Sculptra Aesthetic and Radiesse contain microscopic elements that help new collagen to form. While patients look great after fully healed from non-surgical procedures, they also benefit from long term results.
Also known as VolumaLift, liquid face lift is a series of injectable fillers that are strategically administered to provide all-over lifting benefits. When the gel is dispensed under the skin, it plumps depressions of the skin (lines and wrinkles) to create the look of smoother skin. Patients can also enhance areas of the face like the cheeks, chin, jaw line and lips and tend to lose volume over time. Restylane is a popular option for this procedure, though patients can also choose from Radiesse, Juvederm, or Sculptra injections.
What is the difference between Fraxel re: pair and Fraxel Dual lasers?
Fraxel re: pair was designed following the advent of the original Fraxel re: store (which later became Fraxel Dual) to correct more serious skin issues like wrinkles, age and sun spots, and uneven texture. Because it creates more in-depth changes, the recovery period is longer by a few to several days. Fraxel re: pair is recommended for patients who exhibit moderate to advanced signs of aging. Fraxel Re: pair will do more for deep lines and scars. Although a series of Fraxel Dual treatments can have a dramatic effect on wrinkles and scars, it outperforms Fraxel Re: pair when it comes to addressing pigmentary issues. Sometimes combination staged treatments are performed.
How long is the recovery after laser skin resurfacing?
There is no downtime with Clear + Brilliant. Fraxel Dual 1550 may require 48 hours of downtime due to swelling and Fraxel Dual 1927 1 to 2 days on day 3 to 5 post treatment when the sun damaged skin begins to peel off. Fraxel Re: pair because it is the most aggressive up to 7 to 8 days. Keep in mind, downtime is a relative thing. Older Co2 lasers required 2 to 4 weeks of downtime with skin redness and tenderness lasting for months. Adding topical PRP (platelet rich plasma) immediately after Fraxel Re: pair can reduce downtime and add to the resurfacing results.
What are the risks involved in laser skin resurfacing and dermal fillers?
Although the risks are minimal, Dr. Rubinstein cautions to seek out highly skilled and experienced clinicians. These risks include burns which can lead to scarring and skin pigment loss or unnatural results with dermal fillers. There is also growing trend to use fake lasers and dermal fillers to bring down the cost of treatments. Dr. Rubinstein recommends sticking with “core cosmetic physicians” which comprise dermatologists & plastic surgeons. Dr. Rubinstein enjoys training these established core physicians in the North East on the safest and latest treatment methods.
New York Facial Plastic Surgeon and Laser Expert, Ran. Y. Rubinstein
Dr. Rubinstein of Laser & Cosmetic Surgery Specialists, PC in New York’s Hudson Valley specializes in both surgical and nonsurgical cosmetic corrective procedures. He holds dual board certifications through the American Board of Facial Plastic Surgery and the American Board of Otolaryngology-Head and Neck Surgery and is an active member of the American Society of Laser Medicine & Surgery. With almost 20 years of experience in private practice and educating future medical professionals, as a clinical professor at the New York Presbyterian Hospital in Manhattan, Dr. Rubinstein remains current on clinically proven technology and the latest advancements in the field of facial plastics.
The practice can be reached at 845-863-1772 to schedule a consultation, or fill out Dr. Rubinstein’s Contact Us form to receive an email response or phone call.