Askanesthetician's Blog

An esthetician explores skincare issues and concerns

New Trends in Anti-Aging Procedures: “Vampire” Facelift and Ultherapy March 7, 2011

I recently read with great interest two articles about new in office anti-aging procedures.  The first article was in Harper’s Bazaar, and it was about a new nonsurgical browlift called Ultherapy.  The second article was in The New York Times Skin Deep series about a new trend in facelifts called the “vampire facelift”.    Neither of these procedures are surgical or invasive.  The so-called vampire facelift falls under the category of “liquid facelifts” which is a facial rejuvenation procedure that normally means fillers and Botox are used to create a temporary change in the appearance of one’s face without surgery.   Ultherapy uses ultrasound technology and heat to lift the brows and rejuvenate one’s appearance.

I’ll begin by discussing the vampire facelift.   Let me quote The New York Times article in order to further explain the vampire facelift:

[this procedure] entails having blood drawn from your arm, then spun in a centrifuge to separate out the platelets. They are then injected into your face, with the hope of stimulating new collagen production. Selphyl, as the system is called, arrived on the booming facial-rejuvenation market in 2009, and is now used by roughly 300 doctors nationwide in the name of beauty, said Sanjay Batra, the chief executive of Aesthetic Factors, which manufactures the Selphyl system.

Why would someone choose to pursue this procedure as opposed to having Botox and fillers injected into their face? 

Ghoulish as the procedure sounds, some patients prefer the idea of using their own blood rather than a neurotoxin or synthetic filler to rejuvenate their faces. “We all want to look better,” said Joan Sarlo, 56, who underwent a Selphyl “vamp-lift” performed by Dr. Lisa A. Zdinak, a Manhattan-based doctor whose specialty is ophthalmic plastic surgery. But the “less unnatural the better,” Ms. Sarlo said. “What could be better than your own blood?”

Some doctors say that fillers taken from one’s body are less likely to cause irregularities and bumps in thin-skinned areas than synthetic ones like Sculptra Aesthetic. But at this point, it’s hard to tell whether “platelet-rich fibrin matrix,” or P.R.F.M. (the medical term for the golden-hued platelets that Selphyl extracts), is an effective filler for hollowed-out cheeks and wrinkles.

But for me the crux of any cosmetic procedure comes down to safety and proof that the procedure is safe through FDA approval as opposed to testimonials and heresy.  And here is where things get messy, excuse the pun, with the vampire facelift:

What’s more, doctors and consumers aren’t clear on where Selphyl stands with the F.D.A. In a YouTube video featuring Dr. John Argerson, a board-certified family medicine doctor who works out of Refine MediSpa in Johnson City, Tenn., tells consumers that Selphyl is a “newly F.D.A.-approved filler” for nose-to-lip folds. And in a December 2009 article in Dermatology Times, a trade publication, Dr. Ranella Hirsch, a board-certified dermatologist, said Selphyl is “a new F.D.A. approved dermal filler.” This week, Dr. Hirsch, who doesn’t use Selphyl in her practice, said that she couldn’t explain why she misspoke, adding in an e-mail that “the lack of clarity between F.D.A. approval versus F.D.A. clearance to market is a key point.”

Indeed. The F.D.A. has not approved or cleared P.R.F.M. derived in a Selphyl centrifuge to be marketed for facial rejuvenation. In 2002, the agency cleared a blood-collection system called Fibrinet, whose platelet-rich byproducts orthopedic doctors then used to speed tissue repair. In 2009, this same machine was born again as Selphyl, and since then, the company promoted it as a way to “reverse the natural aging process.” This week, Shelly Burgess, an F.D.A. spokeswoman, said that Selphyl’s maker would have to file an amendment to get clearance to market its blood collection system in a new way, and no such amendment could be found at this writing.

Asked whether Aesthetic Factors’ marketing of Selphyl for cosmetic rejuvenation violated any F.D.A. policy, Ms. Burgess simply wrote, “As a regulatory agency we would not discuss whether a firm’s claims violate our regulations.”

In light of the fact that there is little to no clinical data that this procedure works as claimed, and furthermore since the FDA has neither cleared nor approved this procedure I would steer clear of doing it until there is such approval.  There are so many safe options for liquid facelifts that there is really no need to try something that is still in trial stages.  Who knows?  Maybe 15 years from now a vampire facelift will be the norm but until then I would suggest that you proceed with caution.

 

 

Ultherapy is very different from the vampire facelift described above.  This procedure uses ultrasound heat on your forehead in order to greatly increase collagen production beneath the skin’s surface.  As collagen production increases in that area of your face your brow firms.  Immediately after getting the treatment you will see a smoothing effect, and as your collagen production increases over time your results will improve in the months to come.  And what might be the best news of all, these results are pretty much permanent though some patients may need a touch up in a year.  Ultherapy costs somewhere between $1,000 to $4,000 and has been cleared by the FDA for use on the forehead (according to the Harper’s Bazaar article).  If the machine is used incorrectly a burn could result because of the intense heat generated by the machine.  That heat can also make the procedure less than comfortable. 

According to an article in the April, 2011 issue of Vogue (which I can’t find online unfortunately) Ultherapy can be used on both the face and the neck not just the forehead.  The article explains how Ultherapy works thusly:

Thermal energy bypasses the upper layers of the skin (those conventionally targeted by Fraxel and Thermage), safely heating the underlying connective tissue that lines the facial muscles.  That tissue contracts, resulting in an immediate tighting and, ultimately, a tangible lift.  …  In an attempt to target multiple layers of tissue, doctors then set the device to a shallower depth and make a second pass with the hand piece, this time intentionally aiming its heat at the skin’s upper layers in order to stimulate line-smoothing collagen production.

Furthermore, according to the Vogue article it takes about an hour to complete both the neck and the face using ultrasonic imaging so the doctor performing the procedure can view each layer of the muscle and skin as they work on the patient.  Risks include some swelling and bruising and a feeling of tightness for a few days following the procedure.  And one more thing, the procedure doesn’t feel so great.  It can feel like a hot prickling sensation to intense and short bursts of pain.  

Overall as an option for slowing down the aging process Ultherapy sounds promising.  You can try it out if you feel that your face needs a lift but you aren’t ready for a facelift yet.

One more note – it turns out both of these procedures have been featured on The Rachael Ray Show , How to Look 10 Years Younger,  which has made me wonder – do I need to start watching The Rachael Ray Show in order to keep up with cosmetic procedure trends?  I always thought her show was all about cooking. 

 

Cosmetic Procedures and Practices to Avoid February 21, 2011

Recently I read with horror the story of a young woman who died following a botched cosmetic procedure performed in a hotel room in the Philadelphia area.   There were numerous disturbing things about this tragic story but far and away one of the most upsetting aspect was the idea that someone would go to a hotel room to have what was obviously an unsafe cosmetic procedure.  Reading a story like this makes made me wonder what the thought process one would have behind making such a decision in the first place, let alone going through with it.

Needless to say this tragedy was quite avoidable which makes it even more upsetting.  So that begs the question – how can you be sure that the cosmetic procedure you are getting is safe?  And moreover how can you be sure that the person doing the procedure is legit?

There are a lot of procedures being offered by medical spas that are actually quite controversial and it is best to educate yourself before paying any money let alone proceeding with surgery.  Take for instance a procedure called Lipodissolve which promises to remove small pockets of fat through injections.  Sounds great, right?  Well actually it sounds great only on paper.  In reality the procedure is controversial enough that the FDA is cracking down on medspas that advertise that they perform this procedure.  Not only is the procedure not FDA approved, there is no evidence that it actually works. 

So once again, how do you protect yourself both financially and health-wise when you want to get a cosmetic procedure done?  When selecting a plastic surgeon make sure that they are board certified in plastic surgery and work in an accredited facility.  Ask a lot of questions during your consultation.  And it goes without saying that you should do a consult before any procedure.  If  some place wants you to go ahead with a procedure without a consult with a doctor (not a sales person but a doctor) definitely stay away!  Not only should you feel comfortable to ask about all aspects of a procedure during a consult, but any good doctor shouldn’t give you trouble when you ask about their credentials and experience.  You can quickly figure out if the doctor you’ve consulted with is board certified by logging to the American Board of Medical Specialties and looking up the doctor.  Educate yourself!  There even good resources online like The American Society of Plastic Surgeons website and New Beauty can give you details about popular cosmetic procedures.

Above all use your common sense – if your gut feeling tells you that things don’t feel right – stay away.  If someone offers to do your surgery for a cut-rate price there is usually a reason for that, a bad reason – stay away.  Legitimate places can offer discounts on surgery but if you are quoted a price that is way below the going rate there is probably a bad reason for that.  While the results of cosmetic surgery can be life changing and life enhancing do make sure that you proceed with caution and feel good about your decision before going through with anything.

 

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Elective Cosmetic Surgery for the Right Reasons January 24, 2010

Earlier this week a friend of mine gave me an old copy of More magazine (April 2009).  I had never read More before because I thought there wouldn’t be much in the magazine that I would enjoy since I am not their target demographic (the magazine is meant for women 40 and older, and I have about five years until I reach that milestone).  Much to my surprise I have really enjoyed reading the magazine.

In the copy of the magazine my friend gave me I came across an article by Annie Groer entitled “From Buyout to Face-lift” about her decision to get a face-lift when she turned 60 and had just been laid-off.  I thought it was a great article – thoughtful, funny, and entertaining.  The article also did a wonderful job at describing why someone would choose to have elective cosmetic surgery and why such a choice isn’t entirely vain or ridiculous.  I know many, many women (and men) who consider elective cosmetic surgery a silly, narcissistic decision.  Of course there are numerous, numerous examples of people who choose elective cosmetic surgery for all the wrong reasons – completely giving in to societal pressure to look young and beautiful, deep-seated self loathing, or they are trying to change their appearance to fit in with a certain desired group.  For all those people there are many others who just want to make a few physical  improvements.  Perhaps the way your breasts look bothers you or perhaps your body (no matter how much you exercise or watch what you eat) never “recovered” from having children.  What is so wrong then with getting a few improvements?  It is clear that when you feel good about how you look your attitude and outlook on life changes, your confidence grows, and your ability to cope with what life throws at you is greatly enhanced.  This article clearly shows how a physical improvement can have those desired impacts on your life.  What I also liked about this article is that the author realizes that a face-lift won’t change her life entirely, but it would as she writes “ease [her] entry into [an] uncertain new phase” of her life.  Groer saw the face-lift as a much-needed ego boost.

I expect that more than one person will disagree with mine and Groer’s stance on elective plastic surgery, and I think that it is important to continue to have a debate on the subject since there are many plastic surgery “abusers” and “addicts” out there.  But bottom line – if you can find a way to make yourself look better in order to feel better, and have realistic expectations about the physical and emotional results of your surgery, why not do it?  If elective plastic surgery makes you enjoy your life to the fullest than go for it!  For those reasons I don’t consider the decision to get elective plastic surgery to be a frivolous or selfish decision.  Keep your expectations in check but your goals high and enjoy your new look.

 

 
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