Younger skin, naturally

Like your eyes, your skin can reveal many things about you. For those who want their face and hands to look as young as they feel, a unique treatment aims to smooth out those wrinkles, lines and folds by working with your body’s natural chemistry.

Dr. Keith Burk of the Beechwood Cosmetic and Laser Clinic in Waterloo says a common concern among his patients is the change in their appearance as they age. “What they’re actually seeing from a clinical point of view is a volume loss. So over time we lose volume — we lose volume in our soft tissue, we lose water volume, we lose volume of a substance called hyaluronic acid, we lose collagen, and we actually have inferior migration of the fat pads in our face, which normally give our patients this sort of full, round, heart-shaped appearance.”

While most people don’t realize all these things are occurring, they can see the effect when they look in the mirror. Dr. Sachit Shah of the BC Laser and Skincare Clinic in Surrey, B.C., says many of his patients feel their outer appearance doesn’t match their inner vitality. “We often find people coming in with complaints that they look tired but they don’t feel tired, or they look angry but they don’t feel angry, or their hands have aged rather prematurely,” he says. “We get a lot of men and women who are salespeople, who want to remain very competitive, and so they don’t want to look at all tired or aged.”

According to Burk, the best correction for this are dermal fillers. Fillers restore volume to the areas of the face that have lost it, which produces a lifting effect on the appearance. Doctors can also go behind the areas of permanent wrinkles and add volume in a very localized manner, which pushes the targeted wrinkle out to make it appear smoother.

While there are numerous fillers on the market, a Health Canada-approved treatment known as Radiesse is taking a two-pronged approach to younger-looking skin: immediate results and long-term. Its power lies in tiny calcium hydroxylapatite (CaHA) microspheres that are suspended in an aqueous gel carrier. Once injected, the filler stimulates the body to produce its own natural collagen. At the same time, the patient gets instant volume that helps to smooth out the signs of aging. Over time, the calcium-based microspheres break down and are safely and naturally absorbed by the patient’s body.

Available in Canada since 2005, Radiesse can be used for a range of facial and jaw line contouring, including on nasolabial folds (the two skin folds running from the sides of the nose to the corners of the mouth), marionette lines (lines running from the corners of the mouth to the chin), glabeller lines (vertical and horizontal lines in the forehead area between the eyebrows), nasal defects, and cheek and chin augmentation. It can also be used on the hands. Doctors do not recommend using it on areas where the skin is thin, however, such as the lips.
Most of the other available temporary fillers are hyaluronic acid gels. The main difference between these and Radiesse is longevity, says Dr. Janis Campbell of Laser Rejuvenation Clinics in Calgary. “Radiesse is gaining popularity when a longer-acting filler is desired with immediate results,” she says. “[It] can last up to two years, while hyaluronic gels last six to 12 months… Both types get immediate results and may require topping off with additional product after insertion.”

“THEIR FRIENDS LOOK AT THEM AND SAY, ‘DID YOU HAVE A GOOD SLEEP?’ OR ‘DO YOU HAVE A NEW HAIRDO?’ OR ‘THERE'S SOMETHING DIFFERENT ABOUT YOU; YOU LOOK VERY RELAXED,’ AND THAT'S THE KIND OF COMPLIMENTS THAT THE PATIENT SHOULD BE GETTING.”

Another advantage Radiesse has over other fillers is its “volumizing” power, says Burk. “Radiesse has per unit volume of product a much more robust ability to add volume, to add lift to the sagging tissues of the face or the hands, or anywhere else you’re using the product.” The reason: the filler’s high viscosity and elasticity. A filler with a high viscosity will stay put in the targeted area, while those with lower viscosity are more prone to spreading and splaying into surrounding tissues. Meanwhile, a filler with a high elasticity will resist forces placed on it, such as gravity and skin laxity, as well as provide greater lift to the overlying tissues.

The procedure itself can be performed over a lunch hour. After the recipient site is cleaned, the material is injected using a fanning technique, in which the doctor injects multiple fine threads of material while withdrawing the needle. Patient comfort is aided by topical anesthetic creams or ice, or by adding local anesthetic to the Radiesse. There is little to no downtime following the procedure. “We get a lot of people coming in who are busy so they make special time in between appointments to get it done,” says Shah.

Possible side effects include injection-related reactions such as mild irritation, swelling, itching, bruising or tenderness at the injection site. These typically resolve on their own within five to eight days. Risks of the procedure are similar to other dermal fillers and include bruising and discomfort during administration, and over- or under-correction, which Campbell says tends to be low. As with other fillers, there is also a very small chance that occlusion of a larger blood vessel could result in skin ulceration.

Shah says most of his patients who request Radiesse are women aged 40 and above. Men make up about 10% of those undergoing the procedure at his clinic and are generally 30 years old or above. “Increasingly we’re seeing younger ones — we’ve seen the odd ones in their twenties,” he says. “The oldest lady we’ve treated is 82 and the oldest man probably is 67.” He says most people are good candidates for the procedure, excluding those who are on a lot of blood thinners or certain other medications, or who have certain medical illnesses. “You’d have to be assessed on a case-by-case basis… So really we need to take a good history and do a physical exam before we agree to inject anyone.”

Shah says that the feedback he has received from his patients has been overwhelmingly positive. “Most of my patients are in fact repeat customers, because they like it so much. They get a nice, natural result,” he says. “Their friends look at them and say, ‘Did you have a good sleep?’ or ‘Do you have a new hairdo?’ or ‘There’s something different about you; you look very relaxed,’ and that’s the kind of compliments that the patient should be getting.”

One of Campbell’s happiest patients was a woman who had the backs of her hands done. “She worked with the public and desired hands that looked as rejuvenated as her face.” After the procedure, says Campbell, “she was all smiles.” •