Cosmetic Dermatology Q&A with Dr. Kang

What are some of the most popular cosmetic treatments you offer, and what are the benefits of each?

Some of the most popular cosmetic treatments I do are Botox, Sculptra, and IPL. Botox helps to relax muscle movement so any facial expressions that result in lines can be improved with Botox such as forehead lines, frown lines between the eyebrows, and lines radiating out from the eyes. We can also use Botox for the mild opening of the eyes, lines around the mouth, softening a square jawline, relaxing muscular bands in the neck, and relaxing a gummy smile amongst other things. My goal with Botox is not to freeze the expressions and prevent any wrinkle formation. At 80, we don’t want to look unnaturally smooth but instead, my goal is to slow down the progression of the lines so they are not as creased and as deep as they would be without regular Botox treatments.

Sculptra is one of my personal favorite cosmetic treatments to have done on myself. Sculptra is a filler but acts differently from more well-known fillers such as Juvederm or Restylane. Instead of injecting in a substance where volume is filled in right away, Sculptra is a powder suspended in water that is then injected.  The water will be absorbed within a few days to a week but the powder left behind will stimulate your own collagen to help fill in areas of volume loss. When we age, all aspects of the face lose volume – skin, fat, muscle, and bone – which results in an overall sagginess of the face, a more downturned look rather than a more lifted look. Sculptra helps to address the deeper volume loss to reestablish the deeper foundation that helps to hold up the cheeks and jowls. I love how it rejuvenates the entire face rather than specific parts of it.

IPL is another favorite. IPL is a laser that helps to lighten brown spots resulting from sun exposure. These treatments result in clearer, more youthful-looking skin. Long-term studies also show that IPL helps to gently stimulate collagen so that the quality of the skin improves as well.

Can you share some tips for patients who want to maintain healthy, youthful-looking skin?

Sunscreen, sunscreen, sunscreen. Sun is the thing that ages the skin the most. If you are interested in keeping your skin youthful, sunscreen and general sun protection will be the most helpful. I recommend using at least an SPF 30 sunscreen, though a higher SPF is better. Use once daily on the face, neck, chest, and hands where they are constantly exposed. If you are outdoors for longer periods of time, then try to reapply sunscreen every 1-2 hours as it starts breaking down over time. The brand and type of sunscreen are not as important as the SPF. Nicer brands tend to have a nicer feel on the skin and I only recommend using specifically a physical or chemical sunscreen if there seem to be skin allergies to certain ingredients.

After sunscreen, there are other ingredients I find helpful in keeping skin youthful depending on what a specific patient needs or is looking for. Topical vitamin C helps to stimulate collagen and is a great antioxidant. Retinoid acids help with regular skin cell turnover so that the skin looks brighter.  Glycolic acid products also help to make the skin look brighter as it gently exfoliates dead skin that makes the skin look dull.  Hydroquinone helps to make the skin look more even, lightening excess pigmentation from the sun.

What are some of the biggest misconceptions about cosmetic treatments, and how do you address them with patients?

The biggest misconception that I hear from patients is that when doing cosmetics, will make you look unnatural.  Cosmetic treatments, in general, are trending towards a more natural look. I believe a good cosmetic procedure should not look like you had any procedures done but should give an overall refreshed look. The comments you should be getting from other people are, “You look so good! Did you get a facial/go on vacation/etc?” Not, “Oh! You had Botox/filler/etc done, right?” Cosmetic procedures should be thought of as done in stages, not fixing everything in one visit. I usually like to start off with smaller amounts and work my way up as needed since it is easier to add more later than to take away anything.

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