Is There Anything Skincare Can't Do?

Committing to a quality skincare regimen will set you up for success as you age. But skincare has its limits, which is where a trip to the dermatologist or plastic surgeon comes in.
Expert Opinion
Written by Jeannine Morris Lombardi
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Is There Anything Skincare Can't Do?LightField Studios/Shutterstock

With all of the scientific studies, newfound ingredients and technological advances, you’d think (or at least hope) that your skincare can do it all. Then again, you know better. While your at-home regimen is extremely important, truth is – your favorite lotions and potions can’t do everything.

To better understand the limitations of skincare products, we spoke with the dynamic duo behind LM Medical in NYC, sisters Lesley Rabach, MD, and Morgan Rabach, MD, to find out when it’s time to consider asking a dermatologist or plastic surgeon for help addressing your aesthetic skin concerns. Here’s how to get ahead of the aging process and some of the ways a professional can help when skincare isn’t enough.

Skincare & Sun Care Must Start Early

Your lifestyle and genes play a big role in how your skin ages, but skincare and sun care (or the absence of it) can have a big effect. “If you can get ahead of sun and skin damage by giving your skin the nutrients it needs, then the health of your skin and the way it looks will be in a good place as you age,” says Dr. Morgan, a board certified dermatologist. “Prevention is key to avoiding drastic measures.”

Dr. Lesley, a double board certified facial plastic and reconstructive surgeon, recommends starting with a quality, simple routine in your twenties. “You don’t need to use a ton of different things to have really good skin,” she explains. “With just a few products, you can maintain youthful looking skin for a long time.”

The secret sauce to keeping youthful skin for as long as possible?

  1. Sunscreen
  2. Retinol

“Sunscreen and retinol go together like peanut butter and jelly,” Dr. Morgan explains. “These two products will help your skin fight things as they come up as opposed to having to fix them later.” It should be noted, however, that even if you swear by these two products, eat clean, drink lots of water, and practice an overall healthy lifestyle, there is a natural aging process that happens no matter how well you take care of your skin — and that’s OK.

When Skincare Is Not Enough

There’s something empowering about aging, and the jobs of dermatologists and plastic surgeons are to help you look like the best version of yourself in an age-appropriate manner. While it may be a bit strange to see a woman in her seventies with zero lines on her forehead, both doctors agree that Jennifer Lopez is a good example of aging gracefully. “She has the ‘wow factor’ and is in her fifties,” Dr. Lesley notes.

Here are some things skincare alone can’t accomplish, but — with the right technology and techniques — a dermatologist or plastic surgeon can:

Concern: Fine Lines & Wrinkles

  • Solution: Neurotoxin Injections

Fine lines around your eyes and on your forehead are some of the first signs of aging. No matter how well you take care of yourself, the skin in those areas is very fine and will develop lines. How deep the lines get can be controlled with neurotoxin injections like Botox®, Dysport®, Jeuveau®, and Xeomin®. “Botox® is preventative,” Dr. Lesley says. “It relaxes the muscle a bit, so fine lines disappear. And, if you do it regularly as you age, they won’t get any deeper.” Botox® and the like lasts an average of three to four months depending on the person and area treated. Some patients like to do it like clockwork to never see lines, whereas others prefer twice-a-year maintenance. It’s really a personal preference. About 35 percent of LM Medical’s patients are under 35.

Concern: Volume Loss

  • Solution: Filler

Sad but true: You’ll start losing collagen and bone around your temples, cheeks, and lips in your twenties. Dermal fillers can provide an instant boost and also stimulate collagen production to help replace the natural volume loss that happens overtime. The results of fillers are immediate and can last upwards of to two years (depending on the type).

Concern: Sagging Skin

  • Solution: Ultherapy®

Ultrasound skin tightening therapy, like Ultherapy® is a non-surgical way to lift and firm the skin around your neck, chin, and brows. Most patients only need one treatment to start. Maintenance sessions beginning one- to two-years after the first procedure can sustain and improve the results.

Concern: Tired Eyes

  • Solution: Blepharoplasty

Because the skin around your eyes is so thin, your top eyelid can start to sag and droop onto the lash line resulting in a tired appearance. Surgically, this can be corrected with upper eyelid blepharoplasty. As far as your lower eye area goes, under eye filler can temporarily camouflage hollowness, but lower eyelid blepharoplasty is a more permanent solution. “With the upper eye, we surgically remove the skin from the upper eyelid,” Dr. Lesley explains. “When treating the lower portion, we’re removing fat pads and restoring contour.”

Concern: Lip Size

  • Solution: Lip Filler or Lip Lift

As soon as your lips begin to thin or your lipstick begins to seep into newfound fine lines, the first thing that likely comes to mind is filler. Both Dr. Morgan and Dr. Lesley agree that lip filler is a great temporary solution for plumping up the lips, if injected correctly by a skilled practitioner.

A permanent, albeit surgical, option is a lip lift. Dr. Lesley calls the in-office surgical procedure her “best kept secret,” and patients say it gives them a “wow” effect. During a lip lift, the goal is to shorten the distance between the bottom of your nose and your upper lip by removing skin. Believe it or not, there is an ideal length for this area. As you age, the distance becomes longer and the red part of the top lip begins to invert. By taking a bit of skin from the center base of the septum, the upper lip is pulled back up and, in turn, looks fuller.

Concern: Acne & Acne Scars

  • Solution: Chemical Peels

Acne doesn’t just affect teenagers. For adults that have gotten rid of those pesky pimples, acne scars may remain. “My acne patients who don’t want to be on Accutane or birth control do a series of [chemical] peels to prevent scarring,” Dr. Morgan shares. She likes retinoic acid peels or the Jessner Peel, which uses a combination of salicylic and lactic acids to help remove dead skin cells from the top layer of the skin and smooth scarring.

Concern: Cellulite

  • Solution: Qwo™

Until recently, there wasn’t anything on the market to completely remove cellulite. Creams, massages, and dry brushing all help to temporarily minimize the appearance of cellulite. But that’s just it: They conceal the condition instead of correcting it. The FDA approval of Endo Aesthetics’ Qwo™ (which we covered in depth HERE) — a cellulite-smoothing injectable that targets the fibrous bands underneath your skin that typically cause dimpling — is going to be a game changer. “I can see us begin to use this in conjunction with Sculptra®,” Dr. Morgan says. “We’ve used the [filler] around the dimpling to camouflage cellulite in the past.”

Concern: Body Contour

  • Solution: CoolTone™

No matter how healthy you eat or how often you work out, you just can’t seem to get the definition you believe you deserve. Sound familiar? There are creams that claim to help tone difficult areas if you apply them before a workout, but there is no evidence they actually work. Today, there are a variety of muscle-toning devices that can help. Allergen’s CoolTone™, a non-invasive muscle-stimulating treatment that’s FDA-approved to help strengthen and firm the abdomen, buttocks, and thighs, is one such example. Emsculpt® by BTL is another.

The Takeaway

Just because your skincare routine can’t do all the heavy lifting, doesn’t mean you should ignore it. Serums, creams, and (most importantly) sunscreen is essential to maintaining the health of the skin and is the best way to keep your complexion in tip-top shape between in-office visits.

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JEANNINE MORRIS LOMBARDIis a contributing writer for AEDIT.

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