Stay Healthy and Look Younger with Laser Resurfacing

Susan Van Dyke, M.D. on Her Personal Experience

I have been doing laser resurfacing for nearly 20 years now. In fact, I had the procedure done myself before I ever treated a patient. I was 41 years old and had just been diagnosed with skin cancer. Thankfully it was basal cell carcinoma, the most manageable of the skin cancers. Easily curable and rarely life threatening, this type of cancer is unlike the melanoma that my aunt just passed away from. Around the same time as my diagnosis, my mother had several basal cell cancers removed from her face, and by the time she passed away at the age of 77, she had over a dozen surgeries to remove the sun induced lesions.

This taught me an important lesson – prevention. I sought a way to immediately reduce the risk of contracting additional skin cancers on my face, and remove the sun damage and wrinkles that developed over the years. I decided to undergo laser resurfacing treatment, and decided to make it available to my patients. I flew to La Jolla, California and trained with two icons of laser treatments: Mitch Goldman, MD and Richard Fitzpatrick, MD. I returned to La Jolla a few weeks later and Dr. Fitzpatrick treated me.

At the time, laser resurfacing was harsh and the recovery long, but I never regretted the decision. Today, at the age of 57, I have yet to contract skin cancer on my face. My cosmetic improvement has been fantastic; sun damage and wrinkles gone. Since then, I have treated several hundred patients with amazing results.

Resurfacing fell out of favor for a few years; there was a search for easier ways to accomplish the same dramatic results. About 10 years ago the concept of fractional resurfacing developed and has since become the gold standard in resurfacing. In the last few years, the power of this technique combined with a much quicker recovery period is being appreciated. Active FX and Deep FX (when combined, the treatment is called Total FX) is the very latest in resurfacing. These are the two approaches that I now use at Van Dyke Laser & Skin. We also have Fraxel Dual (for lesser sun damaged skin) and Clear + Brilliant (for early stages of sun damage). With these tools and techniques, I can now give my patients a treatment that fits their needs

We have come a long way!

‘Tis the Season for Giving – Our Fav Gifts!

Every year in December the questions start swirling – what is on everyone’s wish list, and what do I want for myself? We asked our staff at Van Dyke Laser & Skin to list their favorite gift ideas for this holiday season, should you need a little inspiration. Each idea keeps your health and beauty in mind, and even gives a little boost to your spirit! Who knows, you may want to slip this entire list under the pillow of your special someone – you know, as a little hint-hint!

Black Friday is almost here!

The concept of Black Friday is fascinating, really. We, as a country, created an entire dedicated to getting the most “bang” for your buck. Retailers started this eons ago, and ever since, Black Friday has evolved into a holiday of its own.

Three years ago (and just two months into the recession) I was brainstorming with my marketing-genius son, Brian. It was the day before Thanksgiving and the topic of conversation was how to give back to our patients, and how to give them a gift they would truly want. Brian exclaimed “BLACK FRIDAY!” It sounded crazy to me, but why not? We sent out an email to all of our wonderful patients with the promise of a great value on everything we offered. The only requirement was that patients had to prepay over the phone during a 2 hour window to take advantage of the huge savings. We staffed the phones, held our breaths and when the appointed hour arrived…well, inundated doesn’t even begin to describe it!

We killed two birds with one stone. We delivered a great value, offering full-service treatments with our highest level of professionalism (this isn’t Groupon, where often times the savings gets passed along to the consumer in degraded service). Second, we stimulated our local economy during recessionary times.

Three years later, Van Dyke Laser & Skin is strong and healthy. Black Friday has now become a tradition in which we thank our loyal patients from the bottom of our hearts. It’s the perfect end to the Thanksgiving Holiday. Thank you for being a part of the Van Dyke Laser & Skin family!

WHO NEEDS SUNSCREEN IN THE FALL?? YOU DO.

Summer in the desert is over so we no longer need to worry about too much sun, right? Wrong, the sun’s damaging ultraviolet (UV) radiation can harm your skin, regardless of the temperature. The majority of the UV rays that hit the earth, in fact, are ultraviolet A (UVA) rays, which are present in about equal intensity throughout the year. Sun protection is a year-round commitment!

The vast majority of skin cancers are linked to UV exposure. Melanoma, the deadliest form, is continuing to increase in number. Over 68,000 cases were diagnosed last year (including in one of my golfing buddies). Babies born this year have a one in 50 risk of developing melanoma in their lifetime. Nearly every hour in the US someone loses their life to melanoma (including my aunt who died months after the initial diagnosis).

So, what can we do??

SkinCancer.org has some great suggestions for us all.

Fall brings with it many outdoor spectator sports. Here are some suggestions to healthy skin all year round even for the football fan.

  • Wear Sunscreen

    Sunscreen is a must. Choose a product with an SPF of 15 or higher, and some combination of the following UVA-blocking ingredients: avobenzone, ecamsule, oxybenzone, titanium dioxide, and zinc oxide. Apply a full ounce (two tablespoons) of sunscreen to the entire body, including a nickel-sized dollop to the face, 30 minutes before heading outside. Reapply every two hours, or immediately after sweating heavily. And don’t skip the sunscreen if it’s overcast: Up to 80 percent of the sun’s damaging ultraviolet (UV) radiation) can penetrate clouds — and harm your skin.

  • Dress the Part

    The more skin you cover, the better. Long-sleeved shirts and long pants protect the skin on your arms and legs, and are perfect for the changeable fall weather. If you’re worried about overheating, look for clothes made of breathable materials, like certain microfibers and specially-treated athletic wear. For cooler days, densely-woven, dark-colored fabrics (like deep blue denim) are heavy enough to keep you warm, and lightweight enough for comfort.

  • A baseball cap may be your idea of a hat, but a hat with at least a 3” brim all around (such as an outback or bucket hat) will protect your head, neck, and shoulders — the parts of the body that sustain the most sun damage, and the most common sites for precancers and cancers.
  • Cover Your Eyes

    Between five and 10 percent of all skin cancers occur on the eyelid, and UV radiation can also lead to eye diseases such as age-related macular degeneration and cataracts. Protect your eyes with a pair of UV-blocking sunglasses. For the most sun protection, choose larger-sized frames that shield the eyes, eyelids, and surrounding areas, or a wraparound style with side shields.

  • Look for a pair of sunglasses that block 99-100 percent of UV radiation (the sunglasses’ tag or packaging should say this). Make sure your shades fit comfortably. Sunglasses that slip down your nose don’t give as much protection.

  • If you’ll be watching a sport on a solid-color surface (like grass or Astroturf), brown-tinted lenses provide great color contrast and visibility.

  • Sit Strategically

    If possible, sit in the shady section of the stadium or field — under an awning or overhang, if possible. If you can’t find a seat out of the sun, consider bringing a portable shade structure or an umbrella with you.

Beauty after 50

I used to think 40 was old, now I know 50 is not, nor is 60 or 70. Who doesn’t know healthy, vital active men and women in their 80s and even 90s? When I passed my 55th birthday I realized that I was exiting the demographic that cosmetic company’s target. What? Am I no longer visible? At what second in time did my cosmetic desires become irrelevant to the marketers? I was insulted, incensed and not a little depressed.

But I don’t think age is only a number, I have proof. My practice is full of the over 50 crowd and our needs, wants desires may not be the same as they were in our 20s and 30s but we still care about how we look. It is now about making our outsides match our insides. I feel great and I want to look great for the stage that I am in in life.

I introduced CoolSculpting into the practice in March of this year. It literally can freeze fat and make it go away. CoolSculpting is great for treating stubborn areas of fat that does not respond to diet and exercise. As expected there was a huge interest from the public (because it actually works). Not expected was the large number of men and women over 70 who showed up wanting the treatment. Maybe the naked dancing days are over but they still wanted to look better in their clothes. And if fat reduction is not needed Thermage Body does a nice job of tightening up saggy, crepey skin on the arms, legs and tummy.

I find that what we all want is to feel good about what we see in the mirror. We have the ability to look great for our age. We call it skin rejuvenation. Consider laser skin resurfacing, remarkable improvement in sun damage and wrinkles can be achieved with CO2 laser treatments(Active FX, Deep FX and Total FX). Sure there is some downtime (about a week of redness and some swelling) but there is no better way to clear away the years with a single treatment.

I would be remiss if I did not include the fact that loss of volume is a huge factor in making us look “old”. We all suffer from shrinkage of facial fat, muscle and bone. Too bad the skin doesn’t shrink too. The solution? Add the volume back. SculptraAesthetic can do this. It involves several treatments of injections over several months to replace years of lost volume.

I used to think 40 was old, not so, there are so many things that we can do in our 50s 60s 70s and beyond. If you feel good, you can look good.

Clear + Brilliant A New Laser that Promises A Lot: Beauty and Brains!

CLEAR: clean, translucent.

BRILLIANT: wonderful, smart and exciting. (I love when Hugh Grant says it). It also means “sparkly, reflective and shiny” like a diamond.

Clear + Brilliant is now a laser. Interesting name. Can it deliver clean, translucent, wonderful, smart, exciting, sparkly, reflective and shiny skin?

This new laser Clear + Brilliant (C+B) is from Solta, the same world renowned and respected company that makes the FRAXEL laser and THERMAGE. C+ B is designed to fill the gap between the FRAXEL (a serious wrinkle, acne scar, sundamage laser) and the lighter microdermabrasion and superficial peels. This is a welcome addition to our armamentarium to fight aging and sundamage. The younger patient who is not satisfied with the spa offerings but it not yet ready for the serious laser resurfacing treatments will love the C +B.

C+ B comes with a very attractive price point ( one third the cost of a Fraxel) and there is no real downtime. It actually is a lunch time laser. I am pretty excited about being one of twelve centers in the US to get our hands on this laser. It is newly FDA approved (May 2011) and will officially be launched in the US July 1, 2011. It looks like an Apple computer, great design, great technology.

I think it has a future in our lineup of rejuvenating lasers. Although, not sure it will raise your IQ.

Kill the Arms

When did I start hating my arms? Right about the same time that Michelle Obama started to show hers.  Firm, muscular biceps with smooth, tight skin; damn her and her sleeveless dresses!

What exactly is wrong with a flabby upper arm? Try the “wave test”.   Does your upper arm keep waving after you stop?  Not too attractive.  My real epiphany occurred as I tried on a sleeveless dress three weeks ago. It is well into warm weather in the southwest and sleeveless is a must.  Of course the fabulous downlighting provided courtesy of Nordstrom’s fitting room did nothing but highlight my every undulation.  Yes, you can have cellulite on your arms and I do.

Five reasons to not like my arms

  1. Complete absence of muscle definition
  2. Upper arm resembles bowl of cottage cheese
  3. Weird little pouchy thing by my armpit
  4. Crepe paper where my skin used to be
  5. Positive wave test (see above)

My summer project is “kill the arms”, or put more gently, trade in the old arms for new(er) ones. Here is my plan:

I started my campaign on March 25th with a nice dose of Thermage CPT. This is the latest version of the gold standard Thermage skin tightening utilizing radiofrequency energy.  One treatment and I should see less crepiness and tighter looking skin developing over several months.

Three days later I had my upper arms treated with CoolSculpting.  This is the latest in fat reduction utilizing cryolipolysis, cold induced fat reduction.  A giant suction cup draws the saggy fat in-between two plates that slowly cool the area to just above freezing. The fat crystallizes at this temperature but the skin, muscle and nerve tissue are unharmed.  After 3 months I should lose about a 20 to 25% of the fat layer.  Less to love. (CoolSculpting is ideal for abdomen, love handles, muffin top etc… ).

Part of our aftercare for Thermage is a treatment with Triactive (a low level laser/suction/massage) that continues the process of collagen stimulation.  Maintenance treatments can be done weekly or monthly over time, I started at 2 a week and am tapering off to one a month.

Now that I have kick started my arm rejuvenation I have embarked on a daily maintenance of Glytone LipoLift (a low tech massager with a glycolic cleanser) to stimulate circulation and massage out fluid under the skin while showering. After showering I am using a Glytone body lotion with glycolic acid to improve the crepiness.

Oh, yeah, and I started lifting weights.  I figure the bigger my biceps get the better my skin will fit.

My “Kill the Arms” regimen should result in killer arms by mid-summer.  I will get back to you then, I’ve got some family weddings to go to and I am counting on those killer arms.

JDFR Wins When Our Fans Brave the Rain

Rain does not dampen anything. They say rain on your wedding day is good luck. I am here to say that rain on your big open house/fundraiser is lucky too.  After all, we are in Arizona and everyone knows it does not rain in Arizona in April. In fact only days ago it was 100 degrees.  I bought a sleeveless dress knowing I would be sweating through our big event.  But, if you want to make God laugh, tell him your plans.  My plan went from music and silent auction in the shade of sun umbrellas to freezing under a rain tent, it was 44 degrees and pouring. No matter.  We have fans and our fans came out.  Considering that Arizonans generally refuse to leave the house if there is any precipitation we really have great fans!  It was a packed house, we demo’d Coolsculpting (thank you Pinar for donating your tummy to the cause).

We gave lectures and listened to Nick Heward entertain us with beautiful guitar music. But most important to me, we raised over $13,000 for Juvenile Diabetes Research Foundation.  Finding a cure for Type 1 Diabetes is important to me.  My son needs that cure.

Frostbite Has Its Benefits

Who knew that the weird condition of “popsicle panniculitis” would lead to a cosmetic revolution?  Let me explain. When I was in my dermatology residency we had a kid brought to clinic with a pink firm area on his cheek. Turns out that he had left a popsicle in his mouth a little too long and literally froze his fat.  The good news is that it all healed up perfectly.  The take home lesson was that fat freezes easily and skin does not. The little fellow did not get frost bite (which kills skin with severe cold exposure) he just got a temporary chill.

Given this information and a brilliant mind like Harvard’s Rox Anderson the idea of non invasive fat destruction was born.  If fat is gently chilled to just above freezing and kept at that temperature for an hour some of the fat cells are killed but the skin and other structures are left unharmed.  After much study, testing and evaluation the FDA approved the first fat freezing instrument for the non invasive reduction of fat : Coolsculpting by Zeltiq.

Coolsculpting is indeed very cool.  Think: giant suction cup that sucks in that roll of fat (muffin top, tummy roll, back fat, love handle etc…), then the fat is cooled. After about 8 minutes there is very little sensation and you can kick back, grab your ipad and watch Netflix for an hour.  That’s it.  The suction is released, the roll of fat feels cold but warms up quickly with some tingling and you are on your way. The area does stay numb in some for a week or two, some describe the feeling in the area as “jiggly”.  Over the next few weeks the killed fat cells are slowly absorbed and the final result is as much as 25% reduction in the fat layer.

Can you do it again, most definitely, and the results improve. And it is truly non invasive, by non invasive I mean no needles, no incisions, no invasion whatsoever.

Of the patients that I have treated, none had pain, all enjoyed the hour break from their busy day and all went back to work.  They are now anxiously awaiting the results that appear over the next few weeks. It is such an easy treatment that we will be demonstrating it live at our next open house on April 9, 2011.  Maybe I will see you there!  What have you got to lose?

Volume Has It!

Sally Woodbridge, Life Magazine October 1992 and 1944

Aging is not for the faint hearted, or for the skinny as it turns out. I don’t care how much junk you have in your trunk, as you age the volume goes down, not in your butt, but in your face. Who among us has not lost a few pounds and found out that the first place it shows is in the face, great if you are 25, not so great if you are 45. And If you start out skinny your face ages faster simply on the bases of loss of volume.

It’s not just that the fat goes south with age. The whole structure of the face changes including muscles that thin and bones that shrink. Oddly enough the only structure on the face that does not diminish with age is the skin! In fact it stretches and sags, need I say more.

Here is the challenge, retaining a youthful appearance. If we admit that we are losing the volume while the skin is stretching out we have two basic choices: add volume or take away skin. Traditionally the answer from the plastic surgeons has been “cut out the excess skin!” While that is appropriate at times it does not always give the desired result. No patient of mine has ever asked for the “wind tunnel” look, the tight pulled back hallmark of the aging socialite. My patients want to look great for their age and volume is part of the answer.

I feel like an artist with many colors in my paint box. Actually I guess I am more of a sculptor. I use fillers Juvederm, Restylane and Perlane) for instant results. Fillers are famous for making lips plump and softening the sharp edges of nasolabial folds and marionette lines. But the real teller of age is the hollow cheek, think “gaunt”. My favorite answer is Sculptra. I really love the way I can stimulate the patient’s own collagen to round out a concave cheek or temple. The process involves 3 or 4 visits over as many months. Gradual changes occur as the face grows younger, fantastic.

I don’t want to totally ignore the fact that the skin does loosen up. Once the volume is back though you would be amazed at how little tightening may be needed. For moderate skin tightening it is hard to beat Thermage. No downtime and no side effects and gradual firming.

Of course there is always the facelift but even the plastic surgeons are now admitting it is all about the volume.