The 3 Pillars of Facial Rejuvenation

Dr. DeBusk (00:11):
Welcome back to Behind the Double Doors. I'm Dr. Taylor DeBusk, and today on the podcast I'll be talking about the three pillars of facial rejuvenation. So when I talk to people about specifically facelifts or things to really turn back the clock, yes, surgery plays a really big role in rejuvenating the face or creating a younger, more youthful look, yet natural, but it's not the end all be all. So there's three pillars with facial rejuvenation that are important for everybody to know and understand. One is surgery. Pillar two, which is just as important, if not more important, is the management of our skin. And then pillar three is going to be the continued role and need for Botox and then conservative fillers. So with surgery, there's a lot of different things that we can do to achieve a more youthful appearance, and it just depends on the age-related changes that patients have, whether it's heavy or low brows, excess skin of the upper eyelid, if there's fat or any other contouring with the upper eyelid that we need to address with the lower eyelids.

(01:14):
Again, same thing if there's fat that we need to reposition hollows that we need to address that skin laxity. And then with the face and neck, again, we pretty much exclusively offer the extended release deep plain facelift, which maximizes our result, and from a longevity standpoint as well as a natural look. Now with every patient, we kind of tailor our approach because not everybody needs to address all three levels of the face, where some people need to address maybe more. Then I talk about skin management. So I think that's probably one of the most confusing for patients because there are so many products you don't know what to use, when to use how much to use. So I always tell people that the key thing people need to understand, number one, is just the basic skin anatomy. So we have the three layers pretty much where the epidermis is the top layer, and then there's two layers of dermis below.

(02:12):
And there are different things that we do to address one of these three layers. So first is, what should I use every day? What should my daily skincare routine be and when should I start it? Well, we start to notice the loss of collagen in elastin in our skin, in our late twenties, early thirties. So this is when we should start implementing things in our daily routine that help to maintain and stimulate more collagen in the dermis, the deep layers of skin. The four things that I'd recommend everybody be on, one is a retinoid, which is a prescription strength product that helps to stimulate the development of collagen in the deep layer in the dermis. Now, not everybody starts with the prescription strength because it is a little harsh on the skin and people don't like the dryness, the itchiness, the redness, the flakiness that they get associated with it.

(03:02):
So you can start with a retinol, which is an over the counter product and kind of transition your skin or get ready for your skin to eventually be able to use the prescription strength. Now again, we want to use this every night. Immediately after at night, you want to use a moisturizer again just to help reduce some of that dryness and flakiness. And then during the day, the products you want to use every morning is a facial cleanser. You want to use a vitamin C serum immediately after, and then you want to use a moisturizer with SPF. Now, vitamin C is really crucial for maintaining a more youthful appearance to your skin. It has five qualities that I don't know if most people are aware of, but it's a precursor to collagen. So it's kind of like pouring gas on a fire helps to stimulate more collagen growth.

(03:49):
It also reduces the breakdown of collagen as well as reducing the breakdown of elastin. So maintaining those things in our skin. It also reduces melanosis or the development of those dark brown or yellows in our skin, those kind of sunspots liver type spots that we see in the face because of too much sun exposure. And then lastly, it has antioxidant properties. So again, all these things help to maintain youthful skin as well as help to prevent some of those sun damage related changes we get from too much exposure to UV lite. And then again, with the moisturized, with a SPF, that just maintains hydration in the skin and then reduces some of those, again, UV related changes from over exposure of sunlight. Now these are just the fundamentals of the base of what everybody should be using on a daily basis. Then you can implement different things in your routine once you get comfortable with your daily stuff, and there's roles for how onic acids or different types of peptides, all kinds of stuff that you can use.

(04:51):
But I want everybody to understand that those four products that I've mentioned are really what you need to start using in your late twenties, early thirties on a daily basis. Now, there are other things that you can do throughout the year to help stimulate the dermis, so the deeper layers of skin. Now, microneedling is a great, great small procedure. I mean, our aestheticians, they'll do it to themselves. It's an easy thing to do. What it does is it creates controlled holes or controlled trauma into the dermis, which allows your skin to repair itself and stimulates more collagen growth. And then in order to address the epidermis itself, there's several ways you can do it. One is a chemical peel. There's different levels of chemical peels, some more aggressive than others, but the whole goal of that is to take off that epidermis, grow new epidermis, which is thicker and more youthful.

(05:40):
You can also do things like ablative lasers. That's going to be like your CO2 or your Erbium laser. Again, the whole goal is to grow thicker and tighter epidermis to maintain that youthful appearance to the skin. So then the third pillar is the continued use of Botox and filler. So even though these products have been around for a long time, people are still a little bit confused about what they do or what the goal of each product is. Now, Botox or neurotoxins, Botox is a brand. There's several different brands, but whatever works for you I think is what you need to use. So the goal of these is to reduce the movement of the muscle by reducing movement of the muscle. It helps to maintain a smooth appearance to the skin. At the same time, it'll help thicken the skin where those wrinkles that you previously had were usually patients like to use Botox in the forehead or around the brows, around the crow's feet area eyes, and there's some utility for it in the lower face neck.

(06:37):
But this is something that we need to be doing routinely three to four times a year to maintain the thickness of our skin and to really reduce the development of those wrinkles. And then fillers. I know there's a lot, especially nowadays, people like 'em. They don't, it goes in and out. But I think there's a great role for fillers in the face, especially as we get older, because we do lose volume and you can address it surgically, but fillers are a great minimally invasive way to maintain some of that volume. So there are a lot of different types of injectables that help to restore or maintain volume in your face. Now, fillers, the ones we use nowadays are the hyaluronic acid. There are some non dissolvable fillers, but in my practice personally, I'm not a big fan. I like the hyaluronic acid filler because one, you can remove it or dissolve it if you're unhappy with the appearance of it, or if it migrates, if it's a non dissolvable filler, which I've seen and I've had to manage other patients that have had it elsewhere, it's a hard thing to deal with because most oftentimes you have to remove those things surgically.

(07:39):
Now you have other things like biostimulants that help to stimulate more collagen growth in different parts of the face. From what I've seen, I mean, some people have fantastic results, but everybody responds to it a little bit differently. With your hyaluronic acid filler, you have a better idea of how much volume you're putting or how much volume you're getting when you inject one syringe or two syringes with some of the biostimulants. Some people see more collagen growth than others, but I think there's a great role for anything that really helps to reestablish some of those more youthful contours. But like anything you can overdo, filler and create that very unattractive, overfilled, non-natural look. So again, with all three of these pillars, you can't really do one without maximizing the other two.

(08:25):
If you do, then you're really shortchanging yourself and you're not maximizing your result. But I mean, even on a personal note, I really started using specifically vitamin C and the retinol or the retinoid, the prescription strength over the last three years and looking at some of my photos from three years ago, because every year with the family, we take our Easter pictures and the Thanksgiving and Christmas stuff, and personally, I can see an improvement in the texture of my skin and the color of my skin, I mean, has really changed by just implementing these simple things. You can find more photos of my work online, either at our Instagram @Basuplasti surgery, or my personal one @DrTaylordebusk. You can also find it on our website, basuplasticsurgery.com. You could see all of my face rejuvenation, facelifts, brows, eyes, and my rhinoplasty before and afters. So yeah, give it a follow. Give it a look. Maybe some likes.

Announcer (09:28):
Basu Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. To learn more about the practice or ask a question, go to basuplasticsurgery.com/podcast. On Instagram follow Dr. Basu and the team @BasuPlasticSurgery. That's BASU Plastic Surgery. Behind the Double Doors is a production of The Axis, T-H-E-A-X-I-S.io.