Skin care

The importance of continual skin care cannot be stressed enough. There are many different types of skin care products and you will find that you prefer some more than others. The trick to skin care is to find products that agree with your skin and continue to use them on a regular basis. On and off skin care does not maintain your skin adequately and the signs of aging and sun damage will become apparent more quickly. There are a multitude of products such as Clinique, Clarence, Revlon, Verativa, Environ, Dermalogica and Neostrata to name but a few. The choice depends on the compatibility with your skin and accessibility to the products.

In essence skin care can be broken up into two major interconnected sections:

1.    Prevention of accelerated aging and sun-damage.

2.    Care for skin.


Prevention of accelerated aging and sun-damage to skin generally revolves around being well informed about what is harmful to your skin. Avoiding these harmful factors will help in keeping your skin youthful.
Factors which may be harmful to your skin include:
-    Sun exposure:
UV radiation results in collagen damage in your skin as well as decreasing the elasticity of the skin. This makes the skin thinner and more susceptible to damage. In addition, UV radiation is carcinogenic which means that it can cause skin cancers.
Protection from the sun is very important and you should be aware of this at all times. The use of sunscreens, hats and protective clothing is vital and you should even apply make-up that has some form of sun protection in it.
-    Smoking
Smoking also decreases the amount of eleastic fibers in your skin resulting in a poor quality skin.
This is easily prevented by stopping smoking.
-    Oxygen free radicals
Oxygen free radicals result from and may mediate the effects of UV radiation.
Prevention of this involves sun protection which we have already mentioned. In addition, antioxidants such as vitamins A, C, and E act as free radical scavengers. Topical and systemic administration of these vitamins have a photo-protective effect but I advise you to use these as prescribed by a doctor.
-    In addition to barrier protection and antioxidant treatments, the following lifestyle changes are beneficial:
o    selection of a healthy diet with adequate fluid intake for hydration
o    regular exercise
o    proper rest and relaxation
o    minimal alcohol ingestion
o    refraining from smoking

Care for Skin

It is vital to care for your skin every day. Once you have found a product that agrees with your skin you should be diligent and have a routine that you follow every day. There are hundreds of creams and ointments that claim to keep your skin youthful and it is easy to get confused. I will try and simplify this for you.
I feel that every home treatment program should consist of at least the following:
-    facial cleanser
-    skin exfoliants
-    stimulating agents
-    moisturizing agents
-    protective and preventive agents

In the evening.
-    Facial cleansers are important to keep the pores clean and prevent the build-up of bacteria which may cause acne.
-    Products to exfoliate and stimulate the skin are used in the evening as you are at home and not exposed to the sun. Alpha-hydroxy acids (AHAs) and poly-hydroxy acids (PHAs) are found in products used to exfoliate and smooth the skin. Examples of alpha-hydroxy-acids are glycolic acid and lactic acid. These are often combined with a moisturizer.
-    Abrasive scrubs are mechanical exfoliants designed to remove small skin scales with a sponge or scrubbing granules.
-    Stimulating agents (such as Prevage) and skin renewers can also be used in the evening which help the cells regenerate and replenish themselves.

In the morning:
-    These products are oriented towards prevention and protection. Topical and systemic antioxidant containing preparations result in free radical scavenging and reduction of the photoaging process. It is also vital to consider creams that have sun protection.
-    Moisturization increases the water content of the skin and protects injured or exposed skin from harmful or annoying stimuli. If the skin is poorly hydrated, it is more susceptible to harmful factors and it cannot protect itself as well. In addition, the skin lacks its fullness and tends to sag and wrinkle more if it not well hydrated.


botoxFiller injections are excellent alternatives as well as adjuncts to surgical facial rejuvenation. Areas on the face which have deep wrinkles could be filled with a filler and thereby mask the appearance of the wrinkle. Areas that are often filled include the lips, nasolabial folds, marionette lines, and the frown lines. In addition, fillers can be used to augment certain areas on the face which can be used for both aesthetic as well as reconstructive purposes.
There are many different types of fillers and they all have their benefits and pitfalls. Filler injections could either be permanent or not.
My preference to permanent fillers is using your own fat taken from the abdomen or thigh. This fat is then refined and injected into areas which require filling. The benefit of using your own tissue is that there will be no complications regarding rejection. Unfortunately, some of the fat that gets injected does not survive and will be taken up by the body. Although this is not harmful, it may mean that the procedure needs to be repeated to “touch-up” certain areas. This procedure can be done in the office but it is mostly performed in theatre as an adjunct to a facelift.
I do not use any permanent fillers other than fat because I feel that the possible complications outweigh the benefits.
There are many types of non-permanent fillers such as Restylane and Juvederm. Although these products can be derived from other substances, the ones that I prefer are made of hyaluronic acid. This substance is ubiquitous in our bodies and therefore it has very few complications once it is injected. There are several types of Restylane fillers which can be used to fill in deep and superficial wrinkles on the face such as the nasolabial folds, marionette lines, and the frown lines. In addition, the lips can be augmented giving them a fuller and more attractive appearance. The beauty of using this technique is that it is an office based procedure with very little time required off work.
Fillers are often used together with other non-surgical techniques such as botox and chemical peels to give a more complete rejuvenation.
I feel that there is a large gain from these fillers as they provide a youthful appearance with very few side effects. It is quick and easy and it will make you feel more confident and boost your self esteem.  


Chemical peels (chemexfoliation) create a controlled injury to the skin which allows it to heal with a better quality.  There are many types of chemical peels such as glycolic acid peels, phenol peels and trichloracetic acid peels.
I feel that a facial peel should be controllable and must be tailored to your needs. Phenol peels for example give a result which is not dependant on the time of application and therefore the result cannot be tailored to individual needs. On the other hand, the glycolic acid skin renewal peel is considered to be one of the safer and more controlled facial peels. It is by nature a “lighter” peel but this is not to say that results will not be noticed. More accurately, the glycolic acid peel helps maintain the quality of the skin and keeps it well conditioned. Different concentrations exist which can be used depending on the desired result which will be discussed with you.
The chemical peel is done as an office procedure and the recovery time is roughly 2 days. The skin may peel slightly but not always and this is dependent on the concentration that is used. Immediately after the peel, the skin becomes red for approximately 24-48 hours. During this time, this skin should be kept well hydrated with a non-allergenic moisturizer or Vaseline. The skin may feel tight for a few days.
The best results are obtained from several lighter peels roughly 4 weeks apart so that the skin is gradually rejuvenated and not traumatized. During this period, it is a good idea to use good facial products to assist the process of facial rejuvenation. I will discuss this with you.
The complications of such a peel include:
•    Infection
•    Fever blister (herpes) reactivation
•    Hypopigmentation (skin lightening)
•    Hyperpigmentation (skin darkening in patches)
•    Scarring
These complications are very rare and do not often occur if lighter peels are done more often.


Botox is derived from Botulinum toxin which comes from the bacteria Clostridium Botulinum. The toxin has been denatured to a degree that is completely harmless but still has an effect on muscle fibers. Once botox is injected into a muscle it paralyses that muscle but it does not have any systemic effects. It was originally used for squinting of the eyes where botox was injected into the affected muscle thereby paralyzing it and correcting the squint. It has however found its niche in the cosmetic field to get rid of facial wrinkles. Wrinkles are formed by the function of the underlying facial muscles pulling on the skin. This is commonly seen in the forehead, frown lines and crows feet (laugh lines). If the underlying muscle is paralyzed, it cannot pull the skin together and the wrinkles will disappear with time.
Botox injections are done with a very small needle and are relatively painless. Once the injection is done, the muscle will be paralyzed in two to three days. The wrinkles will not disappear immediately but they will start to fade with time. Botox injections last about three to six months and then the muscle function will start to return. Once the muscle function begins to return, further botox injections are required to maintain the result.
It is important to use botox correctly to avoid paralyzing adjacent muscles. This could result in a droopy eyelid. In addition, one can be allergic to an ingredient in the botox injection but this is very rare. I feel that the aim is to provide a more youthful appearance without losing facial expressions completely.
Botox is widely used and it is very successful in removing wrinkles and helping to rejuvenate the face to a fresher and younger look.


PellevePellevéTM is a revolutionary non-surgical procedure to safely treat facial wrinkles with virtually no pain and little downtime. Using advanced radiowave technology, the Pellevé system precisely heats the deep layers of the skin without damaging the epidermis, or top layer. The heat causes the collagen in the skin to contract and tighten. After treatment, the skin begins to produce new collagen, which improves skin firmness. The result is a naturally refreshed appearance.
Unlike some other skin tightening systems, Pellevé doesn’t require anesthesia or skin cooling. Patients can expect to feel a deep warming sensation each time the handpiece touches the area being treated. Because the skin is not numb, the patient can describe the depth of the feeling to the doctor, which helps to ensure the best possible results. They can also return to home or work immediately. Side effects may include mild discomfort during the procedure within the treatment area. Mild swelling and redness may also occur and typically go away within 2 to 24 hours after treatment.
Pellevé can be used to treat the skin on the face, including the eye area. Many people start to see results after just one treatment, with lasting improvement in skin tightness and tone for up to six months. Because a full facial treatment takes only about an hour with little, if any, recovery time, Pellevé fits easily into busy schedules.
In addition to the face, Pellevé can be used to rejuvenate the skin of the hands and other areas of the body. The treatment can be combined with other non-invasive procedures such as Botox and fillers depending on the patient’s need.

The Pellevé machine is multifunctional and it can also ablate small vessels on the face and legs. This treatment is also painless with very good results. For the best results, it’s important to choose a doctor who is experienced in administering Pellevé.