“Skin tightening procedures, such as radiofrequency and ultrasound tightening devices, can be a great adjunct to other cosmetic procedures for patients looking to tighten and stimulate collagen production. It should be noted that studies still need to be done looking at the ‘preventive’ effects of most of these procedures. It is definitely better to prevent, rather than to have to treat and attempt to turn back the clock.”
Dr. González cites a study published in 2015 on the long-term effects of onabotulinumtoxinA on facial lines in identical twins. “… twins were followed for a period of 19 years.2 One received treatment with botulinum toxin regularly every 4 to 6 months to the forehead, glabella and crow's feet, the other twin only received 4 treatments over the 19-year period,” Dr. González says. “Photographic documentation showed no glabellar lines at rest for the treated twin, whereas the sporadically treated twin demonstrated static glabellar lines at rest. Similar findings were seen on the crow's feet area, demonstrating the preventive effects of Botox.”
Dr. González says she practices what she preaches, having started "prejuvenation" in her mid-20s.
“There's no right age to start, but I am definitely an advocate of starting treatments early on if you have a need for it. I talk to [patients] about my experience,” Dr. González says. “I think we are starting to see younger patients become more aware of their skincare needs, and now with social media, they are also more aware of the range of treatment options out there. So, it's very important to know which treatments are appropriate and cost-effective for them, and not necessarily turn these patients away.”
Joshua Zeichner, M.D., director of Cosmetic and Clinical Research in Dermatology at Mount Sinai Hospital, says that cosmetic dermatology, like other specialties in medicine, is moving from treatment to prevention. Dr. Zeichner’s fastest growing group of cosmetic patients are women coming in to treat their “11” lines for their 30th birthdays, he says.
Drs. González, Langsdon and Zeichner report no relevant disclosurfes. Dr. Fabi is a consultant, speaker, trainer and investigator for Allergan, Galderma, Merz, Valeant, Revance, Evolus and other companies.
1. Trindade de almeida A, Carruthers J, Cox SE, Goldman MP, Wheeler S, Gallagher CJ. Patient satisfaction and safety with aesthetic onabotulinumtoxinA after at least 5 years: a retrospective cross-sectional analysis of 4,402 glabellar treatments. Dermatol Surg. 2015;41 Suppl 1:S19-28.
2. Rivkin A, Binder WJ. Long-term effects of onabotulinumtoxinA on facial lines: a 19-year experience of identical twins. Dermatol Surg. 2015;41 Suppl 1:S64-6.
3. 1. Bonati L, Fabi S. Treating the Young Aesthetic Patient: Evidence-Based Recommendations. J Drugs Dermatol. 2017;16(6 Suppl):s81-83.