Steve Somerville
Dr. Kristina Zakhary, facial plastic and reconstructive surgeon, with Joyce Palmer, clinical director at Age-Less.
North of the City
September 08, 2008 09:08 AM
By: Debora Kelly
Looking good for your age, as opposed to not looking your age, is an important distinction in a society that has enthusiastically embraced anti-aging cosmetic treatments and procedures.
“There has been a paradigm shift,” says Dr. Kristina Zakhary, a cosmetic surgeon at Age-less Facial Plastic Surgery, Laser and Skin Care Clinic in Richmond Hill.
“People don’t want to look like they’re 25.”
“Aging gracefully doesn’t mean you have to look older,” adds Joyce Palmer, clinic director.
The clinic is staffed entirely by women, including Dr. Zakhary, who says she understands what women want to look like.
“We have a women’s esthetic sense.
“A lot of women want plastic surgeons who are women — we understand, we don’t want to look like Barbie dolls,” Dr. Zachary says.
Ms Palmer says, “As a patient told me today, ‘I am 67 years old and want to look like a damn good-looking 67-year-old.’ This is what most of us want today, not so much the surgery, but the little ‘target nip and tucks’ that can be done in-office, with very little down time. We want a more youthful face without trying to look 25, which usually means a little botox, replacing lost volume to cheeks, hiding the pre-jowls, hiding the circles under the eyes, softening the lines around the mouth and chin and adding a little volume to lips but not necessarily enlarging them.”
Ms Palmer says, “If it’s a good job, you can never tell — what people are seeing are the botch-ups _— you simply look good for your age.”
One of the newest techniques offered exclusively at the clinic to replace the inevitable loss of volume is Bio-Alcamid, an injectable gel polymer that can be used not only to restore facial contours, but to augment chins and cheeks. The only area it can’t be used is under the eyes and in the lips.
Although Bio-Alcamid is permanent, it’s also adjustable, removable and safe.
“Women love it since it does not have to be repeated every six to nine months,” says Ms Palmer. “It blends with tissue, so it feels very natural to the touch and there are very little risk and complication issues.”
Because Bio-Alcamid is not distributed to general practitioners, only to plastic surgeons specializing in facial work, few clinics in Canada are able to use Bio-Alcamid. Dr. Zachary is a member of the American and Canadian Academy of Facial Plastic and Reconstructive Surgery and the first female fellow of the Canadian Academy of Facial Plastic and Reconstructive Surgery.
Popular in Europe and Britain since 2001 primarily for esthetic applications, Bio-Alcamid was originally approved by Health Canada in 2006 for the treatment of facial lipoatrophy, which is severe facial fat and volume loss resulting from anti-retroviral HIV medications and aging.
Bio-Alcamid, which is made in France, is a non-toxic, non-allergenic, highly biocompatible product recognized by the body as a single molecule. Otherwise degradable, the body naturally forms a thin, soft collagen capsule around it, protecting it from absorption and prolonging its effect long past the six to nine months as with other injectables.
Composed mostly of water, Bio-Alcamid will not move from its original location and can’t fuse with or invade surrounding tissue because it is a single molecule.
Only local anesthetic is required for a 30- to 45-minute procedure, and with only mild discomfort, bruising and swelling, clients are often able to return to work the next day. A single syringe costs $1,200, Ms Palmer says, with cheek injections costing about $4,000.
“I’m very skeptical of trying new techniques right away,” Dr. Zachary says. “There is a lot of new technology, but I have not jumped on the bandwagon. I want to develop a good reputation for doing procedures that work.”
Dr. Zachary typically suggests her new patients try temporary non-invasive procedures first.
“That appeals to people who haven’t done it before, it’s not a life-long commitment.”
It also allows her patients to build trust in her. “We develop a relationship, like a marriage,” she explains with a smile.
Sources: Age-less Facial Plastic Surgery, Laser and Skin Care Clinic, 13311 Yonge St., Suite 114, Richmond Hill, 905-773-9675, www.theagelessclinic.ca, Ascentimedical.com
anti-aging primer
“Things fall down, it’s gravity,” Joyce Palmer, clinic director of Age-less clinic, says ruefully.
Aging is, indeed, inevitable.
There are, however, things a woman can do to slow the process.
“Good skin care is essential, that’s our canvas,” Ms Palmer says: washing, regular exfoliation, moisturizing (water based so it doesn’t clog your pores), always using sunscreen and treatments, including microdermabrasion monthly (taking off the top layer of dead skin) and chemical peels (which improve texture and colour and can alleviate acne if done properly).
She also says eat well, drink eight glasses of water daily and don’t smoke.
Products with vitamin A or retinol are also helpful in renewing the skin.
Ms Palmer suggests using botox as early as the 20s to help delay the onset of wrinkles.
“In your 30s, 40s, when the wrinkles are dynamic, the No. 1 best thing is botox, a purified bovine protein which prevents the skin from ‘crinkling’,” she says.
She cautions that a properly trained doctor, knowledgeable about the amount of botox required and where to inject it, is needed to ensure the wrinkle doesn’t become “agitated”.
“Using too much, in the wrong places is a common mistake — you will look too frozen.”
Botox injections typically last three to four months, requiring shots three to four times a year if the results are to be maintained.
In the 40s, 50s, switch to a creamier moisturizer, she adds.
“No matter how much we take care, time takes its toll.”
The lines, dryness, dullness and loss of volume will appear.
Laser treatments, the newest called fraxel, can reduce wrinkles around your eyes and rejuvenate your skin, improving texture, tone and pore size and erasing brown spots.
Injectables such as Juvederm, a gel made of hyaluronic acid, can instantly restore your skin’s volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses”, the creases running from the bottom of your nose to the corners of your mouth.
Or it may be time to consider a mini face lift, which repairs jowls and a “turkey neck” permanently.
“It really takes off years,” Ms Palmer says.
Peels, microdermabrasion $125 to $150; botox $120 to $700, $300 to $400 forehead; mini face lift $7,500; full face lift $25,000
caption: Before and after botox, Juvederm and Bio-Alcamid
would you
or
wouldn’t you…
It’s hard to resist the notion of turning back time.
With a veritable candy store of non-surgical anti-aging cosmetic procedures out there _— from permanent cosmetics and botox to chemical peels and laser skin resurfacing — many Canadians have given in to the temptation to look and feel better about themselves.
According to an online survey by Medicard Finance and Plastic Surgery Statistics Canada, 70 per cent of consumers are “concerned” about aging, while 33 per cent admit they feel “self-conscious” about the effects of aging. More than half of respondents are concerned about the loss of volume in their faces.
Seventy-two per cent would not hesitate to seek cosmetic enhancement to change something they did not like about their appearance and a further 46 per cent would consider surgery. The majority of consumers, 51 per cent, would treat wrinkles, while 30 per cent stated they wouldn’t.
As attitudes about cosmetic enhancement have become more accepting, the numbers of procedures have skyrocketed _— simple evidence of this is the number of clinics offering anti-aging treatments and procedures that seem to have sprung up on every corner.
According to Medicard, more than 302,000 surgical and non-surgical cosmetic procedures were performed in Canada in 2003, the latest year for which it has statistics.
The most common procedures performed were: injectables, including botox and collagen, with 184,000 procedures; liposuction, with 24,337 procedures; non-surgical face lift, with 17,628 procedures; and breast augmentation, with 16,937 procedures.
Still, consumers carefully consider factors such as results, safety, costs, recovery time and pain. Fear of the unknown is a factor for most consumers, with 78 per cent admitting if they knew they would be guaranteed good results, they would be more comfortable with a procedure.
Equally, 76 per cent said if they knew the procedure was safe, they would consider it while 74 per cent would consider some (or more) cosmetic enhancement if cost was not an issue. Recovery time (57 per cent) and pain (53 per cent) round out the barriers consumers face when weighing their options.