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Dr. Miller News & Press
New in Plasic Surgery: Radiesse and IPL - find out what they can do for you.
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Katie: This morning on our continuing series of Forever Young a guide to life after 50, erasing the lines of time, while many people live very comfortably in their skin as they age, some are looking for a more youthful appearance. Dr. Philip Miller is a facial plastic surgeon at New York University Medical School. Dr. Miller, good morning.
Dr.: Good Morning.
Katie: Nice to see you. What causes your skin to wrinkle in the first place?
Well there are two changes that occur as we grow older, the actual composition of the skin, the texture, changes so we get fine and deep wrinkles as well as some color changes. The second thing that happens is there is a change in elasticity of the skin so it will actually fall forward and we create the deep lines here and in the jowl region.
Katie: So youre saying basically there are two different kinds of wrinkles that people have to deal with.
Dr.: That is correct. There are static wrinkles and dynamic wrinkles.
Katie: Okay, so give me an example and you can do it on my face if you want.
Dr.: Static wrinkles are actual changes within the skin itself. So at rest without moving the muscles of facial expression we see those wrinkles. Dynamic wrinkles are those
Katie: How about like this. Katie: Thank you, thats lovely.
Dr.: Exactly, dynamic wrinkles occur when the muscles below the skin pull on the skin and so when we use the muscles of our face during smiling or frowning well see those wrinkles.
Katie: Right and sometimes do dynamic wrinkles turn into static wrinkles? For example, frown lines or what do you call that little thing right there.
Dr.: The brow lines.
The brow lines because youve moved your face so much then its sort of is a permanent wrinkle in your skin. Okay now lets talk about some of the things people are doing these days because its amazing some of the technology that exists. The first is a laser peel.
Dr.: Thats right.
Katie: Is that where they really almost burn the top layer of your skin off.
Its one modality of a general concept which is to injure the skin and if your injure the skin it will actually regrow in a more youthful appearance than it was before. So one method is a laser peel
???We have an exhibit, wow thats pretty dramatic Dr. Miller dont you think.
Dr.: This is actually a deep peel with a CO2 laser and you can see on the left a photograph of static wrinkles throughout the face. This is a photograph just 14 days after the procedure on the right.
Katie: Ya, so the recovery period isnt that long is it?
Dr.: The recovery period takes a good 14 days but you can get good results in a short amount of time.
Katie: And your skin is quite red and raw right afterwards?
Dr. Miller: Thats correct.
Katie: How much does that cost generally? I know it varies Im sure.
It varies from state to state. But it can anywhere from $2,500 to $7,500 dollars.
Katie: And how long does it last, the results?
Dr.: It brings you back to the state at which you were when you had that skin. And then youll continue to age from there.
Katie: Okay, another method I know that is very popular, I mean I cant believe how many people do this and young women do it to and its botox.
Dr.: Thats right.
Katie: Which is basically botulosium, isnt it?
Dr.: Thats correct. Thats absolutely right. Its a numbing agent or paralytic agent, which numbs the muscles and as I mentioned the dynamic wrinkles which are caused by muscles pulling on the skin could be anesitized either as we raise our eyebrows or as we squint or as we smile. That it will actually numb those muscles and so we wont see those dynamic wrinkles. And here we see a photo of a gentleman a before where there are wrinkles on the sides of his eyes an what are called the crows feet and smile lines. And after the botox injections on the right.
Katie: So usually isnt botox usually done for forehead lines and for brow lines.
Dr.: It can be done for any dynamic wrinkles, in the forehead region, on the sides of the eyes and actually now its being used a little bit on the neck.
Katie: Now you have to do this once every 4 or 5 months.
Dr.: It only lasts 4 to 6 months, thats correct. So re-injections are required.
Katie: Is it expensive?
Dr.: It runs anywhere from $600 dollars to $1000 dollars, again depending on where you are.
Katie: Is it painful?
Dr.: It, only the injection, only the needle. We can apply a numbing medication on the skin so that even the needle injections arent uncomfortable.
Katie: And what about long term studies? Im sorry the idea about injecting my face with botulism makes my skin crawl.
Dr.: Okay, the medication has been used for stibismuis, which is a problem with the eyes as well as for people who have ticks, muscle spasms, muscle ticks of the face and those long term techniques studies have been done and it does very well.
Katie: What about collagen injections?
Dr.: Okay, collagen injections are different than botox because while botox acts on the muscle and isnt really a filling agent. Collagen and new techniques called Cymetra fill the skin from below.
Katie: Does that work well and how long lasting is that?
Dr.: That works well, the new product Cymetra can last up from 6months to a year or so.
Katie: Okay, heres an example of
Dr.: This is Cymetra injection before and after. Were addressing specifically the deep lines between the nose and the mouth and we filled out the region on the right side.
Katie: Alright, well Dr. Philip Miller thanks so much for coming in we appreciate the primer on wrinkles and what you can do about them.
Dr.: Your very welcome, thank you.
Katie: And well be back in a moment but first this is Today on NBC.
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Dr. Philip Miller, MD, FACS, New York plastic surgeon