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Face the new year with a firmer grasp of cosmetic procedures

Looking to kick-start your beauty regimen for a new season of good looks? Here are some of the latest ways plastic surgeons and dermatologists are dealing with common skin care concerns including wrinkles, acne and uneven and saggy skin.

Anti-aging/wrinkle control

When it comes to anti-aging products and procedures, "retinoids [vitamin A], toxins [such as Botox] and fillers are the most straightforward, tried-and-true anti-aging treatments," says Dr. Ava Shamban, who is assistant clinical professor of dermatology at the UCLA-Geffen School of Medicine and who has offices in Santa Monica and Beverly Hills.

Multitasking by having several procedures done in the same session is the future of skin care, she says. For instance, a laser treatment might be followed by topical products. One procedure she performs combines a fractional laser treatment followed by the injection of platelet-rich plasma. In this procedure, the patient's own blood is drawn and placed in a centrifuge to separate out the platelets, then injected into the face to promote collagen growth and smooth skin.

Some less invasive, multitasking treatments that exfoliate, peel, auto-extract impurities and hydrate can be considered upgrades to traditional microdermabrasion, she says. These include the HydraFacial found at spas including the Four Seasons Beverly Wilshire ($185-$395), fourseasons.com) and the Diamond Youth Facial at the Four Seasons Los Angeles ($305, fourseasons.com).

Beverly Hills-based celebrity dermatologist Dr. Harold Lancer, the creator of Lancer skin care products, says that in the world of volume replacement, fairly new treatments include Belotero (for nasolabial folds — a.k.a. smile lines), Voluma (for age- or weight-related saggy skin in the cheek area) and Restylane Silk (for smoothing wrinkles around the mouth).

"All [are] variations of hyaluronic acid and are recent, meaning the past few years, and being used in new ways," says Lancer. "In terms of neurotoxins — Botox, Dysport and Xeomin — what's different is ... how they're used. For example, you can use micro-droplets of these products to help reshape the jawline."

Dr. Macrene Alexiades, associate clinical professor at Yale University School of Medicine, says fractional radiofrequency, a procedure that tightens skin by heating body tissue, "is the best new device category for wrinkle reduction, with only five days of redness" afterward.

Losing fat ages the face and for many size-0 or even simply very active Angelenos this can come with consequences. "L.A. is the land of skinny-headed, yoga-going women who work out and take care of themselves," says Dr. Lisa Cassileth, clinical chief of the Division of Plastic Surgery at Cedars-Sinai Medical Center. "We call them the 'peanut heads.' They look hollow in their temples, hollowed under their cheekbones. When the body looks amazing but the skin quality isn't good you can use [the filler] Sculptra to restore the baby softness, youth and skin quality in the face. We use [Sculptra] differently now. We highly dilute it and use it in many areas in the face — whole-face mini-treatments. But it's key not to over-volumize or you'll look weird."

Acne

Shamban says what's cutting-edge in treating acne is a multimodal approach. "Salicylic acid is a great cleanser and/or toner. We now begin with either prescription Retin-A or an over-the-counter retinol. Coconut oil has antibacterial as well as anti-inflammatory properties, and I often combine it with topicals."

In addition, she says: "There are very effective, at-home blue light devices for acne, especially in combination with topical treatment." These acne-zapping devices include Tria Acne Clearing Blue Light ($299, sephora.com) and Quasar Clear Rayz for Acne ($249, dermstore.com).

Alexiades likes photodynamic therapy, a treatment that combines a drug and a light to kill cells. In her opinion it "is definitely the only treatment that rivals Accutane."

To treat acne scars, stretch marks and deep wrinkles, Lancer uses EndyMed Medical 3DEEP Handpieces, which uses a fractionated radio frequency delivered with tiny pins to smooth and firm skin.

Uneven or dull complexion

Lancer says there are new ways to use photodynamic therapy to treat not only pre-cancerous sun-damaged areas but to get rid of spots, and he says there are a growing number of devices suited for use on darker skin, which can be scarred by conventional laser treatment.

"The Venus Viva treatment is totally ethnic-colorblind, and uses fractionated radio waves with a healing time of just a few days. It's a big deal," he says. "There are so many multiethic patients I see from 80 different countries, and lasers aren't appropriate."

Saggy skin

Sometimes all of the topical lotions, creams, serums and lasers money can buy can't eliminate sagging skin.

"If you have a really saggy neck, cutting and surgery — a traditional neck lift — is really the way to go," says Dr. Scot Bradley Glasberg, immediate past president of the American Society of Plastic Surgeons. But on the horizon, he says, a new injectable called Kybella, used to treat double chins, "may revolutionize the way we treat submental fat, but the jury is still out."

Shamban says she's excited by the filler Voluma to combat mid-face sagginess by adding lift.

The future could even be procedures that grow your own fat in targeted areas.

"This has been researched for years," Cassileth says. "There are government regulations to overcome, but it's going to be such a big deal it's poised to change the entire industry."

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Copyright © 2016, Los Angeles Times
A version of this article appeared in print on December 20, 2015, in the Features section of the Los Angeles Times with the headline "Best face forward - If 2016 is the year you improve your appearance, help is here" — Today's paperToday's paper | Subscribe
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