The following is an article adapted from the September issue of VIVE, an amazing magazine focused on international beauty, fashion and culture based in Central Texas with outlets in San Antonio, Austin, Dallas, Houston, and Midland/ Odessa as well as Brazil and New York. Dr. Jennifer Walden was honored to appear on the cover of this magazine and interview on a timeless topic, beauty through the ages.
Everyday we see beautiful women who age so gracefully and we wonder, “How do they do it?” The appearance of aging depends on many factors such as genetics, diet, health, and lifestyle. We had the opportunity to sit down with renowned Austin, Texas based plastic surgeon, Dr. Jennifer Walden, and talked about beauty maintenance and treatment through the ages. We discussed about how with current advances in the field of cosmetic surgery, we now have an enhanced understanding of anatomical, and biological, changes in the aging face and can anticipate these changes in order to take preventive measures. As more people seek cosmetic surgery for rejuvenation, it is important to understand that treatments delaying the appearance of aging exist as well.
What are the preventative measure to help keep our skin looking healthy and young?
Dr. Walden told us that when treating patients who seek to look younger, it is essential to assess individual needs based on each person’s unique characteristics. She said, “Some will show early hollowing under the eyes and around the mouth, or have sun damage and wrinkles, while others may show early sagging of the facial skin” then added, “Understanding these manifestations of aging has led me to formulate an age-appropriate approach to facial rejuvenation that utilizes a combination of noninvasive and minimally invasive treatments as well as surgery”. When used together properly, these treatments can help delay the aging process and enhance the appearance at any age.
What to do…
… In your 20s
What is the value of sunscreen and what kind do you recommend?
“Signs of aging begin with the condition of the skin itself. Sun damage, smoking, sleep, hydration, and overall physical and mental health contribute to the health of the skin. Therefore, age prevention should start with the right skin care. Younger patients may require products that focus on prevention and maintenance and might need to address hyperactive glands and acne using treatments such as glycolic acid and sunscreens. More mature patients require more intensive agents, such as retinoids and vitamin C to gradually resurface the skin and decrease sunspots and wrinkles.”
Proper protection from ongoing sun exposure and appropriate topical care will help maintain skin’s inherent elasticity, tightness and clarity, which Dr. Walden said will help keep it glowing and looking healthy. “It is also important to remember that the science of skin care is always evolving, and newer products are often emerging onto the market.” Dr. Walden took us on a tour through the decades of life to reveal just how prevention and maintenance can go a long way in the quest for youth and beauty.
“Following any skin treatment and in daily life, it is important to use a quality sunscreen with both zinc and titanium.” Dr. Walden recommends two sunscreens that are appropriate post procedure (laser or microneedling):
- Elta UV Daily SPF 40: A lightweight, protective daily moisturizer and SPF. Hyaluronic acid plumps your skin with lightweight moisture, while micronized zinc and physical barrier agents shield skin from UVA and UVB rays to prevent the visible signs of photoaging. Dr. Walden said, “It hydrates and is gentle enough for post-procedure skin.”
- Elta Physical SPF41: “Lightly tinted, perfect for hiding the post-procedure redness” stated Dr. Walden. It combines Zinc Oxide and Titanium Dioxide to provide optimum UVA/UVB sun protection. It is oil-free, fragrance-free, and paraben-free.
Do you have any different sunblock recommendations for women of ethnicity?
“Women of ethnicity should also be vigilant about sunscreen usage as well. No one is immune to skin cancer. With any skin type, it is important to get annual skin checks by a dermatologist, and be aware skin cancer can target unusual areas. So check the palms of the hands, feet, under the fingernails (your nail beds), and sun-exposed areas such as your forehead and cheekbones. A physical sunblock that contains titanium and zinc are critical for keeping skin conditions such as melanoma and dark spots, caused by sun damage, at bay.” Dr. Walden stated.
… In your 20’s and 30’s
When do you begin to recommend Botox? When do you recommend soft tissue fillers, and in what areas for each age group?
Among the most effective anti-aging treatments available, Botox and Dysport are the neurotoxins that we are now injecting well before deep wrinkles show up. “My injection specialist and I use it in areas all over the face, and do it lightly so you retain expressions, but don’t have lines at rest,” said Dr. Walden. “If the lines are still deeper than what patients want, we’ll inject a bit of the fine-line filler, like Belotero or Restlyane Silk.”
Injectables are still the little indulgence that many celebrities like to deny, but the truth is that A-listers are frequently “filling up”. It’s just harder to discern because fillers, such as Juvederm and Restylane Silk, intended for the lips and lines around the mouth, can be administered in tiny droplets with a very small needle. Many physicians seem to favor these because they result in a more natural look. Perhaps that’s why they’re being used to restore volume in areas that were rarely considered before, like around the temples. Dr. Walden even injects older women’s earlobes that have been overstretched by years of heavy earrings. “And I’ll inject filler or your body’s own fat into the back of the hands of patients who are very thin, because that can be a telltale sign of aging when left untreated,” she added.
… In Your 30’s and 40’s
What is radio frequency? Do you have a radio frequency device and what does it do to our fat and skin?
Some of the most dramatic advancements in skincare have been in the realm of tightening and firming. Ultrasound treatments, cryotherapy, also known as “Freezing the fat” like CoolSculpting, and radiofrequency therapy, such as Venus Legacy, are making it possible to lose unwanted pockets of fat and restore tone quickly with little downtime. Dr. Walden said that the most “social downtime” many of her nonsurgical patients ask for is about two to three days, so they opt for less-ablative lasers or microneedling with shorter gaps between sessions. Radiofrequency, however, requires little to no time away from the spotlight, making it an attractive choice for red carpet regulars. Celebrities like Sofia Vergara are open about getting the type of radiofrequency treatment that Dr. Walden uses, Venus Legacy, while Kim Kardashian and Giselle Bundchen have tweeted photos of themselves after getting microneedling treatments. Dr. Walden’s aestheticians also perform this.
… In Your 30s, 40s and 50s
Over the past several years, the “enhancement” game has changed. “A celebrity in her 40’s may not be going under the knife for a major overhaul, but chances are she is getting frequent minor tune-ups, which can be effective at stopping the clock, or just maintaining it at the status quo.” Walden said. So when Jennifer Lopez took to Twitter recently to deny claims that she’s had plastic surgery, she was pretty much telling the truth. The fact is, with the nonsurgical treatments available now, she likely hasn’t had to. That said, Dr. Walden stated that women in the middle decades of life often come in for an eyelid lift, blepharoplasty, nose-reshaping, rhinoplasty, liposuction of the neck and other areas of the body, breast implants or a lift, and a tummy tuck after having children.
What are light-based therapies and laser?
“These are common procedures done on women in their 30’s and 40’s” Walden stated. “ A MicroLaserPeel skin resurfacing is a quick and effective treatment that uses a special laser to address conditions on the top layer of the skin.” The treatment removes a thin layer of damaged skin to improve texture and provide a more youthful appearance. It provides superior results because it can be administered with great precision of depth and can be custom tailored to your specific skin conditions and desired outcome. “Popular treatment areas are the face and neck, though some people also treat the chest and hands.” Dr. Walden added.
“For those desiring a more aggressive treatment, ProFractional therapy is fractionated laser resurfacing, meaning that only a portion of the skin is treated in a session. Because only a fraction of the patient’s skin is directly treated with the laser, the surrounding untreated tissue promotes rapid healing. The skin’s wound-healing response creates new collagen, which adds firmness and resilience to the skin.” Dr. Walden informed us. “Platelet-rich plasma (PRP) injections can be used with laser and are a treatment method that use components of the body’s own blood that contain a high concentration of proteins and growth factors. This is similar to “juicing”, or extracting the best factors out of something…but in this case for healthy, glowing skin.” She went on to explain that these proteins and growth factors are efficient in stimulating a healing response in damaged tissue areas. By adding this fluid with the laser treatment, collagen and elastin production within the skin are stimulated, diminishing fine lines and tightening the contours of the face with expedited healing times.
What is Broadband Light and what does it treat?
“Broadband light treatments, similar to IPL, are light based treatments often requested by women in their 30’s and 40’s. The light energy delivered by the BBL system gently heats the upper layers of the skin. The heat absorbed by the targeted areas stimulate skin cells to regenerate new collagen foundation, leading to increased skin firmness.” Dr. Walden said. This process also restores skin to its natural beauty, blending its natural colors and making it smoother, vibrant and younger looking. “In addition, the photothermal energy will eliminate fine vessels that cause redness and reduce unwanted melanin that produces pigmented lesions” she added.
Are these modalities safe to treat women and men who have darker skin types?
“Lighter skin types do best with laser and light-based treatments so we use an abundance of caution in our settings in women with darker skin types, due to the risk of skin discoloration” Dr. Walden said. “Microneedling is an option in these patients, as the risk for hyper- or hypopigmentation of the skin is less.” She explained that pretreatment with a bleaching cream, like hydroquinone, and a topical resurfacing agent, like Retin-A, may help the skin “get ready” for these treatments in darker skin types.
What is micro-needling? Is it safe for ethnic skin?
The answer is yes, and Dr. Walden provided us with the following facts regarding micro-needling: sometimes referred to as “Collagen Induction Therapy” or “Percutaneous Induction Needling”, it’s a method of introducing a controlled wound into the skin triggering a release of natural growth factors, new collagen & elastin. This process causes much less damage to the epidermis than dermal rolling or lasers and other ablative treatments, which helps to protect the new skin cell growth. During this procedure, tiny needles are used to create controlled micro-injuries to the skin in order to produce collagen and elastin. The skin’s repair process results in a thicker dermis with the appearance of softer wrinkles. These superficial micro-channels allow topical serums, and creams to be absorbed more effectively into the skin (Dr. Walden’s office has the most advanced medical-grade automated micro-needling device on the market).
“It is a great treatment option for acne scars, wrinkles, sun damage, stretch marks, large pores, uneven tone or texture, and thin skin. Patients with large pores, fine lines, and uneven skin tone will typically need a series of 3 micro-needling sessions, spaced every 4 weeks. Those with moderate to deep wrinkles, stretch marks, acne scars or other scars will likely need a series of 6 (or more) treatments, spaced every 4 weeks. Sessions can alternatively be spaced at every 6-8 weeks, if needed.” Dr. Walden explained. “The face is the most popular area, for obvious reasons. However, microneedling can be performed on all parts of the body including the neck, décolleté, arms, hands, legs, abdomen, and back” she added.
What skin care treatments can be done with microneedling for advanced anti-aging?
“We use a collagen-stimulating botanical-derived hyaluronic acid serum” Dr. Walden stated. “Our hyaluronic acid is infused with an apricot essential oil, Vitamin B5 and potent anti-oxidant Vitamin E. I use it daily as a primer and hydrator, and it’s paraben free, which is a big concern these days. We then add on an oil-soluble Vitamin C serum with the highest bio-availability to aid in evening out skin tone and pigmentation, as well as shrink pores during the procedure. C-Serum also contains Vitamins A, E, and highly potent anti-oxidants that nourish the skin to create a healthy, youthful glow. Microneedling causes an increased absorption rate of products, so it’s important to use appropriate ingredients.” Dr. Walden added, “This can be performed on all skin types, including ethnic skin, as there is little risk of post-inflammatory hyper-pigmentation”.
What is Kybella ?
“Kybella is a newly FDA-approved non-surgical injectable for reducing moderate to severe fat on the upper neck, otherwise known as a ‘double chin’. The injection contains a naturally occurring molecule which helps to dissolve fat.” Dr. Walden stated. When injected properly, all other cells are left healthy and intact. “Using Kybella for treatment on areas other than the ‘double chin’ is not approved or recommended, as it is only FDA recommended for the submental, or under the chin, area.” she informed us.
…In your 50’s, 60’s, and 70’s
What does surgical facelift and necklift accomplish that other non- or minimally invasive procedures don’t do? How long do the results last and what techniques do you use?
“In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces and necks. Deep creases appear beside the mouth, the jaw line slackens and becomes jowly, and the neck develops loose folds and fat deposits. Facelifts counteract these signs of aging by tightening muscle, removing fat and trimming excess skin, giving your face a fresher, youthful look.” Dr, Walden said. “ After surgery, some patients look 10-15 years younger.”
What can a facelift do that the other treatments don’t?
Facelifts, technically known as rhytidectomies, “removal of wrinkles”, rejuvenate the mid-to-lower face and neck. Facelifts are most effective for patients who want to correct midface sagging, deep creases under the eye, deep creases between the nose and mouth (nasolabial folds), jowls due to loss of muscle tone, sagging areas of fat, and loose skin and fat under the chin and jaw. Facelift with necklift are still considered the gold-standard in terms of longevity of result compared to the other lesser involved treatments,” Dr. Walden stated. “I can produce the most restoration back to one’s younger self with a cosmetic surgical procedure. It can take you back decades”.