dr. kim's ultimate guide - drkimsagewellsolutions.com acid plus vitamin c. let the serum(s) dry...

Dr. Kim's Ultimate Guide

Nips, Tucks, Tweaks and Skincare

to look young for life !

By Kimberly Crawford, M.D., F.A.C.P.M., A.B.A.A.R.M.

Nips, Tucks, Tweaks, and Skincare to Look Young For Life

Contents:

Introduction: ................................................................................................................................ 1

Your Anti-aging skin care regimen daily routine: ................................................................ 2

Re-texturizing, firming, and lifting your skin:....................................................................... 6

Introduction to the ways to look younger without plastic surgery: ................................. 6

Fillers: ............................................................................................................................................ 7

Botox and Reloxin: ...................................................................................................................... 8

"Ablative" lasers with "downtime": ......................................................................................... 9

Corrective Chemical Peels: ...................................................................................................... 10

Derma-rolling: ........................................................................................................................... 11

Micro-needling: ......................................................................................................................... 12

My favorite non-invasive lasers: ............................................................................................ 13

The latest "hot thing": Thread Lifts ....................................................................................... 14

Is there a difference between routine skin care and skin care by decade? .................. 15

First, let's talk Plastic Surgery: Don't look as if you've had it! ......................................... 16

Skin Care until age 20: .............................................................................................................. 18

Skin care age 20-30 ................................................................................................................... 18

Skin care and “other” age 30-40 ............................................................................................. 19

Skin care and “other” to from age 40-50 .............................................................................. 20

Skin care and “other” from age 50-60 ................................................................................... 20

Skin care and “other” from 60-70 to continue to look young .......................................... 21

Skin care and other from 70 to 100+ .................................................................................... 22

Postscript: ................................................................................................................................... 22

©2017 Kimberly Crawford, M.D., F.A.C.P.M., A.B.A.A.R.M || www.drkimsagewellsolutions.com || Page | 1

Introduction: If you've read my book "How to Look Young at any Age," you are aware beauty starts from the inside and then emanates to the outside. You absolutely must eat a healthy whole-foods diet. Dietary information has evolved so much that I wholeheartedly agree with other "diet gurus" to recommend you increase the percentage of healthy fats in your diet and lower the amount of carbohydrates. In my last book, I recommended 30% protein, 40% non-processed carbohydrates and 30% fat. I now recommend a minimum of 40% healthy fats such as olive oil, coconut oil, fats found in grass fed meats and pastured eggs, and wild caught fish. For details, please visit my blog at https://www.drkimsagewellsolutions.com.

To review other requirements for healthy, ageless skin, recall that getting rid of oxidative stress and inflammation is necessary. Glycation (stiffening) of cells, including skin cells, occurs at a fasting blood sugar approximately over 85 mg/dL. Normalizing your weight and blood sugar is a must for beautiful skin. Stress will increase levels of cortisol and harmful neurotransmitters such as epinephrine (adrenaline), which will reduce the amount of collagen and elastin in your skin.

You are here to find out what to do "on the outside, " and I aim to deliver. In this book, you'll find the only anti-aging skin care regimen you'll ever need to follow. You'll also learn about the current home and office-based ways to treat your face non-surgically, so you remain youthful looking. Lastly, you'll learn the typical decade by decade tweaks to your entire regimen.

There is no reason you can't look as young as you wish. You don't need to be a movie star to look like one!

To your best health,

"Dr.Kim"


The first thing to have down "pat" for your anti-aging skin care regimen is your daily skin care routine. Always wear sunblock when outdoors, never go to sleep wearing makeup and of course don't smoke, don't drink alcohol excessively, and stay hydrated. Those are the real basics. When you choose products, make sure you are choosing (if possible)organic products. Make sure you choose products free of paraben and silicones, mineral oil, synthetic preservatives, and fragrances because what you put on your skin affects your skin and your health.

If it smells artificial, it is. Don't use it. Needless to say, everything on my website fits the total bill for healthy bodies and healthy skin. And guess what? There are some celebs with their OWN skin care lines who use my products! Noooo, I can't tell you. Having great skin takes proper daily care with the right products and discipline to follow an anti-aging skin care regimen on a daily basis. I now also consider procedures to enhance the youthfulness of skin as part of an overall anti-aging skin care regimen. Yes, of course, I'll get into that too.

Your basic skin care routine: 2x per day

Step 1a – Cleansing

Cleansing is the first step to any good anti-aging skin care regimen. It gets rid of any dirt, oils, germs, debris, and some bacteria from the skin. Unfortunately, there might be harmful effects of cleansers on the skin if you choose one that strips away too much oil.

Many people have dry skin because of their cleansing routines, not because their skin is naturally dry. However, some people do have dry skin from their environment. The bottom line about cleansers is most people do not know that their cleanser is causing skin dryness.

How do you know what type of cleanser to use and where? The first step is to understand your cleanser options:


Bar soaps – They can be the most irritating cleansers, but they're the best way to get rid of dirt and grime. Search for one that is naturally derived. Fortunately, we have a great one, and it's only $6.00 and lasts FOREVER. It smells just heavenly, too. If not for your face, you will love the smell of your showers if you use it for your body.

Liquid cleansers – These have a wide variety of tolerability. Liquids are good for cleaning all but the oiliest skin. For super oily skin, you'll want a gentle scrub cleanser.

Facial cleansers – The mildest cleanser but may not remove oil and dirt as well. Use the mildest cleanser possible that still removes dirt, oil, and debris. Our gentle but effective cleansing milk does the job quite nicely as part of an over 40 anti-aging skin care regimen.

My opinion on how deep to clean:

Clarisonic happens to be my personal and most favorite product to implement in a skin care cleansing routine for patients and clients. I love it, too.

I have tried many rotary devices, and through trial and error found this one. Just to

mention, I have no financial interest in the company. Note that any sort of stimulation of the skin, including the use of a gentle cleaning device such as this, will stimulate collagen and elastin production. That is always a good thing.

Try washing your face and then using a clean head of a machine like this if you have been wearing makeup. You will get “more” off with this! I don’t wear makeup often, but when I do, this provides the best cleansing process and offers many benefits. Yes, there are el-cheapo knock-offs, and you get what you pay for.

Step 1b - Use an all natural toner

It's not necessary, but if you like toners, our toners are made with all natural ingredients. They do not contain the usual array of oil-stripping “garbage” that almost all other toners


have. Again, if you like using a toner, just use one of ours. They all smell great and feel good on your skin. If you use other toners, watch for oil-strippers!

Step 2

Apply a thin layer or layers 1-2x per day of light “serums” with potent anti-aging ingredients best for your skin. A good choice is a penetrating and hydrating form of hyaluronic acid plus vitamin C. Let the serum(s) dry for a minute. One light layer of one "specific use" serum is generally enough unless you are using another for another purpose such as super-hydration or "spots."

Step 2

Apply a layer of the Lifeline Proplus daytime or nighttime serum or, if you find it, a serum with the equivalent amount of stem cells and growth factors. If you haven't read about these products, they are hot in Hollywood and part of many celebrity anti-aging skin care routines. When you have a chance, read why. These products actually help get rid of wrinkles, sagging skin, excess pigmentation and more! If you find anything comparable, please let me know.

Step 3

(Seriously Optional) Dab on elastin stimulating serum to fine lines and places where you will “sag” or are starting to “sag.” Some people prefer this as the step right after washing or toning. I used to be a big fan of the next product, but now, with the Lifeline Proplus products, I don't think they are needed anymore.

Let me cover this “elastin issue.”


Many substances and techniques will stimulate collagen. However, prior to the advent of stem cell and growth factor serums, the only scientifically proven product/ingredient to stimulate elastin was ethocyn. Purchase this on Amazon, in specialty shops and through the MLM Company, Nuskin, as its product “Truface Essence Ultra.” The company will hate that I’m telling you I’ve seen this product at a lower price on Ebay and Amazon. Oh well. But again, if you look at the science behind Lifeline proplus you will note that it stimulates elastin to the point where we truly see visible firming and lifting of the skin. It seems to me to work much better than the long-touted ethocyn, but there has been no head to head studies. So, you choose. I ditched mine when I saw the Lifeline Proplus results.

Step 4 – Moisturizing

Moisturizing is an essential step in good skin care. Sometimes the Nighttime moisturizing Lifeline Proplus serum is sufficient. Unless you have dry skin, it generally is, but this is all an “individual thing.” A good moisturizer can stop the dry skin cycle from spiraling into cracked, thick, flaky skin. An effective moisturizer will have a combination of ingredients which:

Replenish the skin’s natural ingredients that help maintain its structure.

Cut down on damage from free-radicals.

Help the cells function more normally.

If you need extra moisture due to your skin type, the weather, travel or change of season be sure to choose a good moisturizer with nice, organic ingredients

Step 5 – Apply Sunscreen During the Day

The final step in a good anti-aging skin care regimen is using sunscreen. You can easily tell if your skin is oily or dry, requiring a good washing or some added moisture. However, most of the damage to the skin from UV radiation is beneath the surface and happens so slowly that we don’t realize how much damage is happening.

Don’t take small exposures “for granted.” Even those little bits of sun exposure add up over the years and can cause wrinkles, dark spots, and skin cancer. You won't have great skin if you skip this step.

Don’t undo all the money spent and the benefits of an anti-aging skin care regimen by exposing yourself to UV radiation. Find a good broad-spectrum sunscreen and make its application a part of your daily routines like brushing your teeth and bathing.


Re-texturizing, firming, and lifting your skin: I'll be discussing several types of procedures in the next section which will have quite an impact on the texture and firmness of your skin. However, you need to realize that everything you put in your mouth, every bit of exercise you do, and every time you choose skin products wisely, you are contributing to making more collagen, elastin and hyaluronic acid which are the building blocks of your dermis. The dermis is the part of your skin that makes you look young or not. Also, do incorporate exfoliation into your routine. I'll talk more about this when I get into your decade by decade skin care regimen.

Emerging science about mitochondrial health (our energy factories) shows promising results for more skin turnover and collagen synthesis with mitochondrial boosting activities. Such activities include things such "cold blasts" and far-infrared sauna use. An example of a "cold blast" is diving into a cold swimming pool and swimming face-down. An easier example is to run the water of your hot shower on cold the last 30 seconds and give your face a good showering. The jury is still out regarding collagen supplements but they sure can't hurt and just might help. I'll go into proven ways to non-surgically stimulate your skin's building blocks in the next section.

Introduction to the ways to look younger without plastic surgery:

All of the ways to look younger without plastic surgery work best if you have a "virgin face" meaning you haven't had "extensive work done" already. However, they still do work even if you've had a full facelift- I just hope that you haven't gone that far before reading this.

If you are realistic and don't expect to look 30 when you are 60, the technology of "appearance science" is evolving to where it's all about the right inside out care, the best anti aging skin care regimen, the best products and the more current esthetics procedures. No longer do we need to run for the scalpel and risk looking "too tight" or un-natural.

Again, looking young means looking naturally, not artificially young. It's 2017 and life has changed for those of us who want to know how to look young into our 40's, 50's, 60's, 70's, 80's and more. We have advanced esthetic dermatology procedures now. And if you couple them with the right skin care products, you are "in business."

We don't need to immediately have a full face-lift as soon as things start going south as people did in the 60's, 70's and 80's. There are a plethora of dermatology treatments which include everything that stimulates the skin's building blocks.

Those building blocks are collagen, elastin and even hyaluronic acid. All of these diminish in quantity as we get older. However, the great news is we now know how to increase the amount of all of these vital skin structures to keep looking young long past are

©2017 Kimberly Crawford, M.D., F.A.C.P.M., A.B.A.A.R.M || www.drkimsagewellsolutions.com || Page |

7

"expectancy" to look young. You can step out absolutely anywhere with confidence once you get on board with some of what I'm going to talk about in this article. I'll start with what is the least work for you and the most bang for the buck.

A Quick Reminder

Always, always remember that beauty starts with good health. Good health means taking care of your weight, getting enough exercise, and fixing things like oxidative stress and inflammation. It means making sure you have a healthy GI tract and GI microbiome. If you really don't know what I'm talking about, you owe it to yourself to read my first "look younger" book. Then, always remember to use the best, most pure and effective products on your skin. All of the procedures I will mention work tons better if accompanied by the right skin care products.

Fillers:

Cross-linked hyaluronic acid injections:

For an immediate fix, many people turn to “fillers.” A viscous hyaluronic acid is injected into facial folds and creases, plumping wrinkles from the inside out in about five minutes. Cells whose collagen production has waned are fooled into making more.

Cross-linked hyaluronic acid is one of many materials used and is particularly effective. How long such fillers last can depend on the amount used and wrinkle depth. It can cost between $500 to $700 for each cubic centimeter injected.

There is a great variation so be sure to “get it straight” so you get what you want.

Belotero is a thin, fine hyaluronic acid product, for filling in around the mouth and under the eyes. The newest and longest lasting one called Volumina is used to augment cheekbones and essentially “pull up” the face. There are others “in-between” these two. Yes, there is a "five-year filler" but who knows what the face will do in the course of five years? That one scares me a bit.

Radiesse®:

This is a “creamy calcium” and often used for naso-labial fold injections. It tends to last a little longer than hyaluronic injections, but the new Volumina might rival its staying power. It too stimulates collagen production. Between this and the hyaluronic "variants," injections of collagen have gone by the wayside.


8

Sculptra®: Not a filler but achieves similar results:

Approved by the FDA in 2009 for the correction of shallow to deep smile lines and other facial wrinkles, Sculptra® is not a wrinkle filler, but rather, a volumizer. Sculptra® works through a series of injections that fill the depressed areas of the face caused by aging (collagen loss).

Sculptra® is made of a synthetic material known as poly-L-lactic acid, a substance that forms naturally in the body when you exercise. A full Sculptra® treatment consists, on average, of three sessions over a few months, and the results can last for more than two years.

Botox and Reloxin:

Botox®:

Botox® is a popular anti-aging non-surgical treatment that involves injecting a diluted version of the botulinum toxin into muscles on the face. The toxin blocks the signal that tells the muscles to contract or cause the skin around the eyes or forehead to wrinkle.

Botox® is relatively painless and only topical anesthesia is used. Botox® is administered using a fine needle to minimize discomfort. Results typically appear within two weeks and last between four to six months.

But, a disclaimer here: In “real life” results last 12-14 weeks according to most patients surveyed.

There is much criticism about the practice of 20 or 30-somethings using botox. I’m not going to weigh in on that. However, there is evidence that after 10-15 years of use in forehead lines, less and less is needed. Also, it lasts much longer as the lines are possibly filled in with fatty tissue.

Reloxin®:

Reloxin® is an alternative to Botox® that achieves the same results. Like Botox®, it is derived from botulinum toxin type A. Reloxin® results are reported to last longer. Like Botox®, Reloxin® is injected directly into the area treated using a fine needle to minimize discomfort for the patient. The results reportedly last anywhere from five to six months.

Note: According to most women surveyed, Reloxin® lasts the same amount of time as Botox®!


"Ablative" lasers with "downtime":

It is important before doing any procedure that you have done well-informed research. You need to know the Esthetic Dermatologist you have chosen is well trained in the methods I'll mention in a moment.

Fortunately for you, I have conducted the research to steer you in the right direction regarding procedures. After that, it's up to you to "vet" the practitioner you choose, OK? Don't find someone who's "a bargain" because that's usually a recipe for disaster. Invasive (read down time) lasers are really "where it's at" for significant results so, I'll discuss them first.

Carbon dioxide laser resurfacing:

Carbon dioxide laser resurfacing is more invasive, but much more effective for those with a large amount of sun damage. In other words, if you have aging skin and know by looking and being honest with your sunning and smoking history that you need skin re-surfacing then this is for you.

It has a long recovery period. Certainly, lots more than the other lasers I will mention. So, make sure your desires are well known when you have your dermatology consultation. It is a procedure to wipe out sun damage but is definitely also a form of laser skin tightening. In addition, there can be up to 6 months of facial redness.

The hour-long procedure is usually done in an outpatient setting, and patients are sedated. As the laser is passed across the face, it sears through the paper-thin epidermis and into portions of the dermis—the skin’s thicker layer beneath the epidermis—to purge old, damaged collagen and generate four to five times more new collagen than retinoic acid does.

Prepare yourself

Your face essentially becomes an open, oozy wound that must be rigorously cared for until healed. That means virtual house arrest for two weeks, during which skin must be soaked with ice-cold water every few hours then slathered with a layer of ointment to avoid scarring and infection. During this time expect to take pain medications and scale down on the work-from-home stuff.

Once healed, the skin may remain red for up to six months. However, growth factors serums appear to shorten this time. You get some skin tightening with this procedure as well as resurfacing benefits.

Less “invasive” lasers that offer less healing time, which are also “ablatives”:


10

A newer generation of lasers (“fractional ablatives”) are less invasive. They are what the Dermatology Specialists really rely on to augment their botox and filler regimens. They do indeed promote skin tightening, but it’s more “gentle” than you just read with the CO2 laser. Instead of burning off the skin’s entire surface, microscopic beams of energy singe tiny plugs of tissue, leaving areas of untouched skin.

This method promotes quicker healing. Patients are just red and swollen for about a week and can usually resume their daily routine after that. While one carbon dioxide laser resurfacing session may yield results that last eight years, fractional ablatives may require two or three sessions for optimal effects. Looking young is not an inexpensive endeavor. The traditional CO2 procedure can cost between $5,000 to $8,000, and the fractional ablatives, between $3,000 and $5,000 per treatment. Fraxel® is the best known and most widely used fractional ablative laser.

IPL:

Intense pulsed light, or IPL, is an anti-aging non-surgical treatment that uses wavelengths of light to correct wrinkles under eyes, on foreheads and cheeks. It is another way to treat sun-damaged skin.

It is also used as a hair removal treatment. The procedure uses intense bursts of light applied to a small area via a handheld device. The process triggers a damage-control response in the skin, leading it to shed the old skin and take on a smoother, more youthful appearance. There may be mild pain and discomfort following the procedure. This is also often used for “age spots” and other skin discoloration issues such as red blotches with very good results. It too will stimulate collagen and elastin, although not to the extent that the other laser skin tightening methods will.

Corrective Chemical Peels:

When peels are properly administered, they are known to be one of the most powerful non-surgical skin improvements available. They remove cellular buildup, stimulate skin regeneration, and reduce wrinkles, fine lines, large pores, and oiliness. In addition, they improve overall texture and tone.

Undergoing a chemical peel is a popular anti-aging non-surgical treatment because it’s an effective alternative to costly surgery. The procedure involves applying an acid-based solution to small areas of the skin, be it the face, hands, or neck. The acid peel solution is typically washed away after two minutes and, to minimize discomfort, a small fan may be directed to the spot where the acid was applied.

Results:


Depending on the strength of the formula used, it may take several treatments to see any noticeable results. With stronger peels, like phenol peels, the recovery time can be up to three months, because of the severely sunburned look the skin takes on. This peel will allow you to look younger if you're over age 40, but be very careful with this one.

The results of a phenol peel are close to laser skin tightening results of a CO2 laser treatment at a fraction of the cost. Again, be careful because, in un-trained hands, chemical burns which leave scars are not all that un-common. Phenol peels, to be quite honest are not particularly "current." They are a bit of a throw-back to the 70's and are not recommended by most Esthetic Dermatology Specialists. They tend to be more popular in other, less developed countries.

Light glycolic peels can be done as often as bi-weekly with no “down time.” Light TCA peels will work more quickly, and you'll have as little as 3-4 days of “down time.” These are less useful as aids to look younger but are great at clearing acne, reducing pore size and cleaning up minimal sun damage. They fall into the “skin refinement” category. They stimulate collagen and elastin a little bit.

Derma-rolling:

Exactly what does it do?

Dermarolling stimulates collagen production in the skin. It is accomplished by piercing the skin using the roller’s micro-needles and breaking down fine wrinkles, sun damaged skin, acne spots and some types of acne scars to induce tremendous collagen production. The treatment causes a minor pricking sensation if you are using needles of .25mm-1.0 mm in length. The skin needling treatment recommendation for home use is 0.25 mm to 1.0 mm needles.

However, once you know what you're doing (it's not hard), you can use the 1.5 mm rollers at home. Using 1.5 mm needles will require skin numbing cream before the treatment to eliminate any pain you may have. The numbing creams are often known as topical anesthetic ointments. Derma-rolling doesn’t necessarily hurt. However, some people have reported mild pricking sensations during the treatments. It will produce a fresh layer of collagen underneath the epidermis. The newly created collagen layer will thicken the skin and will fill or reduce skin imperfections with several treatments of 1.5 to 2.0 mm needles. Generally speaking, people should seek out professionals to get optimal results for the longer needles.

Derma-rollers will boost the absorption of your favorite skincare products by as much as 1000+ times. The .5 mm roller which can be used daily increases the absorption rate of products by 10,000 times since it creates temporary micro channels into the deeper skin layers. Derma-rollers can significantly maximize the effectiveness of your skin care products and improve your results by 150%.


12

At Home How-to:

You can use a .5 mm roller nightly if you want. I suggest that you first, apply some hyaluronic-C serum or some growth factor serum and then roll away. Follow this with the stem cell peptides and growth factors product to heal up the little holes. You can do this same routine with the 1.0 mm roller, but that is once weekly usage. If you have a 1.5 mm, use it once every 2-4 weeks.

Professional treatments are generally spaced out at 4-6 weeks, and you should utilize these same skincare products for best results. You can buy these rollers on many websites which sell beauty items (including Amazon) and make sure to get a rolling pad you can use alcohol on to sterilize your roller between treatments. Derma-rolling is now firmly entrenched as a part of a good anti-aging skin care regimen.

Micro-needling:

Micro-needling is derma-rolling on steroids. It's not a home procedure. It is a minimally-invasive non-surgical and nonabrasive procedure for facial rejuvenation that involves the use of a micro-needling device to create controlled skin injury.

During this procedure, fine needles rapidly puncture the skin, causing microscopic injury to the skin, which in turn stimulates the growth of new collagen. It works similarly the way lasers do, except mechanically rather than with light and heat. According to studies, micro-needling can help minimize scarring, decrease wrinkles, stretch marks, reduce pore sizes and reverse photo-aging.

There has been a recent proliferation of devices and systems on the market in this category varying in the diameter and length of the microneedles, generally ranging from 0.5 to 3.0 mm. The procedure is well tolerated. It takes up to an hour to complete, depending on the area and severity of the problem or desires of the client. Topical anesthetic cream is used to keep the patient comfortable during the procedure.

How often is it needed?

Patients should be advised that multiple treatments will be necessary. The number of needling sessions depends on the individual skin condition. Three or four treatments may be recommended for mild to moderate acne scarring, whereas deeper scars and stretch marks may require upward of five treatments. Fine line treatment and skin re-texturizing generally take 3-4 treatments.

An interval of 4 to 6 weeks between treatments is typically recommended. Generally, the treated areas recover rapidly from skin needling. The use of growth factor serums decreases healing time dramatically. Celebs and non-celebs use these treatments not just for skin refinement, but for anti-aging collagen stimulation benefits as well. This procedure


13

is considered nearly as effective as the non-ablative lasers we'll discuss next. This too is becoming part of a routine anti-aging skin care regimen. I would suggest you do your own derma-rolling and perhaps 1-2x/annually, have a short series of micro-needling procedures to optimize your whole regimen.

My favorite non-invasive lasers:

GentleWaves:

GentleWaves LED photo modulation is noninvasive, as are all of these next procedures I’ll talk about. This means no down time! Yes, unreal isn't it? Unlike invasive surgical procedures or treatments that use harsh chemicals, GentleWaves uses low-intensity light-emitting diodes (LEDs). These LEDs stimulate the skin’s production of collagen, resulting in more youthful, rejuvenated skin. It also reportedly suppresses the enzymes that break down collagen.

This process only takes five minutes. No aftercare is necessary, and the device is compatible with all skin types. It usually takes four to eight treatments to see results with this anti-aging non-surgical treatment, and the procedure is completely painless. This gets mixed reviews so as always, do your homework.

Thermage®:

Thermage ® is indicated for those who want to address the visible signs of aging in just one treatment. It’s an anti-aging non-surgical procedure with clinical proof showing it safely treats fine lines and wrinkles on most body parts. These include the face, eyes, neck, stomach, arms, hands, thighs, and buttocks.

Thermage® has even been approved by the FDA for improving cellulite.

(My opinion is it doesn't work for cellulite at all. What's more, this and GentleWaves (discussed above) simply don't work as well as the two procedures below. Some women swear by them so "the practitioner" makes a big difference in all of these laser results.)

I could go into detail about the results and benefits of each of these procedures. However, the claims are just not conclusive. I, therefore, urge you to do your research before doing Thermage or GentleWaves as there is an abundance of different reviews. Results depend on who is doing the procedure, not just "the procedure.")

Titan:

Titan skin rejuvenation is an infrared laser treatment that uses light energy to stimulate new collagen growth deep beneath the skin’s surface. It can tighten skin on your face, arms, abdomen, and legs. A Titan procedure can also tighten pores and smooth away fine lines.


14

While some patients report seeing results in as few as one or two months, the full benefits of the Titan procedure are not usually noticeable for at least three to six months.

Another caution: Reviews show best and most predictable results on face and neck only, but it does seem to predictably work in those areas.

Titan on steroids = Ultherapy:

Ultherapy does what Titan does but deeper and more effectively. A painkiller is recommended, and so is a deep pocket as this effective annual treatment runs about $5000. (How to look young? First, have money!) The full benefits are noticeable at 6 months, as with the Titan. I have seen patients have excellent results with this and I do not offer it in my practice so this is an entirely unbiased endorsement. This really gives you great results in the right hands. Research conveys the results are visible mostly in the neck and forehead areas.

Pulsed-Dye Lasers: Not a laser skin tightening procedure but I thought you’d like to know!

Pulsed-dye lasers (PDLs) are a non-surgical treatment used for skin conditions such as port-wine stains, scars, spider veins, and more. Before the procedure starts, the dermatologist may do several test patches to determine the best strength for the laser.

The laser will then be applied to the area being treated. The process sends short pulses to the area.

There may be mild pain, but most of the time they use a cooling spray to minimize any discomfort. PDL treatment only takes a few minutes, and it may require up to three treatments before any results are visible.

Bruising is the most common side effect. When your skin looks better, you look better and younger, so this is why I have included this. I have not discussed lasers or procedures where I have found little to no efficacy in the literature.

The latest "hot thing": Thread Lifts

For the immediate benefits of a surgical neck or facelift, there’s the minimally invasive thread lift. Many refer to it as the contour lift, suture lift or stitch lift. The procedure uses “threads” made out of specialized dissolvable suture material to lift the skin of the eyebrows, mid-face, cheeks, and neck.


15

Unlike facelifts, thread lifts are minor surgery. Thread lift procedures involve a local anesthetic, with a recovery time of just two to three days. The threads dissolve over 6 months and stimulate collagen production.

This is not the same as the non-dissolvable threads used 5-10 years ago which did cause issues because they did not dissolve. Such threads were known by names such as the "Lifestyle Lift." I am not endorsing those types of threads.

These threads provide a quick, easy office procedure and this is (for the record) not plastic surgery. "Nova threads" are the leading "dissolvable" being used.

This is that last of the newest, hottest procedures that is the only non-surgical way to address jowls and sagging necks. A famous actress and business woman (OK-Gwyneth Paltrow!) just went public with her "sugar strings" lift, so I predict that the demand for this will sky-rocket.

The sugar string lifts are not available in the U.S (but are available in London). However, from what I've read, they are likely not as effective (read-stable) as the PDO or Nova threads. If you want to fly to London, go for the musicals!

Is there a difference between routine skin care and skin care by decade?

In a word, yes. We can guesstimate skin care by decade as well as helpful ways to look younger without plastic surgery decade by decade. And most importantly, if you are indeed going to have plastic surgery, let this article be your guide to getting it done how the celebrities do it. I'll tackle this topic first. How old do I look? Is this something you have asked your spouse? Or friends?

I am reminded of Jeff Foxworthy's routine where the wife asks "Honey do these pants make me look fat?" and the audience laughs while Jeff pauses. He then says "Hell no they don't. You're FAT!"

How old to I look seems to me to be one of those questions... Well, if you're going to ask it I want to make sure you get a great answer.

We now have amazing skin care products, esthetic dermatology lasers, fillers, Botox procedures and plastic surgery nip-tucks. I list all of this hoping you will use each "thing" judiciously. Also, always start with inside out skin care to look younger before anything else. I covered all of that in the eight anti-aging products article which deals just with inside-out skincare. To jump ahead with skin care products, here is my review of the best anti aging products 2016 which is "all about topical skincare".


16

First, let's talk Plastic Surgery: Don't look as if you've had it!

For those of you who know me personally or professionally, you are likely thinking..."What? Is she talking first about Plastic surgery? Something she says to do last?" Yes, I am because by the time women are thinking "of doing something," most are making appointments to see Plastic surgeons.

So, while I think this is a terrible way to go about looking young, I'm a realist and always want to give my readers the inside scoop on everything. This is why I'll get this information out of the way so when I discuss skin care by decade, you will be familiar with the information.

Personally, I've been "working on it" with a great anti aging skin care regimen, and adding in Esthetic Dermatology "stuff" the last ten years too. It's not like one morning I woke up, looked in the mirror, checked the year and decided I needed 5 Plastic Surgery procedures. Anyway, let's review what you need to know about plastic surgery. Then, I'll get into keeping young with, as promised nips and tucks and skin care by decade.

Let’s talk about the “facial zones”:

This is how you should view your face if you are considering Plastic Surgery. Zone 1 is your forehead. Zone 2 are your eyes and temples. Zone 3 is your "midface." Zone 4 is your jaw and just above it. Zone 5 is your neck. Remember you want to look younger, not tighter. Bad joke but true, right?


17

When facelifts result in being unnatural, it is from a variety of things. Remember me saying you have to get your skin in shape, get rid of oxidative stress and inflammation and use great skin care products? If not, go back and read that link I gave you when you're done because that is step 1. Again, if not, you won't heal "so great." The next step is to find a great Plastic Surgeon who knows the latest and greatest procedures.

Now regarding the zones, at some point, we lose the war with sagging skin even with our use of Lifeline stem cell skincare, botox, and lasers. If you can’t stand the sagging, it’s time to judiciously pick “by the zone” and by the specific procedure.

The Zone Rule

Good Plastic Surgeons do surgeries just in one or two zones at a time. Also, they don’t insist you have a full facelift under general anesthesia if you just need 1, 2 or up to 3 “zones” attended to.

The secret that movies stars know is never to have more than two adjacent zones "done" at the same time. Doing so is appearance altering, and that is what you want to avoid, right? Who wants everyone saying "Oh wow, you’ve had plastic surgery!?” You want them to say you look great, look rested, or that they love your new hairdo.

So, as an example, you can have an endoscopic brow lift (zone one) and a blepharoplasty (zone 2), but don’t go lower than that. However, you can dip into zone 4 and 5 with a Z-lift and have your jaw and neck “done” at the same time if the surgeon agrees. Got it?

Now let’s talk techniques:

Plastic surgery is forever advancing. Plastic Surgeons, the good ones, will know how to do things like a forehead lift “endoscopically”; being able to make two incisions behind the hairline, so your scar is invisible.

He/she should know how to use lasers for things like jaw tightening, and neck tightening-where incisions are tiny, lasers are inserted to basically "shrink-wrap" loose tissue. Gone are the days when plastic surgery will alter the tilt of your eyes or give you huge visible scars. Scars are now minute and become invisible within 3-6 months.

Now, remember that each procedure, even if it's called a "weekend XYZ" means you are up and around, but you still look like someone punched you in the face for 2+ weeks. It's down time and weighing the pros and cons.

An example of one choice is what to do with upper eyelids drooping and eyebrows appearing to close to the eyes. A blepharoplasty will open the eyes but not fix the brows.

The choice could be getting an endoscopic brow lift or using Ultherapy treatments and Botox®. This is why you need a really good, board certified Plastic Surgeon who specializes


18

in faces. Still, no matter what, you need to keep your insides healthy and use amazing skin care products to optimize whatever procedure you have done.

Do More Before Plastic Surgery

I have discussed lasers, Botox®, and fillers in other articles so make sure you take care of the insides, use great skincare products, use noninvasive techniques well before resorting to plastic surgery, OK? You may or may not have heard of studies where they show people's facelift b/a pics. The "judgment" was a 2-3 year difference.

IMHO these non-results surgeries happen because the women (and men) don't do all of the other things they need to do. So, enough of me nagging you to get healthier. And another thing-be realistic about how young you can look.

My Esthetic Dermatologist says that it is unrealistic for most women to look more than 10 years younger than their stated age. Yea, she says that at age 52 while SHE looks 32! Now let's talk about what your regimen should be for skin care and "tweaks" from girlhood to mature magnificence. I always tell my patients that 60 is the new 40. Further, when they ask how old they look, I tell them honestly that they look a good decade younger because if you are my patient or you have gotten a consult from me on AgeWellSolutions you take care of the insides!

Skin Care until age 20:

Use natural products, don't squeeze your zits and use sunscreen. Use non-comedogenic makeup and don't use tanning booths. Remember that the tattoos you get will be drooping and faded in 25 years and we still don't have the technology to get them perfectly removed. Finally, take plenty of pictures so you can kick yourself for being self-critical when you were this young and effortlessly gorgeous.

Skin care age 20-30

If you were exposed to the sun a lot in your teenage years, you might have started to get sun spots or fine lines under your eyes.

Your skin care regimen:

You might want to add another serum, depending on your current skin condition, such as sun spots.

You can add a night time moisturizer if your skin has started to become dry, otherwise just stay with your regimen and add just one more serum.


19

You want to do at least a weekly exfoliation and for thick, oily skin-two. By the way, I didn't talk about exfoliation per se when I discussed your skin care regimen, but it's very important to keep your pores appearing small and your skin clear and bright. So take a mental note that exfoliation should be a part of your skin care regimen.

You can add a home micro-current device or home LED device to stimulate collagen and elastin. Also, you can add a derma-roller for Esthetician visits or home use. Inter-change derma-rolling and microneedling for collagen stimulation too. Continue some sort of collagen stimulating technique at home or with an Esthetician or N.P. (for life). I won't keep mentioning this.

Close to 30- You might consider starting “prophylactic” Botox® for your forehead and crows feet if you "see them starting to appear." Chemical peels are a good addition, especially if you are acne-prone.

Close to 30- You might consider starting semi-annual laser skin tightening (discussed below) as you are now officially losing elastin and collagen. Don't scoff at the age group I'm suggesting to "get started" as they will be the ones who will NOT need plastic surgery.

Plastic surgery – Don’t do it!

Skin care and “other” age 30-40

During this age, you may start to notice some changes, which are nothing to panic over. I am here to help!

Skin care: Assess need for a third serum, but you should be okay unless you are still sun tanning!

Exfoliations: Assess skin thickness and dullness; increase use and variety but don’t fry your skin.

Non invasive Esthetic Dermatology: This is a great time to start a little Botox® and either Titan or Ultherapy laser skin tightening. Titan works; it doesn't go as deep, and you need 2-3 treatments to get started. It's cheaper than Ultherapy, but not all that much cheaper. Ultherapy is a little painful, but wow, it works. It's once a year on this one. It's also natural, and there is no down time at all!

Fillers in certain areas might be useful, usually the naso-labial lines. The thing about fillers is that they fill in lines and also stimulate collagen and elastin. There are a variety of fillers, and there is also (recall) a product called Sculptra which can be used to fill in where facial fat is lost. Step up the microneedling and/or derma-rolling as needed.


20

Plastic surgery nip-tucks: During this decade some women have eyelids that disappear, so a blepharoplasty isn’t absurd as you are young and will heal. Warning: DO NOT “get addicted” to plastic surgery!

Skin care and “other” to from age 40-50

During these years, menopause is common, mainly around the ages 47-53. Due to hormonal changes with associated loss of collagen, elastin, hyaluronic acid and hormones this might be the big intervention decade. If so, here’s what you do:

Weight gain: Start a great program and try to stick to it. Losing and gaining weight is just awful for facial appearance. Add weight training to maintain your lean muscle mass.

Skin care regimen: Add serums and moisturizers (as much as you need). If, for some reason you don’t have stem cell-growth factor serums on board, now’s the critical time.

Esthetic Dermatology: Switch from Titan to Ultherapy, and start using the “correct” fillers to plump and stimulate collagen and elastin.

Continue to use the derma-rolling and micro-needling. You might need LED treatment for sunspots.

Plastic surgery nip-tucks: You might need a neck tightening or endoscopic brow lift. Hopefully not, but you might and if so it's many "zones" (remember them?) away.

Skin care and “other” from age 50-60

This is the time when most of the carnage occurs so step it all up!

Skin regimen and exfoliation:

Pull out all stops and use three serums, use the roller, use a home device and fight it, baby, fight it!

Stress:

This tends to be a decade of high stress for women. Aging parents, college kids, job, "getting older"-you know the drill. Cortisol levels go up, and that is death to collagen and elastin so you must learn how to control your stress. And in many cases, you'll want to supplement to lower those cortisol levels.

Hormones:


21

Consult with an Anti-aging M.D.; we can all help! Get educated about the health and beauty benefits of bioidentical hormone replacement.

Esthetic Dermatology: For age spots and fine lines you may consider:

Fraxel® treatments. You can also start to use a very thin hyaluronic acid for under eye filling if you haven’t done this yet. You are looking for Belotero. Continue Botox® and fillers, and consider increasing your Ultherapy to every 6 months. See what your decolletage area needs as you can do Ultherapy here for vertical lines, LED for spots and chemical peels for re-texturizing. You can also do Fraxel for re-surfacing.

Nip-tucks:

As stated earlier, now might be the decade for an endoscopic browlift. See if eyelids and forehead wrinkles can be kept under control with botox. See how neck, jaw, and mid-face are holding up with non-invasive treatments. If they are not doing the job, look at getting non-contiguous zone nip-tucks.

Thread lifts:

This would not have been something I would have said okay to 5 years ago, but under the right circumstances, yes- because of the dissolvable threads. If you find someone trained in the latest techniques, they can now use these dissolvable sutures which actually stimulate collagen and elastin. So, this can lift up a slightly sagging jawline and even cheeks and a brow quite nicely. I haven't mentioned this earlier because when you are younger, you heal much better from "real" plastic surgery. But, of course, this is an option when you are younger, too. In fact, it's now my pick of the first plastic-surgery-like option for all areas of the face and neck.

Skin care and “other” from 60-70 to continue to look young

Make sure you are using all of the best anti aging skin care products that you need.

Make sure you also are on the least amount of pharmaceuticals possible and are eating anti-inflammatory and high nutrient, low processed foods and low sugar-crucial at this age. Although this is extremely important at all ages, this is crucial now as health issues potentially increase as we age. (Unless you are seeing an Anti-aging doctor in “real life”).

Continue Esthetic Dermatology procedures that are working for you. Keep up everything discussed previously. You are the new 40, remember?

Nip-tuck mid-face if needed. If the jaw wasn't done when you had your neck done, have that done at the same time, endoscopically with laser assist. If a thread lift can do the trick, try that first.


22

Skin care and other from 70 to 100+

During these decades, it is clear whether you have been taking care of your insides. If you are not your skin will be thin and plastic surgery will be a “stretched canvas affair” if you are just starting this process.

Inside out: Do not have plastic surgery unless this “thin skin issue” is fixed or your results will not be desirable. Remember, nothing is too late. Don’t worry!

Hormones: If skin is thin and fragile looking you need your consult with an anti-aging doctor first!

Regimen: Use what you have been using; you know now what is best! Keep exfoliating, using collagen and elastin stimulating procedures, and you can liberally use thread lifts now-as often as every 6 months if needed. Actually, that is an option at younger ages too. It just can get pricey!

Non-invasive: You should keep all of these up, office and home-based therapies.

Plastic surgery: I am still not a fan of a full facelift. I will always suggest you do things “by the zone.” If you have had a lot of sun damage and are getting skin cancers, this is a great time to combine a nip-tuck in different zones with a CO2 laser procedure. Again, the current thread lifts are looking like the way to go right now as they have gotten rid of the "broken threads" problem and the results include big time collagen stimulation. If you opt for a full facelift, you get what you pay for. So, make sure you have a very skilled surgeon, and you have seen tons of b/a shots.

Postscript:

Health above all else, including the health of your skin (think sunblock!) will ensure that you look your best. Then, rather than purchasing a whole litany of skin care products, choose wisely and choose what's going to actually "do something." Do your research and spend the money for the purest, most effective products you can afford. Products sold at fancy make-up counters have huge markups due to mall overhead costs. Don't pay someone else's overhead. Get the skincare products that work. If you like things like toners, by all means, get a toner, but know that you are not contributing to the "look younger" cause.

I'm sure this book will be obsolete in less than 5 years. I fully expect full body tightening lasers. In my opinion, lasers which stimulate collagen and elastin will truly evolve to be much more powerful. Stem cells, now used in the finest skin care products, will evolve into a dermatological procedure.


23

We'll be using not just platelet-rich plasma as a "roll-in," but it will be combined with our own stem cells to produce new, younger skin. I didn't mention "stand-alone" PRP treatments because they don't do much other than help a bit with healing post-operatively. However, just as stem cell therapy is indeed emerging for joint repair, I believe it will emerge full force in skin rejuvenation.

In addition, we'll learn more about micro-nutrients and how they impact the skin to target supplementation for the skin in a more organized fashion. No doubt, we'll keep seeing the skin care preparations evolve to be more and more of a force, as well. One thing is for sure—this multi-billion dollar quest to "not look old" is a boomer obsession and sure isn't going away anytime soon. You know what else, why should it? Be beautiful.


24

Kim Crawford, M.D., F.A.C.P.M., A.B.A.A.R.M.

About AgeWellSolutions:

We offer comprehensive health and longevity solutions for people who want to control their health and lives and wish to avoid the "inevitabilities" of aging. In short, we help people age well! Our goal is to keep you looking and feeling great, prevent diseases and ameliorate symptoms of any diseases you may have. Dr. Crawford wishes to provide the same results to you that she has provided for many years to close to a thousand private patients. She also has designed the program so that she will be the only one fielding your emails and phone calls about all things "medical".

Dr. Crawford is referred to as one of the leading Specialists in her field and wishes to share her knowledge and make it affordable to all. She believes strongly that anyone joining her program, using the tools such as short entertaining webinars, handouts and unlimited contact with her for personal solutions will benefit enormously. She has four board certifications: Internal Medicine, Preventive Medicine, Sports Medicine and Anti-aging and Regenerative Medicine. She has been an M.D. since 1981. She practices what she preaches.

She was the NBC medical reporter for over a decade -syndicated in the U.S. and Canada on over 250 stations, with her reports also shared on CNN and Medical News Network. Her private medical practice has a long waiting list and patients include CEO's, Political figures, Movie and


25

TV stars, prominent M.D.'s and of course include "regular people" like Dr. Crawford considers herself to be.

"Dr.Kim", as she is known by her patients and members is the best-selling author of "The Anti-aging doctor's weight loss plan that is guaranteed to work" and "How to Super-charge your energy levels for life". She has been the medical consultant to several companies. At Club Marketing and Management Systems (The largest Fitness Club consulting firm in the world), she created what is now known as the model for medically based fitness centers which is used, along with her Wellness Programs, worldwide.

At Moorspa, a Vancouver-based natural spa products company, she has helped conceptualize and formulate anti-aging products which are paraben and all-preservatives free. Her college and medical school research papers were done at the Wistar Institute of Aging, University of Pennsylvania where she worked side by side with Nobel Prize winners. She was a member of the first team to isolate human diploid fibroblasts for tissue culture experiments and also conduct research into the effect natural vitamin E had on the life span of such cells.

"Dr. Kim" lives on the water on the east coast of Florida so she and her husband and family can indulge in water sports. Their four rescue collies are a constant presence not only in her family's personal life but in the videos you will see in her program.

dr. kim's ultimate guide - drkimsagewellsolutions.com acid plus vitamin c. let the serum(s) dry...

Documents