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Triple teaming: Lights, fillers, Botox tackle signs of aging

Article-Triple teaming: Lights, fillers, Botox tackle signs of aging

Key iconKeypoints:

  • A combination of anti-aging treatments with a laser is most effective
  • some people may need facelift, others only need fillers

Dr. Narins
New York — Combination treatment with a light source, a filler and botulinum toxin (Botox, Allergan) can have a significant impact to slowing the appearance of aging in patients, says Rhoda Narins, M.D., clinical professor of dermatology at the New York University School of Medicine and a past president of the American Society for Dermatologic Surgery.

"If you think of the face as a balloon, it is losing volume over time," says Dr. Narins, a dermatologic surgeon in New York.

"You can make the balloon tighter by taking out the skin or you can fill it up again. If you fill it up and smooth it out a little, that can essentially give back that youthful look," she says.


A patient is shown before (left) and after facial treatment with intense pulsed light.
Dr. Narins stresses that nonablative technologies will not, as monotherapies, produce as dramatic results as ablative technologies or a facelift will produce. The use of combination therapies that require no downtime produce a better result than one therapy that offers no downtime.

"We use Thermage® (a radiofrequency machine made by Thermage®) on the face, neck or forehead," Dr. Narins says. "In some patients it gives a really good result. In others, it gives a moderate result, but it is not a facelift. It induces the body to make collagen and tightens the area. We use it in combination with Botox and fillers. You can get unbelievable rejuvenation when you use the three of those in combination."

In some instances, patients require an invasive surgical procedure, such as a facelift, because the patient's skin is so loose, Dr. Narins tells Dermatology Times.

Facelift vs. fillers

"About 10 percent of people need to go for facelifts, but the other 90 percent will look great with filling, because the filling substance not only fills, but induces collagen that smooths out the skin," Dr. Narins says.

"When you combine the 'no downtime' procedures, you can get a great result. There has been a tremendous decrease in the number of facelifts because of the fabulous way we can fill by volumizing now, and not just filling in lines," she says.

Some of the nonablative procedures involve technologies such as lasers, intense pulsed light (IPL) and radiofrequency devices, Dr. Narins says. The ablative technologies, such as fractionated CO2 laser, a CO2 laser or medium peel mean about a week downtime for the patient.

"You get much, much more tightening from these treatments," she says. "If you want to treat acne scarring, there is nothing as good as a CO2 laser."


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