Calgary Guide to Anti-Aging
There’s still no perfect elixir to turn back time, but there is a vast array of highly effective products and procedures that can help reduce the appearance of aging through customized approaches
Illustration Jen Rome
Tales of the Fountain of Youth have been told for thousands of years. Everyone from Alexander the Great and Ponce de León to Capt. Jack Sparrow has sought eternal youth by drinking from a mythical spring.
If only they’d lived a few centuries later, they could’ve popped down to their neighbourhood skin-care clinic for some Botox and laser treatments and saved themselves years at sea and all that sword fighting.
While there’s no single miracle treatment, modern products and procedures are highly effective in helping recapture that youthful look, and the range of options vary in type and intensity depending on your particular skin concerns and the type of results you expect.
“Taking care of your skin is like a marathon, and the aspects involved are moisturizer, sunscreen, exfoliating, healthy lifestyle and so on. Then there are the sprints, and those are the procedures,” explains Marie Bertrand, a microbiologist and owner of Skin Science skin-care clinic. While stressing the importance of a good daily skin-care regime, she acknowledges that topical products can only take you so far in combatting the appearance of aging.
“When people think ‘aging,’ they think, ‘wrinkles,’ but it’s so much more than that,” Bertrand says. “It’s radiance, texture, pore size, brown spots, redness, volume, tightness and wrinkles. And everyone is different, which is why the trend is toward the customized mixing and matching of procedures and products.”
The non-invasive segment of the anti-aging industry has narrowed the gap with plastic surgery, and Sean Carson, owner of Westside Laser & Light, calls that an exciting development.
“Our customers want to look rested, healthy, not stressed, and they are realistic about what can be done to age gracefully by combining today’s lasers with injectables and skin care,” he says. “They want natural-looking results without the risk of looking different, and we are doing that.”
With all that in mind, we took a look at the the products and procedures available to deal with aging concerns to help you determine your best course of action when attempting to look your best, most youthful self.
In the Buff: Exfoliation and Chemical Peels
illustration by jen rome
Exfoliation is just about the quickest and easiest way to restore a youthful appearance by helping even out skin tone and texture and giving it a healthy glow. As we age, an excessive buildup of dead skin cells and a hormonally driven loss of moisture give our complexions a dull, drab appearance. By removing this excess buildup, you can expose skin that feels softer and looks more luminous.
Exfoliating also allows your skin-care products to work more effectively by penetrating the areas between skin cells, says Andrea Scott, co-owner of Skoah.
“As we age, the skin’s inability to naturally shed dead skin cells requires that we use an exfoliator about two to three times weekly,” she says. “It is also important to get regular facials
to exfoliate more deeply.”
There are two basic types of exfoliation: mechanical and chemical. Mechanical involves physically sloughing off dead skin cells and includes scrubs, cleansing brushes like Clarisonic (which gets rave reviews by most professionals and users, alike) and microdermabrasion.
While it’s considered good for normal, combination or dry skin, microderm isn’t great for people over 40 for whom wrinkles are a concern, since the suctioning action involved can actually cause wrinkles, Bertrand warns. She recommends “dermaplaning,” a relatively new treatment in Canada, as an alternative.
“With dermaplaning, we use a scalpel to gently and mechanically exfoliate the skin. It takes 10 minutes, and then we follow up with a chemical peel for a deeper exfoliation,” says Bertrand. The idea of a scalpel may sound scary, but, in reality, dermaplaning feels much like someone scraping your skin with a credit card.
Chemical exfoliation uses chemical action by acids or enzymes to promote cell turnover and, depending on the concentration of the active ingredients, can be gentler or more mighty than mechanical methods for treating sun damage, acne or simply refreshing the skin overall.
Mild peels include enzyme peels using ingredients derived from papaya or pineapple; vitamin C peels, which are good for rosacea and other redness; acid peels like kojic, which is good for pigmentation, and salicylic, which is good for oily, acne-prone skin; and blends like Jessner’s peel, which is a combination of three ingredients.
Mid-depth peels target the intra-epidermal layer, meaning they go deeper, require the supervision of a doctor and involve one to two weeks of downtime while the skin flakes (peels) away, similar to peeling after a sunburn. They’re especially effective for treating sun damage and pre-cancerous lesions.
Deeper peels like phenol peels exist, but they’re rarely done anymore, says Bertrand, explaining that most people looking for those more intense results would now turn to laser treatments.
The Light Fantastic: Lasers
illustration by jen rome
Laser therapy has been used for skin resurfacing for decades and is the go-to treatment for a host of concerns related to the aging face, both on the surface and deep into the dermal layer.
“Laser facial treatments can help to freshen up tired-looking skin and improve sun damage,” says Carson. “We have devices that target redness and brown spots, fine lines and wrinkles, acne scars, pore size and skin tightening. Often, we are producing what we call a controlled thermal injury. Basically, we trick the body into sending in nice, new collagen to the areas we want to see improvement in. And the results are often amazing,”
When laser treatments first came on the market, they could be a bit scary — early CO₂ lasers effectively obliterated the entire outer surface of the skin, leaving it red, raw, prone to infection and taking many weeks to heal. But technology has come a long way and there is now a continuum of laser procedures that vary in intensity and target different issues so you can choose how dramatic you want the results to be and how much downtime and discomfort you’re willing to trade for a fresh, clean slate.
“We have the ability to dial up or dial down, depending on a person’s downtime availability,” says Dr. Louis Grondin, medical director at Sante Cosmetic Laser & Vein Centre, regarding the flexibility of laser treatments and how they can be tailored to the specific needs of the patient. “Laser technology is becoming far more specific all the time. We can be very precise, and, for age-reversal, it’s highly effective.”
Making sense of what different lasers do and what they’re called can be confusing because the information out there is a mix of trade names and industry terminology. The best way to know what treatment is right for you is to get a consultation at a laser clinic to determine what kind of results you want, how much downtime you can allow for and your budget.
Grondin says the Q-Switch laser is one of his favourites to improve the overall look of the skin with no downtime.
“We use it for acne, we use it for rejuvenation,” he says. “It’s a treatment that heats the tissue, cleans the pores, stimulates exfoliation, builds collagen and elastin to tighten the skin, treats brown spots and stimulates the skin to stay healthy. If you have a function you want to look great for, it’s perfect. You can have it done and go out right away.”
Laser Genesis is another example of a gentle, rejuvenating treatment that carries no downtime and is painless (the warmth of the laser can be very relaxing, actually).
Clear + Brilliant stimulates collagen and targets brown spots and is also excellent for reducing pore size and treating acne. The treatment, which feels like tiny pin pricks, can be slightly uncomfortable (numbing cream helps) and leaves your face feeling warm and red for a few hours, and then flaky for a few days. While subtle, but visible results show almost right away, four to six treatments are optimal.
Limelight specifically treats redness, telangiectasia (spider veins) and brown spots. It is mildly uncomfortable (like an elastic snap) but there’s minimal downtime, and brown spots turn darker and eventually peel and fall off. Depending on the severity of your sun damage, doctors typically recommend additional treatments.
The term “fractional” describes a treatment that only affects a selected portion of the skin, leaving the surrounding skin intact. Fractional lasers like Fraxel emit a grid-like pattern rather than a solid beam to create microscopic wounds on the surface of the skin, stimulating the production of collagen and elastin to rebuild the dermis, plumping and firming the skin deep down. In a sense, the effect is similar to aerating your lawn to improve its look while preserving most of the top layer of the grass. Since most of the skin isn’t damaged, there is little to no downtime.
Most of the visible signs of aging are on the surface of the skin in the form of sun damage — brown spots, red spots, fine lines — and can be removed by ablating them with an Erbium laser, often called a resurfacing laser, to reveal baby bottom-like new skin. This is a more aggressive treatment that requires three to five days of downtime while the surface layer of
the skin, which will look red with pinpoint spots of bleeding, heals.
Fractional and Ablative
Ablative, fractional lasers like the Pearl Fractional are the strongest weapons in the arsenal of cosmetic laser therapy and are used for the most challenging scars, acne scars and deep wrinkles, especially around the mouth and eyes. Patients see significant results after just one treatment, though the recovery from this ablative treatment, which includes several days of weeping, oozing skin that requires a layer of Vaseline or Polysporin to prevent infection, is unpleasant. People usually feel comfortable leaving the house after about a week, though skin will still be flaky and sensitive.
Fill ’Er Up: Dermal Fillers
illustration by jen rome
As we age, not only does gravity take its toll, pulling our facial features down, but loss of volume contributes to wrinkles by causing our faces to shrivel up, as the plump, youthful look of a grape gives way to the look of a raisin.
“Aging is the result of cumulative and chronic changes in our facial skeleton, muscles, fat and skin,” says Dr. Rohan Bissoondath, medical director at Preventous Cosmetic Medicine. “As we age, we lose facial fat, and this changes the 3-D appearance of our face and contributes significantly to aging. By replacing facial volume with dermal fillers, we aim to restore balance and proportion to the face. This softens the appearance of aging.”
The most widely used dermal fillers are gels made with hyaluronic acid, a substance that occurs naturally in the body — babies are born with high levels of it, which is why their skin is so plump and smooth. These gels include brands like Restylane and Juvéderm.
Doctors inject the filler under the skin to instantly add volume and smooth wrinkles and folds. Bissoondath says the areas he most commonly treats with fillers are lips, cheeks, nasolabial folds (the lines that go from nose to the corners of the mouth), tear troughs, temples and chin, in that order.
Treatments last from four months to two years, depending on the area injected. While there is such a thing as permanent filler — silicone — Bissoondath says very few doctors use this option.
“You need to consider that the face and its proportions are constantly changing,” he says. “As we age, our filler, its volume and placement, also needs to evolve. In other words, what looks good today in terms of augmentation may not look appropriate in a few years. Temporary fillers allow us to occasionally reassess our patients and keep them looking natural and aging gracefully.”
Of course, we’ve all seen the cautionary tales of too much filler on the faces of Hollywood stars, but that tends to be the fault of the injector and not the filler itself.
“The people who are over-injected often come from L.A., Hollywood, and that’s what we see on TV, so that’s what we associate with,” says Bertrand. “But that’s not the trend in Calgary. The trend here is for a more natural look.”
The effects of fillers are almost instant, though most patients may experience some swelling, which lasts two to three days. That’s the upside. The downside is, yes, it hurts a bit, though some products now contain lidocaine, which takes the edge off. The other potential downside is more serious, which is why Bertrand says it’s of utmost importance to choose an injector who is not only skilled at achieving the desired look but who also knows what to do when things go wrong, which is rare, but does happen.
“Safety is the No. 1 consideration in medicine, and certainly in aesthetic medicine,” says Bissoondath. “Hyaluronic acid dermal fillers can be fairly rapidly metabolized or ‘melted’ by an enzyme called hyaluronidase.” This means that if there’s an error or if the result isn’t exactly what’s wanted, the filler can essentially be neutralized.
Get Spanx for Your Eyes
Not ready to commit to injectable filler? There’s a new innovative two-step eye treatment called Neotensil designed to improve the look of under-eye bags. Available at several medical aesthetic clinics in Calgary, the product almost miraculously gives your under-eye area a temporary lift and reduces the appearance of dark circles for about 16 hours, or until it’s removed. The 50-application take-home kit is $500.
Frozen in Time: Botulinum Neurotoxins
illustration by jen rome
“Botox is like the Beatles. Everyone said they wouldn’t last, but, in fact, they revolutionized music,” says Grondin. “Botox has had the same effect; it’s completely changed the landscape of aging. It’s remarkable that a simple injection with practically no side effects can do so much.”
While it’s the most popular cosmetic treatment in the United States, according to a 2012 report by the American Society of Plastic Surgeons, many people still recoil at the mention of getting Botox, thinking it’ll make them look frozen and expressionless.
“With patients who are nervous, I reassure them that I would prefer to under-treat them, rather than over-treat,” says Bissoondath. “In our two-week follow-up, we can always add a little more if necessary. Avoiding the ‘frozen’ look is not difficult in experienced hands.”
Botulinum neurotoxins (BoNT) like Botox, Dysport and Xeomin are highly purified toxins that can temporarily reduce forehead lines, vertical frown lines and crow’s feet by relaxing the muscles that cause the wrinkles in the first place. They can lift the corners of the mouth as they begin to sag with age and also strategically relax certain muscles to create an eyebrow lift, making the face more open and youthful.
While Botox is the most well-known brand, Dysport, which has been approved in Canada for about a year and a half, is gaining fans since it works a little faster — results start to appear after about 24 hours, whereas Botox takes about 48.
What’s exciting about BoNT isn’t how well it works now, but that physicians are constantly finding new ways to work with it.
“Our understanding of facial anatomy and physiology is constantly increasing,” says Bissoondath. “Along with increased understanding comes more effective use of BoNT to achieve natural-looking results.”
Such new uses include treatments for “witch’s chin,” neck rings, gummy smiles and tightening the jawline as well as a variety of uses for other medical conditions.
BoNT works well on its own but is especially effective when mixed and matched with other procedures like Soft Lift or Liquid Facelift. According to Westside’s website, “[Liquid Lift is] a facial contouring procedure that uses strategically placed BoNT and dermal fillers to address lines, wrinkles, volume loss and sagging. It’s much more subtle than a surgical facelift and has far less downtime and fewer risks.”
Inside Out: Super-Antioxidizing
Glisodin is a brand-new supplement made from an antioxidant enzyme derived from a French melon extract, and it’s being touted as the first effective oral SOD supplement on the market to improve skin health and appearance. SOD, or superoxide dismutase, neutralizes free radicals more effectively than any other antioxidant, according to the company’s website.
Megan McCully, medical esthetician at Westside Laser & Light, says that, though it’s a new product — Westside has carried it for about six months — she’s very optimistic.
“I’ve heard nothing but good things from our patients. People are noticing their skin is brighter and feels better. The science behind it is really promising,” she says.
Westside includes Glisodin in all its treatments to promote healing but also sells it on its own in anti-aging, skin brightening and detoxifying formulas.
Botox at the Dentist
In January 2014, Alberta dentists were given the go-ahead by the Alberta Dental Association and College to offer BoNT to patients. Dentists undergo a comparatively rigorous training protocol learning to administer BoNT for therapeutic purposes, helping relax tight jaw muscles that cause clenching, grinding and headaches, as well as for the typical cosmetic purposes. Couple that with the dentists’ extensive study of facial anatomy in dental school, and what at first may sound like a stretch actually makes good sense.
Give Us a Smile: Cosmetic Dentistry
illustration by jen rome
One of the most noticeable indicators of youth is a healthy, white, straight smile, so it stands to reason that the state of your teeth should be considered in your search for the Fountain of Youth. Yellow, crooked, broken and missing teeth age you, but advances in cosmetic dentistry mean there are a variety of ways to improve your smile and help keep your teeth strong and beautiful. From least-invasive to most, we explore some of the procedures worth investing in.
Great for touch-ups, the pen-like applicator contains a whitening gel, and its active ingredient is hydrogen peroxide, which sticks to your teeth. “When you boil all whitening systems down to a nutshell, they’re all the same,” says cosmetic dentist Dr. Gordon McLachlin from Alpha Dental Care. “The only difference is strength.” People with sensitive teeth and gums should note that the stronger or more concentrated the whitening gel is, the more likely it is to irritate your gums.
Trays made with an impression of your bite are filled with whitening gel. Tray solutions are more potent than whitening pens and are effective on their own or for maintenance after an in-office whitening treatment.
Your dentist paints a high dose of whitening material directly on your teeth. A light or laser is used to activate the material. This can whiten your teeth up to eight shades in one visit. But there’s a downside — zingers, or sharp pains in the teeth, which can last a day or two. These can be mitigated by using a high-fluoride toothpaste, an oral rinse and ibuprofen prior
“Veneers are instant orthodontics,” McLachlin says. Think of them like false fingernails for your teeth. Porcelain veneers in a colour you choose are bonded to the front of discoloured or crooked teeth to create a straight, white smile.
Unlike fake nails, though, veneers are a lifelong commitment, as the teeth — usually the upper front 10 — must be shaved down or prepared to accommodate the overlay. The process takes several hours and patients have to wear temporary tooth covers for a couple of weeks while a lab creates the veneers.
“Veneers can last 10, 20, even up to 30 years. It depends on how well you take care of them,” says McLachlin, adding that, while veneers are as strong or stronger than natural teeth, patients still have to brush, floss and have regular check-ups and must be careful when eating things like candies or nuts — anything hard that can crack a tooth.
Also called full-mouth restoration, all or most of the teeth are completely covered with porcelain crowns, bridges or veneers, helping to reverse the collapsed look in the lower third of the face created by worn-down teeth. Since this type of work is costly and generally not covered by dental plans, it’s tempting to look for cheaper options, like having the work done in Mexico. McLachlin warns against this. “What happens if something goes wrong?” he says. “In Canada and Alberta, there are strict standards of infection control, so patients are protected. In other places, it’s buyer beware. Would you get your teeth done in a place where you wouldn’t drink the water?”