Dr. Josh Fox on the Latest in Treatments for a Younger Look This Summer: Skin Tightening and Face Lifts Without Surgery or Downtime

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According to Dr. Josh Fox, the latest lunchtime fix is a non-invasive cutting-edge treatment using ultrasound to tighten, remodel and subsequently lift sagging skin in the face, jaw and neck.

Wattle. Turkey neck. Double chin. Whatever it’s called, no one likes to see it in the mirror. A facelift can banish the sag, but not everyone can afford the cost or the recovery time. According to Dr. Josh Fox, the latest lunchtime fix is a non-invasive cutting-edge treatment using ultrasound to tighten, remodel and subsequently lift sagging skin in the face, jaw and neck. This stalls aging by putting collagen production into overdrive. Since it uses ultrasound, there is no down time and no scars. Ultherapy has been performed in Europe and Asia for years and FDA-approved in the States since 2009. Since then, it has been touted by the media and featured on “The View”, “Dr. Oz”, and “The Doctors”. In fact, it’s proven so successful with face and neck tightening that some doctors now use the device for cellulite and full body contouring.

How does it work? Ultrasound heat currents are sent deep into layers that produce collagen and elastin. “The reaction to the low levels of ultrasound heat energy causes the skin to contract and stimulates collagen growth,” says Dr. Josh Fox, founder and director of New York and New Jersey-based Advanced Dermatology and the Center for Laser and Cosmetic Surgery. Treatment takes about 30-80 minutes, depending on the areas and topical anesthesia is usually used to offset the slight discomfort. “For the first time in skin rejuvenation, dermatologists are able to see an image of the tissue beneath the skin in order to deliver energy at that depth and see exactly where it’s being delivered,” he explains.

How much gravity will it defy? The effect is refreshed, rather than overdone. No one will whisper: “Did she or didn’t she?” “There is an immediate smoothing effect for better tone and texture,” says Dr. Fox. “Because new collagen is being produced, the results actually improve over time, maximizing at about 3 months time,” says Dr. Fox. When the new collagen grows it will gradually tighten the skin, resulting in a natural skin tissue lift. In a study published by the Journal of American Academy of Dermatology, doctors at Northwestern University studied the brow-lift effects in a procedure treating the full face and neck. Thirty-five patients with a median age of 44 were analyzed: 86% were judged by experienced clinician raters to show clinically significant brow-lift 90 days after treatment (1.7 mm). Some patients have reportedly looked a decade younger when the full results were visible.

What are the side effects? For some people, the skin may look puffy or flushed afterward, but this should last for only a few hours. “Most patients can resume normal activities immediately and can return back to work the day after the procedure,” adds Dr. Fox.

An alternative treatment would be Thermage, a method designed to tighten skin by delivering radio frequency energy to heat deeper layers of the skin and fatty tissue, so it stimulates new collagen growth without affecting the visible epidermis. It’s used to tighten, firm, and contour neck and chin jowls, eyelids, jawline, the eye area, and nasolabial folds. According to studies done at Georgetown and Johns Hopkins universities, significant improvement in cheek and neck laxity was observed in the majority of patients who received thermal tightening, and results continued to be evident 6 months after a single treatment. In terms of brow-lift effects, the majority of eyebrows were lifted by 0.5-2 mm.

Who is the best candidate for this treatment? Woman between the ages of 35-60 are usually the best candidates with moderate sagging show the most expected results. If the skin is too loose, the results will more subtle. It can also be used to maintain results on patients who have had a facelift.

How does it work? A session lasts anywhere between 20 minutes and two hours, depending on the treatment area. A quick heat sensation is felt as the laser hits the rubber-band like collagen, and they regenerate, so skin is “bouncier.” Some studies have indicated that multiple passes of the device over the skin, at lower energy levels, can produce better clinical outcomes. “Contouring continues for the next four to six months, results may last one to two years,” says Dr. Fox.

Which technique does Dr. Fox recommend for his patients? “I feel that the Ulthera is more effective and the results are more measurable. There is a higher patient satisfaction with this technique. Thermage however is still helpful around the eyes and in patients who have responded well to the procedure in the past, “ concludes Dr. Fox.

About: Joshua L. Fox, M.D., F.A.A.D., earned his medical degree from the Mt. Sinai School of Medicine in New York. He completed an internship at Maimonides Hospital in Brooklyn, followed by a three-year dermatology residency at the New York University School of Medicine. A Fellow of the American Academy of Dermatology, Dr. Fox is a leading authority in the field of dermatology, with an expertise in skin cancer, acne, cosmetic surgery and laser procedures and is the author of many dermatologic publications. He is the founder and director of Advanced Dermatology, P.C. of New York and New Jersey and the Center for Laser and Cosmetic Surgery and is on the panel of the American Academy of Dermatology and the American Society of Dermatologic Surgery. He is the director of a fellowship program in Laser & Cosmetic Surgery.http://www.advanceddermatologypc.com. Dr. Fox is also the founder and President of New Age Skin Research Foundation, a national, non-profit [501 (C) (3)] health organization committed to improving the quality of life of those with skin conditions through research and education.


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